Design of experiments to evaluate pH and temperature parameters with different inoculums in domestic biodigester.

The comprehensive management of organic urban solid waste is a concern due to its direct and indirect impact on the environment. Anaerobic Digestion (AD) has been recognized as an alternative and environmentally friendly technology for waste disposal, converting them into organic fertilizers and renewable energy. This research presents an experiment involving four reactors fed with household organic waste, three inoculated with canine, goat, and rabbit manure, and one without inoculum. The experiment was observed for 30 consecutive days to analyze the pH and temperature parameters involved in the AD process in domestic reactors. Statistical methodology, including one-way analysis of variance for assessing the effect of the type of inoculum, Tukey's simultaneous confidence intervals for mean differences, and 90 % confidence intervals for µ in temperature and manure, was utilized. Additionally, main effects analysis of the factors of average temperature and pH were conducted. The results of the one-factor experiment show that the type of inoculum does not significantly influence the variation in pH, while temperature remains relatively stable throughout the AD process. However, the analysis of main effects indicates that goat manure tends to stabilize the temperature with minimal variation, whereas variation is more heterogeneous in the other experiments.

Comparison of basic and advanced behaviour management techniques between Colombian and Spanish parents during regular treatment and in emergency situations.

AIM: To evaluate the acceptance of behaviour management techniques by Spanish and Colombian parents used in paediatric dentistry and the influence of factors that determine their consent during regular treatment and in emergency situations. MATERIALS: An anonymous questionnaire was carried out in which 9 behaviour management techniques (BMTs) used in paediatric dentistry by Spanish and Colombian parents were evaluated in cases of regular dental treatment and in emergency situations (pain and/or dental trauma). The techniques evaluated were: tell-show-do (TSD), voice control, positive reinforcement, distraction, parental presence-absence, nitrous oxide, passive and active restraint, and general anaesthesia. The questionnaire also included information on the sociodemographic information about parents and their children, previous dental experience, and dental anxiety of the parents. The data were analysed using SPSSTM software, r. 26 of IBMTM. A value of p≤ 0.05 was considered as statically significant. RESULTS: A total sample of 124 questionnaire (62 from each country) was obtained. The basic BMT were the most accepted in both countries, especially by Spanish parents. In emergency situations, statistically significant differences were obtained in the acceptance of nitrous oxide and general anesthesia compared to their use in routine treatments (p<0.001). There were no significant differences in the preference of the techniques in relation to the age of the children or parental dental anxiety (p>0.05). An association was found between the socioeconomic status and the acceptance of nitrous oxide (p=0.005) and general anesthesia (p=0.004). CONCLUSION: The basic techniques were the most accepted by Spanish and Colombian parents. However, the Spanish parents had a better perception of both types of techniques compared to the Colombians. Their preference was influenced by factors such as annual income and need for urgent treatment of their children.

Clinical characteristics and comorbidities associated with mortality in patients with COVID-19 in Coahuila (Mexico).

BACKGROUND AND OBJECTIVE: This study aims to describe the characteristics of patients with COVID-19 in a state in northern Mexico and establish the comorbidities associated with mortality. METHODS: Patients with COVID-19, divided into survivors and non-survivors, were analyzed. The data were analyzed using the chi-square test, Student's t-test, and Cox's regression model. RESULTS: A total of 17,479 patients were included and mortality rate of 6.3% was reported. Age over 60 years (HR = 8.04; 95%CI 7.03-9.19), diabetes (HR = 1.63; 95%CI 1.40-1.89), high blood pressure (HR = 1.48; 95%CI 1.28-1.72), obesity (HR = 1.37; 95%CI 1.18-1.60) and chronic kidney disease (HR = 2.06; 95%CI 1.64-2.59) were significantly associated with mortality. CONCLUSIONS: Diabetes, high blood pressure, obesity, and chronic kidney disease increased mortality among patients with COVID-19 in the population of Coahuila, Mexico. The factor that most contributed to risk of death was age over 60 years.

[Clinical characteristics and comorbidities associated with mortality in patients with COVID-19 in Coahuila (Mexico)]. / Características clínicas y comorbilidades asociadas a mortalidad en pacientes con COVID-19 en Coahuila (México).

Background and objective: This study aims to describe the characteristics of patients with COVID-19 in a state in northern Mexico and establish the comorbidities associated with mortality. Methods: Patients with COVID-19, divided into survivors and non-survivors, were analyzed. The data were analyzed using the chi-square test, Student's t-test, and Cox's regression model. Results: A total of 17,479 patients were included and mortality rate of 6.3% was reported. Age over 60 years (HR = 8.04; 95% CI 7.03-9.19), diabetes (HR = 1.63; 95% CI 1.40-1.89), high blood pressure (HR = 1.48; 95% CI 1.28-1.72), obesity (HR = 1.37; 95% CI 1.18-1.60) and chronic kidney disease (HR = 2.06; 95% CI 1.64-2.59) were significantly associated with mortality. Conclusions: Diabetes, high blood pressure, obesity, and chronic kidney disease increased mortality among patients with COVID-19 in the population of Coahuila, Mexico. The factor that most contributed to risk of death was age over 60 years.

Allelic Diversity at Abiotic Stress Responsive Genes in Relationship to Ecological Drought Indices for Cultivated Tepary Bean, Phaseolus acutifolius A. Gray, and Its Wild Relatives.

Some of the major impacts of climate change are expected in regions where drought stress is already an issue. Grain legumes are generally drought susceptible. However, tepary bean and its wild relatives within Phaseolus acutifolius or P. parvifolius are from arid areas between Mexico and the United States. Therefore, we hypothesize that these bean accessions have diversity signals indicative of adaptation to drought at key candidate genes such as: Asr2, Dreb2B, and ERECTA. By sequencing alleles of these genes and comparing to estimates of drought tolerance indices from climate data for the collection site of geo-referenced, tepary bean accessions, we determined the genotype x environmental association (GEA) of each gene. Diversity analysis found that cultivated and wild P. acutifolius were intermingled with var. tenuifolius and P. parvifolius, signifying that allele diversity was ample in the wild and cultivated clade over a broad sense (sensu lato) evaluation. Genes Dreb2B and ERECTA harbored signatures of directional selection, represented by six SNPs correlated with the environmental drought indices. This suggests that wild tepary bean is a reservoir of novel alleles at genes for drought tolerance, as expected for a species that originated in arid environments. Our study corroborated that candidate gene approach was effective for marker validation across a broad genetic base of wild tepary accessions.

Transoral robotic surgery for squamous cell carcinoma of the oropharynx in a primarily human papillomavirus-negative patient population.

PURPOSE: Transoral robotic surgery (TORS) is one of the main treatment options for non-locally advanced primary oropharyngeal cancer in the United States. However, its use is more limited in countries with a low incidence of human papillomavirus (HPV), such as Spain, in patients with advanced disease, and as salvage surgery. To shed light on the use and potential benefit of TORS in Spanish patients, we analyzed the functional and oncologic outcomes of TORS as both primary and salvage surgery in a primarily HPV-negative population which is representative of oropharyngeal squamous cell carcinoma (OPSCC) patients in Spain. MATERIAL AND METHODS: This is a retrospective analysis of prospectively collected data on OPSCC patients treated with TORS at our center between February 2017 and February 2019. RESULTS: Fifty-four OPSCC patients were included; 79.6% were males and 80.5% were HPV negative. Median age was 62 years. Primary surgery was performed on 73.7% (48.1% stage I-II; 51.9% stage III-IV) and salvage surgery on 25.9% of patients. Positive margin rates were 4.3% for T1-2 and 25.8% for T3-4. None of the stage I-II patients and 27.7% of stage III-IV patients required adjuvant treatment. Reconstructive surgery was performed in 19.2% of all patients. Normal swallowing was achieved in 92.7% of patients at 6 months after surgery. 1- and 2-year survival rates for all patients were 94.5% and 89%, respectively. The overall complication rate was 16.1%. Bleeding occurred in 11.5% of patients. Longer hospitalization time was associated with surgical complications (P = 0.03) and reconstructive surgery (P = 0.03) but not with salvage surgery. CONCLUSION: TORS is a safe and effective treatment for HPV-negative T1-2 OPSCC patients. The positive margin rate was worse in T3-4 patients, indicating the need for careful patient selection in this subgroup.

Uso de bastones contralaterales en artrosis de rodilla / Contralateral canes for knee osteoarthritis

INTRODUCCIÓN La artrosis de rodilla es un problema de salud relevante dada su alta prevalencia y discapacidad asociada. Dentro de las alternativas de manejo no farmacológico se ha planteado el uso de bastones, sin embargo no existe consenso en la literatura respecto a su indicación. MÉTODOS Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis, preparamos tablas de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES Identificamos tres revisiones sistemáticas que en conjunto incluyeron cuatro estudios primarios, de los cuales, uno es ensayo aleatorizado. Concluimos que el uso de bastón contralateral en pacientes con artrosis de rodilla probablemente disminuye el dolor. Además, podría aumentar levemente la funcionalidad, pero la certeza de la evidencia es baja.

INTRODUCTION Knee osteoarthritis is a relevant health problem given its high prevalence and associated disability. Within the non-pharmacological management alternatives, the use of canes has been proposed, however, there is no consensus in the literature regarding its indication. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified three systematic reviews including four studies overall, of which one was randomized trials. We conclude that the use of a contralateral cane in patients with knee osteoarthritis probably reduces pain. In addition, it could slightly increase function, but the certainty of the evidence is low.

Comparison of subcutaneous inflammatory response to commercial and engineered zinc hydroxyapatite implants in rabbits / Comparação da resposta inflamatória subcutânea aos implantes de hidroxiapatita comercial e modificada com zinco em coelhos

Hydroxyapatite (HA) is widely used as a biomaterial for bone repair and metallic prostheses coating. The main limitations of the current commercial synthetic hydroxyapatite compounds include high cost and decreased availability, especially for veterinary medicine purposes. Additionally, it is thought that HA biocompatibility and bioactivity could be enhanced by the addition of metal compounds. The objective of this work was to compare the subcutaneous tissue response of commercial and engineered hydroxyapatite obtained from the bovine femur diaphysis mixed with different concentrations of hexa-hydrated Zinc Nitrate in rabbits. Twenty-Five New Zealand female rabbits were used. Five treatments were done according to HA composition (commercial HA, no Zn-HA, 0.1M Zn, 0.2M Zn, and 0.3M Zn). Each treatment was evaluated at five time-points (8, 15, 30, 60 and 90 days post-implantation). Histopathologic analysis was performed to assess inflammation by polymorphonuclear cells infiltration, neovascularization, and fibrosis. Results obtained in this work suggest that general inflammation decreased after 60 days of implantation regardless of Zn concentration. Fibrosis score was increased in the commercial HP compared to control and Zn-hydrated HA. This paper shows that bovine hydroxyapatite is a biocompatible material regardless of nitrate Zinc concentration and has the same properties of commercial hydroxyapatite.(AU)

A hidroxiapatita (HA) é amplamente utilizada como biomaterial para reparo ósseo e revestimento de próteses metálicas. As principais limitações dos atuais compostos comerciais de hidroxiapatita sintética incluem alto custo e menor disponibilidade, especialmente para fins de medicina veterinária. Além disso, acredita-se que a biocompatibilidade e a bioatividade da HA poderiam ser aumentadas pela adição de compostos metálicos. O objetivo deste trabalho foi comparar a resposta tecidual subcutânea de hidroxiapatita comercial e da obtida da diáfise do fêmur bovino misturada com diferentes concentrações de nitrato de zinco hexa-hidratado em coelhos. Foram utilizadas 25 coelhas fêmeas Nova Zelândia. Cinco tratamentos foram feitos de acordo com os compostos de HA (HA comercial, no Zn-HA, 0,1M Zn, 0,2M Zn e 0,3M Zn). Cada tratamento foi avaliado em cinco momentos (oito, 15, 30, 60 e 90 dias após a implantação). A análise histopatológica foi realizada para avaliar a inflamação por infiltração de células polimorfonucleares, neovascularização e fibrose. Os resultados obtidos neste trabalho sugerem que a inflamação geral diminuiu após 60 dias de implantação, independentemente da concentração de Zn. O escore de fibrose foi aumentado na HA comercial comparada com o controle e com a HA hidratada com Zn. Este trabalho mostra que a hidroxiapatita bovina é um material biocompatível independentemente da concentração de nitrato de zinco e possui as mesmas propriedades da hidroxiapatita comercial.(AU)

Comparison of subcutaneous inflammatory response to commercial and engineered zinc hydroxyapatite implants in rabbits / Comparação da resposta inflamatória subcutânea aos implantes de hidroxiapatita comercial e modificada com zinco em coelhos

Hydroxyapatite (HA) is widely used as a biomaterial for bone repair and metallic prostheses coating. The main limitations of the current commercial synthetic hydroxyapatite compounds include high cost and decreased availability, especially for veterinary medicine purposes. Additionally, it is thought that HA biocompatibility and bioactivity could be enhanced by the addition of metal compounds. The objective of this work was to compare the subcutaneous tissue response of commercial and engineered hydroxyapatite obtained from the bovine femur diaphysis mixed with different concentrations of hexa-hydrated Zinc Nitrate in rabbits. Twenty-Five New Zealand female rabbits were used. Five treatments were done according to HA composition (commercial HA, no Zn-HA, 0.1M Zn, 0.2M Zn, and 0.3M Zn). Each treatment was evaluated at five time-points (8, 15, 30, 60 and 90 days post-implantation). Histopathologic analysis was performed to assess inflammation by polymorphonuclear cells infiltration, neovascularization, and fibrosis. Results obtained in this work suggest that general inflammation decreased after 60 days of implantation regardless of Zn concentration. Fibrosis score was increased in the commercial HP compared to control and Zn-hydrated HA. This paper shows that bovine hydroxyapatite is a biocompatible material regardless of nitrate Zinc concentration and has the same properties of commercial hydroxyapatite.(AU)

A hidroxiapatita (HA) é amplamente utilizada como biomaterial para reparo ósseo e revestimento de próteses metálicas. As principais limitações dos atuais compostos comerciais de hidroxiapatita sintética incluem alto custo e menor disponibilidade, especialmente para fins de medicina veterinária. Além disso, acredita-se que a biocompatibilidade e a bioatividade da HA poderiam ser aumentadas pela adição de compostos metálicos. O objetivo deste trabalho foi comparar a resposta tecidual subcutânea de hidroxiapatita comercial e da obtida da diáfise do fêmur bovino misturada com diferentes concentrações de nitrato de zinco hexa-hidratado em coelhos. Foram utilizadas 25 coelhas fêmeas Nova Zelândia. Cinco tratamentos foram feitos de acordo com os compostos de HA (HA comercial, no Zn-HA, 0,1M Zn, 0,2M Zn e 0,3M Zn). Cada tratamento foi avaliado em cinco momentos (oito, 15, 30, 60 e 90 dias após a implantação). A análise histopatológica foi realizada para avaliar a inflamação por infiltração de células polimorfonucleares, neovascularização e fibrose. Os resultados obtidos neste trabalho sugerem que a inflamação geral diminuiu após 60 dias de implantação, independentemente da concentração de Zn. O escore de fibrose foi aumentado na HA comercial comparada com o controle e com a HA hidratada com Zn. Este trabalho mostra que a hidroxiapatita bovina é um material biocompatível independentemente da concentração de nitrato de zinco e possui as mesmas propriedades da hidroxiapatita comercial.(AU)

Perfil clínico y Psicosocial de los Adolescentes de 15 a 18 años Intentadores de Suicidio Hospitalizados en la Clínica Psiquiátrica de la Universidad de Chile (CPU) 2009-2011 / Clinical and Psychosocial Profile of 15 to 18-year-old Adolescents with Suicide Attempts Hospitalized in the Universidad de Chile Psychiatric Clinic (CPU) 2009-2011

El fenómeno suicida ha aumentado en la población general y esto cobra especial relevancia en los adolescentes de nuestro país. Si bien se conocen factores de riesgo asociados, existen aún escasos estudios locales respecto a las características de los adolescentes intentadores de suicidio en población consultante. Métodos: Se consideró población estudio a los adolescentes entre 15 y 18 años hospitalizados en la CPU entre 2009 y 2011, se dividieron intentadores (IS) y no intentadores de suicidio (NIS), registrando características clínicas y sociodemográficas, analizadas luego con el software STATA. Resultados: En el grupo de intentadores de suicidio el 68,13% presentaban historia de intento suicida previo, siendo más frecuente en mujeres. Otra característica distintiva de este grupo es la asociación a conducta suicida de familiar de primer grado y el antecedente de abuso sexual infantil. Palabras Clave: comportamiento suicida, intento suicida, adolescentes, perfil psicosocial, abuso sexual.

The suicidal phenomenon has increased in the general population and this is especially relevant in our country's adolescents. Although there are known risk factors for suicide, there are still few local studies regarding the characteristics of adolescents attempting suicide in our consulting population. Methods: The study population was considered to be 15 to 18-year-old adolescents hospitalized in the CPU between 2009 and 2011, they were divided into suicide attempters (SA) and non suicide attempters (NSA); clinical and sociodemographic characteristics were recorded and later analyzed with the software STATA. Results: In the group of suicide attempters 68.13% presented a history of previous suicide attempts, more frequently in women. Another distinctive feature of this group is the association of suicide attempts to suicidal behavior of a first-degree relative and a history of child sexual abuse.Key words: suicidal behaviour, suicidal attempt, adolescent, psychosocial profile, sexual abuse.

Managing the lionfish: influence of high intensity ultrasound and binders on textural and sensory properties of lionfish (Pterois volitans) surimi patties.

Lionfish (Pterois volitans) is an invasive and predatory species whose proliferation over the Caribbean Sea threatens to cause great damage to coral reefs by negatively affecting the balance of the ecosystem. Control strategies have been the most effective way to reduce the negative impact of the lionfish. The development of diversified food products based on lionfish could support these strategies. The objective of the present study was to investigate the influence of ultrasound and the addition of binders in different concentrations: Egg white liquid (EWL) and corn starch (ST) on texture, microstructure and sensory evaluation properties of patties made of lionfish surimi. Each set of binders was added up to 3% varying proportions. The texture profile, water holding capacity, sensory qualities and fractal dimension of scanning electron microscopy images were analyzed to evaluate the quality of the product based on surimi gel. Results showed that the application of ultrasound and the use of binders enhanced the properties of patties made of lionfish surimi. The addition of EWL (3%) improved the water holding capacity and hardness of the final product. However, the fractal dimension of the images was higher in samples processed using ultrasound and without binder addition.

Condición corporal en caballos de rodeo chileno de élite: estudio preliminar / Body condition in elite Chilean rodeo horses: preliminary study

RESUMEN El objetivo de este estudio fue caracterizar la condición corporal de caballos de rodeo chileno de élite en competencia. Se eligieron al azar 48 caballos raza chilena (15 hembras, 24 machos enteros y 9 machos castrados) participantes del 64° Campeonato Nacional de Rodeo Chileno. La condición corporal de cada caballo se evaluó por inspección visual y palpación según el sistema de Henneke. El rendimiento deportivo se registró como clasificados o no clasificados en la final del campeonato. Se construyeron tablas de frecuencia para la condición corporal por género y por rendimiento deportivo, se calcularon modas como descriptores de tendencia central y se comparó la condición corporal por género y rendimiento deportivo mediante la prueba de Kruskal-Wallis (p < 0,05). La condición corporal presentó una moda de 7, con un rango de 5 a 8. El 87,5% de los caballos tenía condición corporal entre 6 y 7 y se detectó un 6,3% de individuos obesos. No se encontraron diferencias significativas en relación al género ni rendimiento deportivo. Este es el primer estudio que reporta la condición corporal en caballos de rodeo chileno de élite y los resultados sugieren que los valores más frecuentes para esta variable en la raza están entre 6 a 7 puntos.

ABSTRACT The aim of this study was to characterize the distribution of body condition score for elite Chilean rodeo horses in competition. Forty-eight Chilean breed horses (15 mares, 24 stallions and 9 geldings) were randomly chosen for evaluation while participating at the 64th National Championship of Chilean Rodeo 2012. Body condition score for each horse was assessed by visual inspection and palpation according to the Henneke system. The sport performance was recorded as qualified or not qualified to the final round of the competition. Frequencies of body condition score were tabulated according to gender and according to sport performance of the horses. Modes were calculated as central tendency measurements and body condition score was compared between gender and sport performance groups by means of the Kruskal-Wallis test (p < 0.05). The mode of the general body condition score had a value of 7, with range between 5 and 8. 87.5% of the horses had body condition score between 6 and 7 points and 6.3% of them exhibited obesity. No significant differences were found both for gender and sport performance. This is the first study reporting body condition score in Chilean élite horses and results suggest that in the breed the most frequent value for this variable lies between 6 and 7 points.

Enhanced Data Covariance Estimation Using Weighted Combination of Multiple Gaussian Kernels for Improved M/EEG Source Localization.

In the recent past, estimating brain activity with magneto/electroencephalography (M/EEG) has been increasingly employed as a noninvasive technique for understanding the brain functions and neural dynamics. However, one of the main open problems when dealing with M/EEG data is its non-Gaussian and nonstationary structure. In this paper, we introduce a methodology for enhancing the data covariance estimation using a weighted combination of multiple Gaussian kernels, termed WM-MK, that relies on the Kullback-Leibler divergence for associating each kernel weight to its relevance. From the obtained results of validation on nonstationary and non-Gaussian brain activity (simulated and real-world EEG data), WM-MK proves that the accuracy of the source estimation raises by more effectively exploiting the measured nonlinear structures with high time and space complexity.

[Treatment of refractory aggressiveness by amygdalotomy and posteromedial hypothalamotomy by radiofrequency]. / Tratamiento de la agresividad refractaria mediante amigdalotomia e hipotalamotomia posteromedial por radiofrecuencia.

INTRODUCTION: Since, under certain circumstances, defensive or attacking behaviours display a pattern of motor dominance, as observed in subjects who participate in contact or fighting sports, aggressive behaviour was considered to have a dominant motor pattern. With the aim of preventing the functional problems reported with bilateral lesion procedures involving both the central nucleus of the amygdala and the posteromedial hypothalamus, the decision was made to combine them; thus, an amygdalotomy of the central nucleus of the amygdala and a posteromedial hypothalamotomy were to be performed simultaneously and unilaterally, on the basis of the motor dominance of the patient determined by means of the Edinburgh test. PATIENTS AND METHODS: This study describes the surgical experience in a series of nine patients diagnosed with refractory neuroaggressive syndrome. As part of the study protocol, a magnetic resonance brain scan was performed to rule out the presence of neoplasms, vascular diseases, infections and degenerative disorders. The degree of aggressiveness was quantified using Yudofsky's Overt Aggression Scale. Additionally, manual dominance was determined by means of the Edinburgh test. RESULTS AND CONCLUSIONS: Good control of aggressiveness was seen immediately. In some cases it was necessary to reduce the antipsychotic or benzodiazepine medication, as it was seen to increase aggressiveness. Only one case required a second surgical intervention. Follow-up was achieved in 100% of the cases at 24 months and 78% at 36 months.

TITLE: Tratamiento de la agresividad refractaria mediante amigdalotomia e hipotalamotomia posteromedial por radiofrecuencia.Introduccion. Dado que, en algunas circunstancias, las conductas defensivas o de ataque muestran un patron de dominancia motora, tal como se observa en los sujetos dedicados a los deportes de contacto o de lucha, se considero que la conducta agresiva tiene un patron motor dominante. Con el fin de evitar los problemas funcionales descritos con los procedimientos de lesion bilateral tanto del nucleo central de la amigdala como del hipotalamo posteromedial, se decidio combinarlos; es decir, realizar amigdalotomia del nucleo central de la amigdala e hipotalamotomia posteromedial de manera unilateral y simultanea, basandose en la dominancia motora del paciente mediante la prueba de Edimburgo. Pacientes y metodos. Este estudio muestra la experiencia quirurgica en una serie de nueve pacientes con el diagnostico de sindrome neuroagresivo resistente al tratamiento farmacologico. Dentro del protocolo de estudio, se les realizo resonancia magnetica cerebral para descartar la presencia de neoplasias, enfermedades vasculares, infecciones y trastornos degenerativos. El grado de agresividad se cuantifico mediante la escala global de agresividad de Yudofsky. Adicionalmente, se determino la dominancia manual a traves de la prueba de Edimburgo. Resultados y conclusiones. El buen control de la agresividad se observo de modo inmediato. En algunos casos fue necesario reducir la medicacion de antipsicoticos o benzodiacepinas, ya que aumentaban la agresividad. Solo un caso requirio una segunda cirugia. Se logro seguimiento del 100% de los casos en 24 meses y del 78% en 36 meses.

Etiología y evolución de recién nacidos con hipotiroidismo congénito y glándula eutópica / Etiology and evolution of newborns with congenital hypothyroidism and eutopic thyroid gland

RESUMEN Objetivos Analizar las características clínicas, bioquímicas, estudios complementarios, hallazgos moleculares y la prevalencia de glándula eutópica en neonatos con HC pertenecientes al Programa Provincial de Pesquisa Neonatal de Córdoba, Argentina, entre 1996 y 2015. Analizar la evolución de los pacientes que reunieron criterios para una reevaluación. Pacientes y métodos Se analizaron retrospectivamente las historias clínicas de 237 pacientes detectados por pesquisa neonatal en la provincia de Córdoba, Argentina, entre 1996-2015 con una incidencia promedio de 1/2146 pesquisados. Presentaron glándula eutópica 81 pacientes (34%) F35/M46; se excluyeron 10 con síndromes genéticos asociados. Se analizaron los niveles de: TSH, T4T, T4L, T3, TPOAb / TGAb y Tiroglobulina (ECLIA -ROCHE) (VR: >15 días: 6-83 ng/ ml; <15 días: 29-173 ng/ml), ecografía y centellografía de cuello con Tc-99m. El valor de corte de TSH sérica adoptado para la confirmación diagnóstica fue de ≥10 mUI/ml. Se realizaron estudios de biología molecular en casos seleccionados. Se reevaluaron niños mayores de 3 años, sin bocio, con valores normales de Tiroglobulina y sin requerimiento de incrementos en la dosis de LT4. Resultados: La prevalencia de HC y Tiroides Eutópica se mantuvo constante. El 50% de los pacientes (36/71) mostraron hiperplasia glandular tiroidea. El 84% (n: 60 de 71) presentó niveles de TSH sérica ≥20 uUI/ml (20-1186) y el 75% (n: 53 de 71) >40 uUI/ml (40-1186). TGAb and TPOAb fueron positivos en un niño. La determinación de TG fue normal en el 29% (21/71) de los casos, elevada en el 56% (39/71) y baja en el 14% (10/71). Los estudios de biología molecular resultaron diagnósticos en 26 pacientes de 18 familias, demostrándose mutaciones en los genes de: TPO: 9 pacientes, TG: 12 pacientes, NIS: 2 pacientes, DUOX2: 2 pacientes y TRβ: 1 paciente. Se encontraron 11 nuevas mutaciones: tres en TPO, cinco en TG, dos en NIS y una en DUOX2. Se informaron anomalías congénitas en el 11% (8/71) de los pacientes. Se reevaluó el 11% (8/71) de los niños, resultando: HC transitorio n: 5, permanente n: 2 y una niña con Síndrome de Resistencia a las Hormonas Tiroideas. La prevalencia de lactantes con HC y glándula eutópica se mantuvo constante a lo largo de 19 años del Programa. Conclusiones Nuestros estudios demuestran que la prevalencia de Hipotiroidismo Congénito con glándula eutópica se mantuvo estable en los períodos analizados. Este grupo de pacientes se caracterizó predominantemente por presentar HC de carácter permanente acompañado por fenotipos de moderada a severa intensidad. En el futuro deberá profundizarse el conocimiento respecto a la influencia de factores medioambientales, como posibles agentes de riesgo asociados a la génesis de Hipotiroidismo Congénito.

abstract Objectives To describe clinical, biochemical characteristics and complementary studies to diagnosis, molecular findings and the prevalence of eutopic gland in newborn with CH detected through our neonatal screening program in Córdoba, Argentina, between 1996 and 2015. To analyze the evolution of the patients who met criteria for re-evaluation. Patients and methods We retrospectively analysed medical records of 237 patients with CH detected by neonatal screening in Córdoba, Argentina, from 1996 to 2015 with an average incidence of 1/2146 researched. 81 patients (34%) F35/M46 had eutopic thyroid gland; 10 patients with associated genetic syndromes were excluded. TT4, FT4, T3, TSH, TPOAb, TGAb and Thyroglobulin (VR: >15 days: 6-83 ng/ml; <15 days: 29-173 ng/ml) (ECLIA ROCHE), thyroid ultrasonography and 99Tc scan were assessed. The serum TSH cutoff value adopted for diagnostic confirmation was ≥10 mIU/ml. Molecular biology studies were performed in selected cases. Those who had no goiter, with normal thyroglobulin, and had not required increases in L-T4 dose underwent re-evaluation after the age of 3 years. Results The prevalence of HC and thyroid Eutopic remained constant. 50% of the patients (36/71) showed glandular hyperplasia. In 84% (60/71) presented serum TSH levels ≥20 uUI/ml (20-1186) and in 75% (n: 53 of 71) levels >40 uUI/ml (40-1186). TGAb and TPOAb were positive only in one baby. TG levels were: normal in 29% (21/71) of the cases, elevated in 56% (39/71) and low in 14% (10/71). Gene mutations were found in 26 patients from 18 families: TPO: 9 patients, TG: 12 patients, NIS: 2 patients, DUOX2: 2 patients y TRβ: 1 patient. Eleven new mutations were found: three in TPO, five in TG, two in NIS and one in DUOX2. Congenital anomalies were reported in 11% (8/71) patients. The 11% (8/71) of children were re-evaluated resulting in: 5 Transient CH, 2 Permanent CH and 1 with Resistance to Thyroid Hormones. The prevalence of infants with CH and eutopic gland remained constant along 19 years of the Program. Conclusions Our studies show that the prevalence of congenital hypothyroidism with eutopic gland remained stable in the periods analyzed. This group of patients was predominantly characterized by permanent CH accompanied by moderate to severe phenotypes. In the future, knowledge about the influence of environmental factors, as possible risk agents associated with the genesis of Congenital Hypothyroidism, should be deepened.

¿Es efectivo el plasma rico en plaquetas para el tratamiento de la artrosis? / Is platelet-rich plasma effective for osteoarthritis?

INTRODUCCIÓN: El manejo no quirúrgico de la artrosis es variado y los pacientes que la padecen muchas veces persisten sintomáticos a pesar de intentar múltiples alternativas no quirúrgicas. En la última década, se ha planteado el uso de plasma rico en plaquetas intraarticular como alternativa, sin embargo, existe controversia sobre su eficacia clínica y seguridad. MÉTODOS: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos doce revisiones sistemáticas que en conjunto incluyen cuatro estudios primarios, correspondientes a ensayos aleatorizados. Concluimos que la inyección intraarticular de plasma rico en plaquetas podría disminuir levemente el dolor articular, podría mejora la satisfacción del paciente, y no está claro si tiene algún efecto sobre la funcionalidad porque la certeza de la evidencia es muy baja. En cuanto a los efectos adversos, de existir, serían no severos y autolimitados.

INTRODUCTION: Despite varied non-surgical alternatives for the treatment of osteoarthritis, many patients remain symptomatic. In the last decade, the use of intra-articular platelet-rich plasma (PRP) has been proposed as an option. However, there is controversy about its clinical benefit and safety. METHODS: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. CONCLUSIONS: We identified twelve systematic reviews including four studies overall, of which all corresponded to randomized trials. We concluded that intra-articular injection of platelet-rich plasma might slightly decrease joint pain and improve patient satisfaction,vut it is not clear whether it has any effect on functionality because the certainty of the evidence is very low. As for the adverse effects, if they exist, they would be non-severe and self-limited.

¿Cuáles son los beneficios y riesgos de la artroplastia total en rodillas artrodesadas? / What are the benefits and risks of total arthroplasty in arthrodesed knees?

Resumen INTRODUCCIÓN: La conversión de una rodilla previamente artrodesada a una artroplastia total de rodilla es una alternativa poco utilizada. Sin embargo, la artroplastia permitiría entregar una funcionalidad considerablemente mayor a la articulación con artrodesis. Dado que es un procedimiento técnicamente demandante y con eventual desarrollo de complicaciones, existe controversia sobre la real utilidad de este procedimiento. MÉTODOS: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos dos revisiones sistemáticas que en conjunto incluyeron 10 estudios primarios, de los cuales ninguno corresponde a un ensayo aleatorizado. Concluimos que la conversión de artrodesis de rodilla a artroplastia total de rodilla podría aumentar la funcionalidad, pero no está clara la frecuencia o magnitud de las complicaciones ni cuál es el impacto sobre la satisfacción o el dolor porque la certeza de la evidencia es muy baja.

Abstract INTRODUCTION: The conversion of a previously arthrodesed knee to a total knee arthroplasty is an alternative seldom used. However, arthroplasty would provide greater functionality to the arthrodesed joint. Since it is a technically demanding procedure, not exempt from complications, there is controversy about the role of this intervention. METHODS: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified two systematic reviews including 10 studies overall, none of which corresponded to a randomized trial. We concluded the conversion of knee arthrodesis to total knee arthroplasty could increase the functionality, but it is not clear whether it increases the complications or if it has any impact on pain or patient satisfaction because the certainty of the evidence is very low.

Effect of Dialyzable Leukocyte Extract on chronic cervicitis in patients with HPV infection.

The objective of the study was to assess the clinical, histopathological and immunochemical changes induced by dialyzable leukocyte extract (DLE) treatment in patients with chronic cervicitis associated to HPV infection. Fifty-four female Mexican patients diagnosed with chronic cervicitis, cervical intra-epithelial neoplasia grade 1 (CIN 1) and HPV infection were divided into two groups: patients treated with placebo and patients treated with DLE. Clinical and colposcopy evaluations were performed before and after treatments. Cervix biopsies were obtained to analyze histopathological features and to determine the local immunological changes by immunohistochemistry analyses. Placebo-treated patients showed no significant changes in the evaluated parameters. Interestingly, in DLE-treated patients, clinical manifestations of cervicitis diminished and 89% of them remitted the colposcopic lesions. Histological analyses of biopsies from DLE-treated patients showed a decreasing leukocyte infiltrate. Immunochemical analyses showed an increased expression of TGF-ß, while expression of IFN-γ, PCNA, and IL-32 decreased. Our results suggest that DLE can stimulate innate immunity of cervical mucosae, diminishing chronic cervicitis in HPV-infected patients. TRIAL REGISTRATION: Register ISRCTN16429164 Abbreviations: HPV = Human Papilloma Virus; DLE = Dialyzable leukocyte extract.

[Signaling pathways mTOR and AKT in epilepsy]. / Vias de señalizacion mTOR y AKT en epilepsia.

INTRODUCTION: The signaling pathway AKT/mTOR is a central axis in regulating cellular processes, particularly in neurological diseases. In the case of epilepsy, it has been observed alteration in the pathophysiological process of the same. However, they have not described all the mechanisms of these signaling pathways that could open the opportunity to new research and therapeutic strategies. AIM: To review existing partnerships between intracellular signaling pathways AKT and mTOR in the pathophysiology of epilepsy. DEVELOPMENT: Epilepsy is a disease with a high epidemiological impact globally, so it is widely investigated regarding the pathophysiological components thereof. In that search they have been involved different intracellular signaling pathways in neurons, as determinants epileptogenic. Advances in this field have even allowed the successful implementation of new therapeutic strategies and to open the way to new research in the field. CONCLUSIONS: Improving knowledge about the pathophysiological role of the signaling pathway mTOR/AKT in epilepsy can raise new investigations regarding therapeutic alternatives. The use of mTOR inhibitors, has emerged in recent years as effective in treating this disease entity alternative however is clear the necessity of continue the research for new drug therapies.

TITLE: Vias de señalizacion mTOR y AKT en epilepsia.Introduccion. La via de señalizacion AKT/mTOR es un eje central en la regulacion celular, especialmente en las enfermedades neurologicas. En la epilepsia, se ha evidenciado su alteracion dentro de su proceso fisiopatologico. Sin embargo, aun no se han descrito todos los mecanismos de estas rutas de señalizacion, las cuales podrian abrir la puerta hacia nuevas investigaciones y estrategias terapeuticas, que finalmente permitan desarrollar tratamientos efectivos en enfermedades neurologicas como la epilepsia. Objetivo. Revisar las asociaciones existentes entre las rutas de señalizacion intracelular de mTOR y AKT en la fisiopatologia de la epilepsia. Desarrollo. La epilepsia es una enfermedad neurologica con un alto impacto epidemiologico en el mundo, por lo cual es de sumo interes la investigacion de los componentes fisiopatologicos que puedan generar nuevos tratamientos farmacologicos. En esta busqueda se han involucrado diferentes rutas de señalizacion intracelular en neuronas, como determinantes epileptogenos. Los avances en esta materia han permitido incluso la implementacion de nuevas estrategias terapeuticas exitosas y que abren el camino hacia nuevas investigaciones. Conclusiones. Mejorar los conocimientos respecto al papel fisiopatologico de la via de señalizacion mTOR/AKT en la epilepsia permite plantear nuevas investigaciones que ofrezcan nuevas alternativas terapeuticas para el tratamiento de la enfermedad. El uso de inhibidores de mTOR ha surgido en los ultimos años como una alternativa eficaz en el tratamiento de algunos tipos de epilepsias, pero es evidente la necesidad de seguir en la busqueda de nuevas terapias farmacologicas involucradas en estas vias de señalizacion.