Differential proteomics profile of microcapillary networks in response to sound pattern-driven local cell density enhancement.

Spatial cell organization and biofabrication of microcapillary networks in vitro has a great potential in tissue engineering and regenerative medicine. This study explores the impact of local cell density enhancement achieved through an innovative sound-based patterning on microcapillary networks formation and their proteomic profile. Human umbilical vein endothelial cells (HUVEC) and human pericytes from placenta (hPC-PL) were mixed in a fibrin suspension. The mild effect of sound-induced hydrodynamic forces condensed cells into architected geometries showing good fidelity to the numerical simulation of the physical process. Local cell density increased significantly within the patterned areas and the capillary-like structures formed following the cell density gradient. Over five days, these patterns were well-maintained, resulting in concentric circles and honeycomb-like structures. Proteomic analysis of the pre-condensed cells cultured for 5 days, revealed over 900 differentially expressed proteins when cells were preassembled through mild-hydrodynamic forces. Gene ontology (GO) enrichment analysis identified cellular components, molecular functions, and biological processes that were up- and down-regulated, providing insights regarding molecular processes influenced by the local density enhancement. Furthermore, we employed Ingenuity Pathway Analysis (IPA) to identify altered pathways and predict upstream regulators. Notably, VEGF-A emerged as one of the most prominent upstream regulators. Accordingly, this study initiates the unraveling of the changes in microcapillary networks at both molecular and proteins level induced by cell condensation obtained through sound patterning. The findings provide valuable insights for further investigation into sound patterning as a biofabrication technique for creating more complex microcapillary networks and advancing in vitro models.

Scavenging of polystyrene microplastics by sediment particles in both turbulent and calm aquatic environments.

Microplastic particles (MP) are emerging pollutants ubiquitously distributed in all aquatic environments, remaining in suspension in the water column or deposited in sediment beds. MP are suspended in the water column along with other particles with whom they might interact. The current study presents the results of slow-settling MP (Polystyrene) scavenged by fast-settling sediment particles. The study covers a wide range of salinities (from freshwater to saltwater) and shear rates (from calm to mixing ecosystems). In calm regions, the scavenging by fast-settling sediment particles produces the greatest removal of MP from the water column (42 % of MP in suspension), thus increasing the MP pollution of sediment beds. In contrast, turbulence reduces the settling of MP and sediment particles (72 % of MP remain in suspension), causing more pollution than in calm regions. Although salinity increased the buoyancy of MP, the scavenging by sediment has been found to overcome the increase in buoyancy. Consequently, MP are transported to the sediment bed independently on the salinity. Therefore hotspots of MP contamination in aquatic environments need to consider both the MP and sediment interaction and the local mixing of the water column.

Sacroiliac joint dysfunction and lumbar pain. Evaluation in a Brazilian population.

The study intended to evaluate the incidence and evolution of sacroiliac joint dysfunction (SIJD). To reach 50 patients with SIJD diagnosis, 192 patients with low back pain and failure in conservative approach were consecutively examined (26% incidence). Initially patients underwent intra-articular (IA) corticosteroid sacroiliac joint (SIJ) block followed, if necessary, by cooled SIJ radiofrequency or referred to surgical intervention, in order of complexity. From the 50 patients submitted to IA SI block, 41 (82%) referred pain and quality of life improvement and lesser rescue analgesics consumption for 25 weeks. The block induced a prompt onset of pain relief and there was a drop in mean pain score from 8 to 2 cm (p < 0.001) maintained up to 25 weeks. Rescue analgesic consumption also significantly dropped (p < 0.05). However, nine patients (18%) did not refer long lasting improvement in the third week evaluation and underwent cooled radiofrequency. From this population of nine, seven were successful (78%) while two were recommended surgery. In view of the 50 patients, 82% were comfortable after IA block, 18% were submitted to radiofrequency, with a success rate of 78%. The final incidence of surgery suggestion was 4%.

El estudio pretende evaluar la incidencia y evolución de la disfunción de la articulación sacroilíaca (DASI). Para llegar a 50 pacientes con diagnóstico de DASI, se examinaron consecutivamente 192 pacientes con dolor lumbar y fracaso en el abordaje conservador (26% de incidencia). Inicialmente, los pacientes se sometieron a un bloqueo de la articulación sacroilíaca (ASI) con corticosteroides intraarticulares (IA) seguido, si era necesario, de radiofrecuencia ASI enfriada o remitidos a una intervención quirúrgica, en orden de complejidad. De los 50 pacientes sometidos al bloqueo IA SI, 41 (82%) refirieron mejoría del dolor y de la calidad de vida y menor consumo de analgésicos de rescate durante 25 semanas. El bloqueo indujo un rápido inicio del alivio del dolor y hubo una caída en la puntuación media del dolor de 8 a 2 cm (p < 0.001) mantenida hasta 25 semanas. El consumo de analgésicos de rescate también disminuyó significativamente (p < 0.05). Sin embargo, nueve pacientes (18%) no refirieron una mejoría duradera en la evaluación de la tercera semana y se sometieron a radiofrecuencia fría. De esta población de nueve, siete tuvieron éxito (78%), mientras que a dos se les recomendó cirugía. De los 50 pacientes, 82% se sintió cómodo después del bloqueo IA, 18% fue sometido a radiofrecuencia, con una tasa de éxito de 78%. La incidencia final de sugerencia de cirugía fue de 4%.

The waves that make the pattern: a review on acoustic manipulation in biomedical research.

Novel approaches, combining technology, biomaterial design, and cutting-edge cell culture, have been increasingly considered to advance the field of tissue engineering and regenerative medicine. Within this context, acoustic manipulation to remotely control spatial cellular organization within a carrier matrix has arisen as a particularly promising method during the last decade. Acoustic or sound-induced manipulation takes advantage of hydrodynamic forces exerted on systems of particles within a liquid medium by standing waves. Inorganic or organic particles, cells, or organoids assemble within the nodes of the standing wave, creating distinct patterns in response to the applied frequency and amplitude. Acoustic manipulation has advanced from micro- or nanoparticle arrangement in 2D to the assembly of multiple cell types or organoids into highly complex in vitro tissues. In this review, we discuss the past research achievements in the field of acoustic manipulation with particular emphasis on biomedical application. We survey microfluidic, open chamber, and high throughput devices for their applicability to arrange non-living and living units in buffer or hydrogels. We also investigate the challenges arising from different methods, and their prospects to gain a deeper understanding of in vitro tissue formation and application in the field of biomedical engineering.

ω-Conotoxina MVIIC e células-tronco mesenquimais promovem recuperação motora em ratos Wistar após trauma medular agudo / ω-Conotoxin MVIIC and mesenchymal stem cells promote motor recovery in Wistar rats after acute spinal cord injury]

O objetivo deste estudo foi avaliar o efeito da ω-conotoxina MVIIC e das células-tronco mesenquimais (CTM) de forma isolada e sua associação nos ratos submetidos ao trauma medular agudo (TMA). Trinta Rattus novergicus, linhagem Wistar, três meses de idade, foram distribuídos igualmente em cinco grupos experimentais: controle negativo (CN), controle positivo (CP), ω-conotoxina MVIIC (MVIIC), células-tronco mesenquimais da medula óssea (CTM-MO) e associação (MVIIC + CTM-MO). O grupo CN foi submetido à laminectomia sem trauma medular, e os grupos CP, MVIIC, CTM-MO e MVIIC + CTM-MO foram submetidos ao trauma medular contusivo. O grupo CP recebeu, uma hora após o TMA, 10µL de PBS estéril, e os grupos MVIIC e MVIIC + CTM-MO receberam 10µL de PBS contendo 20pmol da ω-conotoxina MVIIC, todos por via intratecal. Os grupos CTM-MO e MVIIC + CTM-MO receberam, 24 horas após, 1x106 de CTM via intravenosa. Avaliou-se a recuperação da função locomotora até o sétimo dia pós-trauma. Os animais tratados com MVIIC + CTM-MO obtiveram recuperação motora após o trauma medular agudo (P<0,05). Conclui-se que essa associação apresentou efeito neuroprotetor com melhora na função locomotora em ratos Wistar.(AU)

The objective of this study was to evaluate the effect of isolated ω-conotoxin MVIIC and mesenchymal stem cells (MSCs) and its association in rats submitted to acute spinal cord injury (SCI). Thirty Rattus norvegicus, Wistar strain, three-month-old rats were randomly distributed in five experimental groups with six animals: negative control (CN), positive control (CP), ω-conotoxin MVIIC (MVIIC), bone marrow mesenchymal stem cells (CTM-MO) and the association (MVIIC + CTM-MO). The CN group underwent laminectomy without spinal cord trauma, and groups CP, MVIIC, CTM-MO and MVIIC + CTM-MO were submitted to contusive spinal cord trauma. The CP group received 10µl of PBS one hour after SCI, and groups MVIIC and MVIIC + CTM-MO received 10µl of PBS containing 20pmol of ω-conotoxin MVIIC, both intrathecally. Groups CTM-MO and MVIIC + CTM-MO received 1x106 of MSCs intravenously 24 hours later. The recovery of locomotor function was evaluated up to seven days post-injury. The animals treated with MVIIC + CTM-MO obtained motor recovery after SCI (P<0.05). It is concluded that this association showed neuroprotective effect with improvements in locomotor function in Wistar rats.(AU)

Association between background parenchymal enhancement and tumor response in patients with breast cancer receiving neoadjuvant chemotherapy.

PURPOSE: To analyze the relationships between background parenchymal enhancement (BPE) of the contralateral healthy breast and tumor response after neoadjuvant chemotherapy (NAC) in women with breast cancer. MATERIALS AND METHODS: A total of 228 women (mean age, 47.6 years±10 [SD]; range: 24-74 years) with invasive breast cancer who underwent NAC were included. All patients underwent breast magnetic resonance imaging (MRI) before and after NAC and 127 patients underwent MRI before, during (after the 4th cycle of NAC) and after NAC. Quantitative semi-automated analysis of BPE of the contralateral healthy breast was performed. Enhancement level on baseline MRI (baseline BPE) and MRI after chemotherapy (final BPE), change in enhancement rate between baseline MRI and final MRI (total BPE change) and between baseline MRI and midline MRI (early BPE change) were recorded. Associations between BPE and tumor response, menopausal status, tumor phenotype, NAC type and tumor stage at diagnosis were searched for. Pathologic complete response (pCR) was defined as the absence of residual invasive cancer cells in the breast and ipsilateral lymph nodes. RESULTS: No differences were found in baseline BPE, final BPE, early and total BPE changes between pCR and non-pCR groups. Early BPE change was higher in non-pCR group in patients with stages 3 and 4 breast cancers (P=0.019) and in human epidermal growth factor receptor 2 (HER2)-negative patients (P=0.020). CONCLUSION: Early reduction of BPE in the contralateral breast during NAC may be an early predictor of loss of tumor response, showing potential as an imaging biomarker of treatment response, especially in women with stages 3 or 4 breast cancers and in HER2 - negative breast cancers.

Estimates of Environmental Exposure to Radiofrequency Electromagnetic Fields and Risk of Lymphoma Subtypes.

We investigated the association between environmental exposure to radiofrequency electromagnetic fields (RF-EMF) and risk of lymphoma subtypes in a case-control study comprised of 322 patients and 444 individuals serving as controls in Sardinia, Italy in 1998-2004. Questionnaire information included the self-reported distance of the three longest held residential addresses from fixed radio-television transmitters and mobile phone base stations. We georeferenced the residential addresses of all study subjects and obtained the spatial coordinates of mobile phone base stations. For each address within a 500-meter radius from a mobile phone base station, we estimated the RF-EMF intensity using predictions from spatial models, and we performed RF-EMF measurements at the door in the subset of the longest held addresses within a 250-meter radius. We calculated risk of lymphoma and its major subtypes associated with the RF-EMF exposure metrics with unconditional logistic regression, adjusting by age, gender and years of education. In the analysis of self-reported data, risk associated with residence in proximity (within 50 meters) to fixed radio-television transmitters was likewise elevated for lymphoma overall [odds ratio = 2.7, 95% confidence interval = 1.5-4.6], and for the major lymphoma subtypes. With reference to mobile phone base stations, we did not observe an association with either the self-reported, or the geocoded distance from mobile phone base stations. RF-EMF measurements did not vary by case-control status. By comparing the self-reports to the geocoded data, we discovered that the cases tended to underestimate the distance from mobile phone base stations differentially from the controls ( P = 0.073). The interpretation of our findings is compromised by the limited study size, particularly in the analysis of the individual lymphoma subtypes, and the unavailability of the spatial coordinates of radio-television transmitters. Nonetheless, our results do not support the hypothesis of a link between environmental exposure to RF-EMF from mobile phone base stations and risk of lymphoma subtypes.

Design and fabrication of 3D-printed anatomically shaped lumbar cage for intervertebral disc (IVD) degeneration treatment.

Spinal fusion is the gold standard surgical procedure for degenerative spinal conditions when conservative therapies have been unsuccessful in rehabilitation of patients. Novel strategies are required to improve biocompatibility and osseointegration of traditionally used materials for lumbar cages. Furthermore, new design and technologies are needed to bridge the gap due to the shortage of optimal implant sizes to fill the intervertebral disc defect. Within this context, additive manufacturing technology presents an excellent opportunity to fabricate ergonomic shape medical implants. The goal of this study is to design and manufacture a 3D-printed lumbar cage for lumbar interbody fusion. Optimisations of the proposed implant design and its printing parameters were achieved via in silico analysis. The final construct was characterised via scanning electron microscopy, contact angle, x-ray micro computed tomography (µCT), atomic force microscopy, and compressive test. Preliminary in vitro cell culture tests such as morphological assessment and metabolic activities were performed to access biocompatibility of 3D-printed constructs. Results of in silico analysis provided a useful platform to test preliminary cage design and to find an optimal value of filling density for 3D printing process. Surface characterisation confirmed a uniform coating of nHAp with nanoscale topography. Mechanical evaluation showed mechanical properties of final cage design similar to that of trabecular bone. Preliminary cell culture results showed promising results in terms of cell growth and activity confirming biocompatibility of constructs. Thus for the first time, design optimisation based on computational and experimental analysis combined with the 3D-printing technique for intervertebral fusion cage has been reported in a single study. 3D-printing is a promising technique for medical applications and this study paves the way for future development of customised implants in spinal surgical applications.

Rice root curling, a response to mechanosensing, is modulated by the rice E3-ubiquitin ligase HIGH EXPRESSION OF OSMOTICALLY RESPONSIVE GENE1 (OsHOS1).

Plant development depends on the perception of external cues, such as light, gravity, touch, wind or nutrients, among others. Nevertheless, little is known regarding signal transduction pathways integrating these stimuli. Recently, we have reported the involvement of a rice E3-ubiquitin ligase (OsHOS1, HIGH EXPRESSION OF OSMOTICALLY RESPONSIVE GENE1), previously associated with abiotic stress response, in root responses to mechanical stimuli. We showed that OsHOS1 is involved in the regulation of root curling after mechanosensing and that RNAi::OsHOS1 plants failed to exhibit the root curling phenotype observed in WT. Interestingly, the straight root phenotype of these transgenics correlated with the up-regulation of rice ROOT MEANDER CURLING (OsRMC, a negative regulator of rice root curling) and was reverted by the exogenous application of jasmonic acid. Altogether, our results highlight the role of the proteasome modulating plant responses to mechanical stimuli and suggest that OsHOS1 is a hub integrating environmental and hormonal signaling into plant growth and development.

Contribution to the characterization of Opuntia spp. juices by LC-DAD-ESI-MS/MS.

Opuntia spp. fruits are considered as health promoting foods due to the diversity of bioactive molecules found in these fruits. The composition in organic acids, flavonols and betalains in the Opuntia ficus-indica juice from a region of Portugal was accomplished for the first time by liquid chromatography and tandem mass spectrometry using an electrospray ionization source operating in negative and positive mode. The methodology used allowed the detection of 44 compounds, from which 32 were identified. Isorhamnetin derivatives were the dominant flavonol glycosides. A total of 9 betalains including 6 betaxanthins and 3 betacyanin were also detected in the fruit juice samples and indicaxanthin, betanin and isobetanin were the major pigments. Phenolic acid and phenylpyruvic acid derivatives were also identified. To our knowledge, it is the first time derivative compounds from piscidic acid, phenolic compounds and betalains are characterized in cactus pear juice using a single LC-DAD-ESI-MS/MS method.

Temporal trends in canine leishmaniosis in the Balearic Islands (Spain): a veterinary questionnaire. Prospective canine leishmaniosis survey and entomological studies conducted on the Island of Minorca, 20 years after first data were obtained.

Leishmaniosis is present in the Mediterranean region of Europe, where Leishmania infantum is responsible for the disease, dogs are the main reservoir, and sand flies of the Phlebotomus genus, subgenus Larroussius, are proven vectors. Some areas, including Minorca in the Balearic Islands, are considered free of the disease, despite the presence of vectors. However, in the context of the current expansion of canine leishmaniosis in parts of Europe, an epidemiological study using a veterinary questionnaire was carried out to establish the current situation of the disease in the Balearic Islands. While 50% of veterinarians thought that the incidence of canine leishmaniosis had not changed over time, 26.2% perceived an increasing trend, mainly those from Minorca, where most of the veterinarians polled (88.1%) considered the new diagnosed cases as autochthonous. A cross-sectional serological study performed in this island gave a seroprevalence rate of 24%. Seroprevalence among animals of local origin and with no history of movements to endemic areas was 31%. The presence of autochthonous canine leishmaniosis in Minorca was not correlated with an increase in vector density. The environmental and climatic factors that influenced the distribution and density of Phlebotomus perniciosus on the island and the possible causes of the apparent emergence of canine leishmaniosis in Minorca are discussed.

High-resolution PLA-based composite scaffolds via 3-D printing technology.

Fabrication of new biodegradable scaffolds that guide and stimulate tissue regeneration is still a major issue in tissue engineering approaches. Scaffolds that possess adequate biodegradability, pore size, interconnectivity, bioactivity and mechanical properties in accordance with the injured tissue are required. This work aimed to develop and characterize three-dimensional (3-D) scaffolds that fulfill the aforementioned requirements. For this, a nozzle-based rapid prototyping system was used to combine polylactic acid and a bioactive CaP glass to fabricate 3-D biodegradable scaffolds with two patterns (orthogonal and displaced double layer). Scanning electron microscopy and micro-computer tomography showed that 3-D scaffolds had completely interconnected porosity, uniform distribution of the glass particles, and a controlled and repetitive architecture. Surface properties were also assessed, showing that the incorporation of glass particles increased both the roughness and the hydrophilicity of the scaffolds. Mechanical tests indicated that compression strength is dependent on the scaffold geometry and the presence of glass. Preliminary cell response was studied with primary mesenchymal stem cells (MSC) and revealed that CaP glass improved cell adhesion. Overall, the results showed the suitability of the technique/materials combination to develop 3-D porous scaffolds and their initial biocompatibility, both being valuable characteristics for tissue engineering applications.

[Validation of a Spanish version of the International Consultation on Incontinence Questionnaire Short-Form]. / Validación del cuestionario International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) en una población Chilena usuaria del Fondo Nacional de Salud (FONASA).

BACKGROUND: The International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) allows the assessment of urinary incontinence management results. AIM: To validate the ICIQ-SF in a Chilean population. MATERIAL AND METHODS: An approved Spanish version of the ICIQ-SF was applied in two opportunities (separated by a mean of 44 days) to 52 women consulting for urinary incontinence in a public hospital and to 25 asymptomatic female workers of the same hospital. Content validity, internal consistency and construct validity of the ICIQ-SF were evaluated. RESULTS: The ages of surveyed women ranged from 21 to 80 years. Internal consistency measured using Cronbach alpha was 0.87. Intra observer agreement, measured using pondered Kappa, was 0.84. 0.86 and 0.8 for each of the three components of the questionnaire, respectively. CONCLUSIONS: This Spanish version of the ICIQ-SF meets the requirements to be used in the Chilean population.

Validación del cuestionario International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) en una población chilena usuaria del Fondo Nacional de Salud (FONASA) / Validation of a Spanish version of the International Consultation on Incontinence Questionnaire Short-Form

Background: The International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) allows the assessment of urinary incontinence management results. Aim: To validate the ICIQ-SF in a Chilean population. Material and Methods: An approved Spanish version of the ICIQ-SF was applied in two opportunities (separated by a mean of 44 days) to 52 women consulting for urinary incontinence in a public hospital and to 25 asymptomatic female workers of the same hospital. Content validity, internal consistency and construct validity of the ICIQ-SF were evaluated. Results: The ages of surveyed women ranged from 21 to 80 years. Internal consistency measured using Cronbach alpha was 0.87. Intra observer agreement, measured using pondered Kappa, was 0.84. 0.86 and 0.8 for each of the three components of the questionnaire, respectively. Conclusions: This Spanish version of the ICIQ-SF meets the requirements to be used in the Chilean population.

El intervalo entre aborto espontáneo y una nueva concepción no afecta el resultado perinatal / Interval between spontaneous abortion and a new pregnancy does not affect perinatal outcome

Objetivo: Determinar la probabilidad de un nuevo aborto espontáneo en función del tiempo que transcurre entre un aborto previo y una nueva concepción. Método: Estudio de cohorte retrospectivo, realizado en Clínica Dávila y Hospital Parroquial de San Bernardo, entre enero de 2007 y septiembre de 2008. Se incluyen mujeres sanas, fértiles, con antecedente de un aborto espontáneo y que dentro de 12 meses posteriores a dicho evento vuelven a concebir. La ocurrencia de un nuevo aborto fue definida como variable dependiente y el tiempo entre el aborto espontáneo y una nueva concepción como variable independiente. Dentro de las variables de control se consideró la edad de la paciente, nivel educacional y la paridad. Se utilizó un modelo de regresión logística múltiple para determinar la asociación entre la variable dependiente e independiente. Resultados: 69 mujeres fueron incluidas en el análisis. La tasa de abortos observada fue de 11,9 por ciento. El 86,2 por ciento logró un parto de término con recién nacido sano. El modelo de regresión logística explicó el 50,3 por ciento de la variación de los datos. Los resultados muestran que por cada mes que transcurre entre un aborto y una nueva concepción el OR de un nuevo aborto disminuye en 7 por ciento, sin embargo, esta asociación no es estadísticamente significativa (OR: 0,93; IC95 por ciento: 0,72 a 1,2). Conclusión: En este estudio el intervalo entre un aborto espontáneo y una nueva concepción, no afecta el resultado perinatal.

Objective: To determine the probability of a new spontaneous abortion based on the time between a previous abortion and a new conception. Methods: Retrospective cohort study realized in Clinica Davila and Hospital Parroquial de San Bernardo, Santiago, Chile, between January 2007 and September 2008. Inclusion criteria: multiparous women with no chronic diseases, a history of one spontaneous abortion and a subsequent pregnancy within 12 months. The occurrence of a new abortion was defined as a dependent variable, and the interval between spontaneous abortion and the new conception as an independent variable. The control population was matched by patient age, educational level and parity. A multiple logistic regression model was used to determine the association between the dependent and independent variables. Results: The sample size was 69 women. The spontaneous abortion rate was 11.9 percent. 86.2 percent of the patients continued their pregnancy and achieved a term birth with healthy newborns. The logistic regression model explained 50.3 percent of the variation in the data. The results of this study shows that for every month that passes between a spontaneous abortion and a new conception, the odds ratio of a new abortion decreases up to 7 percent, although this association was not statistically significant (OR: 0.93; 95 percent CI: 0.72 to 1.2). Conclusion: In this study the interval between spontaneous abortion and a new pregnancy, does not affect perinatal outcome.

Dolor en amigdalectomía: técnica fría versus electrobisturí monopolar: estudio prospectivo randomizado / Postoperative tonsillectomy pain: cold versus monopolar electrocautery technique: prospective randomized trial

Introducción: Existen diferentes técnicas para realizarla amigdalectomía. Dentro de las más frecuentes está la técnica fría (bisturí frío, tijera y asa), y la técnica con electrobistrurí monopolar. No hay consenso que alguna de estas técnicas sea claramente superior a la otra respecto al dolor posoperatorio. Objetivo: Evaluar si la técnica quirúrgica (técnica fría-electrobisturí monopolar) repercute sobre la percepción de dolor posoperatorio. Material y método: Ensayo clínico prospectivo, ciego y randomizado. Se incluyeron 17 pacientes (34 amígdalas), mayores de 5 años sin antecedentes de riesgo, con indicación de amigdalectomía. A cada paciente, previo consentimiento informado y randomización, se le extrajo una amígdala con técnica fría y la contralateral con técnica electrobisturí monopolar. La percepción del dolor se midió con escala visual análoga (EVA) durante los primeros siete días posquirúrgicos. Paciente y familiares fueron enmascarados respecto a la técnica usada a cada lado. Resultados: Se encontraron diferencias en la percepción del dolor entre los días 3 a 7 (p <0,05) y al evaluarse la evolución del dolor en función del tiempo, ésta fue mayor con la técnica de electrobisturí (sin diferencias significativas en los 2 primeros días). Conclusión: En los casos evaluados en este estudio, la amigdalectomía con técnica fría se asocia a menor dolor a contar del tercer día posquirúrgico.

Introduction: There are different techniques for carrying out tonsillectomy. Among the mostcommon ones are the "cold technique" (scalpel, scissors and handle), and the monopolar electrocautery technique. No consensus is available to define which technique is less painful. Aim: To assess the effect of the surgical technique ("cold" vs monopolar electrocautery) on post-operative pain perception. Material ana method: Prospective blind randomized clinical trial. 17 patients with tonsillectomy indication (34 tonsils) over 5 years old, without major surgical risk, and after randomization and obtaining an informed consent, received a tonsillectomy using cold technique and the contra lateral side was removed using monopolar electrocautery technique. Pain perception was measured with visual analogue scale (VAS) during the firstseven days after surgery. Patients and relatives were unaware ofthe technique used on each side. Results: There were differences in pain perception between day 3 and 7 (p <0.05). Assessing evolution across time, pain was higher with the electrocautery technique (no significant difference was found in the first 2 days). Conclusion: Based on our results tonsillectomy using cold technique appears to be associated with less post-operative pain, starting on the third post-surgery day.

Role of Leishmania spp. infestation in nondiagnostic cutaneous granulomatous lesions: report of a series of patients from a Western Mediterranean area.

BACKGROUND: Leishmaniasis is a parasitic disease prevalent in countries of the Mediterranean area. OBJECTIVES: The potential role of Leishmania as the aetiological factor for cutaneous granulomatous lesions in a series of patients from a Western Mediterranean area was evaluated. The practical usefulness of Leishmania-specific polymerase chain reaction (PCR) amplification and immunohistochemical techniques in skin biopsy specimens was assessed. METHODS: Twenty-five skin biopsies diagnosed as nonspecific granulomatous dermatoses were included in the study. A panel of histopathological features was blindly evaluated by two independent observers. Only those cases showing nondiagnostic clinicopathological features and lacking demonstrable microorganisms after bacteriological, mycological or mycobacteriological cultures and specific stains (Ziehl-Neelsen, Giemsa, Gram, periodic acid-Schiff stains) were finally selected. Quantitative real-time PCR was performed in all selected samples. In available samples, immunohistochemical detection of specific Leishmania spp. antigens was also performed. RESULTS: From the selected 25 biopsies, Leishmania spp. DNA was detected by real-time PCR in 13 cases. In seven of eight PCR-positive cases the presence of a varying density of amastigotes could also be demonstrated immunohistochemically. CONCLUSIONS: Leishmania infection seems to be an important aetiological factor in cutaneous granulomatous lesions showing nondiagnostic features in endemic areas. In such areas, Leishmania-specific PCR amplification and/or immunohistochemical studies may be useful diagnostic tools. These techniques may be specifically indicated in the evaluation of patients showing nonspecific granulomatous inflammatory infiltrates of unknown aetiology lacking the histopathological evidence of parasites.

Detección de infección por VIH a través de test rápido en mujeres embarazadas: una estrategia exitosa para disminuir su transmisión vertical / Detection of HIV infection in pregnant women by rapid testing: a successful strategy to reduce its vertical transmission

En Uruguay existe un gran porcentaje de mujeres que no controlan su embarazo y donde la transmisión vertical de la infección por VIH alcanza al 50 por ciento. Objetivo: conocer la prevalencia de infección por VIH en mujeres embarazadas que desconocen su estado serológico, y que no controlan o controlan mal su gestación, y disminuir la transmisión vertical. Pacientes y métodos: entre enero de 2002 y enero de 2004 se realizó el test rápido para detectar infección por VIH a toda mujer embarazada que no supiera su condición serológica y que consultara en el Servicio Gineco-Obstétrico del Centro Hospitalario Pereira Rossell. De acuerdo a la edad gestacional se tomaban las medidas profilácticas consideradas más adecuadas. Se calculó la prevalencia de infección por VIH en esas mujeres y el porcentaje de transmisión a sus hijos. Resultados: hubo 34.338 consultas obstétricas y se realizaron 4.599 tests rápidos. Se detectaron 58 mujeres positivas, 8 de ellas conocían previamente su condición serológica. La prevalencia de infección por VIH fue de 1,1 por ciento (IC95 por ciento 0,8-1,4). Hubo un falso positivo y cuatro abortos. Diez mujeres abandonaron los controles. Doce recibieron antiretrovirales durante el embarazo por más de una semana. Se controlaron 39 niños y 2 fueron infectados. El porcentaje de transmisión fue de 5,1 por ciento. Como algunas mujeres y niños se perdieron en el seguimiento, es necesario complementar la estrategia de un screening de test rápido para infección por VIH con otras medidas como consejería y entrevista con asistente social para optimizar estos resultados.

Patología intracraneana del SNC: alteraciones de la proliferación celular. Hemimegalencefalia en diagnóstico prenatal / CNS intracraneal pathology: Alterations in cellular proliferation. Hemimegalencephaly in prenatal diagnosis

Introducción. Los autores presentan un caso raro de patología del SNC en el que la ecografía obstétrica y la RMN fetal contribuirán decisivamente en el diagnóstico prenatal.Métodos. La hemimegalencefalia se agrava a lo largo de la gestación, lo que explica el diagnóstico, frecuentemente tardío de esta malformación.Resultado y conclusiones. El pronóstico es desfavorable y el tratamiento médico/quirúrgico posnatal es limitado y con resultados dudosos. Las secuelas neurológicas suelen ser graves

Introduction. The authors present a rare case of CNS pathology, in witch the US and the fetal MRI were determinant in its diagnosis.Methods. The hemimegalencephaly gest worse during the pregnancy and that is the reason of the delay of the diagnosis.Result and conclusions. Unfavourable prognosis and a limited medical/surgical treatment with bad results are usual in this situation. Neurological sequels are very common