Colorenal fistula and urinary tract infection in a pediatric patient with acute lymphoblastic leukemia. / Fístula colorrenal e infección de vías urinarias en paciente pediátrico con leucemia linfoide aguda.

INTRODUCTION: Colorenal fistula is rare in the pediatric population. It may occur at any segment involved by ischemia, chronic inflammation, or necrosis. It is typically associated with a preliminary renal lesion that may arise as a result of interventional procedures, inflammatory conditions, colon tumor, and xanthogranulomatous pyelonephritis, among others. CASE REPORT: 15-year-old female patient diagnosed with acute lymphoblastic leukemia admitted at our institution for baseline condition management. During her stay, she experienced gastrointestinal and urinary infectious events. In the assessment and management of those, a left colorenal fistula was found. Surgical treatment was decided upon. DISCUSSION: Colorenal fistula typically occurs secondary to renal inflammation or infection. Clinical signs are highly variable, and treatment is surgical, with the fistulous tract being resected in all cases.

INTRODUCCION: Las fístulas colorrenales son infrecuentes en la población pediátrica. Pueden desarrollarse en cualquier segmento afectado por isquemia, inflamación crónica o necrosis. Suelen estar asociadas a una lesión primitiva en el riñón que puede producirse por procedimientos intervencionistas, enfermedades inflamatorias, tumorales del colon, pielonefritis xantogranulomatosa, entre otras. CASO CLINICO: Paciente femenina de 15 años, con diagnóstico de leucemia linfoide aguda, ingresa a la institución para recibir manejo de su enfermedad de base. Durante su evolución, desarrolla eventos infecciosos (gastrointestinales y urinarios), y en evaluación y manejo de estos se documenta fístula colorrenal izquierda, motivo por el cual se da un enfoque de tratamiento quirúrgico. COMENTARIOS: La fístula renocólica generalmente se presenta secundaria a procesos inflamatorios o infecciosos renales; su presentación clínica es muy variada, y el tratamiento es quirúrgico, incluyendo siempre la resección del trayecto fistuloso.

Electronic implementation dataset to monoparametric control the number of scrolls generated.

The increasing usage of chaotic systems in the development of security systems, from mobile surveillance devices to the implementation of secure communication systems, leads to devising analog electronic implementations of research. This article presents the electronic implementation dataset from a multi-scroll chaotic system capable of generates until 9-scrolls throughout a monoparametric control based on a Saturated Non-Lineal Function (SNLF). The implemented system controls the number of generated scrolls being capable of producing attractors of single scroll and attractors with 3, 5, 7, and 9-scrolls. Moreover, the implemented system produces a family of bistable behaviors. The authors report the phenomenon in [1], where a complete analysis in the system has been carried out.

Targeted therapy combined with radiotherapy in non-small-cell lung cancer: a review of the Oncologic Group for the Study of Lung Cancer (Spanish Radiation Oncology Society).

In recent years, major advances in our understanding of the molecular biology of lung cancer, together with significant improvements in radiotherapy technologies, have revolutionized the treatment of non-small cell lung cancer (NSCLC). This has led to the development of new therapies that target molecular mutations specific to each tumor type, acting on the cell surface antigens or intracellular signaling pathways, or directly affecting cell survival. At the same time, ablative dose radiotherapy can be delivered safely in the context of metastatic disease. In this article, the GOECP/SEOR (Oncological Group for Study of Lung Cancer/Spanish Society of Radiation Oncology) reviews the role of new targeted therapies used in combination with radiotherapy in patients with locally advanced (stage III) NSCLC and in patients with advanced, metastatic (stage IV) NSCLC.

[Odontogenic fibromyxoma]. / Fibromixoma odontogénico.

A 3-year-old boy presented a submandibular mass that progressively increased in size. Pathological study confirmed an odontogenic fibromyxoma. This entity is rare in children.

Fungal peritonitis in 15 patients on continuous ambulatory peritoneal dialysis (CAPD).

Peritonitis is a frequent complication in patients with chronic renal failure on continuous ambulatory peritoneal dialysis (CAPD) treatment. The aim of this study was to know the prevalence of fungal peritonitis on patients undergoing CAPD, and to determine the antifungal susceptibility pattern of the identified isolates. Samples of the peritoneal dialysis fluid from 165 patients on CAPD treatment with peritonitis manifestations were submitted to mycological study (direct microscopic examination, culture and antifungal susceptibility test). Ten Candida isolates were identified, being C. albicans and C. parapsilosis the most common species. From isolates obtained, three species (C. albicans, C. parapsilosis, and C. guilliermondii) presented itraconazole resistance while C. glabrata was resistant to both itraconazole and ketoconazole. Aspergillus fumigatus was associated to peritonitis in three cases and Acremonium sp. in two.

Comparative analysis of the expression and regulation of Wnt5a, Fz4, and Frzb1 during digit formation and in micromass cultures.

Previous studies have shown that three members of the Wnt signaling pathway, the ligand WNT5A, the receptor FZ4, and the Wnt antagonist FRZB1, are implicated in the formation and differentiation of the digits. In this study, we have attempted to establish a functional correlation between them by comparing their expression patterns and their regulation by the signals controlling proliferation and differentiation of the limb mesoderm during formation of the avian digits in vivo and in micromass cultures. In vivo Wnt5a and Fz4 are expressed in the undifferentiated mesoderm of the autopod and in the differentiating digit cartilages. In the undifferentiated mesoderm, the expression of both genes is regulated positively by FGFs and negatively by bone morphogenetic proteins (BMPs). As chondrogenic differentiation starts, Fz4 becomes intensely up-regulated in the aggregate and in the developing perichondrium, whereas transcripts of Wnt5a are excluded from the core of the aggregate but maintained in the surrounding mesenchyme and perichondrium. In addition, at this stage, the expression of both genes become positively regulated by BMPs. These changes in expression and regulation are coincident with the induction of Frzb1 in the chondrogenic aggregate, which is expressed under the positive control of BMPs. Our findings fit with a role of Wnt5a/Fz4 negatively regulating in vivo the initiation and progression of cartilage differentiation. In vitro, only Frzb1 is expressed and regulated in a manner resembling that observed in vivo. Wnt5a and Fz4 are both expressed in the differentiating mesenchyme of micromass cultures, but their expression is not significantly regulated by the addition of FGF-2 or BMP-7 to the culture medium.

Changes in monoaminergic activity in the anterior, medium and posterior hypothalamus, gonadotropins levels and ovarian hormones during puberty of the female rat.

The aim of present study is the analysis of monoamines concentrations changes in the anterior, medium and posterior hypothalamus, as well as changes in serum gonadotropins levels, ovarian steroids and follicular growth during the prepubertal development of the female rat. Noradrenergic activity in the anterior, medium and posterior hypothalamus reached highest level at day 13 after birth, followed by a subsequent decrease from day 15 to 19 and an increase on days 22 and 27 postnatal. At day 1, neural activity in the medium hypothalamus was higher than the activity in the anterior and posterior hypothalamus. Serotoninergic activity in three portions of the hypothalamus was higher throughout the prepubertal development. Follicle-stimulating hormone and luteinizing hormone serum levels increased between days 11 and 17 and decreased from day 19 to 36. The concentration of 17beta-estradiol was consistently low throughout the prepubertal development and increased at day 39 after birth. These results indicate that during the prepubertal development of the rat, the three regions of the hypothalamus show significant changes in the monoaminergic neural activity. There is an inverse relationship between the noradrenergic activity on the anterior and medium hypothalamus and serotoninergic activity in the posterior hypothalamus with ovarian steroids during sexual maturation. These changes may be linked to the development of the neuroendocrine processes that modulate gonadotropin secretion and ovarian function.

[Identification and typing of yeast isolates from hospital patients in Mexico City]. / Identificación y tipificación de levaduras aisladas de pacientes de un hospital de la ciudad de México.

Nosocomial yeast infections have become a major cause of morbidity and mortality in immunocompromised patients. This study presents the frequency of yeasts isolated from different biological products from a Mexico City hospital's patients during one year. C. albicans was isolated in 72.3% of patients, followed by C. glabrata (13.4%) and C. parapsilosis (8%). Twenty different morphotypes were identified and the serotype B was the most frequent (79%).

Identificación y tipificación de levaduras aisladas de pacientes de un hospital de la ciudad de México / Identification and typing of yeast isolates from hospital patients in Mexico City

Nosocomial yeast infections have become a major cause of morbidity and mortality in immunocompromised patients. This study presents the frequency of yeasts isolated from different biological products from a Mexico City hospital's patients during one year. C. albicans was isolated in 72.3 of patients, followed by C. glabrata (13.4) and C. parapsilosis (8). Twenty different morphotypes were identified and the serotype B was the most frequent (79).

Identificación y tipificación de levaduras aisladas de pacientes de un hospital de la ciudad de México / Identification and typing of yeast isolates from hospital patients in Mexico City

Nosocomial yeast infections have become a major cause of morbidity and mortality in immunocompromised patients. This study presents the frequency of yeasts isolated from different biological products from a Mexico City hospitals patients during one year. C. albicans was isolated in 72.3 of patients, followed by C. glabrata (13.4) and C. parapsilosis (8). Twenty different morphotypes were identified and the serotype B was the most frequent (79).(AU)

Identificación y tipificación de levaduras aisladas de pacientes de un hospital de la ciudad de México. / [Identification and typing of yeast isolates from hospital patients in Mexico City]

Nosocomial yeast infections have become a major cause of morbidity and mortality in immunocompromised patients. This study presents the frequency of yeasts isolated from different biological products from a Mexico City hospitals patients during one year. C. albicans was isolated in 72.3

of patients, followed by C. glabrata (13.4

) and C. parapsilosis (8

). Twenty different morphotypes were identified and the serotype B was the most frequent (79

).

Introduction of cyclofem once-a-month injectable contraceptive in Mexico.

A large introductory study of Cyclofem, a once-a-month injectable contraceptive, was conducted in three Mexican provinces. A total of 3457 healthy women participated: 640 women from rural areas (community-based component) and 2817 women from urban and suburban areas (health center-based component). A total of 20,316 women-months of treatment experience were accumulated during a one year period. Cyclofem proved its use-effectiveness (pregnancy rate of 0.03%) and its safety under routine service conditions of family planning facilities in Mexico. The overall life table continuation rate at 1 year was 26.1%. Higher continuation rates were observed in the community-based component (36.6%) as compared to the health center component (23.7%). The most common reason for method discontinuation was change of address. Only 15% of the discontinuations were attributable to the injectable contraceptive method, with the overall 1 year discontinuation rate for bleeding problems (including amenorrhea) was < 11%. These observations underscore the importance of appropriate counseling and follow-up measures, providing convenient access to repeat injections, and other service delivery issues related to continuation of Cyclofem. The results of this trial have once again demonstrated that Cyclofem is a highly effective method with an acceptable side effect profile. In addition, the study provided the elements for its approval by local health authorities and its inclusion into the Ministry of Health Family Planning Program.

PIP: The effectiveness and continuation rates associated with the once-a-month injectable contraceptive Cyclofem were investigated in an introductory trial conducted in three Mexican provinces (Sinaloa, Guanajuato, and Veracruz). Cyclofem contains 25 mg of medroxyprogesterone acetate and 5 mg of estradiol cypionate. A total of 3457 women (640 women from rural communities and 2817 from urban and suburban family planning centers) were enrolled and 20,316 woman-months of treatment experience were accumulated during the 12-month study period. The mean age of study participants was 23.6 years; 70% had previously used at least one contraceptive method. There was only one pregnancy (rate, 0.03%). The overall life-table continuation rate at 1 year was 26.1%, but this rate was higher in the community-based group (36.9%) than in the health center group (22.4%). This discrepancy is presumed to reflect the greater access of clinic clients to other contraception options. Continuation was highest among women 30-34 years of age, those with low levels of education, women with five or more children, and those who did not want more children. Only 14% of discontinuations were method-related. The 1-year discontinuation rate for bleeding problems, including amenorrhea, was 10.2%. These findings indicate Cyclofem is a safe, effective method appropriate for inclusion in Mexico's Ministry of Health Family Planning Program.

Differential effects of transforming growth factors beta 1, beta 2, beta 3 and beta 5 on chondrogenesis in mouse limb bud mesenchymal cells.

The present study was performed to determine whether mammalian TGF-beta isoforms and Xenopus TGF-beta 5 elicit a differential chondrogenic response on mesenchymal cells during mouse limb development. Results showed that TGF-beta isoforms produced a distinct chondrogenic pattern depending on embryonic stage. When they were applied to 5 day micromass cultures of limb mesenchymal cells from embryonic stages 19, 20 and 21, a differential response to all four TGF-beta isoforms assayed was observed. By stage 19 the cells formed a uniform sheet of cartilage cells; by stage 20, mesenchymal cells were more responsive to TGF-beta 1 and TGF-beta 5 than at stages 19 and 21, showing an entire cell layer of chondrogenic cells with higher accumulation of extracellular matrix. The diminished effect of TGF-beta 2 and TGF-beta 3 at stages 20 and 21 was accompanied by a nodular pattern of chondrogenic cells rather than by a uniform sheet, as seen at stage 19. At stage 20 TGF-beta 1 and TGF-beta 5 enhanced the expression of sulfated proteoglycans, type II collagen, cartilage link protein and alkaline phosphatase activity. In contrast, TGF-beta 2 and TGF-beta 3 caused less expression in the same parameters. Only a transient exposure to TGF-beta isoforms at days 1 and 2 of culture stimulate chondrogenesis, indicating that TGF-beta isoforms could regulate chondrogenesis at early stages of chondrocyte differentiation. However, when TGF-beta isoforms were applied to low density cultures of mesenchymal cells, chondrogenesis was enhanced only by 25%, suggesting that TGF-beta isoforms enhanced cartilage differentiation to higher levels in micromass cultures than in situations in which little or no chondrogenic differentiation normally occurs.

[Stimulation of the central dopaminergic receptor in essential hypertensive patients using amantadine]. / La estimulación del receptor dopaminérgico central en el hipertenso esencial mediante el uso de amantadina.

At present, evidence has been accumulating that point out that some central nervous structures, of oblongata to the limbic system, are primarily involved in the control of systemic arterial pressure (AP). In agreement with several experimental and clinical works, a hypothesis has been suggested that a functional defect of the central dopaminergic system could be involved in the etiopathogenesis of essential hypertension (EH). With the objective of analyzing this hypothesis, the effect of dopamine (DA) agonist, amantadine (Am) on heart rate (HR), AP, plasma catecholamines (CA, PCA), urinary DA, noradrenaline (NA), adrenaline (A), vanilmandelic acid (VMA) and homovanillic acid (HVA), was studied in 19 females with established EH. The study included 2 periods: "placebo" and "drug", each one lasting 22 days, with a register of HR and AP in clino and orthostatism, taken every 3-4 days; at the end of each period, CA and their metabolites were measured. During the drug period, oral Am clorhidrate (300 mg/day, t.i.d.) was administered. With the drug, HR was not change with respect to the placebo period; but the AP in both positions, just as PCA, DA, NA and HVA, showed a highly significant decrease; A and VMA displayed a less significant decrease from the statistical point of view. The obtained results and literature data support the hypothesis that in EH there probably exists a genetic disfunction of the inhibitory central dopaminergic receptor of peripheral sympathetic activity, which is susceptible to compensation by use of several dopaminergic agonists, such as Am.

[Diagnosis and treatment of toxoplasmosis by means of radionuclide]. / Diagnóstico y tratamiento de la toxoplasmosis utilizando radionúclidos.

Using antibodies against Toxoplasma gondii labelled with indium-113 metaestable we obtained scan of rats infested with this disease in a simple and harmless way. Also using the same antibodies, but labelled with iodine-131, we destroyed by radiolysis the toxoplasmas of experimental animals with the Medial Lethal Dose obtained "in vitro" experiments. The experimental results are very encouraging and their use in human beings are in currently research in our laboratory and will be the object of a future communication.

[Antihypertensive effect of the vasodilator minoxidil combined with dihydrochlorothiazide and propranolol in resistent hypertension]. / Efecto antihipertensivo del vasodilatador minoxidil combinado con dihidroclorotiazida y propranolol en la hipertensión arterial resistente.

The antihipertensive effect of a diuretic (dihidrochlorothiazide 100-200 mgr.), a betablocker (propranolol 20-180 mgr.) and the vasodilating agent minoxidil (25-70 mgr.), administered daily during 10-16 weeks, was asessed in 18 patients with refractory arterial hypertension (RAH). The arterial blood pressure (mm. of Hg.) differences obtained at the end of a 2 weeks diuretic period and at the end of the triple theraphy period was --53.1 +/- 18.1, p less than or equal to 0.001 (mean, standard deviation and significance) and --26.5 +/- 11.8, p less than or equal to 0.001, for clinostatic sistolic and diastolic pressures, respectively and --45.7 +/- 24.1, p less than or equal to 0.001 and --21.6 +/- 40 (p less than or equal to 0.001) for orthostatic sistolic and diastolic pressures, respectively. 66.6% of cases normalized the blood pressure at the end of the protocol. No significant changes were observed in body weight and pulse rate. In 94.4, 66.6 and 16.6% of cases appeared hypertricosis lanuginosa; edema or palpitations, respectively, as theraphy related symptoms. RAH is an entity of poor prognosis and difficult therapheutic management. In this study a significant antihipertensive response was achieved, which was superior to the one obtained in a similar population treated with other regimens in the same clinic. Despite the opposed attitude to continue the treatment exihibited by most female patients, we believe that minoxidil has enriched the therapheutic armamentarium of this dreadfull type of hypertension.