The Effect of Different Oxygen Surface Functionalization of Carbon Nanotubes on the Electrical Resistivity and Strain Sensing Function of Cement Pastes.

Different studies in the literature indicate the effectiveness of CNTs as reinforcing materials in cement-matrix composites due to their high mechanical strength. Nevertheless, their incorporation into cement presents some difficulties due to their tendency to agglomerate, yielding a non-homogeneous dispersion in the paste mix that results in a poor cement-CNTs interaction. This makes the surface modification of the CNTs by introducing functional groups on the surface necessary. In this study, three different treatments for incorporating polar oxygen functional groups onto the surface of carbon nanotubes have been carried out, with the objective of evaluating the influence of the type and oxidation degree on the mechanical and electrical properties and in strain-sensing function of cement pastes containing CNTs. One treatment is in liquid phase (surface oxidation with HNO3/H2SO4), the second is in gas phase (O3 treatment at 25 and 160 °C), and a third is a combination of gas-phase O3 treatment plus NaOH liquid phase. The electrical conductivity of cement pastes increased with O3- and O3-NaOH-treated CNTs with respect to non-treated ones. Furthermore, the oxygen functionalization treatments clearly improve the strain sensing performance of the CNT-cement pastes, particularly in terms of the accuracy of the linear correlation between the resistance and the stress, as well as the increase in the gage factor from 28 to 65. Additionally, the incorporation of either non-functionalized or functionalized CNTs did not produce any significant modification of the mechanical properties of CNTs. Therefore, the functionalization of CNTs favours the de-agglomeration of CNTs in the cement matrix and consequently, the electrical conductivity, without affecting the mechanical behaviour.

The correlation between immune subtypes and consensus molecular subtypes in colorectal cancer identifies novel tumour microenvironment profiles, with prognostic and therapeutic implications.

BACKGROUND: Solid tumour growth is the consequence of a complex interplay between cancer cells and their microenvironment. Recently, a new global transcriptomic immune classification of solid tumours has identified six immune subtypes (ISs) (C1-C6). Our aim was to specifically characterise ISs in colorectal cancer (CRC) and assess their interplay with the consensus molecular subtypes (CMSs). METHODS: Clinical and molecular information, including CMSs and ISs, were obtained from The Cancer Genome Atlas (TCGA) (N = 625). Immune cell populations, differential gene expression and gene set enrichment analysis were performed to characterise ISs in the global CRC population by using CMSs. RESULTS: Only 5 ISs were identified in CRC, predominantly C1 wound healing (77%) and C2 IFN-γ dominant (17%). CMS1 showed the highest proportion of C2 (53%), whereas C1 was particularly dominant in CMS2 (91%). CMS3 had the highest representation of C3 inflammatory (7%) and C4 lymphocyte depleted ISs (4%), whereas all C6 TGF-ß dominant cases belonged to CMS4 (2.3%). Prognostic relevance of ISs in CRC substantially differed from that reported for the global TCGA, and ISs had a greater ability to stratify the prognosis of CRC patients than CMS classification. C2 had higher densities of CD8, CD4 activated, follicular helper T cells, regulatory T cells and neutrophils and the highest M1/M2 polarisation. C2 had a heightened activation of pathways related to the immune system, apoptosis and DNA repair, mTOR signalling and oxidative phosphorylation, whereas C1 was more dependent of metabolic pathways. CONCLUSIONS: The correlation of IS and CMS allows a more precise categorisation of patients with relevant clinical and biological implications, which may be valuable tools to improve tailored therapeutic interventions in CRC patients.

Incidence and risk factors of superficial and deep vein thrombosis associated with peripherally inserted central catheters in children.

Essentials Pediatric studies on peripherally inserted central catheter (PICC)-related thrombosis are scarce. This study analyzes incidence and risk factors for PICC-related venous thrombosis in children. PICC-related thrombosis is a common, and nearly always, asymptomatic complication. Echo-guided insertion and a catheter to vein ratio < 0.33 may notably decrease this complication. SUMMARY: Background Upper-extremity venous thrombosis is associated with the use of peripherally inserted central catheters (PICCs). Few pediatric studies have focused on this issue. Objectives To determine the incidence and risk factors for PICC-related superficial vein thrombosis (SVT) and deep vein thrombosis (DVT) in children. Patients/methods An observational follow-up cohort study was conducted at a single hospital between June 2012 and June 2015. All patients receiving a PICC were enrolled and followed up, with weekly Doppler ultrasound examination of the catheterized limb until PICC removal. Patient, procedural and follow-up data were analyzed. Results In the study period, 265 PICCs were inserted (median age of patients 6.5 years, interquartile range [IQR] 2.4-13 years; median weight 20 kg, IQR 11-38 kg; 54% males; 67.9% chronically ill), and patients were followed up for a total of 9743 days. The median indwelling time was 21 days (IQR 12-37 days). During follow-up, 88 (33.2% of insertions) PICC-related thromboses (incidence rate [IR] 9.03 per 1000 catheter-days) were diagnosed, 66 (24.9%) as isolated SVT, seven (2.6%) as isolated DVT, and 15 (5.7%) as SVT with associated DVT (IR 6.78, 0.71 and 1.54 per 1000 catheter-days, respectively). Only 9.9% of patients with SVT and 18.2% of those with DVT were symptomatic. The main risk factors for PICC-related SVT and DVT were a catheter/vein ratio of > 0.33 and thrombosis of the catheterized superficial vein, respectively. Conclusions PICC-related thrombosis is a common and nearly always asymptomatic complication in children, the SVT rate being approximately three times higher than the DVT rate. Optimal vein and catheter selection, yielding the lowest possible catheter/vein ratio, may decrease the rate of PICC-related thrombosis.

[Observance and results of concurrent chemoradiotherapy after induction chemotherapy by docetaxel, cisplatin and 5-fluoro-uracil for locally advanced head and neck cancers]. / Observance et résultats de la chimioradiothérapie concomitante après chimiothérapie d'induction par docétaxel, cisplatine et 5-fluoro-uracile pour les cancers de la tête et du cou localement évolués.

PURPOSE: Retrospectively evaluate the safety, feasibility and efficacy of concomitant chemoradiotherapy after induction chemotherapy by docetaxel, cisplatin and 5-fluoro-uracil for locally advanced head and neck cancers. PATIENTS AND METHODS: Patients' data from three radiotherapy centres in South of France, with locally advanced head and neck cancers, and treated between December 2007 and July 2013 by concomitant chemoradiotherapy, after induction chemotherapy by docetaxel, cisplatin and 5-fluoro-uracil, were analysed. Adverse effects were graduated according to CTCAE v3.0 criteria. Overall survival and disease-free survival were calculated according to Kaplan-Meier method. RESULTS: One hundred and sixty-eight patients, mostly oropharynx (38%) T4 (46%) N2 (54%) tumors, received, after induction chemotherapy by docetaxel, cisplatin and 5-fluoro-uracil, a concomitant chemoradiotherapy with platin or cetuximab, which delivered 66 to 70Gy. Grade 3-4 adverse effects were less frequent in the group of patients who received cisplatin (with or withour 5-fluoro-uracil) at 100mg/m(2) each 21 days compared to cetuximab (radiomucositis: 32.5% vs 61%, P=0.018; radioepithelitis: 13% vs 61 %, P<0.0001). Chemopotentiation was incomplete for 21% of patients without impacting survival. Two years overall survival and disease-free survival were respectively of 81% and 64%. Lymph nodes status and WHO status significantly influenced these survivals (overall survival 84% if N<3 vs 56% if N3, P=0.017 and 85 % if WHO status ≤ 1 vs 50% if WHO status>1, P=0.006; disease-free survival 66% if N<3 vs 47% if N3, P=0.046). CONCLUSION: The association of induction chemotherapy by docetaxel, cisplatin and 5-fluoro-uracil and concomitant chemoradiotherapy shows satisfying results with an acceptable toxicity. The terms of the chemopotentiation and its superiority to a single concomitant chemoradiotherapy treatment still remain to be clarified.

Características morfológicas del nervio óptico evaluadas por el tomógrafo láser confocal (HRT3) y polarimetría láser (GDx-VCC) en población normal en la ciudad de Barcelona / Morphological characteristics of the optic nerve evaluated by confocal laser tomography (HRT3) and laser polarimetry (GDx-VCC) in a normal population from the city of Barcelona

OBJETIVO: Evaluar parámetros morfológicos de papila y capa de fibras nerviosas de la retina (CFNR) explorados con el HRT3 y el GDx-VCC en población normal y analizar correlaciones con variables demográficas. PACIENTES Y MÉTODOS: Estudio observacional transversal en el contexto de una campaña de detección de glaucoma en un centro de atención primaria de Barcelona. Se seleccionaron sujetos caucásicos de ascendencia mediterránea, no hipertensos y con riesgo de glaucoma (≥ 60 años o ≥ 40 años con alguno de los siguientes factores de riesgo: antecedentes familiares de glaucoma o de presión intraocular alta o miopía > 3 dioptrías). Se realizó exploración oftalmológica completa incluyendo tomografía láser confocal (HRT3) y polarimetría láser de barrido (GDX-VCC). Todos los sujetos incluidos presentan las pruebas dentro de la normalidad. Se analizaron parámetros estructurales con edad, refracción y paquimetría mediante el test de Spearman. RESULTADOS: Doscientos veinticuatro sujetos incluidos con una media de edad de 63,4 ± 11,1 años. Áreas de disco, excavación y anillo de 2,14 ± 0,52 mm2; 0,44 ± 0,34 mm2 y 1,69 ± 0,38 mm2, respectivamente. Valor medio de la CFNR (GDX) 55,9 ± 6,9 μm. La edad se correlacionó con menor volumen del anillo, mayor índice de morfología de la excavación, mayor profundidad media y máxima de la excavación y menor índice de fibras nerviosas y CFNR (p < 0,05). CONCLUSIÓN: Se proporcionan valores medios y distribución de numerosos parámetros de la papila y la CFNR en población caucásica normal de ascendencia mediterránea. Se observó una pérdida de espesor de la CFNR, adelgazamiento del anillo y aumento de la excavación con la edad

OBJECTIVE: To evaluate morphological parameters of optic disc and retinal nerve fiber layer (RNFL) examined with confocal laser tomography (HRT3) and laser polarimetry (GDx-VCC) in a normal population, and analyze correlations of these parameters with demographic variables. PATIENTS AND METHODS: Cross-sectional study in the context of a glaucoma screening campaign in the primary care center of Barcelona. The individuals selected were non-hypertensive Mediterranean Caucasians with risk for glaucoma development (individuals ≥ 60 years old or ≥ 40 years old with family history of glaucoma or intraocular pressure or myopia > 3 diopter). All subjects underwent a complete ophthalmic examination, confocal laser tomography (HRT3) and scanning laser polarimetry (GDX-VCC), subjects with results within normal limits only being included. Structural parameters were analyzed along with age, refraction, and pachymetry based on the Spearman rank correlation test. RESULTS: A total of 224 subjects included, with a mean age of 63.4 ± 11.1 years. Disc areas, excavation and ring area were 2.14 ± 0.52 mm2, 0.44 ± 0.34 mm 2 and 1.69 ± 0.38 mm2, respectively. The mean RNFL (GDX) was 55.9 ± 6.9 μm. Age was correlated with lower ring volume, highest rate of cup shape measure, largest mean and maximum cup depth, lower nerve fiber index (NFI) and RNFL (all p-values below .05). CONCLUSION: The mean values and distribution of several parameters of the papilla and the RNFL in normal Mediterranean Caucasians population are presented. A loss of thickness of the RNFL, ring thinning, and enlarged cup was observed with increased age

Morphological characteristics of the optic nerve evaluated by confocal laser tomography (HRT3) and laser polarimetry (GDx-VCC) in a normal population from the city of Barcelona.

OBJECTIVE: To evaluate morphological parameters of optic disc and retinal nerve fiber layer (RNFL) examined with confocal laser tomography (HRT3) and laser polarimetry (GDx-VCC) in a normal population, and analyze correlations of these parameters with demographic variables. PATIENTS AND METHODS: Cross-sectional study in the context of a glaucoma screening campaign in the primary care center of Barcelona. The individuals selected were non-hypertensive Mediterranean Caucasians with risk for glaucoma development (individuals≥60 years old or≥40 years old with family history of glaucoma or intraocular pressure or myopia>3diopter). All subjects underwent a complete ophthalmic examination, confocal laser tomography (HRT3) and scanning laser polarimetry (GDX-VCC), subjects with results within normal limits only being included. Structural parameters were analyzed along with age, refraction, and pachymetry based on the Spearman rank correlation test. RESULTS: A total of 224 subjects included, with a mean age of 63.4±11.1 years. Disc areas, excavation and ring area were 2.14±0.52mm(2), 0.44±0.34mm (2) and 1.69±0.38mm(2), respectively. The mean RNFL (GDX) was 55.9±6.9µm. Age was correlated with lower ring volume, highest rate of cup shape measure, largest mean and maximum cup depth, lower nerve fiber index (NFI) and RNFL (all p-values below .05). CONCLUSION: The mean values and distribution of several parameters of the papilla and the RNFL in normal Mediterranean Caucasians population are presented. A loss of thickness of the RNFL, ring thinning, and enlarged cup was observed with increased age.

Análisis de calidad asistencial en Urgencias de Pediatría en la atención integral al paciente pediátrico y su familia. Encuesta de satisfacción / Analysis of care quality in Pediatric Emergencies in the comprehensive care to the pediatric patient and his/her family. Satisfaction survey

Introducción: La obtención de información sobre la satisfacción de los usuarios en su atención en las Unidades de Urgencias de Pediatría constituye un objetivo básico en el análisis de calidad percibida. Objetivo, material y métodos: Analizar la actividad asistencial en una Unidad de Urgencias de Pediatría en un hospital comarcal durante una semana seleccionada al azar y describir el grado de satisfacción del usuario en relación a la atención recibida, información, equipo sanitario e instalaciones. Resultados: El número de visitas urgentes durante la semana seleccionada fue de 297 episodios, realizadas 113 encuestas (37,71%). El 74,1% se identificaron como madres de paciente con media de 37,8 (DE: 6,0) años. El 99,1% refirieron haber podido estar en todo momento con sus hijos durante la actividad clínica, el 99% consideraron estar informados adecuadamente durante el proceso urgente y el 93,6% recibieron información adecuada del manejo domiciliario posterior. Solo el 58% de los profesionales se identificaron adecuadamente. Un 88,4% consideraron adecuado el tiempo de estancia en la Unidad. El 70% refirieron las instalaciones y limpieza como excelentes. La nota media en escala de 10 fue de 8,45 (DE: 1,72). Discusión: De forma global, el 90% de los encuestados refirieron que pudieron estar muy satisfechos con la asistencia recibida en nuestra Unidad. Es necesario mantener este nivel obtenido y mejorar en aquellos puntos considerados débiles, principalmente en todo lo relacionado con nuestra identificación

Introduction: Obtaining of information on user satisfaction regarding their care in the pediatric emergency units is a basic objective in the analysis of perceived quality. Objective, material and methods: Analyze care activity in a pediatric emergency unit in a regional hospital during a randomly selected week and describe the degree of user satisfaction in regards to the care received, information, health care team and facilities. Results: The number of urgent visits during the week selected was 297 episodes, with 113 surveys (37.71%). A total of 74.1% were identified as mothers of the patient with a mean of 37.8 (SD: 6.0) years. Of these, 99.1% reported the possibility of being with their children at all times during the clinical activity and 99% considered they were adequately informed during the urgent process and 93.6% received adequate information for subsequent home management. Only 58% of the professionals were properly identified and 88.4% considered the time of stay in the unit adequate. Facilities and cleanliness were reported as excellent by 70%. The mean grade on the scale of 10 was 8.45 (SD: 1.72). Discussion: Overall, 90% of those surveyed reported they could be very satisfied with the care received in our unit. This level obtained must be maintained and the points considered to be weak improved, mainly in regards to that related with our identification

Ureterocele bilateral en sistema único: un caso particular / Bilateral ureterocele in Single collection system: A particular case

Introducción. El ureterocele es una malformación congénita de la vía urinaria que consiste en la dilatación quística de la porción vesical del uréter. Se presenta un caso infrecuente de ureterocele, revisando los aspectos más importantes que lo hacen tan inusual. Caso clínico. Varón de 7 años ingresado por hematuria en el con texto de una infección del tracto urinario afebril, en la ecografía se observó una ureterohidronefrosis (UHN) derecha en sistema único y la cistouretrografía miccional (CUMS) mostró un ureterocele del mismo lado. La cistoscopia evidenció un ureterocele bilateral ortotópico en sistema único y fue sometido a una ureterocelotomía endoscópica para drenar el sistema hidronefrótico. En control ecográfico al mes del procedimiento, se observó disminución franca de la UHN derecha, pero aparición de dilatación del uréter distal izquierdo, por lo que se decide puncionar también el ureterocele izquierdo. Sus controles posteriores han demostrado ausencia de dilatación de la vía urinaria. Comentarios. Se presenta el caso, poco frecuente, de un varón con ureterocele bilateral ortotópico en sistema único y su manejo clínico. Se discute su particularidad (AU)

Introduction. Ureterocele is an uncommon congenital urinary tract malformation, which consists in a cystic dilation of the vesical portion of the ureter. We present a rare case of ureterocele, reviewing the most important aspects and characteristics that make it so unusual.Case. Seven year old male admitted for hematuria in the context of afebrile urinary tract infection, the ultrasound revealed a right hyd oureteronephrosis (HUN) in a single collecting system and a voiding cystourethogram (VCUG) showed a right ureterocele. A cystoscopy demonstrated the presence of a bilateral orthotopicureterocele in a single collecting system. The patient underwent an endoscopic incision in order to drain the hydronephrotic system. After a month, while performing a check up using ultrasound, we could observe an important reduction in the right HUN, however, it also was acknowledged the presence of dilation of the left distal ureter, reason why it was decided to puncture the left ureterocele. Comments. We present an unusual case: male with a bilateral or thotopicureterocele in a single collecting system and its clinical management. Its particularity is discussed (AU)

Production of antimicrobial peptides is preserved in aging.

There is an increased susceptibility to infections during elderly, mainly because of the decreased efficacy of adaptive immunity to contain microorganisms. Albeit most of the elderly adults develop this deficiency in adaptive immunity only a minor percentage of them developed recurrent infectious diseases, thus innate immunity represents an important barrier to avoid infections in this group of aged people. Since antimicrobial peptides are important molecules of innate immunity in the study we sought to determine whether healthy aging correlates with a proper antimicrobial production. Our results by ELISA and flow cytometry showed that healthy elder individuals produce significant amounts of both cathelicidin and ß-defensin-2 (hBD-2) comparable with those found in healthy young individuals. Our results suggest that during healthy aging the maintenance of the antimicrobial peptide innate immune response may be responsible for the protection against infectious diseases.

[Bilateral ureterocele in single collection system: a particular case]. / Ureterocele bilateral en sistema único: un caso particular.

INTRODUCTION: Ureterocele is an uncommon congenital urinary tract malformation, which consists in a cystic dilation of the vesical portion of the ureter. We present a rare case of ureterocele, reviewing the most important aspects and characteristics that make it so unusual. CASE: Seven year old male admitted for hematuria in the context of afebrile urinary tract infection, the ultrasound revealed a right hydroureteronephrosis (HUN) in a single collecting system and a voiding cystourethogram (VCUG) showed a right ureterocele. A cystoscopy demonstrated the presence of a bilateral orthotopicureterocele in a single collecting system. The patient underwent an endoscopic incision in order to drain the hydronephrotic system. After a month, while performing a check up using ultrasound, we could observe an important reduction in the right HUN, however, it also was acknowledged the presence of dilation of the left distal ureter, reason why it was decided to puncture the left ureterocele. COMMENTS: We present an unusual case: male with a bilateral orthotopicureterocele in a single collecting system and its clinical management. Its particularity is discussed.

[Biosimilar medicines. Scientific and legal disputes]. / Medicamentos biosimilares. Controversias científicas y legales.

Patent expiry dates for early biotechnological drugs is giving rise to the availability of biosimilar drugs. According to the EMEA, these are defined as drugs with a biotechnological origin that have proven comparable to their reference product once the latter's patent expired. Modifications in the manufacturing process of biotechnological medications or treatment changes from one biotechnological molecule to another have not been debated until these biosimilar drugs have become available. It is then that, among other issues, the potential risks of their substitution for reference molecules became controversial. EMEA guidelines for biosimilar drug approval grant that these will be as effective and safe as any other newly available biotechnological medicinal product, or as any other drug undergoing changes in its manufacturing processes once marketed. Their availability will promote competition and reduce the high financial impact healthcare systems endure following the introduction of new therapies based on biotechnological drugs.

Medicamentos biosimilares. Controversias científicas y legales / Biosimilar medicines. Scientific and legal disputes

La caducidad de las patentes de los primeros medicamentos biotecnológicos comercializados está dando origen a la aparición en el mercado de los medicamentos biosimilares. Éstos se definen, según la EMEA, como fármacos de origen biotecnológico que han demostrado ser comparables al medicamento de referencia, una vez que su patente ha expirado. Las modificaciones en el proceso de fabricación de medicamentos biotecnológicos o el cambio de tratamiento de una molécula biotecnológica a otra no ha sido tema de debate hasta la aparición en el mercado de estos medicamentos biosimilares. Es entonces cuando se ha polemizado, entre otras cuestiones, sobre los posibles riesgos de su intercambio con la molécula de referencia. Las guías publicadas por la EMEA, para la autorización de fármacos biosimilares, aseguran que éstos sean tan eficaces y seguros como cualquier otro fármaco nuevo de biotecnología que se comercializa o como cualquier otro que, estando comercializado, cambia su proceso de fabricación. Su entrada en el mercado promoverá la competencia y conseguirá disminuir el alto impacto económico que soportan los sistemas sanitarios, tras la incorporación de nuevas terapias basadas en el uso de medicamentos de biotecnología (AU)

Patent expiry dates for early biotechnological drugs is giving rise to the availability of biosimilar drugs. According to the EMEA, these are defined as drugs with a biotechnological origin that have proven comparable to their reference product once the latter’s patent expired. Modifications in the manufacturing process of biotechnological medications or treatment changes from one biotechnological molecule to another have not been debated until these biosimilar drugs have become available. It is then that, among other issues, the potential risks of their substitution for reference molecules became controversial. EMEA guidelines for biosimilar drug approval grant that these will be as effective and safe as any other newly available biotechnological medicinal product, or as any other drug undergoing changes in its manufacturing processes once marketed. Their availability will promote competition and reduce the high financial impact healthcare systems endure following the introduction of new therapies based on biotechnological drugs (AU)

Documento de Consenso sobre el uso de factores estimuladores de colonias de granulocitos biosimilares para la corrección de la neutropenia asociada en pacientes con cáncer / No disponible

No disponible

Utilización del aprendizaje basado en problemas en la enseñanza de física en estudiantes de medicina: comparación con enseñanza tradicional / Problem based learning in physics: comparison with traditional teaching in medical students

Background: Problem based learning, integrating basic science with clinical problems, is one of the most recommended forms of teaching for medical schools. Aim: To compare a problem based learning program for physics with traditional teaching methods. Material and methods: In the physics course, first year medical students were separated in groups with traditional learning and problem based teaching. Both groups were subjected to the same knowledge and qualitative evaluations. Results: At the end of the course, cognitive performance in both groups was similar (60.8 and 61.3 percent among traditional teaching and problem based learning groups respectively). However, students assigned to the problem based learning group evaluated significantly better the teaching methodology and process. Conclusions: Physics education, using problem based learning, obtains the same cognitive results but a higher degree of satisfaction than traditional teaching among students

Language barriers.

AIDS: The impact of language and cultural barriers in obtaining information about HIV and AIDS is described. It is difficult for people in the United States who speak English as a second language, or do not speak it at all, to translate material or obtain written information in their native language. Different cultures and values may alter how people relay and process information. HIV-infected people are encouraged to support each other and contribute to the dissemination of information.^ieng

Detection of Mycoplasma hominis and Ureaplasma urealyticum in women sexually active or not.

Genital mycoplasmas play an important role in genitourinary tract disease. The purpose of this study was to isolate M. hominis and U. urealyticum from vaginal and throat swabs and urine from women sexually active or not. Samples were taken from women with (cases) or without (controls) genitourinary tract disease and were dipped inoculated into 1 ml of E broth with arginine or urea and ten-fold dilutions were done. Samples were incubated at 37 degrees C until phenol red indicator changed to color purple. Identification of species was done by polymerase chain reaction technique. M. hominis was identified with oligonucleotides that correspond to the nucleotide sequence of 16S rRNA gene and U. urealyticum was identified with oligonucleotides that correspond to the nucleotide sequence of the urease gene (Blanchard et al.). There was no statistical difference (X2 P > .05) between isolation percentages from vaginal swabs, while there was statistical difference between urine samples. These mycoplasmas were isolated in higher percentages from pubertal girls and were recovered until the fifth ten-fold dilution both from vaginal swabs and urine. For throat swabs they were only recovered from sexually active women.

[Sustained monomorphic ventricular tachycardia in myotonic dystrophy]. / Taquicardia ventricular monomórfica sostenida en la distrofia miotónica.

Myotonic dystrophy is an hereditary multisystemic disease, characterized by slowly progressive myotonic atrophy of skeletic muscles. The heart is frequently affected with occurrence of arrhythmias and His-Purkinje system dysfunction and, less frequently, myocardial dysfunction. The surface ECG is the most sensible indicator of heart disease, and the most common electrophysiological finding is the prolongation of the H-V interval. Patients usually have few cardiovascular symptoms, but when present, the most frequent are: syncope, arrhythmias, atrioventricular block, congestive heart failure and sudden death. We present two patients with sustained monomorphic ventricular tachycardia as initial presentation of cardiac disease.