Adverse cardiovascular, obstetric and perinatal events during pregnancy and puerperium in patients with heart disease.

BACKGROUND AND OBJECTIVES: cardiovascular changes during pregnancy carry greater risk in heart disease. We analyze cardiovascular, obstetric and perinatal adverse effects associated with congenital and acquired heart disease during pregnancy and postpartum. MATERIALS AND METHODS: Cross-sectional and retrospective study, which included the 2017-2023 registry of pregnant or postpartum patients hospitalised with diagnosis of congenital or acquired heart disease. Adverse events (heart failure, stroke, acute pulmonary edema, maternal death, obstetric haemorrhage, prematurity and perinatal death) were compared with the clinical variables and the implemented treatment. RESULTS: 112 patients with a median age of 28 years (range 15-44) were included. Short circuits predominated 28 (25%). Thirty-six patients (32%) were classified in class IV of the modified WHO scale for maternal cardiovascular risk. Heart failure occurred in 39 (34.8%), acute lung edema 12 (10.7%), stroke 2 (1.8%), maternal death 5 (4.5%), obstetric haemorrhage 4 (3.6%), prematurity 50 (44.5%) and perinatal death 6 (5.4%). Shunts were associated with prematurity (adjusted odds ratio 4; 95% CI: 1.5-10, p = 0.006). Peripartum cardiomyopathy represented higher risk of pulmonary edema (adjusted OR 34; 95% CI: 6-194, p = 0.001) and heart failure (adjusted OR 16; 95% CI: 3-84, p = 0.001). An increased risk of obstetric haemorrhage was observed in patients with prosthetic valves (adjusted OR 30; 95% CI: 1.5-616, p = 0.025) and with the use of acetylsalicylic acid (adjusted OR 14; 95% CI: 1.2-16, p = 0.030). Furthermore, the latter was associated with perinatal death (adjusted OR 9; 95% CI: 1.4-68, p = 0.021). CONCLUSIONS: severe complications were found during pregnancy and postpartum in patients with heart disease, which is why preconception evaluation and close surveillance are vital.

Phytochemical profile and nematicidal activity of a hydroalcoholic extract from Cazahuate flowers (Ipomoea pauciflora M. Martens & Galeotti) against Haemonchus contortus infective larvae

@#Haemonchus contortus (Hc) is a hematophagous parasite affecting the health and productivity of flocks. The administration of chemical anthelmintic drugs (AH) is the common method of deworming; however, generates resistance in the parasites to AH and it is a public health risk due to drug residues in milk, meat and sub-products. Natural compounds from plants are explored to diminish this parasitosis, improving their health and productivity, without the negative effects of AH. Ipomoea genus is a group of climbing plants belonging to the Convulvulaceae family possessing perennial leaves and tuberous roots. Medicinal properties has been attributed to this plant including nutritional agents, emetics, diuretics, diaphoretics, purgatives and pesticides. The objective of this study was assessing the in vitro nematocidal activity of a hydroalcoholic extract (HA-E) obtained from Ipomoea pauciflora (Cazahuate) flowers against Hc infective larvae (L3) and to identify its phytochemical profile (PhC-P). The assay was carried out using microtiter plates (MTP). Four HA-E concentrations were assessed and Ivermectin and distilled water were used as positive and negative control groups, respectively. Approximately 100 Hc L3 were deposited in each well (n=12) and incubated at 25–35°C for 7 days. Data were analyzed using ANOVA and a General Linear Model (GLM) followed by Tukey test (P<0.05). The treatments showing a concentration-dependent effect (CDE) were analyzed to identify their 50% and 90% lethal concentrations (CL50, 90) via a Probit Analysis. The highest mortality was observed at 50 mg/mL (82.64 ± 0.71%) and the lowest at 6.25 mg/mL (56.46 ± 2.49%), showing a CDE with increasing mortality from 6.25 to 50 mg/mL. The PhC-P revealed the presence of alkaloids, coumarins, flavonoids, tannins and triterpenes/ sterols. A HA-E from flowers of I. pauciflora will be considered to assess its potential use in the control of haemonchosis in small ruminants.

[Patent foramen ovale. An update for primary care]. / Foramen oval permeable. Una actualización para atención primaria.

Patent foramen ovale (FOP) is the most prevalent cause of cryptogenic strokes in people under 60 years old. Although it is usually asymptomatic, it has a high risk of producing paradoxical embolism and, therefore, stroke with indeterminate outcomes. The study should be started based on clinical suspicion, and includes a multidisciplinary assessment and a determination of the type of treatment to be performed. The therapeutic possibilities range from conservative treatment (indefinite antithrombotic treatment), to its percutaneous closure (currently the most widely used). The first objective is to decrease the number of stroke recurrences. Conservative treatment should be reserved for those cases of low embolic risk. The risk assessment must be individualised, fundamentally based on the anatomical characteristics of the FOP and the patient clinic picture. The use of the RoPE risk scale (The Risk of Paradoxical Embolism) should be a tool to consider.

A propósito de tres casos: ptosis y cefalea en diferentes escenarios / Ptosis and headaches in different scenaries: a presentation of 3 cases

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Investigation on Sb distribution for InSb/InAs sub-monolayer heterostructure using TEM techniques.

InSb/InAs sub-monolayer (SML) nanostructures such as SML quantum dots offer sharper emission spectra, a better modal gain and a larger modulation bandwidth compared to its Stranski-Krastanov counterpart. In this work, the Sb distribution of SML InSb layers grown by migration enhanced epitaxy has been analyzed by transmission electron microscopy (TEM) techniques. The analysis of the material by diffraction contrast in 002 dark field conditions and by atomic column resolved high angle annular dark field-scanning TEM reveal the presence of a low Sb content InSbAs continuous layer with scarce Sb-rich InSbAs agglomerates. The intensity profiles obtained by both techniques point to Sb segregation during growth. This segregation has been quantified using the Muraki segregation model obtaining a high segregation coefficient R of 0.81 towards the growth direction. The formation of a continuous InSbAs wetting layer as a result of a SML deposition of Sb on the InAs surface is discussed.

Structural characterization of bulk and nanoparticle lead halide perovskite thin films by (S)TEM techniques.

Lead halide (APbX3) perovskites, in polycrystalline thin films but also perovskite nanoparticles (NPs) has demonstrated excellent performance to implement a new generation of photovoltaic and photonic devices. The structural characterization of APbX3 thin films using (scanning) transmission electron microscopy ((S)TEM) techniques can provide valuable information that can be used to understand and model their optoelectronic performance and device properties. However, since APbX3 perovskites are soft materials, their characterization using (S)TEM is challenging. Here, we study and compare the structural properties of two different metal halide APbX3 perovskite thin films: bulk CH3NH3PbI3 prepared by spin-coating of the precursors in solution and CsPbBr3 colloidal NPs synthetized and deposited by doctor blading. Both specimen preparation methods and working conditions for analysis by (S)TEM are properly optimized. We show that CH3NH3PbI3 thin films grown by a one-step method are composed of independent grains with random orientations. The growth method results in the formation of tetragonal perovskite thin films with good adherence to an underlying TiO2 layer, which is characterized by a photoluminescence (PL) emission band centered at 775 nm. The perovskite thin films based on CsPbBr3 colloidal NPs, which are used as the building blocks of the film, are preserved by the deposition process, even if small gaps are observed between adjacent NPs. The crystal structure of CsPbBr3 NPs is cubic, which is beneficial for optical properties due to its optimal band gap. The absorption and PL spectra measured in both the thin film and the colloidal solution of CsPbBr3 NPs are very similar, indicating a good homogeneity of the thin films and the absence of aggregation of NPs. However, a particular care was required to avoid long electron irradiation times during our structural studies, even at a low voltage of 80 kV, as the material was observed to decompose through Pb segregation.

Formaldehyde induces DNA strand breaks on spermatozoa and lymphocytes of Wistar rats.

Formaldehyde (FA) interacts with biological molecules such as DNA and it induces DNA-protein cross-links (DPCs), oxidative stress, reactive oxygen species (ROS), methylation, chromosomal damage, fragmentation, and adducts of DNA, which are considered the most important genotoxic effects caused by exposure to FA. The purpose of this study was to evaluate the percentage of DNA fragmentation on lymphocytes and spermatozoa from Wistar rats exposed to different doses of FA. The results about the percentage of fragmentation of DNA in lymphocytes and spermatozoa, were statistical different from controlled group versus treated groups respectively to (p < 0.05). Pathological changes were observed in the seminiferous tubules, especially in rats exposed to 30 mg/kg of FA. This study provided additional evidence supporting that FA induces DNA strand breaks in both cells and therefore genotoxic damage in Wistar rats.

Radial and tangential migration of telencephalic somatostatin neurons originated from the mouse diagonal area.

The telencephalic subpallium is the source of various GABAergic interneuron cohorts that invade the pallium via tangential migration. Based on genoarchitectonic studies, the subpallium has been subdivided into four major domains: striatum, pallidum, diagonal area and preoptic area (Puelles et al. 2013; Allen Developing Mouse Brain Atlas), and a larger set of molecularly distinct progenitor areas (Flames et al. 2007). Fate mapping, genetic lineage-tracing studies, and other approaches have suggested that each subpallial subdivision produces specific sorts of inhibitory interneurons, distinguished by differential peptidic content, which are distributed tangentially to pallial and subpallial target territories (e.g., olfactory bulb, isocortex, hippocampus, pallial and subpallial amygdala, striatum, pallidum, septum). In this report, we map descriptively the early differentiation and apparent migratory dispersion of mouse subpallial somatostatin-expressing (Sst) cells from E10.5 onward, comparing their topography with the expression patterns of the genes Dlx5, Gbx2, Lhx7-8, Nkx2.1, Nkx5.1 (Hmx3), and Shh, which variously label parts of the subpallium. Whereas some experimental results suggest that Sst cells are pallidal, our data reveal that many, if not most, telencephalic Sst cells derive from de diagonal area (Dg). Sst-positive cells initially only present at the embryonic Dg selectively populate radially the medial part of the bed nucleus striae terminalis (from paraseptal to amygdaloid regions) and part of the central amygdala; they also invade tangentially the striatum, while eschewing the globus pallidum and the preoptic area, and integrate within most cortical and nuclear pallial areas between E10.5 and E16.5.

Sperm chromatin dispersion by formaldehyde in Wistar rats.

Formaldehyde (FA) is an environmental xenobiotic, which is genotoxic and carcinogenic to humans and animals; it induces DNA damage, mutations, and clastogenicity during critical cytogenetic events. FA-mediated oxidative stress is an important mechanism that has been associated with the induction of cytotoxic and genotoxic damage. Therefore, the objective of this study was to evaluate the dispersion of sperm chromatin and reproductive parameters induced by exposure to different concentrations of FA in Wistar rats. Compared to the percentage of sperm with fragmented DNA in the control group (18.10 ± 8.62%), the percentage of sperm with fragmented DNA increased following exposure to 5, 10, and 30 mg FA/kg body weight (29.60 ± 8.44, 85.20 ± 20.94 and 96.0 ± 7.87, respectively; P = 0.0001). Histopathological alterations were evident, especially in the seminiferous tubules. In conclusion, this study provides experimental evidence concerning the genotoxicity of FA, with particular reference to the decreased sperm concentration and motility and increased dispersion of DNA chromatin in rats.

Decreased frequency, but normal functional integrity of mesenchymal stromal cells derived from untreated and Imatinib-treated chronic myeloid leukemia patients.

In vitro, Imatinib inhibits the proliferation and stimulates the osteogenic and adipogenic differentiation of mesenchymal stromal cells (MSC). However, it is unknown whether Imatinib affects the biology of MSC in vivo. We asked whether MSC from long-term Imatinib-treated CML patients were affected by the in vivo treatment. MSC from untreated and Imatinib-treated patients displayed normal functional properties (i.e. proliferation, immunophenotype, differentiation and hematopoietic supportive capacity) - but a decreased frequency. In vitro, Imatinib lost its effect when discontinued; which suggest that it has a reversible effect on MSC. Therefore it might lose its effect on MSC after discontinuation in vivo.

Solar photocatalytic activity of TiO2 modified with WO3 on the degradation of an organophosphorus pesticide.

In this study, the solar photocatalytic activity (SPA) of WO3/TiO2 photocatalysts synthesized by the sol-gel method with two different percentages of WO3 (2 and 5%wt) was evaluated using malathion as a model contaminant. For comparative purpose bare TiO2 was also prepared by sol-gel process. The powders were characterized by X-ray diffraction (XRD), Raman spectroscopy, diffuse reflectance UV-vis spectroscopy (DRUV-vis), specific surface area by the BET method (SSABET), scanning electron microscopy (SEM), high resolution transmission electron microscopy (HRTEM) and scanning transmission electron microscopy with a high annular angle dark field detector (STEM-HAADF). The XRD, Raman, HRTEM and STEM-HAADF analyses indicated that WO3 was present as a monoclinic crystalline phase with nanometric cluster sizes (1.1 ± 0.1 nm for 2% WO3/TiO2 and 1.35 ± 0.3 nm for 5% WO3/TiO2) and uniformly dispersed on the surface of TiO2. The particle size of the materials was 19.4 ± 3.3 nm and 25.6 ± 3 nm for 2% and 5% WO3/TiO2, respectively. The SPA was evaluated on the degradation of commercial malathion pesticide using natural solar light. The 2% WO3/TiO2 photocatalyst exhibited the best photocatalytic activity achieving 76% of total organic carbon (TOC) abatement after 300 min compared to the 5% WO3/TiO2 and bare TiO2 photocatalysts, which achieved 28 and 47% mineralization, respectively. Finally, experiments were performed to assess 2% WO3/TiO2 catalyst activity on repeated uses; after several successive cycles its photocatalytic activity was retained showing long-term stability.

Relationship between weakness and phase angle in advanced cancer patients with fatigue.

OBJECTIVE: This study aims to determine the relationship between weakness and bioimpedance analysis (BIA)-derived phase angle in a population of untreated cancer patients with fatigue. METHODS: We prospectively evaluated 41 treatment-naive cancer patients of several origins that presented with performance status 1-2, weight loss >5% in the last 6 months, and Fatigue Numeral Scale score >4. Weakness was considered a physical component of the multidimensional fatigue syndrome and was evaluated through several parameters utilizing hand grip strength technique by dinamometry. The same assessment was also performed on a healthy control population (n = 20). BIA-derived phase angle was also determined by BIA. RESULTS: Compared to healthy controls, cancer patients exhibited significant differences in all the parameters: median fatigue was 6 (range 5-9), evaluated maximal strength mean was 27 ± 10.71 vs. 42 ± 10.74 kg (p < 0.0001 for patients vs. control, respectively), and muscle strength difference (max-min muscle strength) was also statistically different (p < 0.0001). We also determined parameter associations within the patient population. We found statistical significant correlations between median phase angle score and endurance muscle with percentage of weight loss (r = 0.43, p = 0.03) for head and neck cancer patients, and in non-small cell lung cancer patients, grip work correlated significantly with normal or decreased phase angle (r = 0.85), p = 0.006 (Spearman Rank Correlation). CONCLUSIONS: Weakness could be correlated with normal or decreased phase angle in a population with ambulatory advanced cancer with fatigue naive of treatment. We also found a significant relationship between median phase angle score and endurance muscle with percentage of weight loss in the subpopulation of patients with head and neck carcinoma.

Toxins from Physalia physalis (Cnidaria) raise the intracellular Ca(2+) of beta-cells and promote insulin secretion.

Physalia physalis is a marine cnidarian from which high molecular weight toxins with hemolytic and neurotoxic effects have been isolated. In the present work, two novel toxins, PpV9.4 and PpV19.3 were purified from P. physalis by bioactive guideline isolation. It involved two steps of column chromatography, gel filtration and RP-HPLC. The molecular weights were 550.7 and 4720.9 Da for PpV9.4 and PpV19.3, respectively. In the light of the Edman sequencing results, the structure of these toxins included the presence of modified amino acids. Both toxins increased the percentage of insulin secreting beta-cells and induced cytosolic Ca2+ elevation. To date, this is the first report of low molecular weight toxins increasing insulin secretion purified from cnidarians, by constituting a new approach to the study of beta-cells physiology.

Seguridad y eficacia de la colocación del catéter de diálisis peritoneal aguda por punción en pacientes con síndrome urémico hemolítico asociado a diarrea / Safety and efficacy of percutaneous acute peritoneal dialysis catheter placement in patients with post-diarrheal hemolytic uremic syndrome

Introducción: La diálisis peritoneal aguda (DPA) es la modalidad dialítica preferentemente seleccionada para niños con injuria renal aguda por síndrome urémico hemolítico postdiarreico (SUH D+). Evaluamos la seguridad y eficacia de la colocación por punción percutánea del catéter de DPA con anestesia local en niños con SUH D+. Pacientes y métodos: Se revisaron las historias clínicas de todos los pacientes con SUH D+ internados entre el 1 de enero de 1998 y el 31 de diciembre de 2008 en el Hospital de Pediatría Prof. Dr. Juan P. Garrahan. La seguridad se evaluó por la presencia de eventos adversos mayores relacionados con la colocación del catéter (per foración de vísceras y/o vasos mayores abdominales, sangrado que requiera transfusión) y menores (infección del sitio de salida y peritonitis dentro de las 48 hs del procedimiento). La eficacia se evaluó a través de la colocación exitosa del catéter y su buen funcionamiento. Además se registró la necesidad de recambio luego de su uso por mal funcionamiento. Resultados: Identificamos 149 pacientes que realizaron DPA, edad de 20.2 meses (rango 2,9-111) y peso de 11,35 kg (rango 5-24.4). Recuento de plaquetas previo al procedimiento de 89000 (22000-148000) mm3. Seguridad: el único efecto adverso detectado fue el desarrollo de peritonitis en un paciente. No se registró perforación de órganos ni de vasos mayores abdominales, ni sangrado severo, ni infección del sitio de salida. Eficacia: en todos los casos el catéter fue colocado exitosamente y en 48 pacientes (32.2%) hubo que recambiarlo por mal funcionamiento. Tanto la colocación como el recambio fueron realizadas en todos los casos por el nefrólogo al pie de la cama. Conclusión: la colocación del catéter de DPA por punción es un procedimiento seguro y eficaz.

ntroduction: Acute peritoneal dialysis (DPA) is the dialytictreatment of choice for children with acute kidney injury dueto post-diarrheal hemolytic uremic syndrome (D+HUS). In thisstudy safety and efficacy of percutaneous placement of anAPD catheter under local anesthesia in children with D+HUSwas assessed. Patients and methods: We reviewed the cli-nical charts of all patients with D+HUS admitted to thePediatric Hospital Prof. Dr. Juan P. Garrahan betweenJanuary 1, 1998 and December 31, 2008. Safety was eva-luated based on the presence of major (perforation of theviscera and/or major abdominal vessels, bloody dialysaterequiring red-blood-cell transfusion) and minor (exit-siteinfection and peritonitis within 48 hs of the procedure) adverse events associated with catheter insertion. Efficacy was assessed based on successful catheter insertion and func-tioning. Additionally, the need for catheter replacement dueto malfunction was recorded. Results: We identified 149patients with a mean age of 20.2 months (range, 2.9-111)and weight of 11.35 kg (range, 5-24.4) who underwent APD.Median platelet count previous to the procedure was 89000(range, 22000-148000) mm3. Safety: The only adverse eventfound was the development of peritonitis in one patient.Organ or major vessel perforation, severe bleeds, or exit-site infection were not observed. Efficacy: In all patients the catheter was successfully inserted and in 48 patients (32.2%) the catheter had to be replaced due to malfunctioning. Both placement and replacement were performed by a nephrologist at the bedside in all cases. Conclusion: Percutaneous APD catheter insertion is a safe and efficacious procedure.

Role of the non-canonical notch ligand delta-like protein 1 in hormone-producing cells of the adult male mouse pituitary.

To better understand the role of the non-canonical Notch ligand delta-like protein 1 (DLK1), in hormone-producing cells, we studied the cell distribution and subcellular localisation of DLK1 in the pituitary of male adult 129/SvJ mice, and analysed the variations in the hormone-producing cells associated with the lack of this gene in Dlk1 knockout mice. The results obtained showed the presence of DLK1-immunoreactive (ir) cells in all hormone-producing cells of the anterior pituitary. Immunoelectron microscopy showed DLK1-ir in the rough endoplasmic reticulum and inside secretory vesicles, suggesting that DLK1 is released together with pituitary hormones. Moreover, we found that prolactin (PRL)-DLK1-ir cells are in intimate contact with follicle-stimulating hormone (FSH)-ir-DLK1-negative cells. In Dlk1 knockout mice, we detected a significantly lower number of gowth hormone (GH)-ir cells, a reduction in the FSH and PRL immunostaining intensity, and a significant decrease in FSH mRNA expression compared to wild-type mice. An increase in pituitary GH mRNA expression and serum leptin levels was also found. These findings provide evidence supporting several regulatory functions of DLK1 in the pituitary gland.

Talla final en pacientes transplantados renales bajo tratamiento con hormona de crecimiento / Final height in renal transplant patients after growth hormone treatment

El retardo de crecimiento es un importante problema clínico aun no resuelto ni correctamente manejado en niños con insuficiencia renal crónica (IRC). La optimización de todos los parámetros metabólicos y nutricionales no siempre lleva a una mejoría del crecimiento en estos pacientes. Desde hace aproximadamente 20 años se utiliza el tratamiento con rhGH para mejorar la talla en este grupo de niños. La bibliografía internacional muestra mejoría de la velocidad de crecimiento en estos pacientes sin embargo la experiencia publicada en la talla final (TF) alcanzada por los mismos es escasa. Los objetivos de este estudio fueron:1) evaluar la talla final alcanzada por pacientes transplantados renales(TxR) que recibieron tratamiento con rhGH (GrGH) comparándolos con un grupo control (GrC) con similares características clínicas, 2) evaluar los factores predictores de la TF, y 3) la repercusión de dicho tratamiento en la función renal. La TF en el GrGH fue significativamente mayor que la TF del GrC (-1.96 ± 1.13 vs -3.48 ± 1.19 SDS respectivamente, p <0.05). La talla (SDS) al inicio del tratamiento con rhGH fue la única variable significativa para predecir la respuesta al tratamiento (p= 0.001). Se observó una disminución significativa ClCr final en ambos grupos (GrGH: 76 ± 18 vs 66 ± 14 ml/min/m2 sup p<0.05; GrC: 72 ± 19 vs 56 ± 9 ml/min/m2 sup, p<0.05) lo que sugiere una caída similar del filtrado glomerular en ambos grupos independiente del tratamiento. Conclusión: Nuestros hallazgos permiten confirmar que el tratamiento con rhGH es efectivo para mejorar la talla final en pacientes TxR sin afectar la función renal (AU)

Growth retardation is a common and significant clinical problem that is not adequately managed in children with chronic renal disease. Despite optimization of metabolic parameters the growth of this patients not always amelioreted. About 20 years ago rhGH treatment became to be used for this group of children to optimization final height.The international experience show that rhGH treatment improve growth velocity but the results about final heigth are scarse. The aims of our trial were: 1) to evaluate final height in renal transplant patients treated with rhGH (n=23) comparing with a control group not treated with rhGH (n=14) with similar characteristics, 2) to evaluate the effect of rhGH on creatinine clearance,3) to establish predictive variables for final height. Final Heigth was significantly greater in treated group vs control group (-1.9±1.1 vs -3.5±1.2, p<0.05). Initial height was the only significant variable to predict final height (p=0.001). We described a significantly decrease of creatinine clearence in both groups during follow up (GH Group 76±9 vs 66±14 ml/min/m2 sup, p<0.05 and Control Group 72.5±19 vs 56±9 ml/min/m2 sup, p= p<0.05).This suggest a similar decrese of creatinine clearence in both groups. Conclution: Our data confirm that rhGH treatment was effective in improving final height in renal transplant patients and did not decline allograft function (AU)

Efecto del Kinesio taping sobre la respuesta refleja de los músculos bíceps femoral y gemelo externo / Effect of Kinesio taping on reflex response of biceps femoris and gastrocnemius lateralis

ObjetivoAnalizar el efecto inmediato de la aplicación de Kinesio Tape (KT) sobre la respuesta refleja de los músculos bíceps femoral y gemelo externo ante un desequilibrio rápido e inesperado aplicado sobre la rodilla mediante una técnica conocida como quick release.Material y métodosEn el estudio participaron voluntariamente 11 sujetos sanos (23,6±3,0 años; 171,8±6,8cm y 63,3±9,7kg). Se utilizó un goniómetro electrónico para determinar el inicio del desequilibrio y electromiografía de superficie para comparar la intensidad y la latencia de la respuesta refleja de los músculos referidos entre dos condiciones diferentes: sin vendaje (control) y con vendaje (KT). Con el objeto de valorar la fiabilidad interobservador, dos grupos de investigadores calcularon por separado la intensidad (pico de la electromiografía normalizada) y la latencia de la respuesta (tiempo desde el inicio del desequilibrio hasta el inicio de la activación muscular).ResultadosLos datos obtenidos por ambos grupos fueron similares (t-test: p≥0,204). Asimismo, con la excepción del pico de activación del músculo gemelo externo en la condición KT (coeficiente de correlación intraclase [ICC] = 0,363) se obtuvieron correlaciones elevadas entre los grupos para la mayor parte de las variables (0,741≤ICC≤0,996). En relación con el efecto del vendaje, no se encontraron diferencias significativas entre las condiciones control y KT (t-test: p≥0,123), aunque la tendencia observada fue una respuesta de menor intensidad y mayor latencia cuando se aplicó el KT.ConclusionesNuestros resultados sugieren que la aplicación del KT no tiene un efecto inmediato sobre la respuesta refleja de los músculos analizados(AU)

ObjectiveTo analyze the immediate effect of the application of Kinesio Tape (KT) on reflex response of biceps femoris and gastrocnemius lateralis subject to a sudden and unexpected perturbation applied to the knee by means of a technique known as quick release.MethodsEleven healthy individuals volunteered to take part in this study (23.6±3.0 years; 171.8±6.8cm; and 63.3±9.7kg). An electrogoniometer was used to determine the onset of the perturbation and superficial electromyography was recorded to compare the intensity and the latency of the reflex response of biceps and grastrocnemius under two different conditions: without bandage (control) and with bandage (KT). In order to assess the inter-experimenter reliability, two groups of researchers independently calculated the response intensity (peak of the normalized electromyography) and latency (the time it takes between the start of the perturbation and the onset of muscle activation).ResultsThe data obtained by both groups were similar (t-test: p≥0.04). In addiction, with the exception of the activation peak of grastrocnemius in the KT condition (ICC=0.363), high correlations between groups were found for most of the variables (0.741≤ICC≤0.996). With regard to the effect of the bandage, significant differences between the control and the KT conditions were not found (t-test: p≥0.123). However, the observed trend was a muscular response of lower intensity and larger latency when the KT was used.ConclusionsOur results suggest the application of KT does not have an immediate effect on the reflex response of the analyzed muscles(AU)

Embarazo Tubárico Asociado a Teratoma de Ovario, Hallazgos Ecográficos y Laparoscopicos: Reporte de un Caso / Tubal Pregnancy Asociated with oVarian Teratoma, Ecographic and Laparoscopic Findings: Case Report

RESUMEN Mujer de 28 años con retraso menstrual de 15 días. Examen físico: dolor en ambas fosas ilíacas, escaso sangrado, fondos de saco laterales dolorosos no abombados y fondo de saco de Douglas (FSD) levemente doloroso. Se realizaron 3 ecografías diferentes. Observamos la evolución del embarazo ectópico desde la típica imagen ecográfica redondeada con saco en su interior hasta la imagen heterogénea (hemática) que resultó ser un aborto tubárico por laparoscopia y biopsia. Hubo correlación con el BHCG en descenso. La búsqueda bibliográfica no encontró descripciones de asociaciones iguales al caso descrito.

ABSTRACT We report a case of a 28 year old woman with 15 days menstrual delay, abdominal pain and small bleeding. During physical examination, we found no pain in lateral pouches and slight pain in pouch of Douglas. Three different vaginal ultrasounds were perfomed by 3 professionals. We saw ultrasonographic evolution of an ectopic pregnancy from typical image with a sac within it to heterogeneous image (blood). Laparoscopy and biopsy confirm these findings. BHCG correlates with them, showing descendent levels. Bibliographic search didn’t find similar cases to our patient.

Trasplante renal 1988 - 2008 / Kidney transplantation 1988- 2008

Evaluación retrospectiva de 575 trasplantes (TX), 64,3 por ciento con donante cadavérico (DC), en 550 pacientes (311 varones) edad por x: 10.8 más menos 4.2 años, efectuados entre 1988 y 2008. edad por de donante: DC 22.5 más menos 14 años y DVR: 37.3 más menos 7.7 años. Principales causas de IRC: nefropatía por reflujo: 34,1 por ciento, hipo-displasia: 15.1 por ciento, SUH; 12.9 por ciento, GSF: 9.82 por ciento, glomerulonefritis varias: 16.4 por ciento. Inmunosupresion: en la mayoría de los pacientes, Cicloporina A; Azatioprina o micofenolato mofetil o ácido micofenólico y esteroides con linfo o timoglobulina secuencia en TXDC y profilaxis con gaciclovir en riesgo de infección por CMV. La sobrevida actuarial funcional renal (SA) a 1.3 a 5 años fue 96.5 por ciento, 94.4 por ciento y 86,2 por ciento TX DVR y 90,1 por ciento, 85,5 por ciento y 77.6 por ciento TX DC, p= 0.04, similar a resultados en EEUU (NAPRCTS 1999 - 2002). La GSF con 45.5 por ciento de recurrencia del síndrome nefrótico, tuvo inferior SA al 5to año, p= 0.001, comparado con otras etiologías de IRC. Los TX sin diálisis (D) previa, p= 0.003. Tuvieron trombosis 2.61 por ciento de los TX, más frecuentes con DPCA pre tx que con hemo D o sin diálisis, p= 0.01, con TXDC, p= 0.02 y con TX de donantes < de 6 años, p = 0.02. Los pacientes que requirieron diálisis post trasplante, tuvieron mayor creatinina al año D: 1.8 más menos 2.27 mg/dl.SD: 1.19 más menos 1.2, p < 0.01, e inferior SA al quinto año, p=0.001. Con tiempo de isquemia fria superior a 24 horas, 31,6 por ciento de los DC necesitaron diálisis. El rechazo celular agudo se dianosticó en el 14,8 por ciento de los pacientes. Las causas más frecuentes de fracaso del trasplante fueron: nefropatía crónica (69,8 por ciento) asociado a inadecuada adherencia en 54.7 por ciento, trombosis (12.6 por ciento), recurrencia (5.9 por ciento), ausencia de función (5 por ciento) rechazo severo (5 por ciento)Desarrollaron enfermedad.