Cranial osteology and paleoneurology of Tarjadia ruthae: An erpetosuchid pseudosuchian from the Triassic Chañares Formation (late Ladinian-?early Carnian) of Argentina.

Tarjadia ruthae is a quadrupedal terrestrial pseudosuchian from the Middle-early Upper Triassic of the Chañares Formation, La Rioja Province, Argentina. Originally, this species was identified as an indeterminate archosaur and later as a doswelliid archosauriform based on very fragmentary specimens characterized by the ornamentation of the skull roof and osteoderms. Additional specimens (including skulls and postcrania) recovered in the last decade show that Tarjadia is an erpetosuchid, an enigmatic pseudosuchian group composed of six species registered in Middle-Upper Triassic continental units of Tanzania, Germany, Scotland, North America, Brazil, and Argentina. Tarjadia ruthae from Argentina and Parringtonia gracilis from Tanzania are the best preserved and more abundant species. Although the monophyly of Erpetosuchidae is well supported, alternative high-level positions within Archosauria have been suggested, such as sister taxon to Crocodylomorpha, Aetosauria, or Ornithosuchidae. In order to improve the knowledge about the erpetosuchids, we performed a detailed description and paleoneurological reconstruction of the skull of Tarjadia ruthae, based on two articulated partial skulls (CRILAR-Pv 478 and CRILAR-Pv 495) and other fragmentary specimens. We analyzed the stratigraphic and geographic occurrence of historical and new specimens of Tarjadia and provided a new emended diagnosis (the same for the genus as for the species, due to monotypy) along with a comparative description of the cranial endocast. The skull of Tarjadia is robust, with a thick and strongly ornamented skull roof, triangular in dorsal view, with concave lateral margins at mid-length that form an abrupt widened posterior region. The external nares are the smallest openings of the skull. The antorbital fossa is deeply excavated and has a small heart-shaped fenestra with both lobes pointing anteriorly. The supratemporal fenestrae are as large and rounded as the orbits, and the infratemporal fenestrae are L-shaped with an extensive excavation along the jugal, quadratojugal and quadrate. The hemimandibles are low, slightly concave on the dentigerous region and strongly convex on the posterior region, conferring them a S-shaped profile in dorsal view. The external mandibular fenestra is small and elliptic, being twice longer than high. The maxillary dentition is restricted to the anterior to mid region of the rostrum. Since the braincase of both specimens is partially damaged, the dorsal surface of the brain could not be entirely reconstructed. As a result, the endocast is anteroposteriorly elongated and seemingly flat, and the cephalic flexure seems to be lower than expected for a suchian. The labyrinth is twice wider than high, the semicircular canals are remarkably straight, and the anterior canal is longer than the posterior one.

[Candidemia: characteristics in elderly patients]. / Candidemia: características en los adultos mayores.

BACKGROUND: Candidemia is a nosocomial bloodstream infection and an important cause of comorbidity and mortality. Elderly patients present the highest rates of candidemia but data about this population is scarce. AIMS: To describe characteristics of candidemia in elderly patients, to identify risk factors associated with mortality and to evaluate the usefulness of a predictive score. METHODS: A retrospective observational study of candidemia in elderly patients from a tertiary care hospital was carried out. We analyzed all Candida bloodstream infections during an eight-year period in patients older than 60 years. RESULTS: Fifty-nine episodes were included. Diabetes was the most frequent comorbidity. Most candidemia were catheter related infections (45%). Only 17% of patients had a Candida score > 2.5. Overall mortality at 48 hours was 20%, and at 15 days was 49%. Mortality-related factors were shock, assisted mechanical ventilation, thrombocytopenia, renal failure and leukocytosis (p range < 0.0001-0.006). On multivariate analysis septic shock was independently associated with mortality (HR 4.02 [CI 95% 1.18-13.72] p = 0.026). CONCLUSIONS: Nearly half of patients with candidemia died during the first fifteen days. Shock, assisted mechanical ventilation, thrombocytopenia, renal failure, and leukocytosis were factors associated with mortality. The predictive score was not useful in this population.

Candidemia: características en los adultos mayores / Candidemia: characteristics in elderly patients

Resumen Introducción: La candidemia es una micosis sistémica asociada a los cuidados de la salud de elevada morbimortalidad. Los adultos mayores presentan las tasas más altas y la información en esta población es escasa. Objetivos: Describir las características de las candidemias en los adultos mayores, identificar factores asociados a mortalidad y evaluar la utilidad de un score predictor. Métodos: Estudio retrospectivo de las candidemias en adultos mayores en un hospital de la ciudad de Buenos Aires. Se analizaron todos los episodios en pacientes mayores de 60 años en un período de ocho años. Resultados: Se incluyeron 59 episodios. La co-morbilidad más frecuente fue diabetes mellitus. El principal sitio de origen fue infección asociada a catéter (45%). Sólo 17% presentó un Candida score mayor a 2,5. La mortalidad global a las 48 h fue 20% y a 15 días 49%. Las variables asociadas a mortalidad fueron: shock, asistencia respiratoria mecánica (ARM), plaquetopenia, insuficiencia renal y leucocitosis (rango p < 0,0001-0,006). En el análisis multivariado el shock fue la única variable independiente asociada a mortalidad (HR 4,02 [IC 95% 1,18-13,72], p = 0,026). Conclusiones: La mitad de los adultos mayores con candidemia falleció en los primeros 15 días. Shock, ARM, plaquetopenia, insuficiencia renal y leucocitosis fueron factores asociados a mortalidad. El score predictor de uso habitual no fue útil en esta población.

Abstract Background: Candidemia is a nosocomial bloodstream infection and an important cause of comorbidity and mortality. Elderly patients present the highest rates of candidemia but data about this population is scarce. Aims: To describe characteristics of candidemia in elderly patients, to identify risk factors associated with mortality and to evaluate the usefulness of a predictive score. Methods: A retrospective observational study of candidemia in elderly patients from a tertiary care hospital was carried out. We analyzed all Candida bloodstream infections during an eight-year period in patients older than 60 years. Results: Fifty-nine episodes were included. Diabetes was the most frequent comorbidity. Most candidemia were catheter related infections (45%). Only 17% of patients had a Candida score > 2.5. Overall mortality at 48 hours was 20%, and at 15 days was 49%. Mortality-related factors were shock, assisted mechanical ventilation, thrombocytopenia, renal failure and leukocytosis (p range < 0.0001-0.006). On multivariate analysis septic shock was independently associated with mortality (HR 4.02 [CI 95% 1.18-13.72] p = 0.026). Conclusions: Nearly half of patients with candidemia died during the first fifteen days. Shock, assisted mechanical ventilation, thrombocytopenia, renal failure, and leukocytosis were factors associated with mortality. The predictive score was not useful in this population.

DATINK pilot study: an effective methodology for ballpoint pen ink dating in questioned documents.

Establishing the approximate age of an ink entry from a questioned document is often a complicated task and a controversial issue in forensic sciences. Among the existing approaches, the analysis of solvents in ballpoint inks may be a useful parameter for determining the age of ink on paper. In recent years, several ink dating methods have been proposed. These methods have been based on the analysis of common ink solvents using gas chromatography/mass spectrometry (GC/MS) as the analytical platform. Despite these recent methods, several questions remain. The aim of this work was to develop an ink dating methodology (DATINK) for documents written by ballpoint pens based on the disappearance of volatile solvents from the ink entry. Multiple solid-phase microextraction (MHS-SPME) coupled to GC/MS was used to measure the solvents from ink entries made with four BIC(®) ballpoint pens. The ß parameter, the remaining fraction of the analyte in the system after one equilibration, corresponding to the successive extractions was considered for modelling a mathematical equation for later ink age dating. Preliminary tests of DATINK method showed that it was possible to detect the presence of ink solvents on documents up to the studied five years. The analyses of different real samples of known age were analyzed in terms of ß values, which provided a mean relative error of 21%. The proposed use of ß parameter for estimating the absolute age of ballpoint ink entries has shown promising results with a standard deviation of ß ranging from 0.002 to 0.004.

[IgM, IgG and IgA rheumatoid factors in rheumatoid arthritis]. / Factores reumatoides IgM, IgG e IgA en la artritis reumatoide.

The IgM, IgG and IgA rheumatoid factors (RF) were studied by ELISA in the serum of 122 patients with rheumatoid arthritis (RA) associating the Waaler-Rose test results, with the clinical and radiological aspects of the disease. 75 patients (61%) had RF IgM positive according to the Waaler-Rose test while the ELISA showed positive in 104 (85%). The RF (IgG was positive in 64 cases (52%) and RF IgA in 82 (67%). The levels of RF IgA were correlated to RF IgM levels, determined by the Waaler-Rose test (p < 0.01) and ELISA (p < 0.001), while RF IgG levels were not correlated to RF IgM or IgA. There was a significant correlation between RF IgA titles and Lansbury's index (p < 0.01), and between RF IgG and sedimentation rate (p < 0.01). In patients with extraarticular disease high levels of RF have been observed, especially RF IgM and IgA. We concluded that the ELISA technique is the preferred method to measure the RF.

[Rhabdomyolysis, ventricular fibrillation and respiratory insufficiency as a form of presentation of type-I renal tubular acidosis]. / Rabdomiolisis, fibrilación ventricular e insuficiencia ventilatoria como forma de presentación de una acidosis tubular renal tipo I.

The renal tubular acidosis type 1 might be laboratory findings or a group of muscular symptoms, renal complication or delayed growth. It can also be a non-frequent case of rhabdomyolysis, producing serious cardiac and respiratory complications such as those described in this case. This tubular disease can produce alteration of calcium and ionic metabolism, and stimulation of renin-angiotensin-aldosterone axis, both reversible with the correction of the systemic pH with alcalin.

[Neutrophil chemotaxis in patients with chronic active hepatitis]. / Quimiotaxis de los neutrófilos en pacientes con hepatitis crónica activa.

The serum of 18 patients diagnosed as having chronic active hepatitis (CAH) was studied in order to ascertain the neutrophil motility in healthy person serum. The chemotaxis and the chemokinesis induced by the serum of the patients were lower than those obtained using a control serum. When the control serum, activated by zymosan, was added to the patients serum a decrease of chemotaxis was observed. Contrary to this, when activated serum of patients was added to the control serum, there was no alteration of chemotaxis. We concluded that serum of patients affected by CAH have an inhibitor of the motility of neutrophils.