Ureaplasma parvum causes hyperammonemia in a pharmacologically immunocompromised murine model.

A relationship between hyperammonemia and Ureaplasma infection has been shown in lung transplant recipients. We have demonstrated that Ureaplasma urealyticum causes hyperammonemia in a novel immunocompromised murine model. Herein, we determined whether Ureaplasma parvum can do the same. Male C3H mice were given mycophenolate mofetil, tacrolimus, and prednisone for 7 days, and then challenged with U. parvum intratracheally (IT) and/or intraperitoneally (IP), while continuing immunosuppression over 6 days. Plasma ammonia concentrations were determined and compared using Wilcoxon rank-sum tests. Plasma ammonia concentrations of immunosuppressed mice challenged IT/IP with spent broth (median, 188 µmol/L; range, 102-340 µmol/L) were similar to those of normal (median, 226 µmol/L; range, 154-284 µmol/L, p > 0.05), uninfected immunosuppressed (median, 231 µmol/L; range, 122-340 µmol/L, p > 0.05), and U. parvum IT/IP challenged immunocompetent (median, 226 µmol/L; range, 130-330 µmol/L, p > 0.05) mice. Immunosuppressed mice challenged with U. parvum IT/IP (median 343 µmol/L; range 136-1,000 µmol/L) or IP (median 307 µmol/L; range 132-692 µmol/L) had higher plasma ammonia concentrations than those challenged IT/IP with spent broth (p < 0.001). U. parvum can cause hyperammonemia in pharmacologically immunocompromised mice.

Efectividad clínica del método mucotérmico para regular la fertilidad: resultados de un programa aplicado en la comuna de San Bernardo / Clinical efficacy of natural family planning methods: outcomes of study design in comuna of San Bernardo, Chile

Antecedentes: Los métodos naturales modernos para la regulación de la fertilidad (MNMRF) son un sistema estandarizado de instrucciones que, aplicadas correctamente por la usuaria, le permiten diagnosticar con precisión los días de infertilidad y de fertilidad presentes en un ciclo menstrual. Su aplicabilidad clínica como método para regular la fertilidad ha sido ampliamente documentada. Los MNMRF permiten, a su vez, evaluar el funcionamiento endocrino gonadal de la usuaria. Objetivos: El objetivo principal fue determinar la efectividad clínica para espaciar los embarazos de los MNMRF en un programa aplicado en la comuna de San Bernardo. El objetivo secundario fue describir las características socio demográficas de las usuarias de los MNMRF. Método: Estudio de cohorte prospectivo. La intervención consistió en la instrucción modular de un método mucotérmico. Resultados: Se reportan los resultados de todas las pacientes consecutivas ingresadas al programa entre el 1° de enero de 1996 hasta el 31 de diciembre de 2003 que hayan finalizado la instrucción. Contactaron el programa 600 pacientes, de las que 389 (64,8 por ciento) comenzaron efectivamente el proceso de instrucción completándolo a la fecha de cierre de este análisis el 67,6 por ciento de ellas (263/389). La efectividad clínica, calculada con tabla de sobrevida, fue de 94,3 por ciento (IC: 86,8-97,6). Conclusiones: El método natural enseñado es altamente efectivo para espaciar o limitar los nacimientos.

Síndrome PFAPA: un nuevo caso / PFAPA syndrome: a new case

Se describe un caso de síndrome PFAPA en un niño de 4 años. Este síndrome consiste en episodios de fiebre periódica, estomatitis aftosa, faringitis y linfadenopatía cervical. Aunque es un proceso benigno, se acompaña de gran morbilidad y alto componente de ansiedad familiar, debido a que los episodios recurren periódicamente (AU)

A case of PFAPA syndrome in a 4-year-old boy is presented. The syndrome consists of periodic fever, aphthous stomatitis, pharyngitis and adenopathy. The disorder is benign, but is associated with a high morbidity rate. Ultimately, there is a progressive decrease in the incidence of periodic fever (AU)

New method to calculate the N2 evolution from mixed venous blood during the N2 washout.

To model the normalized phase III slope (Sn) from N2 expirograms of the multibreath N2 washout is a challenge to researchers. Experimental measurements show that Sn increases with the number of breaths. Previously, we predicted Sn by setting the concentration (atm) of mixed venous blood (Fbi,N2) to a constant value of 0.3 after the fifth breath to calculate the amount of N2 transferred from the blood to the alveoli. As a consequence, the predicted curve of the Sn values showed a maximum before the quasi-steady state was reached. In this paper, we present a way of calculating the amount of N2 transferred from the blood to the alveoli by setting Fbi,N2 in the following way: In the first six breaths Fbi,N2 is kept constant at the initial value of 0.8 because circulation time needs at least 30 s to alter it. Thereafter, a single exponential function with respect the number of breaths is used: Fbi = 0.8 exp[0.112(6-n)], in which n is the breath number. The predicted Sn values were compared with experimental data from the literature. The assumption of an exponential decay in the N2 evolved from mixed venous blood is important in determining the shape of the Sn curve but new experimental data are needed to determine the validity of the model. We concluded that this new approach to calculate the N2 evolution from the blood is more meaningful physiologically.

Punciones lumbares seriadas en el tratamiento de la hidrocefalia posthemorrágica en pretérminos / Serial lumbar punctures in the treatment of posthemorrhagic hydrocephalus in preterm infants

Presentamos los 26 casos de hidrocefalia posthemorrágica neonatal diagnosticados en nuestro hospital en un período de cinco años. Se analizan las características clínico-biológicas de los pacientes, el tratamiento administrado y la evolución clínica. En seis de los casos se efectuaron punciones lumbares seriadas con el fin de drenar el líquido cefalorraquídeo y disminuir la presión intracraneal. No fue necesario otro tipo de tratamiento en cuatro de los casos. La ecografía doppler cerebral permite diagnosticar el aumento de la presión intracraneal y es un complemento eficaz en la aplicación de la técnica de las punciones lumbares repetidas. Revisamos también la bibliografía correspondiente al tratamiento de la hidrocefalia posthemorrágica en recién nacidos pretérmino (AU)

Derrame pleural como complicación de la alimentación parenteral por vía central en el recién nacido: a propósito de un caso / Pleural effusion as a complication of central parenteral feeding in the newborn: based on one

Presentamos un caso de derrame pleural como complicación de la colocación de un catéter epicutáneo en el recién nacido, por perforación de la arteria pulmonar derecha, discutiendo sobre la forma de presentación y manejo. A pesar de la seguridad con que este tipo de catéteres son utilizados en el neonato, son posibles las complicaciones, sobre todo en forma de perforación vascular, como en nuestro caso (AU)

[Evoked otoacoustic emissions in school children]. / Otoemisiones acústicas evocadas en escolares.

OBJECTIVE: The aim of this work was to determine the usefulness of evoked otoacoustic emissions (OEAE) as a screening method for the diagnosis of hearing loss in schoolchildren. PATIENTS AND METHODS: To this end and by using this method, we have studied 1,202 ears of 616 children in the 1st and 2nd grades of elementary school with a mean age of 6.2 years. The equipment employed was an Otodynamic Analyzer (ILO 88) by Otodynamics, Ltd and the program ILO 88, version 3.94. RESULTS: The results were OEAE positive in 1,041 ears (86.6% passed the test) and OEAE negative in 161 ears (13.4% failed the test). We have determined the percentiles of all the parameters of the test and of the responses in order to establish the normal values in this age group. CONCLUSIONS: The use of the OEAE for the detection of hearing loss should not be restricted to newborns. The OEAE can also be used as an auditive screening test in schoolchildren.

Hypertrophic cardiomyopathy in preterm infants treated with dexamethasone.

UNLABELLED: Steroid therapy has been widely used in neonates for its beneficial effects. Adverse side-effects have been described, also affecting the cardiovascular system. We report two cases of hypertrophic cardiomyopathy in two preterm newborns secondary to dexamethasone treatment. Full recovery occurred after discontinuing steroids. Risk/benefit ratios must be carefully considered before using steroids in the neonatal period. CONCLUSION: Serial echocardiographic evaluations should be performed to evaluate prevalence and clinical relevance of hypertrophic cardiomyopathy in preterm infants treated with dexamethasone.

[Sturge-Weber syndrome: experience with 14 cases]. / Síndrome de Sturge-Weber: Experiencia en 14 casos.

OBJECTIVE: The objective of this study was to review the cases of Sturge-Weber syndrome (SWS) diagnosed and followed-up in our center over the last 25 year period in order to evaluate their clinical characteristics, evolution and therapeutical response. PATIENTS AND METHODS: A retrospective review of the records of patients diagnosed of SSW (facial nevus flammeus at least over the first branch of the trigeminal nerve and ipsilateral leptomeningeal angioma) was performed. RESULTS: Fifteen patients were found in our records, with one of them being excluded from the study due to the lack of follow-up. From the remaining 14, 11 had been diagnosed before the age of 18 months. Nevus flammeus was located on the right side in 8 cases, bilaterally in 3 and on the left side in the other 3 patients. Four cases had glaucoma, 3 of which had good evolution after trabeculotomy. Thirteen of the 14 patients had seizures, usually contralateral to the nevus flammeus. The main drugs used were phenytoin, phenobarbital, valproic acid and carbamazepine. Ten of the 13 patients treated had a good therapeutical response. The EEG was abnormal in 12 patients, two of them occurring during the follow-up period. The main abnormality found was an interhemispherical asymmetry. Nine patients developed hemiparesis. In reference to the neuroimaging. MR was better than CT in evaluating parenchymatous atrophy, which was present in all patients, and the abnormalities of the white and grey matters (9 and 8 patients, respectively). CONCLUSIONS: Early evaluation of newborns with nevus flammeus affecting the first branch of the trigeminal nerve must be done, including an MR with contrast and an ophthalmological exam.

[Prevention of hemorrhagic disease in newborns in the Valencia community: current aspects and trends]. / Profilaxis de la enfermedad hemorrágica del recién nacido en la Comunidad Valenciana: aspectos actuales y tendencias.

OBJECTIVE: The aim of this study was to document the current patterns and trends in the prophylaxis of hemorrhagic disease of the newborn in the Community of Valencia. PATIENTS AND METHODS: We sent a questionnaire to all public maternity units asking about prophylaxis instructions, including dosage, via of administration and changes in these instructions during the last ten-year period. RESULTS: During the study period, a total of 397,104 infants were born. In 1985, all thirteen maternity units gave intramuscular prophylaxis. In 1990, fifteen of 16 maternity units gave parenteral prophylaxis, with the other giving oral vitamin K. Currently, of the eighteen public center 14 (77.8%) give intramuscular prophylaxis and the remaining 4 (22.2%) use an oral route. These 4 centers cover an area representing a population of 17.9% of the live births in 1994. CONCLUSIONS: In our community there is little evidence of change to oral route for the administration of vitamin K in the prophylaxis of hemorrhagic disease of the newborn. Because a doubt remains in the efficacy of oral vitamin K, a centralized system to control all cases of hemorrhagic disease of the newborn should be established in order to check the security of this route of administration.

[Recording of evoked otoacoustic emissions in adult normal hearing population. Percentile of normalcy]. / Registro de otoemisiones provocadas en población adulta normoyente: percentiles de normalidad.

Evoked otoacustic emissions recording hold some promise as a fast objective and non-invasive audiological procedure to study the cochlea at the outer hair cell level. This study has been made in 100 voluntary normal hearing adults. We evaluate the auditory system by means of evoked otoacustic emissions with a non-linear click. This report resumes methods and results in these normal grown-up ears.

[The study of evoked otoacoustic emissions in children]. / Estudio de otoemisiones acústicas provocadas en niños.

We evaluated the auditory system of 41 children by means of evoked otoacoustic emission. The children were selected from a school population and range in age from 3 to 16 years. No hearing problems were detected prior to this study. The stimulus was a nonlinear click with a frequency of 21/s. All the children but one had echo sizes over 9.72 dB SPL. The mean echo size was 13.23 dB SPL with a reproducibility of 74.81%. Average echo sizes for each frequency are presented. There were no significant differences in the series with respect to the adult comparative pattern used except for the child with an unknown perceptive disorder. We conclude that the test is reliable and highly sensitive, and that it detects small conductive and sensory hearing losses. It is fast, easy, painless and does not require sedation, making it particularly interesting for hearing assessments in childhood.

[Comparative study of tonal liminal audiometry and evoked otoacoustic emissions in school screening programs]. / Estudio comparativo entre audiometría tonal liminar y otoemisiones evocadas en las revisiones escolares.

Early diagnosis of deafness is an important objective during the pediatric age. This study compares two different audiological techniques, otoacoustic emissions (OEA) and tonal audiometry (AUD), to be used as screening methods in school revisions programmed for 6 years olds. The correlation between techniques is very good (97% of the positives and 92% of the negatives). The OEA method is objective and faster if the environmental noise is low; if not, AUD seems to be more reliable. At this age (6 years), the otoacoustic emissions have characteristics of the adult age.

[The usefulness of provoked acoustic otoemissions in the study of olivo-cochlear reflex]. / Utilidad de las otoemisiones acústicas provocadas en el estudio del reflejo olivo-coclear.

The paper reports the experimental task done by the AA, in order to probe objectively the being of a feed-back circuit of cochlear interconnexion. This loop is basically represented by the medial efferent olivo-cochlear system. With that purpose they have analyzed the variations produced in the provoked acoustic otoemissions by clicks registered in one ear when the contralateral ear is stimulated with a white noise of 80 dB HL. The results shows that after stimulation of the contralateral cochlea with a white noise a decrease of the global amplitude of the PAOE is observed and also a decrease of the several amplitudes composing the frequency spectrum, but retaining the same morphological pattern.

[Influence of the contralateral acoustic stimulation on the acoustic otoemissions: response modulation by the efferent olivocochlear system]. / Influencia de la estimulación acústica contralateral sobre las otoemisiones acústicas: modulación de la respuesta por el sistema eferente olivococlear.

We have correlated in 16 patients (32 ears), the modifications de EOEs before and after sound stimulation of the contralateral ear. The recording of the EOEs has been performed in a sound proof room with ILO 88 from Otodynamics Ltd., the analysis has been made with the ILO 88 V.3.5 software. We have tried to study the modulator rol of the medial efferent coclear system on the external ciliated cells. In the results we observe a decrease of the amplitude in the EOEs when the contralateralmears is stimulated a white noise, in relation with the nonstimulation situation. When pures tones are used contralateral stimulation the decrease in the EOEs amplitude takes place in the same frequency spectrum as the pure tone used.

Diseno del proceso y planta piloto para la extracción de cloruro de potasio del Salar de Uyuni

Este resúmen engloba el trabajo en sus dos fases, en el capítulo 1 se discuten aspectos relacionados al uso del producto, las fuentes de materia prima, tipo de minerales en los que se encuentra el KCI, características físicas y químicas de salmueras recolectadas en la costra superficial de tres regiones del salar, en el capítulo 2 se efectuan algunas consideraciones teóricas en relación al proceso particularmente en las operaciones que controlan la producción, el capítulo 3 es la introducción a la metodología experimental, se desarrollan en esté capítulo los métodos científicos de experimentación, el capítulo 4 resultados y discusión, es más amplio debido a que es acá donde se presentan los resultados, la discusión de resultados es ante todo una explicación de los fenómenos que pudieron influenciar al proceso; el capítulo 5 considera los siguientes aspectos relacionados con los usos y características del producto a obtener en planta piloto, también se efectúa una descripción de la materia prima y sus posibles fuentes, el capítulo 6 es una breve descripción de antecedentes referentes a la producción del KCI y del proceo propuesto, el capítulo 7 ingeniería del proyecto es la parte central del diseño preliminar de planta, donde se efectuan el balance de materiales, dimensionamiento y selección de equipos y maquinarias, localización de la planta y el costo instalado a esta.