Persistent pulmonary abnormalities after 18 months of SARS-CoV-2 pneumonia.

OBJECTIVE: To describe persistent pulmonary abnormalities detected on HRCT after 18 months of SARS-CoV-2 pneumonia, and to determine their extension and correlation with pulmonary function. PATIENTS AND METHODS: A prospective cross-sectional study with an initial cohort of 90 patients in follow-up due to persisting lung abnormalities on imaging, functional respiratory impairment and/or respiratory symptoms. Of these, 31 (34%) were selected for analysis due to the persistence of their lung abnormalities on HRCT at 18 months after infection. A double reading was performed for each HRCT (62 observations). RESULTS: Of the 31 patients included: 20 (65%) were men; mean age was 67 years; 17 (55%) were smokers/ex-smokers. The mean hospitalisation time was 38 days. Eighteen (58%) patients were admitted to intensive care units. Five patients (16%) suffered an acute pulmonary thromboembolism and three (9.7%) had a pneumothorax. The mean time between the onset of pneumonia and the follow-up HRCT was 20.34 months. Nineteen percent of patients suffered from total lung function abnormalities; and ground-glass opacities and reticulation were present in 12% and 4.5% respectively. The findings of the 62 readings were: ground-glass opacities (100%), reticulation (83%), subpleural curvilinear lines (62%), parenchymal bands (34%), traction bronchiectasis (69%), displacement of vessels/fissures (46%) and honeycombing (4.9%). Pulmonary function 18 months after the acute episode revealed a mean FVC of 92% of predicted value, with an FVC < 80% of predicted value in 11 patients (35.4%). Mean DLCO was 71% of predicted value, with a DLCO < 80% in 22 patients (70%). We observed a statistically significant relationship between total lung function abnormalities on HRCT and FVC (P < 0.05), and a trend towards statistical significance with DLCO (P = 0.051); there was a statistically significant relationship between the presence of ground-glass opacities and FEV1/FVC (P < 0.01). The relationships between reticulation and FVC, FVC%, FEV1, FEV1% and DLCO% were also considered statistically significant (P < 0.05). CONCLUSION: Persistent interstitial lung abnormalities are seen on HRCT for a subset of patients infected with SARS-CoV-2 pneumonia. Seventy percent of these patients suffered a slight decrease in DLCO.

[Moyamoya disease: revision and description of a number of pedriatic cases]. / Enfermedad de moyamoya: descripción de una serie de casos pediátricos.

INTRODUCTION: Moyamoya disease is caused because of progressive occlusion of the arterial circle of Willis, leading to a compensatory net-like abnormal vessels development. The objective is to describe the number of cases in our center (tertiary hospital). PATIENTS AND METHODS: Retrospective study. Revision of pediatric medical histories diagnosed of moyamoya disease or moyamoya syndrome (in case of predisposing disease) between 2005 and 2018. Demographic variables were collected, related to diagnosis, risk factors, treatment, and follow-up. RESULTS: Seven cases were collected with a median age of 6 years and an equitable distribution by sex. Five associated predisposing pathologies (Down syndrome, neurofibromatosis, sickle cell disease, Behcet). The main clinical diagnosis was neurological focus (five cases), followed by epileptic seizures (four), and headache (two). One was asymptomatic at diagnosis. Six strokes were documented, five of them were isquemic. The arteriography (goldstardard) was made in five patients. Five presented bilateral involvement of the vessels, the internal carotid arteries and the middle cerebral arteries were the most affected. Six received acetylsalicylic acid treatment and five of them required antiepileptic drugs. Revascularization surgery (encephaloduroarteriomyosinangiosis) was performed in four patients, and in one, strokes persisted. The most prevalent sequelae were hemiparesis and psychomotor retardation. CONCLUSIONS: The risk factors presented in our patients match to those described in the literature. The symptoms at the onset can be diverse and ischemic strokes predominate in our series. Revascularization surgery was effective in more than half of the cases. Subsequent follow-up is necessary to assess complications and sequelae.

TITLE: Enfermedad de moyamoya: descripción de una serie de casos pediátricos.Introducción. La enfermedad de moyamoya se produce por la oclusión de las arterias alrededor del polígono de Willis y genera una amplia red de vasos colaterales. El objetivo es describir la serie histórica de nuestro centro (hospital terciario). Pacientes y métodos. Es un estudio retrospectivo. Se hizo una revisión de historias clínicas de pacientes pediátricos diagnosticados de enfermedad o síndrome de moyamoya (si patología predisponente) entre 2005 y 2018. Se recogieron variables demográficas, relacionadas con el diagnóstico, factores de riesgo, tratamiento y seguimiento. Resultados. Se obtuvieron siete casos, con una mediana de edad de seis años y distribución por sexos equitativa. Cinco asociaban patologías predisponentes (síndrome de Down, neurofibromatosis, drepanocitosis y Behçet). La clínica predominante en el diagnóstico fue focalidad neurológica (cinco casos), seguida de crisis epilépticas (cuatro) y cefalea (dos). Un paciente era asintomático en el momento del diagnóstico. Se documentaron seis ictus, cinco de los cuales fueron isquémicos. La arteriografía (técnica de referencia) constaba en cinco pacientes. Cinco presentaban afectación bilateral y estaban mayormente afectadas las arterias carótidas internas y las cerebrales medias. Seis recibieron tratamiento con ácido acetilsalicílico y cinco necesitaron fármacos antiepilépticos. La cirugía de revascularización (encefaloduroarteriomiosinangiosis) se realizó en cuatro pacientes y en uno persistieron los ictus. Las secuelas más prevalentes fueron hemiparesia y retraso psicomotor. Conclusiones. Los factores de riesgo presentados en nuestros pacientes se ajustan a los descritos en la bibliografía. La clínica en el inicio puede ser diversa y predominan los ictus isquémicos en nuestra serie. La cirugía de revascularización fue efectiva en más de la mitad de los casos. Es necesario un seguimiento posterior para evaluar complicaciones y secuelas.

Enfermedad de moyamoya: descripción de una serie de casos pediátricos / Moyamoya disease: revision and description of a number of pedriatic cases

Introducción: La enfermedad de moyamoya se produce por la oclusión de las arterias alrededor del polígono de Willis y genera una amplia red de vasos colaterales. El objetivo es describir la serie histórica de nuestro centro (hospital terciario). Pacientes y métodos: Es un estudio retrospectivo. Se hizo una revisión de historias clínicas de pacientes pediátricos diagnosticados de enfermedad o síndrome de moyamoya (si patología predisponente) entre 2005 y 2018. Se recogieron variables demográficas, relacionadas con el diagnóstico, factores de riesgo, tratamiento y seguimiento. Resultados: Se obtuvieron siete casos, con una mediana de edad de seis años y distribución por sexos equitativa. Cinco asociaban patologías predisponentes (síndrome de Down, neurofibromatosis, drepanocitosis y Behçet). La clínica predominante en el diagnóstico fue focalidad neurológica (cinco casos), seguida de crisis epilépticas (cuatro) y cefalea (dos). Un paciente era asintomático en el momento del diagnóstico. Se documentaron seis ictus, cinco de los cuales fueron isquémicos. La arteriografía (técnica de referencia) constaba en cinco pacientes. Cinco presentaban afectación bilateral y estaban mayormente afectadas las arterias carótidas internas y las cerebrales medias. Seis recibieron tratamiento con ácido acetilsalicílico y cinco necesitaron fármacos antiepilépticos. La cirugía de revascularización (encefaloduroarteriomiosinangiosis) se realizó en cuatro pacientes y en uno persistieron los ictus. Las secuelas más prevalentes fueron hemiparesia y retraso psicomotor. Conclusiones: Los factores de riesgo presentados en nuestros pacientes se ajustan a los descritos en la bibliografía. La clínica en el inicio puede ser diversa y predominan los ictus isquémicos en nuestra serie. La cirugía de revascularización fue efectiva en más de la mitad de los casos. Es necesario un seguimiento posterior para evaluar complicaciones y secuelas.(AU)

Introduction: Moyamoya disease is caused because of progressive occlusion of the arterial circle of Willis, leading to a compensatory net-like abnormal vessels development. The objective is to describe the number of cases in our center (tertiary hospital). Patients and methods: Retrospective study. Revision of pediatric medical histories diagnosed of moyamoya disease or moyamoya syndrome (in case of predisposing disease) between 2005 and 2018. Demographic variables were collected, related to diagnosis, risk factors, treatment, and follow-up. Results: Seven cases were collected with a median age of 6 years and an equitable distribution by sex. Five associated predisposing pathologies (Down syndrome, neurofibromatosis, sickle cell disease, Behçet). The main clinical diagnosis was neurological focus (five cases), followed by epileptic seizures (four), and headache (two). One was asymptomatic at diagnosis. Six strokes were documented, five of them were isquemic. The arteriography (goldstardard) was made in five patients. Five presented bilateral involvement of the vessels, the internal carotid arteries and the middle cerebral arteries were the most affected. Six received acetylsalicylic acid treatment and five of them required antiepileptic drugs. Revascularization surgery (encephaloduroarteriomyosinangiosis) was performed in four patients, and in one, strokes persisted. The most prevalent sequelae were hemiparesis and psychomotor retardation. Conclusions: The risk factors presented in our patients match to those described in the literature. The symptoms at the onset can be diverse and ischemic strokes predominate in our series. Revascularization surgery was effective in more than half of the cases. Subsequent follow-up is necessary to assess complications and sequelae.(AU)

Boosted Hyperthermia Therapy by Combined AC Magnetic and Photothermal Exposures in Ag/Fe3O4 Nanoflowers.

Over the past two decades, magnetic hyperthermia and photothermal therapy are becoming very promising supplementary techniques to well-established cancer treatments such as radiotherapy and chemotherapy. These techniques have dramatically improved their ability to perform controlled treatments, relying on the procedure of delivering nanoscale objects into targeted tumor tissues, which can release therapeutic killing doses of heat either upon AC magnetic field exposure or laser irradiation. Although an intense research effort has been made in recent years to study, separately, magnetic hyperthermia using iron oxide nanoparticles and photothermal therapy based on gold or silver plasmonic nanostructures, the full potential of combining both techniques has not yet been systematically explored. Here we present a proof-of-principle experiment showing that designing multifunctional silver/magnetite (Ag/Fe3O4) nanoflowers acting as dual hyperthermia agents is an efficient route for enhancing their heating ability or specific absorption rate (SAR). Interestingly, the SAR of the nanoflowers is increased by at least 1 order of magnitude under the application of both an external magnetic field of 200 Oe and simultaneous laser irradiation. Furthermore, our results show that the synergistic exploitation of the magnetic and photothermal properties of the nanoflowers reduces the magnetic field and laser intensities that would be required in the case that both external stimuli were applied separately. This constitutes a key step toward optimizing the hyperthermia therapy through a combined multifunctional magnetic and photothermal treatment and improving our understanding of the therapeutic process to specific applications that will entail coordinated efforts in physics, engineering, biology, and medicine.

Scrutinizing the role of size reduction on the exchange bias and dynamic magnetic behavior in NiO nanoparticles.

NiO nanoparticles (NPs) with a nominal size range of 2-10 nm, synthesized via high-temperature pyrolysis of a nickel nitrate, have been extensively investigated using neutron diffraction and magnetic (ac and dc) measurements. The magnetic behavior of the NPs changes noticeably when their diameter decreases below 4 nm. For NPs larger than or equal to this size, Rietveld analysis of the room temperature neutron diffraction patterns reveals that there is a reduction in the expected magnetic moment per [Formula: see text] ion with respect to bulk NiO, which is linked to the existence of a magnetically disordered shell at the NP surface. The presence of two peaks in the temperature dependence of both the dc magnetization after zero-field-cooling and the real part of the ac magnetic susceptibility is explained in terms of a core (antiferromagnetic, AFM)/shell (spin glass, SG) morphology. The high-temperature peak ([Formula: see text] K) is associated with collective blocking of the uncompensated magnetic moments inside the AFM core. The low-temperature peak ([Formula: see text] K) is a signature of a SG-like freezing of the surface [Formula: see text] spins. In addition, an exchange bias (EB) effect emerges due to the core/shell magnetic coupling. The cooling field and temperature dependences of the EB effect and the coercive field are discussed in terms of the core size and the effective magnetic anisotropy of the NPs. However, NiO NPs of 2 nm in size no longer show AFM order and the [Formula: see text] magnetic moments freeze into a SG-like state below [Formula: see text] K, with no evidence of EB effect.

Interplay between microstructure and magnetism in NiO nanoparticles: breakdown of the antiferromagnetic order.

The possibility of tuning the magnetic behaviour of nanostructured 3d transition metal oxides has opened up the path for extensive research activity in the nanoscale world. In this work we report on how the antiferromagnetism of a bulk material can be broken when reducing its size under a given threshold. We combined X-ray diffraction, high-resolution transmission electron microscopy, extended X-ray absorption fine structure and magnetic measurements in order to describe the influence of the microstructure and morphology on the magnetic behaviour of NiO nanoparticles (NPs) with sizes ranging from 2.5 to 9 nm. The present findings reveal that size effects induce surface spin frustration which competes with the expected antiferromagnetic (AFM) order, typical of bulk NiO, giving rise to a threshold size for the AFM phase to nucleate. Ni(2+) magnetic moments in 2.5 nm NPs seem to be in a spin glass (SG) state, whereas larger NPs are formed by an uncompensated AFM core with a net magnetic moment surrounded by a SG shell. The coupling at the core-shell interface leads to an exchange bias effect manifested at low temperature as horizontal shifts of the hysteresis loop (~1 kOe) and a coercivity enhancement (~0.2 kOe).

Meningitis por estreptococo agalactie en adulto joven / Meningitis due to estreptococcus agalactiae in young adult

Se ha detectado un incremento de infecciones en adultos por estreptococo del grupo B o agalactie los últimos años. Pueden causar bacteriemias, celulitis, neumonía, endocarditis, artritis y meningitis. Presentamos el caso de una mujer que sufrió una meningitis complicada con distress respiratorio y septicemia cuya evolución,sin embargo, fue favorable con el tratamiento instaurado. Este estreptococo es responsable de menos del 2% de casos de meningitis en adultos, siendo de alto riesgo las embarazadas y los pacientes con enfermedades crónicas como diabetes, cirrosis,cáncer, traumatizados, enfermedades autoinmunes, infectados por VIH o postoperatorios. Su mortalidad oscila del 27 al 34%. Aunque la incidencia es superior en mayores de 60 años con enfermedades crónicas hay un aumento progresivo en pacientes adultos inmunocompetentes, por lo que este agente causal no debe obviarse ante la presentica de meningitis de rápida instauración en un adulto joven

Its detected and increment of group B streptococcus or agalactie adults infection in recent years. Can be responsible of bacteremia, cellulites, pneumonia, endocarditis, arthritis and meningitis. We report a meningitis young female case, with serious complications like a distress respiratory syndrome and sepsis, but good evolution with antibiotics. Group B streptococcus is the responsible than near of 2% adult meningitis, and is associated to pregnancy and underlying conditions like diabetes, cirrhosis, cancer, trauma, inmunologic illness, HIV infection or surgery. The mortality is around 27,34%. The incidence is superior in elderly with debilitating diseases but there is a progressive increment in patients without diseases, so we mustn´t forget this etiology in fast instauration meningitis in a young adult

[The multistemmed structure of Juniperus thurifera: adaptive advantage in a severe environment?]. / La structure multicaule du genévrier thurifère: avantage adaptatif à un environnement sévère?

A comparative study of radial growth and biomass between multistemmed trees with variable number of stems and single-stemmed trees was carried out to better understand determinism and organisation of multicaulis structure of a juniper species (Juniperus thurifera L.) growing in high Mediterranean mountains (High Atlas, Morocco). It appears that all the stems of the same tree have similar ages and so simultaneous development. Their mean annual radial increments show significant differences because of probable competition for water and nutrient supply and obvious physical competition for space. The multistemmed trees characterized by low number of stems have the same mean annual radial growth as single-stemmed trees and more generally all multistemmed junipers have a higher biomass. The multicaulis structure of Juniperus thurifera thus could be considered as an adaptation to severe environment, characterized not only by hard topographical, edaphic and climatic conditions, but by strong human pressure too.

Modulation by extracellular and intracellular iodide of volume-activated Cl- current in HeLa cells.

The patch-clamp technique was used to study the effect of extracellular and intracellular iodide on the properties of the volume-activated anion current in HeLa cells. Upon hypotonic challenge, HeLa cells responded by activating an outwardly rectifying Cl- current. Replacement of extracellular Cl- by I-, a more permeable anion, increased the peak outward and inward current, reduced the magnitude of deactivation observed at depolarized potentials and shifted the half-maximal (V0.5) deactivation voltage towards more positive values. On the other hand, when internal Cl- was replaced by I- the volume-activated current was not observed in normal, Cl--rich hypotonic extracellular solution. However, switching to a hypotonic extracellular solution containing a mixture of Cl- and I- resulted in the activation of the volume-sensitive current. Furthermore, once the current was activated, I- could be excluded from the external solution without significantly affecting the current properties. These results suggest that the permeant anion plays a crucial role in the gating mechanism of the volume-activated Cl- current, influencing the swelling-dependent activation and the voltage-dependent deactivation processes.

Theophylline and fibrocystic breast disease.

After literature reports linking fibrocystic breast disease (FBD) to methylxanthine ingestion, a pilot study was undertaken to investigate the possible contribution of theophylline to this effect. The major goal of this project was to measure the effect of theophylline therapy on FBD in asthmatic women. All women attending an allergy clinic or an obstetrics/gynecology clinic over a 9-month period were examined to clinically assess FBD and were asked to complete a detailed questionnaire covering health history, other risk factors, and drug and dietary methylxanthines. The sample included 62 asthmatic women, 66 allergic but not asthmatic women, and 72 nonallergic and nonasthmatic women. By use of the FBD clinical taxonomy with its 19-point scale going from 0 to 18 that was developed for this study, the three groups did not differ significantly in terms of mean severity of FBD. On analyzing the effect of each of the methylxanthines on FBD severity, there is clear evidence that total methylxanthines was a contributing factor in FBD severity with or without adjustment for relevant variables, such as age, menopause, pregnancies, and groups. Theophylline was significant only when adjustments were made for age, pregnancy, and menopause in contrast to caffeine that was only significant with no adjustments.