Trastornos por déficit de atencional con hiperactividad en la población infantojuvenil / Attention deficit hyperactivity disorders in the child and adolescent population

El Trastorno por déficit atencional con hiperactividad (TDAH) es un trastorno crónico, del neurodesarrollo con una prevalencia de 5,29% en la población pediátrica. Las manifestaciones clínicas incluyen síntomas de hiperactividad, impulsividad y desatención que conducen a un deterioro funcional en el desarrollo social, familiar y escolar. Si bien en los últimos años ha habido un aumento en su reconocimiento, la heterogeneidad clínica y la alta comorbilidad pueden obstaculizar su diagnóstico. En el presente trabajo se revisarán diferentes aspectos de la presentación clínica y del abordaje terapéutico de este trastorno

The attention hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder with a prevalence of 5.24% in pediatric population. The clinical presentation includes symptoms of hyperactivity, impulsivity and inattention with a functional impairment in social, family and scholar development. Even though in the last years it has been well recognized, its clinical heterogeneity and high comorbidity hampers its diagnosis. In this article different aspects of the clinical presentation and therapeutic approach of this disorder will be reviewed

Impact of specimen adequacy on the assessment of renal allograft biopsy specimens.

The Banff classification was introduced to achieve uniformity in the assessment of renal allograft biopsies. The primary aim of this study was to evaluate the impact of specimen adequacy on the Banff classification. All renal allograft biopsies obtained between July 2010 and June 2012 for suspicion of acute rejection were included. Pre-biopsy clinical data on suspected diagnosis and time from renal transplantation were provided to a nephropathologist who was blinded to the original pathological report. Second pathological readings were compared with the original to assess agreement stratified by specimen adequacy. Cohen's kappa test and Fisher's exact test were used for statistical analyses. Forty-nine specimens were reviewed. Among these specimens, 81.6% were classified as adequate, 6.12% as minimal, and 12.24% as unsatisfactory. The agreement analysis among the first and second readings revealed a kappa value of 0.97. Full agreement between readings was found in 75% of the adequate specimens, 66.7 and 50% for minimal and unsatisfactory specimens, respectively. There was no agreement between readings in 5% of the adequate specimens and 16.7% of the unsatisfactory specimens. For the entire sample full agreement was found in 71.4%, partial agreement in 20.4% and no agreement in 8.2% of the specimens. Statistical analysis using Fisher's exact test yielded a P value above 0.25 showing that - probably due to small sample size - the results were not statistically significant. Specimen adequacy may be a determinant of a diagnostic agreement in renal allograft specimen assessment. While additional studies including larger case numbers are required to further delineate the impact of specimen adequacy on the reliability of histopathological assessments, specimen quality must be considered during clinical decision making while dealing with biopsy reports based on minimal or unsatisfactory specimens.

Impact of specimen adequacy on the assessment of renal allograft biopsy specimens

The Banff classification was introduced to achieve uniformity in the assessment of renal allograft biopsies. The primary aim of this study was to evaluate the impact of specimen adequacy on the Banff classification. All renal allograft biopsies obtained between July 2010 and June 2012 for suspicion of acute rejection were included. Pre-biopsy clinical data on suspected diagnosis and time from renal transplantation were provided to a nephropathologist who was blinded to the original pathological report. Second pathological readings were compared with the original to assess agreement stratified by specimen adequacy. Cohen's kappa test and Fisher's exact test were used for statistical analyses. Forty-nine specimens were reviewed. Among these specimens, 81.6% were classified as adequate, 6.12% as minimal, and 12.24% as unsatisfactory. The agreement analysis among the first and second readings revealed a kappa value of 0.97. Full agreement between readings was found in 75% of the adequate specimens, 66.7 and 50% for minimal and unsatisfactory specimens, respectively. There was no agreement between readings in 5% of the adequate specimens and 16.7% of the unsatisfactory specimens. For the entire sample full agreement was found in 71.4%, partial agreement in 20.4% and no agreement in 8.2% of the specimens. Statistical analysis using Fisher's exact test yielded a P value above 0.25 showing that - probably due to small sample size - the results were not statistically significant. Specimen adequacy may be a determinant of a diagnostic agreement in renal allograft specimen assessment. While additional studies including larger case numbers are required to further delineate the impact of specimen adequacy on the reliability of histopathological assessments, specimen quality must be considered during clinical decision making while dealing with biopsy reports based on minimal or unsatisfactory specimens.

Colonization of sorghum and wheat by seed inoculation with Gluconacetobacter diazotrophicus.

Colonization of sorghum and wheat after seed inoculation with Gluconacetobacter diazotrophicus strains PAL 5 and UAP 5541/pRGS561 (containing the marker gene gusA) was studied by colony counting and microscopic observation of plant tissues. Inoculum levels as low as 10(2) CFU per seed were enough for root colonization and further spreading in aerial tissues. Rhizoplane colonization was around 7 log CFU g(-1) (fresh weight). G. diazotrophicus was found inside sorghum and wheat roots with populations higher than 5 log CFU g(-1) (fresh weight). Stem colonization remained stable for 30 days post inoculation with endophyte concentrations from 4 to 5 log CFU g(-1) (fresh weight) (in both plants). Population in leaves decreased continuously being undetectable after 17 days post inoculation.

Study of a cutaneous leishmaniasis outbreak in General Vedia, Province of Chaco, 1996.

Between March and July 1996, a focalized epidemic outbreak of cutaneous leishmaniasis in General Vedia, province of Chaco, associated to the gallery forest of the Oro river was verified. The incidence rate in the area, which was 0-2/000 cases in preceding years, reached 8/000 cases in 1996. The risk of symptomatic infection was similar between sexes, but was different when analyzing the different age groups by sex, suggesting a greater relative importance of the peridomestic transmission for the females and of the transmission in the subtropical forest for the males. Specimens of Lutzomyia intermedia, a species already incriminated as a vector of Leishmaniasis in other provinces of northern Argentina, were captured and identified in the focus locality in May 1996. The possible causes of the outbreak related to the climatic variables and the vector abundance are analyzed and the results in the framework of possible preventive and control activities are discussed.

Phenytoin as the first option in female epileptic patients?

OBJECTIVE: Phenytoin (PHT) is one of the first-choice drugs in several epileptic syndromes, mostly in partial epilepsies, in which case it is effective as carbamazepine and phenobarbital. However, like any other anti-epileptic drug (AED), unpleasant side-effects are not rare. The aim of this study is the evaluation of dermatological troubles related to chronic PHT usage in female patients. METHOD: Between 1990-93, 731 new patients underwent investigation for epilepsy at the Multidisciplinary Clinic for Epilepsy in our State. In this sample 283 were AED users at the time of the first assessment. Sixty one female patients taking PHT were identified. They were taking PHT in a dosage ranging from 100 to 300 mg daily, in mono or polytherapy regimen, during 1-5 previous years. RESULTS: More than 50% of the sample showed coarse facial features made by the combination of several degrees of acne, hirsutism and gingival hyperplasia. CONCLUSION: Except in emergency situations, PHT should not be prescribed as the first option to the treatment of female epileptic patients, because not uncommonly the cosmetic side-effects are more socially handicapping than the epileptic syndrome by itself.

Cross-reactivity of anti-10kD heat shock protein antibodies in leprosy and tuberculosis patients.

The response to recombinant 10-kD heat shock protein (HSP) of Mycobacterium leprae (rML10) was evaluated by indirect ELISA in sera from leprosy patients, household contacts, tuberculosis patients and healthy controls in a leprosy-endemic area in the North East of Argentina. Some technical parameters were analyzed: within-assay and between-assay variability, dose-response curves and detectability indexes (specificity and sensitivity) of ELISA applied to measure anti-10 kDa antibodies. High levels of these antibodies have already been reported in positive bacilloscopy patients; herein we have also demonstrated that tuberculosis patients sera cross-react with this M. leprae antigen. This test seems to have a low sensitivity and specificity for leprosy detection; it confirms that antibodies against highly conserved HSP antigens are important in the polyclonal response against mycobacterial epitopes in leprosy as well as in tuberculosis.

Branched connections to the septum and to the entorhinal cortex from the hippocampus, amygdala, and diencephalon in the rat.

Neuronal cell populations giving origin to bifurcating projections to the septum and the entorhinal cortex were studied in the rat by means of double retrograde labeling using the fluorescent tracers Fast Blue and Diamidino Yellow. Double labeled pyramidal neurons were consistently detected in the temporal level of the CA1 area and subiculum of the hippocampal formation, where they represented at least 50% of the cells retrogradely labeled from the entorhinal injections. Double labeled neurons were also detected in the amygdala, where they prevailed in the basal complex. Scattered double labeled neurons were observed in a number of hypothalamic nuclei, with a slight predominance in the preoptic region. Finally, a few double labeled cells were detected in the midline thalamus, and especially in the thalamic paraventricular nucleus. In all these structures, double labeled neurons were located ispilaterally to the injection sites. The present data indicate that the septum and entorhinal cortex are tightly interconnected by axonal bifurcations deriving from a variety of telencephalic and diencephalic sources.

Paracoccidioidomicosis. Nuestra experiencia. / Paracoccidioidomycosis. Our experience

En el presente trabajo hemos controlado 30 pacientes con paracoccidioidomicosis, 17 de ellos fueron diagnosticados en el ultimo ano, todos varones, edad promedio de 44 anos al inicio de su enfermedad, con una demora promedio a la consulta de 8 meses.Predominan las formas clinicas mixtas (cutaneo-mucosa-pulmonar; cutaneo-mucosa y mucopulmonar) en un 84% de los casos; la mayoria provienen de areas rurales o suburbanas. El 85% fueron tratados con ketoconazol (derivado imidazolico con accion antifungica de amplio espectro) con muy buenos resultados. Se realizan controles clinicos, laboratoriales y serologicos periodicos para evaluar la mejoria, la regresion clinica de las lesiones precede a la negativizacion serologica y no hemos encontrado alterado el hepatograma de estos pacientes

Paracoccidioidomicosis. Nuestra experiencia. / Paracoccidioidomycosis. Our experience

En el presente trabajo hemos controlado 30 pacientes con paracoccidioidomicosis, 17 de ellos fueron diagnosticados en el ultimo ano, todos varones, edad promedio de 44 anos al inicio de su enfermedad, con una demora promedio a la consulta de 8 meses.Predominan las formas clinicas mixtas (cutaneo-mucosa-pulmonar; cutaneo-mucosa y mucopulmonar) en un 84% de los casos; la mayoria provienen de areas rurales o suburbanas. El 85% fueron tratados con ketoconazol (derivado imidazolico con accion antifungica de amplio espectro) con muy buenos resultados. Se realizan controles clinicos, laboratoriales y serologicos periodicos para evaluar la mejoria, la regresion clinica de las lesiones precede a la negativizacion serologica y no hemos encontrado alterado el hepatograma de estos pacientes

Retención de sulfuro de hidrógeno en aire con carbón activado o impregnado

Considera la necesidad de sistemas de retención de sulfuro de hidrógeno que podría aparecer habitualmente o en forma accidental en la atmósfera de determinados recintos de plantas de agua pesada. Para este fin, se hizo un estudio de las propiedades de adsorción de diversos carbones activados y de su aplicación en sistemas de retención. Se determinaron propiedades que permitiesen clasificarlos en función de su comportamiento como adsorbentes, por ej. capacidad de adsorción, eficiencia de retención, calor desprendido de la reacción y otros parámetros (humedad, densidad, etc.) relacionados con su aplicación práctica en filtros de retención. Finalmente, se desarrolló un método de impregnación con solución de hidróxido de sodio para uniformar y mejorar las propiedades de los distintos productos comerciales

Retención de sulfuro de hidrógeno en aire con carbón activado o impregnado

Considera la necesidad de sistemas de retención de sulfuro de hidrógeno que podría aparecer habitualmente o en forma accidental en la atmósfera de determinados recintos de plantas de agua pesada. Para este fin, se hizo un estudio de las propiedades de adsorción de diversos carbones activados y de su aplicación en sistemas de retención. Se determinaron propiedades que permitiesen clasificarlos en función de su comportamiento como adsorbentes, por ej. capacidad de adsorción, eficiencia de retención, calor desprendido de la reacción y otros parámetros (humedad, densidad, etc.) relacionados con su aplicación práctica en filtros de retención. Finalmente, se desarrolló un método de impregnación con solución de hidróxido de sodio para uniformar y mejorar las propiedades de los distintos productos comerciales