Sociodemographic, biological, and developmental characteristics of preschool children born full-term and preterm. / Desarrollo, antecedentes biológicos y características sociodemográficas en preescolares con y sin antecedentes de prematuridad.

In Chile, preterm birth is the main cause of infant mortality and morbidity. However, there is little information on the particular characteristics of preterm-born preschool children. OBJECTIVE: To describe the sociodemographic, biological, and developmental characteristics of Chilean preschool children born full-term and preterm. SUBJECTS AND METHOD: A secondary analysis of the databases of the 2010 Longitudinal Survey of Early Childhood (ELPI) was conducted. Children between 2 and 4 years of age with information on gestational age at birth were selected. Late-term infants were excluded. The sample included 8,571 children, of whom 9.78% were preterm newborns. Variables related to sociodemographic characteristics, biological risk factors, and psychomotor development were considered. A descriptive and association analysis (Chi-square) was performed to establish whether the differences between the compared groups were significant. RESULTS: No differences were observed regarding the proportion of sex, geographic area of residence, and health prognosis. Most premature infants reside in urban areas and they have higher biological risk factors. In addition, they have lower average scores than those born at term in all development areas. CONCLUSIONS: The information presented raises the need to analyze the interaction of prematurity with social risk in the development of preterm infants of different gestational ages.

[Developmental care of premature newborns: Fundamentals and main characteristics]. / Cuidados del desarrollo en recién nacidos prematuros: Fundamentos y características principales.

Premature newborns, especially the extreme ones, need to be cared for in the different units in the neonatal services. In addition to ensuring the survival of these newborns, these services have gra dually incorporated interventions to promote their development. This review provides an updated synthesis of developmental-focused neonatal care. First, it describes the neurobiological theoretical foundations that explain how the so-called "neonatal stress" can affect the development of a prema ture child. Later, it reviews the Synactive Theory, which is one of the theoretical models that contri bute to understanding the characteristics of the care focused on development. Regarding this care, the evidence and challenges for implementing are described and addressed from a critical perspective, pointing out the strengths and weaknesses. This article highlights the importance of improving the quality of care that preterm newborns received in NICUs, promoting resilience and/or the best pos sible developmental potential in these children, in addition to strengthening the role of parents in neonatal care.

Dopamine D2 receptor agonist, bromocriptine, remodels adipose tissue dopaminergic signalling and upregulates catabolic pathways, improving metabolic profile in type 2 diabetes.

BACKGROUND AND OBJECTIVES: The therapeutic effects of the dopamine D2 receptor (D2R) agonist, bromocriptine, in type 2 diabetes (T2D) have been attributed to central nervous system actions. However, peripheral dopamine directly modulates glucose uptake in insulin-sensitive tissues and lipid metabolism in adipose tissue (AT). We hypothesized that the dopaminergic system may be impaired in the adipose tissue of patients with T2D and that the therapeutic actions of bromocriptine could involve the modulation of metabolism in this tissue. METHODS: The expression of dopamine receptors was evaluated in visceral AT samples from patients with obesity and stratified in several groups: insulin sensitive (IS); insulin resistance (IR) normoglycaemic; insulin resistant prediabetic; insulin resistant diabetic, according to Ox-HOMA2IR, fasting glycaemia and HbA1c levels. T2D Goto-Kakizaki rats (GK) were fed a high-caloric diet (HCD) for five months and treated with bromocriptine (10 mg/kg/day, i.p.) in the last month. The levels of dopaminergic system mediators and markers of insulin sensitivity and glucose and lipid metabolism were assessed in the peri-epididymal adipose tissue (pEWAT) and brown (BAT) adipose tissues, liver, and skeletal muscle. RESULTS: Patients with IR presented a decreasing trend of DRD1 expression in the visceral adipose tissue, being correlated with the expression of UCP1, PPARA, and insulin receptor (INSR) independently of insulin resistance and body mass index. Although no differences were observed in DRD2, DRD4 expression was significantly decreased in patients with prediabetes and T2D. In HCD-fed diabetic rats, bromocriptine increased D1R and tyrosine hydroxylase (TH) levels in pEWAT and the liver. Besides reducing adiposity, bromocriptine restored GLUT4 and PPARγ levels in pEWAT, as well as postprandial InsR activation and postabsorptive activation of lipid oxidation pathways. A reduction of liver fat, GLUT2 levels and postprandial InsR and AMPK activation in the liver was observed. Increased insulin sensitivity and GLUT4 levels in BAT and an improvement of the overall metabolic status were observed. CONCLUSIONS: Bromocriptine treatment remodels adipose tissue and the liver dopaminergic system, with increased D1R and TH levels, resulting in higher insulin sensitivity and catabolic function. Such effects may be involved in bromocriptine therapeutic effects, given the impaired expression of dopamine receptors in the visceral adipose tissue of IR patients, as well as the correlation of D1R expression with InsR and metabolic mediators.

Cervical Artery Dissections with and without stroke, risk factors and prognosis: a Chilean prospective cohort.

We aimed to characterize spontaneous cervical artery dissection (CeAD) patients with and without stroke and describe risk factors for cerebrovascular complications in a Chilean prospective cohort. METHODS: Consecutive CeAD patients admitted to a Chilean center confirmed by neuroimaging. Logistic regression was used. RESULTS: 168 patients were included, median follow-up time was 157 days. Stroke occurred in 49 (29.2%) cases, 4 (2%) patients died, all of whom had a stroke, and 10 (6%) presented CeAD recurrence. In univariate analyses, men (odds ratio [OR] 3.97, 95% confidence interval [CI] 1.97-8.00, P < 0.001), internal carotid artery CeAD (OR 2.82, 95% CI 1.38-5.78, P = 0.005) and vessel occlusion (OR 4.45, 95% CI 1.38-14.38, P = 0.035) increased stroke risk. Conversely, vertebral artery dissection (OR 0.35, 95% CI 0.16-0.74, P = 0.006) and longer symptom onset to admission (O-A) time (OR 0.79, 95% CI 0.70-0.90, P < 0.001) were associated to decreased stroke risk. After multivariate analysis, men (OR 2.88, 95% CI 1.32-6.27, P = 0.008) and O-A time (OR 0.80, 95% CI 0.69-0.92, P = 0.002) remained independently associated with stroke. CONCLUSION: CeAD presented commonly as a non-stroke entity, with favorable prognosis. Albeit to a higher frequency of CeAD in women, stroke occurred predominantly in men, who were admitted earlier.

Consideraciones anestésicas en pacientes con microdeleción del cromosoma 22q11 / Anesthetic issues in patients mycrodeletion syndrome produced by the deletion of chromosome 22q11

The syndrome produced by the deletion of chromosome 22q11 corresponds to a pattern of anomalies that occurs when a specific region of chromosome 22 is lost, specifically called 22q11.2. This microdeletion corresponds to the most frequent chromosomal alteration in humans, which has a prevalence of 1 per 4,000 live births. This includes a great variety of phenotypes, many of them subclinical, among which the Di George syndrome and the Velocardiofacial syndrome stand out. The main cause of mortality is of cardiac origin. Embryologically, this microdeletion is associated with alterations in the differentiation and migration of the pharyngeal system, with consequent craniofacial, cardiac, airway, thymus and parathyroid alterations, among others. In this sense, these patients present a higher risk of complications such as inmunodeficiency, hypocalcemia and hemorrhagic risk. From the surgical and anesthetic point of view, they can present cardiopathies of greater complexity of correction, which in some cases is also related to anatomical airway alterations which can constitute an important challenge when operating this type of patients. Considering the above, there is an increase in perioperative risk which could increase mortality. The objective of this review is to present the characteristics and behavior of this group of patients in the correction of their heart diseases, so that they are known by the anesthesiologists who work in the cardiovascular area.

El síndrome de microdeleción 22q11 corresponde a un patrón de anomalías que se produce al perderse una región específica del cromosoma 22, específicamente llamada 22q11.2. Esta microdeleción corresponde a la alteración genética más frecuente en humanos la cual tiene una prevalencia de 1 cada 4.000 recién nacidos vivos. Incluye una gran variedad de fenotipos, muchos de ellos subclínicos, entre los que destaca el síndrome Di George y el síndrome Velocardiofacial. La principal causa de mortalidad es de origen cardíaco. Embriológicamente la microdeleción se asocia a alteraciones en diferenciación y migración del aparato faríngeo, con las consiguientes alteraciones cráneo-faciales, cardíacas, de vía aérea, timo y paratiroides, entre otras. En ese sentido, presentan mayor frecuencia de complicaciones tales como infecciones, hipocalcemia y riesgo hemorrágico. Desde el punto de vista quirúrgico y anestésico pueden presentar cardiopatías de mayor complejidad de corrección, asociado o no a alteraciones anatómicas en vía aérea lo que puede constituir un importante desafío al momento de intervenir. Lo anterior aumenta el riesgo perioperatorio, lo que podría derivar en aumento de la mortalidad. El objetivo de esta revisión es presentar las características y comportamiento de este grupo de pacientes en la corrección de sus cardiopatías, de modo que sean un aporte para los anestesiólogos que se desempeñan en el área cardiovascular.

Tumor lymphocyte immune response to preoperative radiotherapy in locally advanced rectal cancer: The LYMPHOREC study.

Introduction: Some studies have suggested that baseline tumor-infiltrating-lymphocytes (TILs), such as CD8+ and FoxP3+ T-cells, may be associated with a better prognosis in colorectal cancer. We sought to investigate modulation of the immune response by preoperative radiotherapy (preopRT) and its impact on survival in locally advanced rectal cancer (LARC). Materials & Methods: We analyzed data for 237 patients with LARC who received RT. Density of TILS (CD8+ and FoxP3+) in intraepithelial (iTILs) and stromal compartments (sTILs) were evaluated from surgery pathological specimens and biopsies performed at baseline. The primary endpoint was to assess the impact of infiltration of the tumor or tumor site after preopRT on progression-free survival (PFS) and overall survival (OS). Secondary endpoints were the impact of dose fractionation scheme on TILs. Results: In univariate analysis, several factors significantly correlated (p<0.05) with PFS and/or OS (T-stage, M-stage, the delay between RT and surgery). A high level of post-treatment FoxP3+ TIL density correlated significantly with a better PFS (p = 0.007). In multivariate analysis, a decrease in the CD8+/FoxP3+ iTILs ratio after preopRT correlated with better PFS and OS (p = 0.049 and p = 0.024, respectively). More particularly, patients with a delta CD8+/FoxP3+ <-3.8 had better PFS and OS. Interestingly, the dose fractionation scheme significantly influenced the CD8+/FoxP3+ ratio after treatment (p = 0.027) with a lower ratio with hypofractionated RT (≥2 Gy). Conclusion: Patients with LARC who had a significant decrease in the CD8+/FoxP3+ ratio after preopRT were more likely to live longer. This ratio needs to be validated prospectively to guide physicians in adjuvant treatment decision-making.

Apoptotic intrinsic pathway proteins predict survival in canine cutaneous mast cell tumours.

Mast cell tumours (MCTs) are the most frequent canine round cell neoplasms and show variable biological behaviours with high metastatic and recurrence rates. The disease is treated surgically and wide margins are recommended. Adjuvant chemotherapy and radiotherapy used in this disease cause DNA damage in neoplastic cells, which is aimed to induce apoptotic cell death. Resisting cell death is a hallmark of cancer, which contributes to the development and progression of tumours. The aim of this study was to investigate the expression of the proteins involved in the apoptotic intrinsic pathway and to evaluate their potential use as prognostic markers for canine cutaneous MCTs. Immunohistochemistry for BAX, BCL2, APAF1, Caspase-9, and Caspase-3 was performed in 50 canine cases of MCTs. High BAX expression was associated with higher mortality rate and shorter survival. BCL2 and APAF1 expressions offered additional prognostic information to the histopathological grading systems. The present results indicate that variations in the expression of apoptotic proteins are related to malignancy of cutaneous MCTs in dogs.

HER2-positivity rates in breast cancer: no variation over time when clinicopathological features and testing are stable.

HER2 status is essential for breast cancer subtyping and for systemic treatment decisions as patients with HER2-positive tumours can benefit from anti-HER2 targeted therapies. However, few data are available on the current HER2-positive breast cancers rate and its evolution across years. Using data from the Côte d'Or breast cancer registry, we identified, between 1998 and 2011, 3220 women with invasive breast cancer diagnosed in the same laboratory which carries out regular internal quality controls and participates in multiannual international quality control programmes. Throughout the studied period of time, despite an increase of annual breast cancer cases, HER2 positivity rate remained stable (13.1%; P = 0.495), as did the proportion of tumours with positive hormone receptor status (P = 0.467) and the proportion of SBR grade II/III tumours (P = 0.747). Other characteristics, less strongly associated with HER2-positive status, showed either no annual variation (nodal and metastatic status, tumour size) or an annual positive trend (mean age, lobular carcinomas) or an annual negative trend (ductal carcinomas). These data reveal that in a population with stable clinical and pathological characteristics, and with the use of standardised assays, HER2 positivity rate remains stable over time. These results also emphasise that current HER2 positivity rate is lower than initially reported.

Increased expression of tissue inhibitor of metalloproteinase-1 correlates with improved outcome in canine cutaneous mast cell tumours.

Canine mast cell tumour (MCT) is a biologically heterogeneous disease. The extracellular matrix degradation promoted by matrix metalloproteinases (MMPs) has been studied in an attempt to elucidate the mechanisms involved in the biological behaviour of tumours. The aim of this study was to characterize the expression of MMP-2 and -9 and tissue inhibitors of metalloproteinase (TIMP)-1 and -2 in canine cutaneous MCTs and to evaluate their prognostic values. Immunohistochemical staining for MMP-2, MMP-9, TIMP-2 and TIMP-1 was performed in 46 canine cases of MCTs. TIMP-1 expression showed an independent prognostic value for post-surgical survival and disease-related mortality. Dogs with MCTs showing less than 22.9% mast cell TIMP-1 positivity were more prone to die because of the disease and had a shorter post-surgical survival. This article suggests the involvement of TIMP-1 in MCT progression, by contributing to a good outcome in patients with MCTs.

Predictive factors of pathologic complete response of HER2-positive breast cancer after preoperative chemotherapy with trastuzumab: development of a specific predictor and study of its utilities using decision curve analysis.

PURPOSE: The aim of this study was to assess the Institut Gustave Roussy/M.D. Anderson Cancer Center (IGR/MDACC) nomogram in predicting pathologic complete response (pCR) to preoperative chemotherapy in a cohort of human epidermal growth factor receptor 2 (HER2)-positive tumors treated with preoperative chemotherapy with trastuzumab. We then combine clinical and pathological variables associated with pCR into a new nomogram specific to HER2-positive tumors treated by preoperative chemotherapy with trastuzumab. PATIENTS AND METHODS: Data from 270 patients with HER2-positive tumors treated with preoperative chemotherapy with trastuzumab at the Institut Curie and at the Georges François Leclerc Cancer Center were used to assess the IGR/MDACC nomogram and to subsequently develop a new nomogram for pCR based on multivariate logistic regression. Model performance was quantified in terms of calibration and discrimination. We studied the utility of the new nomogram using decision curve analysis. RESULTS: The IGR/MDACC nomogram was not accurate for the prediction of pCR in HER2-positive tumors treated by preoperative chemotherapy with trastuzumab, with poor discrimination (AUC = 0.54, 95% CI 0.51-0.58) and poor calibration (p = 0.01). After uni- and multivariate analysis, a new pCR nomogram was built based on T stage (TNM), hormone receptor status, and Ki67 (%). The model had good discrimination with an area under the curve (AUC) at 0.74 (95% CI 0.70-0.79) and adequate calibration (p = 0.93). By decision curve analysis, the model was shown to be relevant between thresholds of 0.3 and 0.7. CONCLUSION: To the best of our knowledge, ours is the first nomogram to predict pCR in HER2-positive tumors treated by preoperative chemotherapy with trastuzumab. To ensure generalizability, this model needs to be externally validated.

[Smoking among undergraduate university students]. / Diagnóstico del consumo de tabaco en estudiantes de pregrado de la Pontificia Universidad Católica de Valparaíso.

BACKGROUND: Smoking is one of the major Public Health problems worldwide. AIM: To study the frequency of tobacco smoking among undergraduate students of a Chilean university. MATERIAL AND METHODS: An opinion survey was sent by e-mail to all undergraduate students of a university, registering gender, age, study years, study area, smoking behavior, motivation (reason for smoking), intention to quit and tobacco law perception. RESULTS: 1,008 (57% females) out of 11,679 surveys were answered back. Prevalence of active smoking among respondents was 36%, without association with gender, age or years of study. However, students from scientific areas had a lower prevalence. Seventy seven percent of smokers manifested the intention to quit the habit or have started quitting already. Ninety six percent were acquainted with the tobacco law and by 73% agreed with it. CONCLUSIONS: Smoking is highly prevalent among university students. It is necessary to develop strategies for smoking cessation within universities that may prevent or reduce tobacco smoking among students.

Immunohistochemical Expression of the Pluripotency Factor OCT4 in Canine Mast Cell Tumours.

Cancer stem cells (CSCs) are related to malignancy and resistance to chemotherapy in several tumours. OCT4 is a 'pluripotency factor' that is expressed by these cells. The aim of the present study was to investigate OCT4 expression in canine cutaneous mast cell tumours (MCTs) by means of immunohistochemistry. Twenty-eight cases were evaluated and showed variable immunolabelling patterns. The dogs were treated by surgery alone and followed up for a minimum of 180 days. No significant difference was found between histopathological grades and similar results were obtained for mortality due to the disease and post-surgical survival. These preliminary results suggest that OCT4 expression is not a precise prognostic indicator for canine MCT.

Diagnóstico del consumo de tabaco en estudiantes de pregrado de la Pontificia Universidad Católica de Valparaíso / Smoking among undergraduate university students

Background: Smoking is one of the major Public Health problems worldwide. Aim: To study the frequency of tobacco smoking among undergraduate students of a Chilean university. Material and Methods: An opinion survey was sent by e-mail to all undergraduate students of a university, registering gender, age, study years, study area, smoking behavior, motivation (reason for smoking), intention to quit and tobacco law perception. Results: 1,008 (57% females) out of 11,679 surveys were answered back. Prevalence of active smoking among respondents was 36%, without association with gender, age or years of study. However, students from scientific areas had a lower prevalence. Seventy seven percent of smokers manifested the intention to quit the habit or have started quitting already. Ninety six percent were acquainted with the tobacco law and by 73% agreed with it. Conclusions: Smoking is highly prevalent among university students. It is necessary to develop strategies for smoking cessation within universities that may prevent or reduce tobacco smoking among students.

Expression of NR1I3 in mouse lung tumors induced by the tobacco-specific nitrosamine 4-(methylnitrosamino)-4-(3-pyridyl)-1-butanone.

Nuclear receptor subfamily 1, group I, member 3 (NR1I3) is reported to be a possible novel therapeutic target for some cancers, including lung, brain and hematopoietic tumors. Here, we characterized expression of NR1I3 in a mouse model of lung carcinogenesis induced by 4-(methylnitrosamino)-4-(3-pyridyl)-1-butanone (NNK), the most potent tobacco carcinogen. Lung tumors were collected from mice treated with NNK (400 mg/kg) and euthanized after 52 weeks. Benign and malignant lesions were formalin-fixed and paraffin-embedded for histology and immunohistochemistry, with samples snap-frozen for mRNA analysis. Immunohistochemically, we found that most macrophages and type I and II pneumocytes expressed NR1I3, whereas fibroblasts and endothelial cells were NR1I3-. Compared with benign lesions, malignant lesions had less NR1I3+ tumor cells. Gene expression analysis also showed an inverse correlation between NR1I3 mRNA expression and tumor size (P=0.0061), suggesting that bigger tumors expressed less NR1I3 transcripts, in accordance with our immunohistochemical NR1I3 tests. Our results indicate that NR1I3 expression decreased during progression of malignant lung tumors induced by NNK in mice.

Prevalencia de depresión en pacientes adultos con enfermedad celíaca / Prevalence of depression in adult celiac disease patients

Introduction: Celiac disease (CD) is an autoimmune disorder that affects the gastrointestinal tract and other systems like the neuropsychiatric system, where depression is the most frequent disease. Objectives: To determine the prevalence of depression in adult celiac patients and relate these results with the adherence to a gluten-free diet. Materials and Methods: Descriptive cross-sectional study, with +18-year-old patients diagnosed with CD, confirmed with biopsy. 123 subjects from Fundación Convivir and from Instituto de Diagnóstico Gastroenterológico answered Beck Depression Inventory II (BDI-II) vía e-mail, which consists of 21 questions on personal aspects of their life; and also a survey on general aspects generales. A result of > 20 points was considered depression. Results: Average age was 38.9 years, 82.9 percent female. 17.1 percent (21 cases) present with depression according to BDI-II score. 62.6 percent adhere to the diet and 10.4 percent present depression; on the other hand, of 37.4 percent that are non-adherent, 28.3 percent present this disease. The association between both variables is statistically significant (p < 0.014). Discussion: High prevalence of depression was determined in CD patients compared to 9 percent, corresponding to the countries global figure. Most of them showed previous history of depressive disease. Adequate adherence to a gluten-free diet is associated to lower prevalence of depression.

Introducción: La enfermedad celíaca (EC) es una patología autoinmune que afecta al aparato gastrointestinal y a otros sistemas como el neuro-psiquátrico, área en la que la depresión es la patología más frecuente. Objetivos: Determinar la prevalencia de depresión en pacientes adultos con EC y relacionar resultados con la adherencia o no a una dieta libre de gluten. Materiales y Métodos: Estudio descriptivo de corte transversal que incluyó a pacientes de 18 años o más, con diagnóstico de EC confirmado por biopsia. Se aplicó vía correo electrónico el Inventario de Depresión de Beck II (BDI-II) que consta de 21 preguntas sobre aspectos de su vida personal; y una encuesta de antecedentes generales a 123 sujetos provenientes de la Fundación Convivir y del Instituto de Diagnóstico Gastroenterológico. Se consideró depresión si el puntaje es > 20 puntos. Resultados: La edad promedio fue de 38,9 años y el 82,9 por ciento eran mujeres. El 17,1 por ciento (21 casos) presentan depresión según la escala de BDI-II. El 62,6 por ciento son adherentes a la dieta y presentan depresión el 10,4 por ciento; en cambio del 37,4 por ciento que no son adherentes, el 28,3 por ciento presenta esta patología. La asociación entre ambas variables es estadísticamente significativa (p < 0,014). Discusión: Se determinó una alta prevalencia de depresión en pacientes con EC en comparación con 9 por ciento que corresponde a la cifra global del país. La mayoría de ellos presentaban antecedentes previos de enfermedad depresiva. Una adecuada adherencia a la dieta libre de gluten se asocia a una menor frecuencia de depresión.

Frecuencia de riesgo neurobiológico en recién nacidos / Neurobiological risk frequency on newborns

Introducción: Los niños de alto riesgo o vulnerabilidad neurobiológica son aquellos que por sus antecedentes pre, peri o postnatales tienen una mayor probabilidad de presentar alteraciones en su desarrollo psicomotor. La evidencia sugiere que estos niños deben ingresar a Programas de Atención Temprana. objetivo: Describir la frecuencia de niños de alto riesgo neurobiológico que nacieron en hospitales públicos del Servicio de Salud Vina del Mar Quillota, durante al ano 2008. Paciente y Método: Se utilizó un diseno descriptivo a partir del análisis de información existente en los libros de registros de los servicios de maternidad y neonatología, del universo de niños nacidos vivos en hospitales públicos de la red de este servicio. Resultados: Los niños de alto riesgo representaron un 21,01 por ciento del total de recién nacidos vivos. Los factores de riesgo biológico más frecuentes fueron la prematurez (11,4 por ciento), el retardo de crecimiento intrauterino (9,0 por ciento) y el bajo peso de nacimiento (7,8 por ciento). Conclusión: Este estudio epidemiológico, representa el punto de partida para explorar la necesidad existente de disponer de registros estadísticos de los distintos factores de riesgo biológico y contar con espacios formales para realizar atención temprana en el servicio de salud Vina del Mar Quillota con el propósito de prevenir y tratar alteraciones del desarrollo psicomotor en todos los niños con riesgo neurobiológico.

Introduction: High-risk or neurobiological vulnerable children are those who are more likely to have alterations in their psychomotor development during their pre-, peri-, or post-natal periods. Evidence suggests that these children must have early medical care. objective: To describe the frequency of high-risk neuro-biological infants born during 2008 in Vina del Mar Quillota public health hospitals. Methods: A descriptive design was used based on the analysis of existing information in the maternity and neonatology record books regarding live births in public hospitals of this service network. Results: The high-risk children accounted for 21.01 percent of all live births. The most frequent biological risk factors were prematurity (11.4 percent), intrauterine growth retardation (9.0 percent) and low birth weight (7.8 percent). Conclusion: This epidemiological study represents the starting point for exploring the existing need to have statistical records of the various risk factors as well as have formal spaces for early treatment in the Quillota Vina del Mar health service to prevent and treat abnormal psychomotor development in all children with neurobiological risk.

Historia de un caso con esquizofrenia parafrenizada o parafrenia fantástica y sistematizada / Evolution of a case of paraphrenized schizophrenia or fantastic and systematezed paraphrenia

This case treats about an unmarried 57 years old man, who I know since 1972 after a first germ episode ofhomosexual panic, auditive hallucinations and badly modulated affectivity. Diagnosis was Paranoid Schizophrenia and was treated with TEC, Tioridazina, and subsequently with comprehensive and directive psychotherapy. The patient accepted his homosexualism that he practices promiscuously with thieves and exploiters, one of which he threw down from his apartment causing his death, an incident for which he was declared inimputable. He developed a two-being feeling, the patient and a woman that he name "siameses". She procures him gays. He disguises as a woman and is surprised that no one seems interested in him. In 1976 he began a vivency based on the existence of a Principate of Bahía Naranjo, the biggest country on Earth. This Principate, founded in 1460, is a monarchy with an emperor and a chronicler (the patient), who writes about the daily life of the country. The patient has allotted the first author the task of keeping untouched his chronicles in the library of the Psychiatric Institute in Santiago in order that in 100 years the psychiatrists discover his illness thruth. The patient presents no alteration of thinking, do not use neologisms, though presents a double orientation. Based on these traits the treating psychiatrist has postulated a Personality Disorder and a Paraphrenized Schizophrenia or a Fantastic and Systematized Paraphrenia. He badly tolerates neuroleptics and presently takes300 mgs of Chlorpromazine; no Atypical Antipsychotics have been used so far because of economic reasons. Although he receives a pensioning from the Army, he misspends his money and does not accept taking other kinds of medicines.

Este caso trata sobre un hombre soltero de 57 años que conozco desde 1972 cuando presentó un episodio de pánico homosexual, alucinaciones auditivas y una afectividad mal modulada. Se le diagnóstico Esquizofrenia Paranoide y fue tratado con Terapia electroconvulsiva y Tioridazina. Posteriormente se continuó con una psicoterapia comprensiva y directiva. El paciente aceptó su homosexualismo que practicó promiscuamente con gay, drogadictos y explotadores a uno de los cuales lanzó al vacío desde su departamento falleciendo inmediatamente. Fue declarado inimputable. El desarrolló la presencia de dos personalidades una masculina y otra femenina. Se vestía de mujer y se sorprendía que a la gente no le llamara la atención. En 1976 empieza a afirmar y escribir que existe el Principado de Bahía Naranjo, el más grande del mundo, fundado en 1460 gobernado por una monarquía con un emperador y el paciente lleva un registro de la vida cotidiana del Pricipado. Este libro se lo va entregando al médico pues debe ser guardado en la biblioteca del Instituto Psiquiátrico para que en 100 años más los psiquiatras descubran su verdadera enfermedad. El enfermo no presenta alteraciones formales del paciente ni neologismos y tiene doble orientación. Basado en estas características se ha postulado un trastorno de Personalidad y una Esquizofrenia parafrenizada o una Parafrenia Sistematizada y Fantástica. Ha tolerado mal varios antipsicóticos y actualmente toma Clorpromazina 300 mgrs. Aunque recibe un montepío de las FF.AA. el paciente derrocha su dinero y no acepta antipsicóticos atípicos.

3,5-Dimethyl-1-thiocarbamoylpyrazole and its Pd(II) complexes: synthesis, spectral studies and antitumor activity.

Complexes of the type [PdX2(tdmPz)] {X=Cl-(1), Br-(2); I-(3); SCN-(4); tdmPz=1-thiocarbamoyl-3,5-dimethylpyrazole} have been synthesized and characterized. Compound 1 was formed from the reaction between [PdCl2(CH3CN)2] and 1-thiocarbamoyl-3,5-dimethylpyrazole. Complexes 2, 3 and 4 were obtained by metathesis of the chloro groups from 1 by bromide, iodide and thiocyanate ions, respectively. All the compounds and cisplatin have been tested in vitro by MTT assay for their cytotoxicity against three murine cancer cell lines: mammary adenocarcinoma (LM3 and LMM3) and lung adenocarcinoma (LP07) as well towards normal murine peritoneal exudate cells (PEC). Promising cytotoxic effect against LM3 has been found for 3 showing IC50 equal to 24.5 microM which is comparable to the value obtained for cisplatin (30.3 microM).

[Isolated mandibular B-cell lymphoma revealed by inferior alveolar nerve anesthesia]. / Lymphome B mandibulaire isolé révélé par une anesthésie du nerf alvéolaire inférieur.

INTRODUCTION: Mandibular lymphomas are rare and most often revealed by painless swelling. The authors report the case of a mandibular lymphoma revealed by an isolated lesion of the inferior alveolar nerve evolving for eight months. CASE REPORT: A 41-year-old male patient was followed for left mandibular pain, with progressive hypoesthesia of the left inferior alveolar nerve. The radiological assessments remained normal during eight months. Then a vestibular tumor developed in front of tooth 34. The biopsy revealed a B-cell lymphoma. No other localization was found. The patient was in complete remission two years after polychemotherapy. DISCUSSION: Our observation is unusual in its clinical presentation. Mandibular lymphomas most often present as a painless swelling, sometimes ulcerated in the mouth. They are very rarely diagnosed after an isolated hypoesthesia of V3. Lymphomas are the second most frequent head and neck lymphomas after epidermoid carcinomas, but the frequency seems to be increasing. In almost all the cases, they present as B-cell tumours of the DLBCL subtype in the WHO classification. Mandibular localizations account for only 0.6% of the cases. They are often misdiagnosed as a dental problem. The complete remission rate after chemotherapy ranges from 60 to 80% at one year. Nevertheless, the prognosis remains bad with a survival rate of only 50% at five years.