Ascitis pancreática traumática, manejo conservador: reporte de un caso / Post-traumatic pancreatic ascites, conservative management: a case

Resumen Objetivo: Presentar el caso de un paciente masculino adulto joven, con ascitis pancreática secundaria a lesión del conducto pancreático por trauma abdominal cerrado, tratado con éxito con terapia conservadora. Materiales y Método: Datos e imágenes recopilados de la historia clínica del Hospital Universitario de Santander, previo consentimiento informado. Resultados: Sexo masculino de 21 años con antecedente de trauma abdominal cerrado, quien consulta por distensión, dolor abdominal progresivo y pérdida de peso no cuantificada. Ante sospecha de lesión de conducto pancreático se solicitó pancreatografía por resonancia magnética que evidencia una alteración del segmento proximal del conducto pancreático principal asociado a lesión quística en el borde anterior de la unión de la cabeza con el cuerpo pancreático. Se decidió manejo conservador por 4 semanas con colocación de dren abdominal, reposo intestinal, asociado a nutrición parenteral total y análogos de somatostatina. Discusión: Un 5% del trauma abdominal cerrado puede provocar pancreatitis y fugas en el conducto pancreático. Conclusión: La lesión del conducto pancreático principal debe sospecharse en todos los pacientes con trauma abdominal cerrado. El manejo debe realizarse con una planificación cuidadosa y exhaustiva.

Aim: To present the case of a young adult male patient, with pancreatic ascites secondary to pancreatic duct injury due to blunt abdominal trauma, treated successfully with conservative therapy. Materials and Method: Data and images were obtained from the clinical chart of the "Hospital Universitario de Santander" with prior informed consent. Results: 21-year-old male patient with a blunt abdominal trauma background, who consulted for distension, progressive abdominal pain, and subjective weight loss. Due to suspicion of a pancreatic duct injury, a magnetic resonance cholangiopancreatography was requested, which showed an alteration of the proximal segment of the main pancreatic duct associated with a cystic lesion at the anterior border of the junction between the pancreatic head and body. Treatment consisted of a 4-week conservative therapy with the placement of an abdominal drain, bowel rest, associated with total parenteral nutrition and somatostatin analogs. Discussion: A 5% of blunt abdominal trauma can cause pancreatitis and pancreatic duct leaks. Conclusión: Pancreatic duct injury should be suspected in every patient with blunt abdominal trauma. Management must be done with careful and thorough planning.

Ventilación no invasiva en insuficiencia respiratoria aguda pediátrica: rol del terapeuta ventilatorio / Non-invasive mechanical ventilation in pediatric acute respiratory failure: the role of the respiratory therapist

Currently, Chilean pediatric intensive care units use non-invasive mechanical ventilation as ventilation support in acute respiratory conditions. However, there are differences in methodology and the number of patients treated annually. These units have a physiotherapist who has progressively incorporated skills related to non-invasive mechanical ventilation application, as well as to other forms of respiratory support and care in general. At present the role of the therapist is fundamental to the ventilatory support of patients with acute respiratory failure

En la actualidad todas las unidades de cuidados intensivos pediátricos nacionales utilizan Ventilación Mecánica no Invasiva como método de soporte ventilatorio en condiciones agudas, no obstante, estas difieren en metodología de aplicación y número de pacientes conectados anualmente. El kinesiólogo que se desempeña como terapeuta respiratorio en estas unidades, ha incorporado de manera progresiva competencias técnicas que lo relacionan con la aplicación de la ventilación no invasiva, así como con otras formas de soporte ventilatorio y cuidados respiratorios en general. Particularmente en ventilación mecánica no invasiva, existe importante dependencia de los cuidados que este profesional puede ofrecer y que son requeridos durante todo el desarrollo de la terapia

Carcinoma familiar de tiroides no medular: reporte de un caso clínico y revisión de la literatura / Familial non medullary thyroid carcinoma: report of a case and literature review

El carcinoma tiroideo familiar no medular (CFTNM) representa aproximadamente entre el 3,2% y 9,6% de todos los cánceres de tiroides, y se define por la presencia de cáncer diferenciado de tiroides en 2 o más familiares, en ausencia de otros síndromes familiares conocidos o exposición a radiación. Si bien su fisiopatología es aún incierta, algunos investigadores postulan un patrón de herencia dominante con penetrancia incompleta, no habiendo aún un gen específico responsable. Esta entidad suele presentarse a una menor edad y con características más agresivas que en su forma esporádica. Dado el interés por conocer la presentación de esta enfermedad y las recomendaciones para su manejo, se presenta el caso de una paciente diagnosticada con cáncer papilar de tiroides con el antecedente de 4 familiares con la misma patología. Actualmente el tamizaje mediante ecografía cervical y biopsia por punción aspiración con aguja fina de los nódulos tiroideos es el examen de elección ante la presencia del antecedente de CFTNM, ya que aún no hay estudios genéticos disponibles. La tiroidectomía total más disección ganglionar es el tratamiento de elección. Debido al comportamiento más agresivo y peor pronóstico del CFTNM, es necesaria un alto índice de sospecha y una investigación completa en la presencia de un componente familiar.

The non-familial medullary thyroid carcinoma (FNMTC) represents approximately between 3.2 and 9.6% of all thyroid cancers, and is defined by the presence of differentiated thyroid cancer in 2 or more families in the absence of other known familial syndromes or radiation exposure. Although the pathophysiology is still uncertain, some investigators posit a dominant pattern of inheritance with incomplete penetrance, but still there is no specific gene responsible. It occurs at a younger age and with more aggressive characteristics than the sporadic form. Because of the interest in learning about the presentation of this disease and its recommendations, we present the case of a patient diagnosed with papillary thyroid cancer with a history of 4 family with the same pathology. Actually cervical screening by ultrasound and the fine needle aspiration biopsy (FNAB) of thyroid nodules is the examination of choice in the presence of a history of FNMTC, since no genetic studies yet available. Total thyroidectomy with lymph node dissection is the treatment of choice. Because the more aggressive behavior and poor prognosis of FNMTC, a high index of suspicion and a full investigation is required in the presence of a familial component.

Preterm infant gut colonization in the neonatal ICU and complete restoration 2 years later.

Preterm infants in a neonatal intensive care unit (NICU) are exposed to multidrug-resistant bacteria previously adapted to the hospital environment. The aim of the present study was to characterize the bacterial antibiotic-resistant high-risk lineages colonizing preterm infants during their NICU stay and their persistence in faeces after 2 years. A total of 26 preterm neonates were recruited between October 2009 and June 2010 and provided 144 faecal samples. Milk samples (86 mother's milk, 35 human donor milk and 15 formula milk) were collected at the same time as faecal samples. An additional faecal sample was recovered in 16 infants at the age of 2 years. Samples were plated onto different selective media, and one colony per morphology was selected. Isolates were identified by 16S rDNA nucleotide sequence and MALDI-TOF. Antibiotic susceptibility (agar dilution), genetic diversity (RAPD, PFGE and MLST) and virulence factors (only in enterococcal and staphylococcal isolates) were determined by PCR. A high proportion of antibiotic-resistant high-risk clones was detected in both faecal and milk samples during the NICU admittance. Almost all infants were colonized by Enterococcus faecalis ST64 and Enterococcus faecium ST18 clones, while a wider genetic diversity was observed for the Gram-negative isolates. Multidrug-resistant high-risk clones were not recovered from the faecal samples of the 2-year-olds. In conclusion, the gut of preterm infants admitted to the NICU might be initially colonized by antibiotic-resistant and virulent high-risk lineages, which are later replaced by antibiotic-susceptible community ones.

El papel del reconocimiento en la integración social de las personas discapacitadas: análisis de modelos de inserción laboral para personas ciegas en el área metropolitana de Monterrey / The role of recognition in the social integration of disabled persons: analysis of models of employment for blind people in the metropolitan area of Monterrey

Partiendo de la tesis de que el reconocimiento es una precondición para una vida en sociedad (Honneth, 2010:32) debido a que: a) hace posible la construcción de la identidad; b) incide en la relación con uno mismo; c) es el fundamento de la empatía y solidaridad; d) incide en la valoración social de una actividad; e) y afecta incluso la distribución de bienes materiales (Honneth, 2010: 43). Consideramos que la forma como son reconocidos los diversos grupos sociales influye en la valoración de sus actividades, cualidades y aportaciones sociales, organiza y determina su acceso a la distribución de los bienes materiales socialmente disponibles. Desde esta perspectiva es que analizamos los datos empíricos obtenidos a través de la elaboración de entrevistas a profundidad a personas ciegas del AMM; y qué organismos a partir de cómo los modelos de inserción laboral desarrollados por las distintas Asociaciones de las que los entrevistados forman parte materializan, en sus prácticas de inserción, un determinado imaginario social sobre las personas ciegas. Asimismo consideramos que ese imaginario social incide en la autopercepción de las mismas personas. Finalmente concluimos que las personas con discapacidad enfrentan una especie de negación de reconocimiento con relación a sus cuerpos. Ello inhibe y reprime el desarrollo de sus capacidades y habilidades para conocer y aprehender el mundo.

Starting from the thesis that recognition is a precondition for a life in society (Honneth, 2010:32) because: a) makes possible the construction of identity; b) affects the relationship with oneself; c) is the foundation of empathy and solidarity; d) affects the social value of an activity; e) and affects even distribution of material goods (Honneth, 2010: 43). Consider how they are recognized various social groups affect the value of their activities, qualities and social contributions, organizes and determines their access to distribution of material goods socially available. From this perspective, we analyze the empirical data obtained through the development of in-depth interviews to blind the AMM and how organisms from employment models developed by different organizations which respondents are part materialize, insertion practices in a particular social imaginary of the blind. We also believe that social imagery affects self perception of the same people. Finally we conclude that persons with disabilities we face a kind of denial of recognition in relation to their bodies. This inhibits and suppresses the development of their skills and abilities to appreciate and understand the world.

Bacteriological, biochemical, and immunological modifications in human colostrum after Holder pasteurisation.

OBJECTIVE: The objective of this work was to evaluate the effect of Holder pasteurisation of human colostrum on a variety of microbiological, biochemical, and immunological parameters. METHODS: Colostrum samples from 10 donors, and 8 samples of mature milk used as controls, were heated at 62.5°C for 30 minutes. Bacterial counts and the concentration of furosine, lactose, myoinositol, glucose, lactulose, cytokines, and immunoglobulins were determined before and after the heat treatment. RESULTS: Mean bacterial counts in nonpasteurised colostrum samples oscillated between 2.72 and 4.13 log10 colony-forming units per millilitre in the agar media tested. Holder pasteurisation led to the destruction of the bacteria originally present in the samples. Furosine was detected in all samples before pasteurisation and increased significantly after the heat treatment (from 6.60 to 20.59 mg/100 g protein). Lactulose content was below the detection limit in nonpasteurised colostrum, but it was detected in all samples and quantified in 7 of them (from 10.68 to 38.02 mg/L) after Holder pasteurisation. Lactose, glucose, and myoinositol concentrations did not change after Holder pasteurisation. The concentrations of most cytokines and immunoglobulins were significantly higher in colostrum than in mature milk samples. Immunoglobulin content, both in colostrum and in milk samples, was reduced during pasteurisation, whereas, among cytokines, only macrophage inflammatory protein-1ß, interleukin-7, and granulocyte-macrophage-colony-stimulating factor concentrations were affected by this heat treatment. CONCLUSIONS: Lactulose and furosine content could be used as heat treatment indicators in colostrum samples. Holder pasteurisation modified the immunological profile of both colostrum and mature milk.

Successful factorial design for the optimization of methylprednisolone encapsulation in biodegradable nanoparticles.

Due to their crystalline nature, the encapsulation of hydrophobic corticosteroids within polymeric nanoparticles by o/w solvent evaporation method is often difficult to achieve. The aim of this study was to evaluate the effect of both process and formulation parameters on the encapsulation of a model corticosteroid: methylprednisolone (MP). For this purpose, a 3(2)factorial design was performed evaluating the effects of the concentration of emulsifiers and sonication time on the manufactured nanoparticles, followed by a multiresponse optimization. The study also included the evaluation of other parameters such as the type of organic solvent used, polymer characteristics and the initial mass of drug. The optimal nanoparticle formulation using 0.25% (w/v) of emulsifying agent (Polyvinyl-alcohol, PVA) and 5 min of sonication was then characterized. The highest encapsulation was obtained with an organic phase consisting of acetone: dichloromethane (1:1), polyD,L-lactide-co-glycolide (PLGA) 50:50 as polymer and an initial mass of 6.6 mg of methylprednisolone. Nanoparticles size and ζ potential of optimized formulation were respectively around 230 nm and -14 mV. Differential scanning calorimetry (DSC) and X-ray diffraction (XRD) demonstrated that the drug was molecularly dispersed within the nanoparticles. Release study showed that MP-loaded nanoparticles sustained drug release for up to 120 h. This study reflects the importance of factorial design to optimize the manufacture of nanoparticles encapsulating hydrophobic drugs.

Optimisation of entrapped activated carbon conditions to remove coloured compounds from winery wastewaters.

The objective of this work was to study the entrapped conditions of activated carbon in calcium-alginate beads for the clarification of winery wastewaters. An incomplete 3(3) factorial design was carried out to study the efficiency of activated carbon (0.5-2%); sodium alginate (1-5%); and calcium chloride (0.050-0.900 M), on the following dependent variables: colour reduction at 280, 465, 530 and 665 nm. The activated carbon and calcium chloride were the most influential variables in the colour reduction. Nearly 100% colour reductions were found for the wavelengths assayed when employing 2% of activated carbon, 5% of sodium alginate and intermediate concentrations of calcium chloride (0.475 M). Instead, other conditions like, 2% of activated carbon, 4% of sodium alginate and 0.580 M of calcium chloride can also give absorbance reductions close to 100%.

Utilidad de la ecografía con contraste en la práctica clínica diaria. Estudio multicéntrico español CEUS / Usefulness of contrast-enhanced ultrasonography in daily clinical practice: A multicenter study in Spain

Objetivos: El objetivo de este estudio multicéntrico ha sido evaluar si la ecografía con contraste permite aumentar el rendimiento diagnóstico de la ecografía basal. Material y métodos: En este estudio prospectivo multicéntrico realizado en 42 hospitales se incluyeron 1.786 pacientes con estudios ecográficos considerados como no concluyentes. El 84,9% fueron ecografías abdominales (incluyendo estudios hepáticos, renales, esplénicos y de otras localizaciones), el 6,2% fueron estudios vasculares periféricos, el 4,3% fueron estudios mamarios y el 4,6% fueron estudios de otras localizaciones. Se evaluó el tipo de ecografía con contraste (Doppler color o método específico de contraste), el tipo de contraste, la dosis y el número de dosis y el tipo de administración (en forma de bolo o infusión). Sobre los hallazgos obtenidos en la ecografía con contraste se valoró si conseguía aumentar el rendimiento diagnóstico de la ecografía basal y si permitía un diagnóstico concluyente. Resultados: El 99,9% de los estudios se realizó con SonoVue, con una dosis de contraste (84,8%) y en forma de bolo (98,5%). En el 91,6% de los casos la ecografía con contraste aumentó el rendimiento diagnóstico de la ecografía basal, y en el 69,2% permitió un diagnóstico de certeza. El mayor rendimiento diagnóstico se obtuvo en los estudios de troncos supraaórticos con un diagnóstico definitivo en el 95,4% de los casos, seguido por el área abdominal con resultado concluyente en el 72,6% de los casos. Conclusiones: El uso de la ecografía con contraste aumentó significativamente el rendimiento diagnóstico de la ecografía basal, y se obtuvo un resultado concluyente en la mayoría de los casos (AU)

Objectives: We aimed to determine whether the use of ultrasonographic contrast agents improves the diagnostic performance of ultrasonography (US).Material and methods: We carried out a prospective multicenter study in 42 hospitals. We included 1786 patients with inconclusive US; 84.9% of the inconclusive studies were abdominal US (including studies of the liver, kidneys, spleen, and other sites), 6.2% were studies of the peripheral vessels, 4.3% were breast studies, and 4.6% were other studies. We evaluated the type of contrast-enhanced US (color Doppler or contrast-specific method), type of contrast agent, dose and number of doses, and type of administration (bolus or infusion). We evaluated whether the findings at contrast-enhanced US improved the diagnostic performance of unenhanced US and whether they enabled a conclusive diagnosis to be reached. Results: The contrast agent SonoVue was used in 99.9% of the studies; a single dose of contrast agent was used in 84.8%, and the contrast agent was administered in bolus in 98.5%. Contrast-enhanced US improved the diagnostic performance in 91.6% of cases and enabled the conclusive diagnosis in 69.2%. The best diagnostic performance was obtained in the supraaortic trunks, where a definitive diagnosis was reached in 95.4% of cases, followed by the abdominal area, with a conclusive diagnosis in 72.6% of cases. Conclusions: The use of contrast-enhanced US significantly improved the diagnostic performance of US and enabled a conclusive diagnosis in most cases (AU)

[Usefulness of contrast-enhanced ultrasonography in daily clinical practice: a multicenter study in Spain]. / Utilidad de la ecografía con contraste en la práctica clínica diaria. Estudio multicéntrico español CEUS.

OBJECTIVES: We aimed to determine whether the use of ultrasonographic contrast agents improves the diagnostic performance of ultrasonography (US). MATERIAL AND METHODS: We carried out a prospective multicenter study in 42 hospitals. We included 1786 patients with inconclusive US; 84.9% of the inconclusive studies were abdominal US (including studies of the liver, kidneys, spleen, and other sites), 6.2% were studies of the peripheral vessels, 4.3% were breast studies, and 4.6% were other studies. We evaluated the type of contrast-enhanced US (color Doppler or contrast-specific method), type of contrast agent, dose and number of doses, and type of administration (bolus or infusion). We evaluated whether the findings at contrast-enhanced US improved the diagnostic performance of unenhanced US and whether they enabled a conclusive diagnosis to be reached. RESULTS: The contrast agent SonoVue was used in 99.9% of the studies; a single dose of contrast agent was used in 84.8%, and the contrast agent was administered in bolus in 98.5%. Contrast-enhanced US improved the diagnostic performance in 91.6% of cases and enabled the conclusive diagnosis in 69.2%. The best diagnostic performance was obtained in the supraaortic trunks, where a definitive diagnosis was reached in 95.4% of cases, followed by the abdominal area, with a conclusive diagnosis in 72.6% of cases. CONCLUSIONS: The use of contrast-enhanced US significantly improved the diagnostic performance of US and enabled a conclusive diagnosis in most cases.

[A guide to the clinical diagnosis and urgent treatment of neonatal hyperammonaemia]. / Guía clínica de diagnóstico y tratamiento urgente de hiperamonemia neonatal.

Symptomatic hyperammonaemia in newborn is a medical emergency that should be recognised in its early stages, specifically diagnosed and aggressively treated to improve the immediate and long-term prognosis of these children. The paediatrician and the neonatal doctor should have a diagnosis-therapy scheme for its urgent management.

Guía clínica de diagnóstico y tratamiento urgente de hiperamonemia neonatal / A guide to the clinical diagnosis and urgent treatment of neonatal hyperammonaemia

La hiperamonemia sintomática en el recién nacido es una urgencia médica que debe reconocerse de manera precoz, diagnosticarse de manera específica y tratarse de forma intensiva para mejorar el pronóstico inmediato y a largo plazo de estos niños. Para esto, es necesario que el pediatra en general y el neonatólogo en particular tengan presente una secuencia diagnostico terapéutica de actitud inmediata que contribuya a una adecuada actuación (AU)

Symptomatic hyperammonaemia in newborn is a medical emergency that should be recognised in its early stages, specifically diagnosed and aggressively treated to improve the immediate and long-term prognosis of these children. The paediatrician and the neonatal doctor should have a diagnosis-therapy scheme for its urgent management (AU)

[Sun rays diaphragm: an ultrasonographic sign of interstitial involvement in the base of the lung]. / Diafragma en rayos de sol: signo ecográfico de afectación intersticial de la base pulmonar.

OBJECTIVES: The purpose of this article is to present a new ultrasonographic sign: the spiculated diaphragm or sun rays diaphragm, that makes it possible to suspect disease in the base of the lung, generally involving the subpleural interstitium, during abdominal ultrasound examination. MATERIAL AND METHODS: We present a study of seven patients in whom the diaphragm was observed as an echogenic, curvilinear, thickened image with numerous echogenic vertical lines or bands radiating from it posteriorly during abdominal ultrasound examination using a sectorial transducer. We have named this spiculated appearance of the diaphragm sun rays diaphragm. All patients underwent posteroanterior and lateral plain-film chest x-rays and high-resolution chest computed tomography (CT) with slices of the bases of the lungs. RESULTS: The chest pathology responsible for this finding was pulmonary fibrosis (n = 2), mitral valulopathy with heart failure (n = 2), unilateral atresia of the pulmonary vein (n = 1); combined miliary tuberculosis and Pneumocystis infection in an AIDS patient (n = 1), and carcinomatous lymphangitis (n = 1). CONCLUSIONS: When a spiculated or sun rays diaphragm is observed during abdominal ultrasonography, disease involving the base of the lung (generally the subpleural interstitium) should be suspected; thus, in the absence of prior clinical knowledge of lung disease, additional examinations such as plain-film chest x-rays or thin slice chest CT should be performed.

Diafragma en rayos de sol: signo ecográfico de afectación intersticial de la base pulmonar / Sun rays diaphragm: an ultrasonographic sign of interstitial involvement in the base of the lung

Objetivos. El propósito de este estudio es presentar un nuevo signo ecográfico: el diafragma espiculado o diafragma en rayos de sol, que permite sospechar la existencia de patología en la base pulmonar, generalmente del intersticio subpleural, durante la realización de una ecografía abdominal. Material y métodos. Presentamos un estudio de 7 pacientes en quienes, con ecografía abdominal y transductor sectorial de 3,5 MHz, se observó el diafragma como una imagen ecogénica, curvilínea y engrosada, de la cual salían numerosas líneas o bandas ecogénicas verticales de dirección posterior, que le daban un aspecto espiculado que se denominó diafragma en rayos de sol. En todos los casos se completó el estudio con radiografía simple de tórax posteroanterior y lateral y con cortes basales de tomografía computarizada (TC) de tórax de alta resolución. Resultados. La patología torácica responsable de este hallazgo ecográfico correspondía a: fibrosis pulmonar (2 casos); valvulopatía mitral con fracaso cardiaco (2 casos); atresia unilateral de vena pulmonar (1 caso); infección combinada por tuberculosis miliar y neumocistis en paciente infectado por el virus de la inmunodeficiencia humana (VIH) (1 caso); linfangitis carcinomatosa (1 caso). Conclusiones. Cuando en el curso de una ecografía abdominal se observa un diafragma espiculado o en rayos de sol hay que pensar que suele indicar una afectación de la base pulmonar, generalmente del intersticio subpleural, de tal forma que si clínicamente no es conocida será conveniente realizar estudios posteriores mediante radiografía simple y/o TC de tórax con cortes finos (AU)

Objectives. The purpose of this article is to present a new ultrasonographic sign: the spiculated diaphragm or sun rays diaphragm, that makes it possible to suspect disease in the base of the lung, generally involving the subpleural interstitium, during abdominal ultrasound examination. Material and methods. We present a study of seven patients in whom the diaphragm was observed as an echogenic, curvilinear, thickened image with numerous echogenic vertical lines or bands radiating from it posteriorly during abdominal ultrasound examination using a sectorial transducer. We have named this spiculated appearance of the diaphragm sun rays diaphragm. All patients underwent posteroanterior and lateral plain-film chest x-rays and high-resolution chest computed tomography (CT) with slices of the bases of the lungs. Results. The chest pathology responsible for this finding was pulmonary fibrosis (n = 2), mitral valulopathy with heart failure (n = 2), unilateral atresia of the pulmonary vein (n = 1); combined miliary tuberculosis and Pneumocystis infection in an AIDS patient (n = 1), and carcinomatous lymphangitis (n = 1). Conclusions. When a spiculated or sun rays diaphragm is observed during abdominal ultrasonography, disease involving the base of the lung (generally the subpleural interstitium) should be suspected; thus, in the absence of prior clinical knowledge of lung disease, additional examinations such as plain-film chest x-rays or thin slice chest CT should be performed (AU)

Comparison between different hydrolysis processes of vine-trimming waste to obtain hemicellulosic sugars for further lactic acid conversion.

Trimming vine shoot samples were treated with water under selected operational conditions (autohydrolysis reaction) to obtain a liquid phase containing hemicellulose-decomposition products. In a further acid-catalyzed step (posthydrolysis reaction), xylooligosaccharides were converted into single sugars for the biotechnological production of lactic acid using Lactobacillus pentosus. A wide range of temperatures, reaction times, and acid concentrations were tested during the autohydrolysis-posthydrolysis process to investigate their influence on hemicellulose solubilization and reaction products. The maximum concentration of hemicellulosic sugars was achieved using autohydrolysis at 210 degrees C followed by posthydrolysis with 1% H2SO4 during 2 h. Data from autohydrolysis-posthydrolysis were compared with the results obtained at the optima conditions assayed for prehydrolysis (3% H2SO4 at 130 degrees C during 15 min) based on previous works. Prehydrolysis extracted more hemicellulosic sugars from trimming vine shoots; however, the protein content in the hydrolysates from autohydrolysis-posthydrolysis was higher. The harsher conditions assayed during the autohydrolysis process and the higher content of protein after this treatment could induce Maillard reactions decreasing consequently the concentration of hemicellulosic sugars in the hydrolysates. Therefore, despite the several advantages of autohydrolysis (less equipment caused by the absence of mineral acid, less generation of neutralized sludges, and low cost of reagents) the poor results obtained in this work with no detoxified hydrolysates (Q P = 0.36 g/L h, Q S = 0.79 g/L h, Y P/S = 0.45 g/g, Y P/Sth = 61.5 %) or charcoal-treated hydrolysates (Q P = 0.76 g/L h, Q S = 1.47 g/L h, Y P/S = 0.52 g/g, Y P/Sth = 71.5 %) suggest that prehydrolysis of trimming vine shoots with diluted H2SO4 is more attractive than autohydrolysis-posthydrolysis for obtaining lactic acid through fermentation of hemicellulosic sugars with L. pentosus. Besides the higher hemicellulosic sugars concentration achieved when using the prehydrolysis technology, no detoxification steps are required to produce efficiently lactic acid (Q P = 1.14 g/L h; Q S = 1.64 g/L h; Y P/S = 0.70 g/g; Y P/Sth = 92.6 %), even when vinification lees are used as nutrients (Q P = 0.89 g/L h; Q S = 1.54 g/L h; Y P/S = 0.58 g/g; Y P/Sth = 76.1 %).

[Brain abscess: about a clinical series of 30 patients]. / Absceso cerebral: a propósito de una serie de 30 casos.

A retrospective study was designed to ascertain the main clinical features of 30 patients admitted for brain abscess between 1989 and 2005. A contiguous source of infection was identified in 40% of cases, direct inoculation secondary to trauma or neurosurgery in 23,3%, and a distant source in 23,3%. Fever, headache and sensorial involvement were the main clinical manifestations. Temporal and frontal lesions were predominant. Microbiological information was available in only half of cases, prevailing polymicrobial and gram-positive bacterial infections. Most patients underwent surgical procedures (66.7%) and the rest received only medical therapy. During antimicrobial treatment, 6 patients (20%) suffered a serious adverse event that prompted discontinuation or change of therapy. Failure of treatment was observed in 40%, including 3 deaths (10%), non-programmed surgical drainage or reintervention (16.7%) and changes of the antimicrobial regimen (13.3%). Eight patients were discharged with sequels (26.7%), and during follow-up, 21% presented major events (death or brain abscess-related readmission).

Absceso cerebral: a propósito de una serie de 30 casos / Brain abscess: about a clinical series of 30 patients

Se diseñó un estudio para conocer las principales características clínicas en 30 pacientes atendidos por absceso cerebral entre 1989 y 2005. La puerta de entrada predominante fue por contigüidad (40 por ciento) y luego inoculación directa por neurocirugía-trauma o diseminación hematógena (23,3 por ciento). La fiebre, cefalea y el compromiso de conciencia fueron las manifestaciones cardinales y la localización predominante fue temporal o frontal. Se observó un predominio de infecciones polimicrobianas y por cocáceas gram positivas. La mayor parte fue sometida a tratamiento quirúrgico (66,7 por ciento) y el resto a tratamiento médico solamente. Durante el tratamiento antimicrobiano, 6 pacientes (20 por ciento) presentaron una reacción adversa que obligó a su suspensión o a cambio. Se observó fracaso del tratamiento médico-quirúrgico en 40 por ciento de los casos, incluyendo 3 decesos (10 por ciento letalidad), drenaje quirúrgico no programado o reintervenciones (16,7 por ciento) o ajustes de esquema (13,3 por ciento). Ocho pacientes presentaron secuelas al alta (26,7 por ciento) y durante el seguimiento, 21 por ciento presentó rehospitalizaciones relacionadas o falleció.

Novel alternative splicing predicts a truncated isoform of the NMDA receptor subunit 1 (NR1) in embryonic rat brain.

The expression of mesencephalic brain derived neurotrophic factor (BDNF) has been shown to be regulated by dopaminergic neuronal functioning and glutamate receptors (GluRs). In turn, BDNF participates in the regulation of mesencephalic GluRs' expression. In the present study we analyzed, using semi-quantitative RT-PCR, the effect of BDNF as well as of the GluRs agonists NMDA and trans-(+/-)-1-Amino-(1S,3R)-cyclopentane dicarboxylic acid (t-ACPD), on the expression levels of the NMDA GluR subunit 1 (NR1) mRNA, using rat cultured mesencephalic neurons. In the course of this study, a novel rat mRNA splice variant of NR1 was identified. This new NR1 mRNA isoform is characterized by the insertion of an 82 base pair intron containing an inframe stop codon, thus predicting the expression of a putative truncated protein of 465 amino acids. The RT-PCR and in situ hybridization reveals that the novel NR1 mRNA is expressed in various brain regions of the rat embryo, whereas no expression was detected in the adult rat brain. The modulation of the novel NR1 mRNA isoform by both BDNF and the metabotropic GluR agonist t-ACPD, suggests that the resulting putative NR1 truncated protein may be relevant in the regulatory network of glutamatergic neurotransmission in the developing central nervous system.