Prevalence of Rheumatic Diseases and Quality of Life in the Saraguro Indigenous People, Ecuador: A Cross-sectional Community-Based Study.

Rheumatic diseases are more prevalent and aggressive in indigenous population groups, providing medical attention for which poses a challenge for the rheumatologist. OBJECTIVE: To estimate the prevalence of musculoskeletal (MSK) disorders and rheumatic diseases in the Saraguro indigenous people in Ecuador, as well as to identify the main factors associated with the health status of this population. METHODS: This observational, cross-sectional study focused on the community was conducted using the COPCORD (Community-Oriented Program for Control of Rheumatic Diseases) methodology. The required data were obtained using the following instruments: (1) a screening for MSK disorders and rheumatic diseases; (2) a sociodemographic questionnaire; (3) a functional capacity Health Assessment Questionnaire Disability Index questionnaire; and (4) the quality of life EQ-5D-3L (EuroQoL) questionnaire. The rheumatologists working with the indigenous community were responsible for examining and treating study participants suffering from MSK disorders. RESULTS: The study sample comprised 2687 individuals, with mean age of 44 (SD, 19.9) years, 1690 (62.9%) of whom were women; Kichwa speakers comprised 32.4% (872), and 1244 (46.3%) reported MSK pain. The most prevalent conditions were as follows: low back pain (9.3%), hand osteoarthritis (OA, 7.2%), knee OA (6.5%), rheumatic regional pain syndrome (5.8%), fibromyalgia (1.8%), and rheumatoid arthritis (1.3%). Lower education level, unemployment, cooking with firewood, and rheumatic diseases were associated with a lower quality of life. CONCLUSIONS: Musculoskeletal disorders, rheumatic diseases, and rheumatoid arthritis were found to be highly prevalent in the studied population. Rheumatoid arthritis and hand OA had the most significant impact on the quality of life.

Hollow PdAg-CeO2 heterodimer nanocrystals as highly structured heterogeneous catalysts.

In the present work, hollow PdAg-CeO2 heterodimer nanocrystals (NCs) were prepared and tested as catalysts for the selective hydrogenation of alkynes. These nanostructures combine for the first time the beneficial effect of alloying Pd with Ag in a single NC hollow domain with the formation of active sites at the interface with the CeO2 counterpart in an additive manner. The PdAg-CeO2 NCs display excellent alkene selectivity for aliphatic alkynes. For the specific case of hydrogenation of internal alkynes such as 4-octyne, very low over-hydrogenation and isomerization products were observed over a full conversion regime, even after prolonged reaction times. These catalytic properties were remarkably superior in comparison to standard catalysts. The promotion of Ag on the moderation of the reactivity of the Pd phase, in combination with the creation of interfacial sites with the CeO2 moiety in the same nanostructure, is pointed as the responsible of such a remarkable catalytic performance.

A General One-Pot Methodology for the Preparation of Mono- and Bimetallic Nanoparticles Supported on Carbon Nanotubes: Application in the Semi-hydrogenation of Alkynes and Acetylene.

A facile and straightforward methodology for the preparation of monometallic (copper and palladium) and bimetallic nanocatalysts (NiCu and PdCu) stabilized by a N-heterocyclic carbene ligand is reported. Both colloidal and supported nanoparticles (NPs) on carbon nanotubes (CNTs) were prepared in a one-pot synthesis with outstanding control on their size, morphology and composition. These catalysts were evaluated in the selective hydrogenation of alkynes and alkynols. PdCu/CNTs revealed an efficient catalytic system providing high selectivity in the hydrogenation of terminal and internal alkynes. Moreover, this catalyst was tested in the semi-hydrogenation of acetylene in industrially relevant acetylene/ethylene-rich model gas feeds and showed excellent stability even after 40 h of reaction.

Nitrous Oxide and Ammonia Emissions from Cattle Excreta on Shortgrass Steppe.

Grazing cattle redistribute nitrogen (N) consumed in forage through urine and feces patches. The high concentration of N in these patches often exceeds the uptake demands of the local plant community, thereby providing ideal conditions for losses of reactive N. However, knowledge on nitrous oxide (NO) and ammonia (NH) emissions from excretal patches on shortgrass steppe grassland is limited. We studied the effect of cattle urine (1002 kg N ha) and feces (1021 kg N ha) patches on NO and NH emissions in two sites with contrasting vegetation: (i) cool-season (C3) 'Bozoisky-Select' Russian wildrye [ (Fisch.) Nevski], pasture (C3Past) and (ii) C4-dominated native shortgrass steppe rangeland (C4SS). Nitrous oxide and NH were measured using semi-static and semi-open chambers, respectively. Cumulative NO emissions were 217 and 173% greater and cumulative volatile NH emissions were 339 and 157% greater on C3Past compared with C4SS from the urine and feces treatments, respectively. Nitrous oxide emission factors were 0.20 and 0.05% for urine and 0.07 and 0.03% for feces on C3Past and C4SS, respectively. Our findings suggest that using the IPCC Tier 1 default emission factor (2%, 95% CI = 0.7-6%) to estimate NO emissions from cattle excretal patches on shortgrass steppe grassland would result in a significant overestimation for these dryland systems. Ammonia emission factors were 35 and 10% for urine and 7 and 5% for feces on C3Past and C4SS, respectively. With the exception of the urine treatment on C3Past, observed NH emissions were consistent with the IPCC Tier 1 default assumption that 20% (95% CI = 5-50%) of excretal N is volatilized as NH+NO.

Advances in the preparation of highly selective nanocatalysts for the semi-hydrogenation of alkynes using colloidal approaches.

In the last decade, the semi-hydrogenation of alkynes has experienced significant advances in terms of fine control of alkene selectivity and prevention of the over-hydrogenation reaction. Such advances have been possible to a large extent through the progress in colloidal methods for the preparation of metallic nanoparticles. The present review describes the contributions in the field of the selective hydrogenation of alkynes involving the utilization of colloidal methodologies. These approaches permit the fine modulation of several parameters affecting the catalytic performance of the active phase such as the particle size, the bulk and the surface structure and composition. For the transformation of liquid substrates, the nature of the stabilizers, the reducing agents and the metal precursors employed for the synthesis of the catalysts can be tuned to enhance the alkene selectivity. In contrast, in catalytic transformations of gaseous substrates, the presence of adsorbed species at the metal surface usually gives detrimental results while the interplay between the support and the active phase appears to be a more convincing alternative for catalyst tuning.

Effect of the Polymeric Stabilizer in the Aqueous Phase Fischer-Tropsch Synthesis Catalyzed by Colloidal Cobalt Nanocatalysts.

A series of small and well defined cobalt nanoparticles were synthesized by the chemical reduction of cobalt salts in water using NaBH4 as a reducing agent and using various polymeric stabilizers. The obtained nanocatalysts of similar mean diameters (ca. 2.6 nm) were fully characterized and tested in the aqueous phase Fischer-Tropsch Synthesis (AFTS). Interestingly, the nature and structure of the stabilizers used during the synthesis of the CoNPs affected the reduction degree of cobalt and the B-doping of these NPs and consequently, influenced the performance of these nanocatalysts in AFTS.

Morbimortalidad anestésica y sus factores de riesgo en pacientes con fractura de cadera / Anesthetic morbidity and mortality and risk factors in patients with hip fracture

Introducción: el envejecimiento poblacional condiciona incremento de la fractura de cadera y tratamiento quirúrgico consecuente.Objetivos: describir la morbimortalidad anestésica y sus factores de riesgo en pacientes con fractura de cadera. Métodos: se realizó estudio analítico longitudinal prospectivo en el Servicio de Anestesiología y Reanimación del Hospital Universitario Manuel Ascunce Domenech de Camagüey, de agosto de 2012 a agosto de 2013. El universo fue de 235 pacientes con fractura de cadera bajo intervención quirúrgica. La muestra quedó conformada por similar número de pacientes (población objetivo). Los datos fueron recogidos a propósito de la investigación con las variables de interés y procesados en SPSS. Se emplearon métodos de análisis estadístico univariado y multivariado. Resultados: las complicaciones intraoperatorias más frecuentes fueron hipotensión arterial y sangrado, mientras que en el posoperatorio fueron náuseas y vómitos, hipotensión arterial e isquemia miocárdica. Los valores de Odds ratio mostraron que los factores asociados a esas complicaciones fueron la presencia de anemia, evaluación ASA-III, momento quirúrgico mayor de 24 h, hipertensión arterial, cardiopatía isquémica y sangrado intraoperatorio. La mortalidad fue escasa por tromboembolismo pulmonar y el análisis de regresión logística determinó que los factores de mayor riesgo fueron laringoespasmo, hipertensión transoperatoria y evaluación ASA-III.Conclusiones: la morbilidad estuvo mediada por factores relacionados con las comorbilidades y estado general del paciente, el momento de la cirugia y las incidencias perioperatorias. La mortalidad fue dada por tromboembolismo pulmonar, con factores de riesgo asociados a eventos perioperatorios y estado del paciente(AU)

Introduction: Population aging conditions increased hip fracture and subsequent surgical treatment. Objectives: To describe the anesthetic morbidity and mortality and their risk factors in patients with hip fracture. Methods: A prospective, longitudinal, analytic, study was carried out in the Department of Anesthesiology of Manuel Ascunce Domenech University Hospital of Camagüey, from August 2012 to August 2013. The sample group was 235 patients with hip fracture and under surgical intervention. The sample was made up by the similar number of patients (target population). Data collection was performed on purpose of the research with the variable of interest and processed in SPSS. Univariate and multivariate methods of statistical analysis were used. Results: The most frequent intraoperative complications were hypotension and bleeding, while in the postoperative period there was a manifestation of nausea and vomits, hypotension and myocardial ischemia. Odds ratio values showed that the factors associated with these complications were the presence of anemia, ASA-III assessment, higher surgical time of 24 hours, hypertension, ischemic heart disease and intraoperative bleeding. Mortality for pulmonary embolism was low and logistic regression analysis determined that the major risk factors were laryngospasm, intraoperative hypertension, and ASA-III assessment.Conclusions: morbidity was mediated by factors related to comorbidities and the general condition of the patient, the time of surgery and the perioperative incidents. Mortality manifested due to pulmonary embolism, with risk factors associated with perioperative events and the patient's condition(AU)

Morbimortalidad anestésica y sus factores de riesgo en pacientes con fractura de cadera / Anesthetic morbidity and mortality and risk factors in patients with hip fracture

Introducción: el envejecimiento poblacional condiciona incremento de la fractura de cadera y tratamiento quirúrgico consecuente. Objetivos: describir la morbimortalidad anestésica y sus factores de riesgo en pacientes con fractura de cadera. Métodos: se realizó estudio analítico longitudinal prospectivo en el Servicio de Anestesiología y Reanimación del Hospital Universitario Manuel Ascunce Domenech de Camagüey, de agosto de 2012 a agosto de 2013. El universo fue de 235 pacientes con fractura de cadera bajo intervención quirúrgica. La muestra quedó conformada por similar número de pacientes (población objetivo). Los datos fueron recogidos a propósito de la investigación con las variables de interés y procesados en SPSS. Se emplearon métodos de análisis estadístico univariado y multivariado. Resultados: las complicaciones intraoperatorias más frecuentes fueron hipotensión arterial y sangrado, mientras que en el posoperatorio fueron náuseas y vómitos, hipotensión arterial e isquemia miocárdica. Los valores de Odds ratio mostraron que los factores asociados a esas complicaciones fueron la presencia de anemia, evaluación ASA-III, momento quirúrgico mayor de 24 h, hipertensión arterial, cardiopatía isquémica y sangrado intraoperatorio. La mortalidad por tromboembolismo pulmonar fue escasa y el análisis de regresión logística determinó que los factores de mayor riesgo fueron laringoespasmo, hipertensión transoperatoria y evaluación ASA-III. Conclusiones: la morbilidad estuvo mediada por factores relacionados con las comorbilidades y estado general del paciente, el momento de la cirugia y las incidencias perioperatorias. La mortalidad fue dada por tromboembolismo pulmonar, con factores de riesgo asociados a eventos perioperatorios y estado del paciente(AU)

Introduction: Population aging conditions increased hip fracture and subsequent surgical treatment. Objectives: To describe the anesthetic morbidity and mortality and their risk factors in patients with hip fracture. Methods: A prospective, longitudinal, analytic, study was carried out in the Department of Anesthesiology of Manuel Ascunce Domenech University Hospital of Camagüey, from August 2012 to August 2013. The sample group was 235 patients with hip fracture and under surgical intervention. The sample was made up by the similar number of patients (target population). Data collection was performed on purpose of the research with the variable of interest and processed in SPSS. Univariate and multivariate methods of statistical analysis were used. Results: The most frequent intraoperative complications were hypotension and bleeding, while in the postoperative period there was a manifestation of nausea and vomits, hypotension and myocardial ischemia. Odds ratio values showed that the factors associated with these complications were the presence of anemia, ASA-III assessment, higher surgical time of 24 hours, hypertension, ischemic heart disease and intraoperative bleeding. Mortality for pulmonary embolism was low and logistic regression analysis determined that the major risk factors were laryngospasm, intraoperative hypertension, and ASA-III assessment. Conclusions: morbidity was mediated by factors related to comorbidities and the general condition of the patient, the time of surgery and the perioperative incidents. Mortality manifested due to pulmonary embolism, with risk factors associated with perioperative events and the patient's condition(AU)

myPhyloDB: a local web server for the storage and analysis of metagenomic data.

myPhyloDB v.1.1.2 is a user-friendly personal database with a browser-interface designed to facilitate the storage, processing, analysis, and distribution of microbial community populations (e.g. 16S metagenomics data). MyPhyloDB archives raw sequencing files, and allows for easy selection of project(s)/sample(s) of any combination from all available data in the database. The data processing capabilities of myPhyloDB are also flexible enough to allow the upload and storage of pre-processed data, or use the built-in Mothur pipeline to automate the processing of raw sequencing data. myPhyloDB provides several analytical (e.g. analysis of covariance,t-tests, linear regression, differential abundance (DESeq2), and principal coordinates analysis (PCoA)) and normalization (rarefaction, DESeq2, and proportion) tools for the comparative analysis of taxonomic abundance, species richness and species diversity for projects of various types (e.g. human-associated, human gut microbiome, air, soil, and water) for any taxonomic level(s) desired. Finally, since myPhyloDB is a local web-server, users can quickly distribute data between colleagues and end-users by simply granting others access to their personal myPhyloDB database. myPhyloDB is available athttp://www.ars.usda.gov/services/software/download.htm?softwareid=472 and more information along with tutorials can be found on our websitehttp://www.myphylodb.org. Database URL:http://www.myphylodb.org.

Evaluación de las características morfológicas de la aurícula izquierda por tomografía computarizada multicorte / Determination of the anatomical characteristics of the left atrium by computed tomography

Objetivo: Describir las características morfológicas de la aurícula izquierda, las venas pulmonares y la orejuela mediante tomografía computarizada en pacientes con fibrilación auricular paroxística o persistente, así como su posible impacto en el aislamiento eléctrico de venas pulmonares y la exclusión percutánea de la orejuela izquierda. Métodos:Se revisaron las imágenes obtenidas mediante tomografía computarizada de todos los pacientes mayores de 18 años con fibrilación auricular paroxística o persistente, sometidos a ablación de venas pulmonares entre el 1o. de enero de 2011 y el 30 de junio de 2012. Se excluyeron aquellos con antecedentes de ablación previa de venas pulmonares, fibrilación auricular permanente y cirugía cardíaca previa. Se hizo reconstrucción multiplanar, reconstrucción tridimensional de la anatomía y reconstrucción endoluminal en casos seleccionados. Resultados: Se incluyeron 46 pacientes (37 hombres; 80,5%), con un promedio de edad de 59,7 ± 11,1 años (rango 22 a 81 años). Se encontró alta prevalencia de venas accesorias, en su mayoría derechas, y un solo caso de venas accesorias izquierdas. Así mismo, se halló mayor diámetro del ostium de las venas pulmonares en comparación con lo descrito previamente, y mayor distancia a la primera bifurcación. De 46 pacientes, 11 (24%) tuvieron un diámetro de la orejuela mayor de 28,5 mm y 9 (19,5%) un diámetro que superaba los 30 mm, puntos de corte establecidos para el uso de dispositivo de cierre de la orejuela. Conclusión:Existen diferencias poblacionales en el drenaje venoso pulmonar y en la anatomía, que deben tenerse en cuenta al realizar intervenciones para el manejo de la fibrilación auricular.

Objective: Describe the anatomical characteristics of the left atrium and pulmonary veins in patients with paroxysmal or persistent atrial fibrillation using computed tomography images and the possible impact these might have on pulmonary vein ablation and percutaneous left atrial appendage occlusion. Methods: Evaluation of computed tomography images from adult patients with paroxysmal or persistent atrial fibrillation who were treated with pulmonary vein ablation from January 1st, 2011 to June 30th 2012. Patients with previous cardiac surgery, pulmonary vein ablation or permanent atrial fibrillation were excluded. Multiplanar reconstrucion was performed in all patients, with three dimensional and endoluminal reconstruction performed in select patients. Results: Forty six patients (37 male, 80.5%) with a mean age of 59.7 ± 11.1 years (range: 22-81 years) were included. Accessory veins were common, most of them on the right side with only one case of left sided accessory vein. A larger size of the venous ostia and a longer distance from the ostia to the first bifurcation than previously described was found. A total of 11 patients (24%) had a left atrial appendage ostium diameter larger than 28.5 mm and 9 patients (19.5%) had a diameter larger than 30 mm, which is the maximum limit for the use of left atrial appendage devices. Conclusions:Anatomical characteristics of the left atrium and pulmonary veins have variations in different populations which should be taken into account prior to pulmonary vein ablation and left atrial appendage occlusion.

Chloral hydrate in pediatric magnetic resonance imaging: evaluation of a 10-year sedation experience administered by radiologists.

BACKGROUND: Chloral hydrate is a sedative that has been used for magnetic resonance imaging (MRI). OBJECTIVE: To evaluate the use, effectiveness and safety of chloral hydrate administered by radiologists for the sedation of children who require MRI procedures. MATERIALS AND METHODS: We retrospectively reviewed the clinical charts for all patients ages 0 - 10 years old who underwent sedation with chloral hydrate for MRI from January 2000 to December 2010. Demographic factors, dose information, indication for MRI, therapeutic failures and adverse reactions to the drug were reviewed. RESULTS: One thousand, seven hundred and three children (946 males, 757 females) with a median age of 2.5 years (range: 4 days - 9.91 years) received chloral hydrate. Moderate to deep sedation was achieved in 1,618/1,703 (95%) of the patients, 35/1,703 (2.1%) of the patients failed to achieve moderate to deep sedation, and 47/1,703 (2.8%) of the patients woke up during MRI examination. Adverse reactions were present in 31/1,703 (1.8%) of the patients. Three severe adverse reactions occurred (0.18%). A single dose of chloral hydrate (40-60 mg/kg) was administered to 1,477/1,703 patients (86.7%). An additional dose of chloral hydrate (10-20 mg/kg), given 15 min after the first dose or when the patient woke up during the MRI examination, was required in 226/1,703 patients (13.3%). The likelihood of requiring an additional dose in children older than 2 years was 2.2 times the likelihood compared to children younger than 2 years (OR = 2.2 [95%CI: 1.6-3.0]). The use of a reduced dose (<50 mg/kg) was not associated with a higher therapeutic failure rate (OR = 1.04 [95%CI 0.57-1.89]). CONCLUSION: Chloral hydrate is an appropriate sedation option for pediatric patients in MRI services when strict patient selection criteria are met. The use of a reduced dose does not affect the effectiveness of sedation. The lack of data regarding the presence of transient oxygen desaturation, the time to induce sedation and the exact duration of sedation are limitations of this study.

Assessment of cardiac volumes using an isotropic whole-heart dual cardiac phase sequence in pediatric patients.

PURPOSE: To evaluate the accuracy of a three-dimensional dual phase (3D DP) whole-heart technique for cardiac volumetric assessment in pediatric patients with cardiac abnormalities. MATERIALS AND METHODS: The institutional approved this study, and informed consent was obtained from patients or their guardians. This prospective study involved 31 pediatric patients (mean age, 7.9 years; range, 15 days to 15 years) for the assessment of cardiac abnormalities using cardiovascular MR. A standard protocol was performed for assessing cardiac anatomy and function. For evaluating the 3D DP technique, statistical comparison with a 2D cine multi-slice technique (2D steady-state free-precession [SSFP]) was performed using linear regression, intraclass correlation coefficient, and Bland Altman plots. RESULTS: Left (LV) and right (RV) ventricular cardiac volumes obtained with the 3D DP technique were in strong agreement with those obtained with the 2D SSFP technique for small and large ventricular volumes. The intraclass correlation coefficients (ICC) between both techniques were 0.992 for the LV end-diastolic volume (EDV), 0.983 for the LV end-systolic volume (ESV), 0.952 for the LV-systolic volume (SV), 0.992 for the RV-EDV, 0.992 for the RV-ESV, 0.928 for the RV-SV. Interobserver analysis indicated good reproducibility for both the 2D SSFP and the 3D DP techniques. CONCLUSION: The 3D DP technique provides as accurate cardiac volumes as the 2D SSFP technique in the pediatric population, but with the added benefits of easier data acquisition and detailed anatomical information of the whole heart and great vessels in a single free-breathing scan.

[Correlation between the magnetic resonance imaging morphometry and the clinical and electroencephalographic findings in patients diagnosed with ulegyria and epilepsy]. / Correlación de la morfometría por resonancia magnética con los hallazgos clínicos y electroencefalográficos de pacientes con diagnóstico de ulegiria y epilepsia.

INTRODUCTION: Ulegyria is a cortical lesion affecting neighbouring vascular zones, which gives the convolutions a mushroom-like appearance. It is an important cause of occipital epilepsy. AIM. To correlate patients diagnosed clinically, electrically and morphometrically with ulegyria and epilepsy by comparing the thickness of the cortex in the zones affected by ulegyria with the normal cortical thickness reported in the literature and the average cortical thickness of healthy subjects. PATIENTS AND METHODS: Ten patients with ulegyria confirmed by magnetic resonance imaging were included in the study; all of them were submitted to a clinical interview, an electroencephalographic study and cortical morphometric analysis based on volumetric T1 sequences. RESULTS: Findings included a predominance in males, neurodevelopmental retardation and epilepsy. Ulegyria was mainly parietooccipital, frequently bilateral, with statistically significant thinning of the cortical thickness in the site of the lesion and an increase in the thickness of the cortex in the areas surrounding the lesion. CONCLUSIONS: We report on a series of patients with ulegyria with characteristics similar to those existing in the literature and by means of morphometry we detected an increase in the thickness of the cortex around the areas affected by ulegyria. These findings could point to the presence of adaptive neuroplasticity in the neurons that surround the scar tissue or they may be the result of mechanical changes of normal tissue in response to the loss of volume of the ulegyria-affected area, although these data need to be replicated in a study with a greater number of patients.

Correlación de la morfometría por resonancia magnética con los hallazgos clínicos y electroencefalográficos de pacientes con diagnóstico de ulegiria y epilepsia / Correlation between the magnetic resonance imaging morphometry and the clinical and electroencephalographic findings in patients diagnosed with ulegyria and epilepsy

Introducción. La ulegiria es una lesión cortical propia de zonas vasculares limítrofe, que da a las circunvoluciones unaspecto de hongo. Es una causa importante de epilepsia occipital. Objetivo. Correlacionar clínica, eléctrica y morfométricamente a los pacientes con diagnóstico de ulegiria y epilepsia comparando el espesor cortical de las zonas ulegíricas con el espesor cortical normal comunicado en la bibliografía y el promediodel espesor cortical de sujetos sanos.Pacientes y métodos. Se incluyeron diez pacientes con ulegiria comprobada imaginológicamente con resonancia magnética,los cuales se sometieron a una entrevista clínica, un estudio electroencefalográfico y un análisis morfométrico cortical a partir de secuencias T1 volumétricas. Resultados. Encontramos un predominio del sexo masculino, retraso en el neurodesarrollo y epilepsia. La ulegiria fueen su mayoría parietooccipital, frecuentemente bilateral, con adelgazamiento del espesor cortical en el sitio de la lesiónsignificativamente estadístico y aumento del grosor de la corteza en las zonas periféricas a la lesión.Conclusión. Describimos una serie de pacientes con ulegiria con características similares a las existentes en la bibliografíay detectamos en morfometría un aumento en el espesor cortical que rodea las zonas ulegíricas. Estos hallazgos podrían indicar bien la presencia de neuroplasticidad adaptativa en las neuronas que rodean el tejido cicatricial o el resultado de cambios mecánicos del tejido normal en respuesta a la pérdida de volumen de la zona ulegírica, datos que se deben replicaren un estudio con un mayor número de pacientes (AU)

Introduction. Ulegyria is a cortical lesion affecting neighbouring vascular zones, which gives the convolutions a mushroomlikeappearance. It is an important cause of occipital epilepsy. Aim. To correlate patients diagnosed clinically, electrically and morphometrically with ulegyria and epilepsy by comparing the thickness of the cortex in the zones affected by ulegyria with the normal cortical thickness reported in the literatureand the average cortical thickness of healthy subjects. Patients and methods. Ten patients with ulegyria confirmed by magnetic resonance imaging were included in the study;all of them were submitted to a clinical interview, an electroencephalographic study and cortical morphometric analysisbased on volumetric T1 sequences.Results. Findings included a predominance in males, neurodevelopmental retardation and epilepsy. Ulegyria was mainlyparietooccipital, frequently bilateral, with statistically significant thinning of the cortical thickness in the site of the lesion and an increase in the thickness of the cortex in the areas surrounding the lesion. Conclusions. We report on a series of patients with ulegyria with characteristics similar to those existing in the literature and by means of morphometry we detected an increase in the thickness of the cortex around the areas affected byulegyria. These findings could point to the presence of adaptive neuroplasticity in the neurons that surround the scar tissue or they may be the result of mechanical changes of normal tissue in response to the loss of volume of the legyriaaffectedarea, although these data need to be replicated in a study with a greater number of patients (AU)

Informatics in radiology: use of CouchDB for document-based storage of DICOM objects.

Picture archiving and communication systems traditionally have depended on schema-based Structured Query Language (SQL) databases for imaging data management. To optimize database size and performance, many such systems store a reduced set of Digital Imaging and Communications in Medicine (DICOM) metadata, discarding informational content that might be needed in the future. As an alternative to traditional database systems, document-based key-value stores recently have gained popularity. These systems store documents containing key-value pairs that facilitate data searches without predefined schemas. Document-based key-value stores are especially suited to archive DICOM objects because DICOM metadata are highly heterogeneous collections of tag-value pairs conveying specific information about imaging modalities, acquisition protocols, and vendor-supported postprocessing options. The authors used an open-source document-based database management system (Apache CouchDB) to create and test two such databases; CouchDB was selected for its overall ease of use, capability for managing attachments, and reliance on HTTP and Representational State Transfer standards for accessing and retrieving data. A large database was created first in which the DICOM metadata from 5880 anonymized magnetic resonance imaging studies (1,949,753 images) were loaded by using a Ruby script. To provide the usual DICOM query functionality, several predefined "views" (standard queries) were created by using JavaScript. For performance comparison, the same queries were executed in both the CouchDB database and a SQL-based DICOM archive. The capabilities of CouchDB for attachment management and database replication were separately assessed in tests of a similar, smaller database. Results showed that CouchDB allowed efficient storage and interrogation of all DICOM objects; with the use of information retrieval algorithms such as map-reduce, all the DICOM metadata stored in the large database were searchable with only a minimal increase in retrieval time over that with the traditional database management system. Results also indicated possible uses for document-based databases in data mining applications such as dose monitoring, quality assurance, and protocol optimization.

Meningioma intraventricular del trígono derecho: reporte de un caso / Intraventricular meningioma of the right trigone: a case report

Los meningiomas son tumores originados de las cubiertas aracnoideas. La localización intraventricular es rara especialmente los originados en el trígono ventricular derecho. Objetivo: reportar un caso de localización atípica de un meningioma intracraneal. Caso clínico: paciente femenina de 68 años con historia de crisis cerebrales focales y cefalea de un mes de evolución, los estudios de Resonancia Nuclear Magnética muestran una lesión localizada en el trígono derecho. Se realiza abordaje quirúrgico directo y excéresis total. El resultado patológico demostró un Meningioma fibroblástico. Conclusiones: El abordaje y excéresis de meningiomas intraventriculares puede ser llevado a cabo exitosamente y en ausencia de complicaciones importantes.

Meningiomas are tumors originated from arachnoidal membranes. Its intraventricular location is uncommon especially the originated in the right ventricular trigone. Objective: to report a case of atypical localization of intracranial meningioma. Case report: a female patient of 68-year old with history of focal brain crisis and headache of a month of evolution. Nuclear magnetic resonance studies show a lesion in the right trigone. Direct surgical approach and total exeresis was carried out. The pathological result showed a fibroblastic meningioma. Conclusions: the surgical approach and exeresis of intraventricular meningioma may be carried out successfully with no significant complications.

Meningioma intraventricular del trígono derecho: reporte de un caso / Intraventricular meningioma of the right trigone: a case report

Los meningiomas son tumores originados de las cubiertas aracnoideas. La localización intraventricular es rara especialmente los originados en el trígono ventricular derecho. Objetivo: reportar un caso de localización atípica de un meningioma intracraneal. Caso clínico: paciente femenina de 68 años con historia de crisis cerebrales focales y cefalea de un mes de evolución, los estudios de Resonancia Nuclear Magnética muestran una lesión localizada en el trígono derecho. Se realiza abordaje quirúrgico directo y excéresis total. El resultado patológico demostró un Meningioma fibroblástico. Conclusiones: El abordaje y excéresis de meningiomas intraventriculares puede ser llevado a cabo exitosamente y en ausencia de complicaciones importantes (AU)

Meningiomas are tumors originated from arachnoidal membranes. Its intraventricular location is uncommon especially the originated in the right ventricular trigone. Objective: to report a case of atypical localization of intracranial meningioma. Case report: a female patient of 68-year old with history of focal brain crisis and headache of a month of evolution. Nuclear magnetic resonance studies show a lesion in the right trigone. Direct surgical approach and total exeresis was carried out. The pathological result showed a fibroblastic meningioma. Conclusions: the surgical approach and exeresis of intraventricular meningioma may be carried out successfully with no significant complications (AU)

Factores predictivos de la evolución en pacientes con lesiones intracraneales tratados por método estereotáctico en Camagüey / Predictive factors for the evolution in patients treated with stereotactic technique in Camagüey

El tratamiento de lesiones intracraneales mediante técnicas estereotácticas se ha incrementado en la actualidad como parte de las técnicas de mínima invasión. Objetivo: caracterizar el comportamiento de los pacientes tratados por este método. Método: se realizó un estudio analítico longitudinal y prospectivo en la sala de neurocirugía del Hospital Universitario Manuel Ascunce Domenech. El universo estuvo constituido por 110 pacientes sometidos a proceder estereotáctico desde febrero de 2007 hasta septiembre de 2010. La muestra de tipo no probabilístico, coincidió con el universo. Para la recolección de datos se confeccionó una encuesta y se utilizaron técnicas univariadas y multivariadas de procesamiento de datos. Resultados: predominaron pacientes masculinos entre 31 y 60 años con lesiones profundas de origen glial. Los factores que influyeron en la evolución fueron alteración de consciencia, hipertensión endocraneana y lesiones que desviaban la línea media. Conclusiones: se identificaron los factores que influyeron en la evolución de los pacientes.

The treatment of intracranial lesions by stereotactic techniques has increased today as part of minimal invasive surgical techniques. Objective: to characterize the behavior of patients treated by this method. Method: a longitudinal and prospective analytical study was conducted in the neurosurgical ward at the University Hospital Manuel Ascunce Domenech. The universe was made up of 110 patients subject to stereotactic procedure from February 2007 to September 2010. Non probabilistic-type sample was used and it coincided with the universe. A survey was made for data collecting, multivariate and univariate techniques of data processing were used. Results: male patients between 31 and 60 years old with deep lesions of glial origin prevailed. Factors that influenced in the evolution of patients were consciousness disturbances, endocranial hypertension and midline shift lesions. Conclusions: factors that influenced in the evolution of patients were identified.

Factores predictivos de la evolución en pacientes con lesiones intracraneales tratados por método estereotáctico en Camagüey / Predictive factors for the evolution in patients treated with stereotactic technique in Camagüey

El tratamiento de lesiones intracraneales mediante técnicas estereotácticas se ha incrementado en la actualidad como parte de las técnicas de mínima invasión. Objetivo: caracterizar el comportamiento de los pacientes tratados por este método. Método: se realizó un estudio analítico longitudinal y prospectivo en la sala de neurocirugía del Hospital Universitario Manuel Ascunce Domenech. El universo estuvo constituido por 110 pacientes sometidos a proceder estereotáctico desde febrero de 2007 hasta septiembre de 2010. La muestra de tipo no probabilístico, coincidió con el universo. Para la recolección de datos se confeccionó una encuesta y se utilizaron técnicas univariadas y multivariadas de procesamiento de datos. Resultados: predominaron pacientes masculinos entre 31 y 60 años con lesiones profundas de origen glial. Los factores que influyeron en la evolución fueron alteración de consciencia, hipertensión endocraneana y lesiones que desviaban la línea media. Conclusiones: se identificaron los factores que influyeron en la evolución de los pacientes (AU)

The treatment of intracranial lesions by stereotactic techniques has increased today as part of minimal invasive surgical techniques. Objective: to characterize the behavior of patients treated by this method. Method: a longitudinal and prospective analytical study was conducted in the neurosurgical ward at the University Hospital Manuel Ascunce Domenech. The universe was made up of 110 patients subject to stereotactic procedure from February 2007 to September 2010. Non probabilistic-type sample was used and it coincided with the universe. A survey was made for data collecting, multivariate and univariate techniques of data processing were used. Results: male patients between 31 and 60 years old with deep lesions of glial origin prevailed. Factors that influenced in the evolution of patients were consciousness disturbances, endocranial hypertension and midline shift lesions. Conclusions: factors that influenced in the evolution of patients were identified (AU)