A Computational Study on the Role of Parameters for Identification of Thyroid Nodules by Infrared Images (and Comparison with Real Data).

According to experts and medical literature, healthy thyroids and thyroids containing benign nodules tend to be less inflamed and less active than those with malignant nodules. It seems to be a consensus that malignant nodules have more blood veins and more blood circulation. This may be related to the maintenance of the nodule's heat at a higher level compared with neighboring tissues. If the internal heat modifies the skin radiation, then it could be detected by infrared sensors. The goal of this work is the investigation of the factors that allow this detection, and the possible relation with any pattern referent to nodule malignancy. We aim to consider a wide range of factors, so a great number of numerical simulations of the heat transfer in the region under analysis, based on the Finite Element method, are performed to study the influence of each nodule and patient characteristics on the infrared sensor acquisition. To do so, the protocol for infrared thyroid examination used in our university's hospital is simulated in the numerical study. This protocol presents two phases. In the first one, the body under observation is in steady state. In the second one, it is submitted to thermal stress (transient state). Both are simulated in order to verify if it is possible (by infrared sensors) to identify different behavior referent to malignant nodules. Moreover, when the simulation indicates possible important aspects, patients with and without similar characteristics are examined to confirm such influences. The results show that the tissues between skin and thyroid, as well as the nodule size, have an influence on superficial temperatures. Other thermal parameters of thyroid nodules show little influence on surface infrared emissions, for instance, those related to the vascularization of the nodule. All details of the physical parameters used in the simulations, characteristics of the real nodules and thermal examinations are publicly available, allowing these simulations to be compared with other types of heat transfer solutions and infrared examination protocols. Among the main contributions of this work, we highlight the simulation of the possible range of parameters, and definition of the simulation approach for mapping the used infrared protocol, promoting the investigation of a possible relation between the heat transfer process and the data obtained by infrared acquisitions.

Nasal airflow simulations suggest convergent adaptation in Neanderthals and modern humans.

Both modern humans (MHs) and Neanderthals successfully settled across western Eurasian cold-climate landscapes. Among the many adaptations considered as essential to survival in such landscapes, changes in the nasal morphology and/or function aimed to humidify and warm the air before it reaches the lungs are of key importance. Unfortunately, the lack of soft-tissue evidence in the fossil record turns difficult any comparative study of respiratory performance. Here, we reconstruct the internal nasal cavity of a Neanderthal plus two representatives of climatically divergent MH populations (southwestern Europeans and northeastern Asians). The reconstruction includes mucosa distribution enabling a realistic simulation of the breathing cycle in different climatic conditions via computational fluid dynamics. Striking across-specimens differences in fluid residence times affecting humidification and warming performance at the anterior tract were found under cold/dry climate simulations. Specifically, the Asian model achieves a rapid air conditioning, followed by the Neanderthals, whereas the European model attains a proper conditioning only around the medium-posterior tract. In addition, quantitative-genetic evolutionary analyses of nasal morphology provided signals of stabilizing selection for MH populations, with the removal of Arctic populations turning covariation patterns compatible with evolution by genetic drift. Both results indicate that, departing from important craniofacial differences existing among Neanderthals and MHs, an advantageous species-specific respiratory performance in cold climates may have occurred in both species. Fluid dynamics and evolutionary biology independently provided evidence of nasal evolution, suggesting that adaptive explanations regarding complex functional phenotypes require interdisciplinary approaches aimed to quantify both performance and evolutionary signals on covariation patterns.

An Infrared Thermal Images Database and a New Technique for Thyroid Nodules Analysis.

Thyroid nodules diseases are a common health problem and thyroidal cancer is becoming increasingly prevalent. They appear in the neck and bottom neck region, superficially over the trachea. Cancer tissues are characterized by higher temperatures than surrounding tissues. Thermography is a diagnostic tool increasingly used to detect cancer and abnormalities. Artificial intelligence is an approach which can be applied to thyroid nodules classification, but is necessary to have a proper number of cases with proven diagnosis. In this paper, a new database that contain infrared thermal images, clinical and physiological data is presented. The description of each nodule per patient, and the acquisition protocol (based on Dynamic Infrared Thermography approach) is considered as well. A semi-automatic method for image registration was implemented to pre-process the thermograms and a new method for the Region of Interest (ROI) extraction is proposed. Moreover, the obtained ROI results are confirmed by medical specialists and turned available for future comparison with other works.

Efecto biológico de la recuperación nutricional en las concentraciones séricas de citocinas inflamatorias en el niño desnutrido grave / Biological effect of nutritional recovery on serum concentrations of inflammation cytokines in the malnourished child

El niño con desnutrición grave tiene una disfunción de la respuesta inmune que puede aumentar de manera significativa la morbilidad y la mortalidad por infecciones. El objetivo de la presente investigación fue evaluar el efecto de la recuperación nutricional en las concentraciones séricas de citocinas inflamatorias; tales como: interleucina 12 (IL-12), interleucina 17 (IL-17), interferón gamma (IFN-γ) y factor de necrosis tumoral alfa (TNF-α). En un estudio de tipo prospectivo y longitudinal, se seleccionó la población con base a criterios clínicos y antropométricos, constituida por 24 niños desnutridos graves en edades comprendidas entre 1 y 2 años, quienes formaban parte de un programa de recuperación nutricional. La concentración sérica de las citocinas investigadas se determinó antes y después del tratamiento nutricional, empleando la técnica de Inmunoanálisis Enzimático (ELISA) de doble anticuerpo. Para establecer comparaciones se utilizó la t de Student, y se consideró una p<0,05 como estadísticamente significante. Se observó una diferencia en las concentraciones de IL-12, IL-17, IFN-γ y TNF-α antes y después del tratamiento (p<0,05), lo cual parece indicar que la desnutrición per se provoca un estado inflamatorio y que 2 meses de apoyo nutricional intensivo, favorecen no solo la recuperación clínica del niño desnutrido grave, sino también la recuperación de su respuesta inmunitaria en cuanto a la producción de mediadores solubles como son las citocinas.

Children with severe malnutrition have a dysfunction of the immune response that can significantly increase morbidity and mortality from infections. The aim of this investigation was to evaluate the effect of nutritional recovery in serum measurements of inflammatory cytokines; such as interleukin 12 (IL-12), interleukin 17 (IL-17), interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α). In a prospective and longitudinal study, 24 severe malnourished children aged between 1 and 2 years-old, who were part of a program of nutritional recovery, were selected based on clinical and anthropometric criteria. Serum measurements of cytokines were determined before and after dietary treatment, using the technique of sandwich Enzyme-Linked ImmunoSorbent Assay (ELISA). For comparisons, Student’s t test was used, considered p <0.05 as statistically significant. A difference was observed in the concentrations of IL-12, IL-17, IFN-γ and TNF-α before and after treatment (p <0.05), which suggests that malnutrition provokes an inflammatory state and two months of intensive nutritional support, not only promotes the clinical recovery of severe malnourished children, but also the recovery of the immune response with regard to the production of soluble mediators, such as cytokines.

Biological effect of nutritional recovery on serum concentrations of inflammation cytokines in the malnourished child. / Efecto biológico de la recuperación nutricional en las concentraciones séricas de citocinas inflamatorias en el niño desnutrido grave.

Children with severe malnutrition have a dysfunction of the immune response that can significantly increase morbidity and mortality from infections. The aim of this investigation was to evaluate the effect of nutritional recovery in serum measurements of inflammatory cytokines; such as interleukin 12 (IL-12), interleukin 17 (IL-17), interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α). In a prospective and longitudinal study, 24 severe malnourished children aged between 1 and 2 years-old, who were part of a program of nutritional recovery, were selected based on clinical and anthropometric criteria. Serum measurements of cytokines were determined before and after dietary treatment, using the technique of sandwich Enzyme-Linked ImmunoSorbent Assay (ELISA). For comparisons, Student's t test was used, considered p <0.05 as statistically significant. A difference was observed in the concentrations of IL-12, IL-17, IFN-γ and TNF-α before and after treatment (p <0.05), which suggests that malnutrition provokes an inflammatory state and two months of intensive nutritional support, not only promotes the clinical recovery of severe malnourished children, but also the recovery of the immune response with regard to the production of soluble mediators, such as cytokines.

Función renal y tromboprofilaxis en pacientes con fractura de cadera / Renal function and thromboprophylaxis in patients with hip fractures

Objetivos: demostrar que la determinación de creatinina sérica por sí sola no permite conocer la función renal, necesitándose la realización de una tasa de filtración glomerular, mediante una ecuación que utilice el valor de creatinina sérica obtenido y las variables edad, sexo y raza. Desarrollar el sistema computarizado Nefrocalc que permite conocer de forma rápida el valor estimado de filtración glomerular.Métodos: se realizó un estudio retrospectivo de 100 pacientes que se habían operado por fractura de cadera, en los cuales se utilizó un compuesto de heparina como profilaxis antitrombótica; se usó dosis uniforme. Las dosis de anticoagulantes se ajustaron en casos de daño renal, el cual se demostró midiendo la función renal.Resultados: pudo demostrarse que los pacientes del estudio ancianos en su mayoría tuvieron una declinación de la tasa de filtración glomerular demostrativa de insuficiencia renal, considerándose que debió hacerse ajuste de la dosis de heparina, en aquellos pacientes afectos de insuficiencia renal moderada.Conclusiones: la concentración de creatinina sérica no brindó la posibilidad de evaluar la función renal, pero la tasa de filtración glomerular sí resultó el mejor índice para evaluar esa función; este índice pudo ser estimado a partir de una ecuación con las variables edad, sexo, raza y la concentración sérica de creatinina, mediante el sistema computarizado NEFROCALC. En pacientes ancianos, cuando los valores de tasa de filtración glomerular denotaron disminución moderada de la función, debió ajustarse la dosis del anticoagulante. No se recomendó su utilización en pacientes con disminución severa del filtrado glomerular(AU)

Objectives: demonstrate that serum creatinine determination alone is not enough to know about renal function, and that it is necessary to estimate the glomerular filtration rate through an equation including the serum creatinine value obtained and also the variables age, sex and race. Develop the computerized system NEFROCALC to quickly estimate glomerular filtration.Methods: a retrospective study was conducted of 100 patients undergoing hip fracture surgery who were given a heparin compound as antithrombotic prophylaxis. A uniform dosage was used. Doses of anticoagulants were adjusted in cases of renal damage, which was determined by measuring renal function.Results: it was found that the patients under study most of whom were elderly persons showed a decline in the glomerular filtration rate signaling renal failure, leading to the conclusion that the heparin dose should have been adjusted in patients with moderate renal failure.Conclusions: serum creatinine concentration did not make it possible to evaluate renal function. The best value to evaluate renal function was the glomerular filtration rate, which could be estimated through an equation including the variables age, sex, race and serum creatinine concentration using the computerized system NEFROCALC. The dose of anticoagulant should have been adjusted in elderly patients with glomerular filtration rates signaling moderate renal failure. Its use was not recommended in patients with a severe decline in glomerular filtration(AU)

Función renal y tromboprofilaxis en pacientes con fractura de cadera / Renal function and thromboprophylaxis in patients with hip fractures

Objetivos: demostrar que la determinación de creatinina sérica por sí sola no permite conocer la función renal, necesitándose la realización de una tasa de filtración glomerular, mediante una ecuación que utilice el valor de creatinina sérica obtenido y las variables edad, sexo y raza. Desarrollar el sistema computarizado Nefrocalc que permite conocer de forma rápida el valor estimado de filtración glomerular. Métodos: se realizó un estudio retrospectivo de 100 pacientes que se habían operado por fractura de cadera, en los cuales se utilizó un compuesto de heparina como profilaxis antitrombótica; se usó dosis uniforme. Las dosis de anticoagulantes se ajustaron en casos de daño renal, el cual se demostró midiendo la función renal. Resultados: pudo demostrarse que los pacientes del estudio ancianos en su mayoría tuvieron una declinación de la tasa de filtración glomerular demostrativa de insuficiencia renal, considerándose que debió hacerse ajuste de la dosis de heparina, en aquellos pacientes afectos de insuficiencia renal moderada. Conclusiones: la concentración de creatinina sérica no brindó la posibilidad de evaluar la función renal, pero la tasa de filtración glomerular sí resultó el mejor índice para evaluar esa función; este índice pudo ser estimado a partir de una ecuación con las variables edad, sexo, raza y la concentración sérica de creatinina, mediante el sistema computarizado NEFROCALC. En pacientes ancianos, cuando los valores de tasa de filtración glomerular denotaron disminución moderada de la función, debió ajustarse la dosis del anticoagulante. No se recomendó su utilización en pacientes con disminución severa del filtrado glomerular(AU)

Objectives: demonstrate that serum creatinine determination alone is not enough to know about renal function, and that it is necessary to estimate the glomerular filtration rate through an equation including the serum creatinine value obtained and also the variables age, sex and race. Develop the computerized system NEFROCALC to quickly estimate glomerular filtration. Methods: a retrospective study was conducted of 100 patients undergoing hip fracture surgery who were given a heparin compound as antithrombotic prophylaxis. A uniform dosage was used. Doses of anticoagulants were adjusted in cases of renal damage, which was determined by measuring renal function. Results: it was found that the patients under study most of whom were elderly persons showed a decline in the glomerular filtration rate signaling renal failure, leading to the conclusion that the heparin dose should have been adjusted in patients with moderate renal failure. Conclusions: serum creatinine concentration did not make it possible to evaluate renal function. The best value to evaluate renal function was the glomerular filtration rate, which could be estimated through an equation including the variables age, sex, race and serum creatinine concentration using the computerized system NEFROCALC. The dose of anticoagulant should have been adjusted in elderly patients with glomerular filtration rates signaling moderate renal failure. Its use was not recommended in patients with a severe decline in glomerular filtration(AU)

Función renal y tromboprofilaxis en pacientes con fractura de cadera / Fonction rénale et thrombo-prophylaxie chez les patients atteints de fracture de hanche / Renal function and thromboprophylaxis in patients with hip fractures

Objetivos: demostrar que la determinación de creatinina sérica por sí sola no permite conocer la función renal, necesitándose la realización de una tasa de filtración glomerular, mediante una ecuación que utilice el valor de creatinina sérica obtenido y las variables edad, sexo y raza. Desarrollar el sistema computarizado Nefrocalc que permite conocer de forma rápida el valor estimado de filtración glomerular. Métodos: se realizó un estudio retrospectivo de 100 pacientes que se habían operado por fractura de cadera, en los cuales se utilizó un compuesto de heparina como profilaxis antitrombótica; se usó dosis uniforme. Las dosis de anticoagulantes se ajustaron en casos de daño renal, el cual se demostró midiendo la función renal. Resultados: pudo demostrarse que los pacientes del estudio ancianos en su mayoría tuvieron una declinación de la tasa de filtración glomerular demostrativa de insuficiencia renal, considerándose que debió hacerse ajuste de la dosis de heparina, en aquellos pacientes afectos de insuficiencia renal moderada. Conclusiones: la concentración de creatinina sérica no brindó la posibilidad de evaluar la función renal, pero la tasa de filtración glomerular sí resultó el mejor índice para evaluar esa función; este índice pudo ser estimado a partir de una ecuación con las variables edad, sexo, raza y la concentración sérica de creatinina, mediante el sistema computarizado NEFROCALC. En pacientes ancianos, cuando los valores de tasa de filtración glomerular denotaron disminución moderada de la función, debió ajustarse la dosis del anticoagulante. No se recomendó su utilización en pacientes con disminución severa del filtrado glomerular(AU)

Objectives: demonstrate that serum creatinine determination alone is not enough to know about renal function, and that it is necessary to estimate the glomerular filtration rate through an equation including the serum creatinine value obtained and also the variables age, sex and race. Develop the computerized system NEFROCALC to quickly estimate glomerular filtration. Methods: a retrospective study was conducted of 100 patients undergoing hip fracture surgery who were given a heparin compound as antithrombotic prophylaxis. A uniform dosage was used. Doses of anticoagulants were adjusted in cases of renal damage, which was determined by measuring renal function. Results: it was found that the patients under study most of whom were elderly persons showed a decline in the glomerular filtration rate signaling renal failure, leading to the conclusion that the heparin dose should have been adjusted in patients with moderate renal failure. Conclusions: serum creatinine concentration did not make it possible to evaluate renal function. The best value to evaluate renal function was the glomerular filtration rate, which could be estimated through an equation including the variables age, sex, race and serum creatinine concentration using the computerized system NEFROCALC. The dose of anticoagulant should have been adjusted in elderly patients with glomerular filtration rates signaling moderate renal failure. Its use was not recommended in patients with a severe decline in glomerular filtration(AU)

Objectifs: démontrer que la seule mesure de la créatinine sérique ne permet pas de connaître la fonction rénale, qu'il faut aussi mesurer le taux de filtration glomérulaire au moyen d'une équation utilisant la valeur de créatinine sérique obtenue et les variables telles que l'âge, le sexe et la race. Mettre en application le système assisté par ordinateur Nefrocalc permettant de connaître rapidement la valeur estimée de filtration glomérulaire. Méthodes: une étude rétrospective de 100 patients opérés de fracture de hanche, dont leur traitement a utilisé un composé d'héparine comme prophylaxie anti-thrombotique, a été effectuée. Les doses d'anticoagulants ont été ajustées en cas de défaillance rénale, laquelle a été confirmée en mesurant la fonction rénale. Résultats: on a démontré que les patients de l'étude des personnes âgées en majorité- ont eu une diminution du taux de filtration glomérulaire ce qui a démontré la défaillance rénale. Un ajustement de la dose d'héparine a été considéré chez les patients atteints de défaillance rénale modérée. Conclusions: la concentration de créatine sérique n'a pas permis d'évaluer la fonction rénale, mais le taux de filtration glomérulaire a été le meilleur indice pour évaluer cette fonction ; cet indice a pu être estimé à partir d'une équation avec des variables telles que l'âge, le sexe, la race, et de la concentration sérique de créatinine, au moyen du système assisté par ordinateur NEFROCALC. Lorsque les taux de filtration glomérulaire ont indiqué une diminution modérée de la fonction chez les patients âgés, la dose de l'anticoagulant a dû être ajustée. Son utilisation a été déconseillée chez les patients dont leur taux de filtration glomérulaire a diminué(AU)

Fórmula De Marco y su efecto sobre la microalbuminuria en pacientes con manifestaciones clínicas de pie diabético isquémico infectado / De Marco formula and its effects on microalbuminuria in patients presenting with clinical manifestations of infected ischemic diabetic foot

Se realizó un ensayo clínico a doble ciegas en pacientes con pie diabético isquémico infectado, que presentaron microalbuminuria. Un grupo recibió tratamiento convencional y fórmula De Marco y el otro, tratamiento convencional, para evaluar la eficacia del tratamiento sobre la microalbuminuria, independiente de la lesión del pie. Se determinó concentración de excreción de albúmina, creatinina en orina y suero, hemoglobina glicosilada, glicemia y filtrado glomerular, antes y después del tratamiento en ambos grupos. Se obtuvo una disminución significativamente estadística de la microalbuminuria, mayor en mujeres. Se concluye que la terapéutica con la fórmula De Marco disminuye la microalbuminuria y la hemoglobina glicosilada en pacientes con pie diabético isquémico infectado, independiente de la lesión del pie(AU)

A double-blind clinical assay was carried out in patients with infected ischemic diabetic foot, who presented with microalbuminuria. A group was treated by conventional method and De Marco formula whereas the other group received the traditional treatment. The objective was to evaluate the efficacy of treatment of microalbuminuria, regardless of the foot lesion. Concentrations of albumin excretion, urine and serum creatinine, glycosylated hemoglobin, glycemia and glomerular filtering were determined before and after treatment in both groups. The reduction of microalbuminuria was statistically significant and higher in women. It was concluded that therapeutics with De Marco formula lowers microalbuminuria and glycosylated hemoglobin in patients with infected ischemic diabetic foot regardless of the foot lesion(AU)

Etanercept therapy for psoriasis in a patient with concomitant hepatitis C and liver transplant.

We report a case of a 49 year-old male who had undergone liver transplant due to hepatitis C, Laennec's cirrhosis, and hepatocellular carcinoma, and was treated with etanercept for recalcitrant generalized psoriasis. Clearance of psoriasis was achieved without any adverse effects or complications of his current conditions.

Disease evolution of patients with mycosis fungoides--a report of 30 cases.

Mycosis fungoides is the most common disease of the primary cutaneous T-cell lymphoma group. This is a retrospective study to evaluate the outcome of 30 patients with mycosis fungoides who were followed up for at least 3 years, 18 of them followed for 5 years and 9 of them followed for 7 years. A total of 10 patients achieved a sustained remission, 2 patients achieved a remission but then relapsed and three patients died from lymphoma-related death. It is concluded that the majority of the patients with T1 or T2 stage MF usually have a good prognosis. As a rule, those who do progress further in the disease have advanced stages at the moment of the diagnosis; the disease progression occurring during the first 3-5 years after diagnosis.

Bullous solar elastosis.

Solar elastosis is a recognized manifestation of chronic sun exposure affecting mainly Caucasian skin. Recognizable clinical manifestations of solar elastosis include cutis rhomboidalis nuchae, Favre-Racouchot syndrome, actinic comedonal plaque, nodular forms such as elastomas, elastic nodule of the ear and elastotic bands, collagenous plaques of the hand, and colloid milia. We report two patients with an unusual presentation of vesicular lesions clinically and histopathologically situated in zones of severe solar elastosis that has been previously referred to as bullous solar elastosis.

Craniometric variation and the settlement of the Americas: testing hypotheses by means of R-matrix and matrix correlation analyses.

New archaeological findings and the incorporation of new South American skull samples have raised fundamental questions for the classical theories of the Americas' settlement. The aim of this study was to estimate craniometric variability among several Asian and Native American populations in order to test goodness of fit of the data to different models of ancient population entries and dispersions into the New World. Our data set includes Howells' variables recorded on East Asian, North American, and South American natives (except for Na-Dene speakers). Five Fuego-Patagonian samples and one Paleoamerican sample were also included. A multivariate extension of the R-matrix method for quantitative traits was used to obtain Fst values, which were considered estimations of intergroup variation. Three main models for the peopling of the New World were represented in hypothetical design matrices. Matrix permutation tests were performed to quantify the fit of the observed data with 1) geographical separation of the samples and 2) three ways of settlement, which were the Three Migration Model (TMM), the Single Wave Migration model (SWM), and the Two Components Settlement Model (TCS). R-matrix results showed high levels of heterogeneity among Native Americans. Matrix permutation analyses suggested that the model involving high Amerindian heterogeneity and two different morphological patterns or components (derived "Mongoloid" vs. generalized "non-Mongoloid") explains better the variation observed, even when the effects of geographical separation are removed. Whether these patterns arose as a result of two separate migration events or by local evolution from Paleoamericans to Amerindians remains unresolved.

The settlement of Patagonia: a matrix correlation study.

Matrix correlation represents an innovative methodology to evaluate the explanatory power of several hypotheses by measuring their correspondence with observed morphological variation. In this paper, we view the origins of Patagonians from a matrix correlation approach. Personal and published data on nonmetric cranial traits were used to estimate a biological distance matrix involving five major groups from Patagonia and two from the northwest and northeast regions of Argentina. To evaluate correspondence with other important factors, we used a geographic distance matrix and four design matrices, representing several patterns of settlement and differentiation. Biological distance was found to be strongly associated with spatial separation; the correlation between geography and nonmetric cranial distances was highly significant. When geographic distance is held constant, correlation between a model representing high levels of heterogeneity between the samples and morphological (nonmetric) variation becomes highly significant.

Tratamiento del glaucoma neovascular con criocirugía

Se hizo un estudio descriptivo, longitudinal y prospectivo de 19 pacientes con glaucoma neovascular, tratdos por medio de criocirugía en el Servicio de Oftalmología del Hospital General Clínicoquirúrgico ginecobstétrico Santiago de Cuba durante el primer semestre de 1998, de donde se derivó que el citado métodoconstituye un tratamiento eficaz y alternativo al respecto, tanto por su bajo costo como por la ausencia de riesgos y complicación en su aplicación (AU)

Tratamiento del glaucoma neovascular con criocirugía

Se hizo un estudio descriptivo, longitudinal y prospectivo de 19 pacientes con glaucoma neovascular, tratdos por medio de criocirugía en el Servicio de Oftalmología del Hospital General Clínicoquirúrgico ginecobstétrico Santiago de Cuba durante el primer semestre de 1998, de donde se derivó que el citado métodoconstituye un tratamiento eficaz y alternativo al respecto, tanto por su bajo costo como por la ausencia de riesgos y complicación en su aplicación

Papillon-Lefevre syndrome: a case report and review of the literature

Papillon-Lefevre syndrome is a rare autosomal recessive syndrome associated with palmoplantar keratoderma and early onset periodontal disease that results in loss of the teeth. Actinomyces Actinomycetemcomitans causing periodontal damage, and alterations in the polymorphonuclear leukocyte function have been postulated or probable pathogenetic mechanism. Early recognition of this entity as well as a multidisciplinary management may help in the prognosis of these cases

Diagnóstico Topográfico de las Hematurias en pacientes pediátricos mediante el porcentaje de hematíes dismórficos / Topographic diagnosis of hematurias in pediatric patients by means of a percentage of dimorphic red cells

Se realizó un estudio para fijar el porcentaje de hematíes dismórficos que sirva de punto de corte óptimo para el diagnóstico topográfico de las hematurias en pacientes pediátricos. Se utilizaron datos clínicos y de laboratorio de 77 pacientes con hematuria glomerular y 15 con hematuria no glomerular. Mediante una metodología estadística se obtuvo 14 por ciento como valor del punto, con lo que se asigna al grupo de las hematurias glomerulares todo paciente que presente una cifra de hematíes dismórficos igual o superior. El área bajo la curva ROC (Receiver Operating Characteristic) asociada a este test fue 0,9597, lo que indica una elevada exactitud para la prueba, basntante cercana del valor idal, 1,0 que indica una discriminación perfecta(AU)