Preexcitación cardiaca sin taquicardia en deportistas de alto rendimiento / Cardiac pre-excitation without tachycardia in high-performance athletes

Presentamos el caso de un paciente asintomático, deportista de alto rendimiento, al que tras la realización de un electrocardiograma se le diagnosticó de síndrome de preexcitación cardíaca sin taquicardia, realizándose una ablación de la vía accesoria. La preexcitación cardíaca es la existencia de una o varias vías accesorias que conducen sin paso por el nodo auriculoventricular. Se plantea la importancia de realizar estudios cardiólogicos a todos aquellos pacientes que realizan actividades deportivas intensas

We present the case of an asymptomatic patient, a high-performance athlete, who, after an electrocardiogram, was diagnosed with cardiac pre-excitation syndrome without tachycardia. He underwent an ablation of the accessory pathway. Cardiac pre-excitation consists in one or several accessory pathways which bypass the atrioventricular node. It is important to carry out a cardiac study in all patients who practice intense sport activities

Infección por Mycobacterium chimaera diseminada tras sustitución de válvula aórtica / Disseminated infection due to mycobacterium chimaera after aortic valve replacement

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Automatic recognition of severity level for diagnosis of diabetic retinopathy using deep visual features.

Diabetic retinopathy (DR) is leading cause of blindness among diabetic patients. Recognition of severity level is required by ophthalmologists to early detect and diagnose the DR. However, it is a challenging task for both medical experts and computer-aided diagnosis systems due to requiring extensive domain expert knowledge. In this article, a novel automatic recognition system for the five severity level of diabetic retinopathy (SLDR) is developed without performing any pre- and post-processing steps on retinal fundus images through learning of deep visual features (DVFs). These DVF features are extracted from each image by using color dense in scale-invariant and gradient location-orientation histogram techniques. To learn these DVF features, a semi-supervised multilayer deep-learning algorithm is utilized along with a new compressed layer and fine-tuning steps. This SLDR system was evaluated and compared with state-of-the-art techniques using the measures of sensitivity (SE), specificity (SP) and area under the receiving operating curves (AUC). On 750 fundus images (150 per category), the SE of 92.18%, SP of 94.50% and AUC of 0.924 values were obtained on average. These results demonstrate that the SLDR system is appropriate for early detection of DR and provide an effective treatment for prediction type of diabetes.

Síndrome de Boerhaave / Boerhaave’s Syndrome

Presentamos el caso de un varón de 37 años que acude a consulta de Atención Primaria por presentar dolor abdominal acompañado de vómitos con sangre y que, tras diferentes valoraciones y una segunda visita al servicio de urgencias, es ingresado en planta, donde se le diagnostica de perforación esofágica espontánea o síndrome de Boerhaave, precisando intervención quirúrgica urgente (AU)

We present the case of a 37-year-old man who goes to Primary Care Consultation afflicted with abdominal pain together with blood in vomit. After several evaluations and a second visit to Emergency Service, he is hospitalized, where he is finally diagnosed with Boerhaave Syndrome (spontaneous esophageal perforation), requiring urgent surgery (AU)

El envejecimiento afecta a las pruebas de compleción de raíces y reconocimiento pero no a la generación de categorías / Aging affects word-stem completion and recognition but not category generation

En este estudio investigamos el efecto de la edad en dos tareas de memoria implícita, la prueba de compleción de raíces y la de generación de categorías, y comparamos la actuación de jóvenes y mayores en estas pruebas con la actuación en una prueba de memoria explícita (reconocimiento ‘antiguo-nuevo’). Nuestra predicción fue que los jóvenes actuarían mejor que los mayores en la prueba de reconocimiento, mientras que ambos grupos mostrarían efectos de priming similar en ambas pruebas de memoria implícita. Los resultados mostraron: (a) en los dos grupos de edad hubo priming en ambas tareas de memoria implícita; (b) los jóvenes mostraron más priming que los mayores en la tarea de compleción de raíces, mientras el priming fue similar en ambos grupos en la tarea de generación de categorías; y (c) los jóvenes actuaron mejor que los mayores en la prueba de memoria explícita. Estos resultados no solo mostraron disociación entre las tareas de memoria implícita y explícita, sino también entre dos tareas de memoria implícita (AU)

In this study, we investigated the effect of aging on two implicit memory tasks, word-stem completion and category generation, and on explicit recognition. We compared the performance of young and older adults on these implicit memory tasks with those of explicit recognition. We expected better performance of young than older adults in the explicit memory task and similar priming in both implicit memory tasks. The results showed that young adults performed better than older adults in the recognition task. Moreover, both age groups showed priming in the implicit memory tasks, although priming was greater in young adults compared to older adults in the word-stem completion memory task, whereas both age groups showed similar levels of priming in the category generation task. The present results showed dissociations as a function of age not only between the explicit and the implicit tasks but also between the implicit tasks (AU)

[Aging affects word-stem completion and recognition but not category generation]. / El envejecimiento afecta a las pruebas de compleción de raíces y reconocimiento pero no a la generación de categorías.

In this study, we investigated the effect of aging on two implicit memory tasks, word-stem completion and category generation, and on explicit recognition. We compared the performance of young and older adults on these implicit memory tasks with those of explicit recognition. We expected better performance of young than older adults in the explicit memory task and similar priming in both implicit memory tasks. The results showed that young adults performed better than older adults in the recognition task. Moreover, both age groups showed priming in the implicit memory tasks, although priming was greater in young adults compared to older adults in the word-stem completion memory task, whereas both age groups showed similar levels of priming in the category generation task. The present results showed dissociations as a function of age not only between the explicit and the implicit tasks but also between the implicit tasks.

La mayor adhesión a la dieta mediterránea no se asocia a un mejor control metabólico en pacientes con diabetes tipo 1 / Greater adherence to mediterranean diet is not associated with better metabolic control in patients with type 1 diabetes

Objetivos: El objetivo del presente estudio es evaluar el nivel de adhesión al modelo de dieta mediterránea en un grupo de pacientes con diabetes tipo 1 y analizar si un mayor nivel de adherencia a la dieta mediterránea se asocia con un mejor control metabólico y de factores de riesgo vascular. Material y métodos: Estudio observacional descriptivo realizado en 132 pacientes con diabetes tipo 1 de 33,7 ± 11,7 años de edad media. La adhesión a la dieta mediterránea fue evaluada mediante cuestionario validado que proporciona una puntuación entre 0 y 14. Los parámetros clínicos, antropométricos y metabólicos analizados han sido recopilados mediante entrevista personal, estudio del historial clínico y extracción analítica orientada a la evaluación del control metabólico. Resultados: La adhesión media a la dieta mediterránea fue de 8,9 ± 1,9 puntos; el 59% de los pacientes presentó una puntuación igual o inferior a 9 puntos. No se encontraron diferencias significativas en la adhesión a la dieta mediterránea por ninguno de los parámetros clínicos, antropométricos ni analíticos analizados. Los pacientes con mayor nivel de adhesión a la dieta mediterránea no presentaban perfiles lipídicos más favorables, menores niveles de hemoglobina glucosilada ni una menor prevalencia de complicaciones microvasculares. Conclusiones: La mayoría de los pacientes con diabetes tipo 1 evaluados en nuestro estudio muestran un nivel medio-bajo de adhesión al modelo tradicional de dieta mediterránea. La mayor adhesión a la dieta mediterránea no se asoció a un mejor control metabólico ni de otros factores de riesgo vascular(AU)

Objectives: The objective of the present study is to evaluate the level of adherence to the Mediterranean diet model in a group of patients with type diabetes 1 and to determine whether a higher level of adherence to a Mediterranean diet is associated with a better metabolic control or vascular risk factors. Material and methods: A descriptive study was conducted on 132 patients with type diabetes 1 and a mean age 33.7 ± 11.7 years. Adherence to the Mediterranean diet was evaluated by means of a validated questionnaire that provided a score between 0 and 14. The clinical, anthropometric and metabolic parameters analysed were compiled by means of personal interviews; a study of the clinical history and analytical results measured for metabolic control. Results: The mean adherence to the Mediterranean diet scored 8.9 ± 1.9 points, with 59% of the patients having a score of 9 points or lower. Significant differences in adherence to the Mediterranean diet were not found for any of the clinical, anthropometric or analytical parameters analysed. Patients with a higher level of adherence to the Mediterranean diet did not have more favourable lipid profiles, or lower levels of glycated haemoglobin, or less microvascular complications. Conclusions: Most patients with type diabetes 1 evaluated in our study showed a level medium-low level of adherence to the traditional Mediterranean diet model. Higher adherence to the Mediterranean diet was not associated with better metabolic control or other vascular risk factors(AU)

A new device to present textured stimuli to touch with simultaneous EEG recording.

The study of touch has recently grown, due mainly to the extensive use of several types of actuators that stimulate several subsystems of touch. There is a widespread interest in applying these mechanisms to the study of the neurophysiological correlates of tactual perception. In this article, we present a new device (the tactile spinning wheel [TSW]) for delivering textured surfaces to the finger pad. The TSW allows one to control several parameters of the stimulation (angular speed, texture, etc.) and, connected to an EEG recording system, makes it possible to study neural electrophysiological events. The device consists of a rotating platform on which the tactile stimuli are fixed, a system that synchronizes stimuli onset with the EEG system, and an electronic interface that controls the platform. We present the technical details of the TSW, its calibration, and some experimental results we have obtained with this device.

Molecular analysis of rifampicin-resistant Mycobacterium tuberculosis isolated in Spain (1996-2001). Description of new mutations in the rpoB gene and review of the literature.

Mutations of the 81-bp-core region of rpoB gene associated with rifampicin resistance were studied in 169 clinical strains of Mycobacterium tuberculosis isolated from Spain between 1996 and 2001. The analysis identified 16 single base changes, one deletion, two insertions and five multiple mutations (with two or three codons implicated). Eight strains had no mutations, although they were resistant by the proportion method. The five single nucleotide changes with two or three codons implicated and one insertion have not been previously reported. The analysis of the RFLP-IS6110 pattern showed a great heterogeneity (159 individual patterns and four patterns with two or three strains) that suggests no geographical or temporal relations between the studied strains. The concordance rate of InnoLipa Rif-Tb probe with sequencing and phenotypic methods was 94.6%. The results indicate that the InnoLipa probe assay may be useful for rapid screening of the most frequent mutations found in rifampicin-resistant M. tuberculosis strains.

Mycobacterium simiae Infection in an Immunocompromised Patient without Acquired Immunodeficiency Syndrome.

We report a case of lung infection due to Mycobacterium simiae in an immunocompromised patient without acquired immunodeficiency syndrome. The patient had multiple pulmonary nodules similar to those seen in cases of lung disease caused by Mycobacterium avium in elderly women. Appropriate therapy for M. simiae disease should be determined because, in some cases, the risk of adverse effects can outweigh the potential benefits of treatment.

Presentación de un caso: colecistitis aguda alitiasica filtrante en el Hospital Regional y Docente Isidro Ayora de Loja / Presentation of a case: filter alitiásica acute colecistitis in the Regional Hospital and Educational Isidro Ayora de Loja

Se presenta un caso de colecistitis aguda alitiásica (CAA) filtrante, en una paciente de 14 años, la misma que presenta un cuadro abdominal agudo. Al ser diagnosticado se procedió a realizar una laparostomía exploratoria, encontrándose biliperitoneo y colecistitis aguda sin etiología aparente. Se destaca la dificultad diagnóstica por tratarse de una patología poco frecuente en esta edad...