[Evaluation of the crossed cerebro-cerebellar activation to determine language lateralization in patients with brain tumors]. / Evaluación de la actividad cerebro-cerebelar cruzada para determinar la lateralidad del lenguaje en pacientes con tumores cerebrales.

BACKGROUND: The crossed cerebro-cerebellar (CCC) activation facilitates the diagnosis of cortical language lateralization, but needs to be explored with language tasks suitable for patients with different age ranges, educational attainment and eventual presence of language deficits. AIM: To determine the effect of demographic variables in the performance of three language tasks in healthy volunteers and to determine the CCC activation of these tasks as a functional magnetic resonance imaging (fMRI) paradigm in brain tumor patients. MATERIAL AND METHODS: The behavioral performance (correct responses and reaction time) of three language tasks (verbal fluency, semantic and phonological decision tasks) was first examined in 76 healthy volunteers balanced by age and educational level. Later, these tasks were implemented as fMRI paradigms to explore CCC language activation of 20 patients with potential diagnosis of brain tumors. RESULTS: The performance of the verbal fluency task was affected by age. The CCC language activation was reproducible with the semantic and phonological tasks. The combination of the tasks determined typical and atypical language lateralization in 60% and 40% of our patients, respectively. CONCLUSIONS: The verbal fluency task must be implemented with care as a clinical fMRI paradigm. Our results suggest that semantic and phonological tasks can be a good alternative for brain tumor patients with language deficits.

Evaluación de la actividad cerebro-cerebelar cruzada para determinar la lateralidad del lenguaje en pacientes con tumores cerebrales / Evaluation of the crossed cerebro-cerebellar activation to determine language lateralization in patients with brain tumors

Background: The crossed cerebro-cerebellar (CCC) activation facilitates the diagnosis of cortical language lateralization, but needs to be explored with language tasks suitable for patients with different age ranges, educational attainment and eventual presence of language deficits. Aim: To determine the effect of demographic variables in the performance of three language tasks in healthy volunteers and to determine the CCC activation of these tasks as a functional magnetic resonance imaging (fMRI) paradigm in brain tumor patients. Material and Methods: The behavioral performance (correct responses and reaction time) of three language tasks (verbal fluency, semantic and phonological decision tasks) was first examined in 76 healthy volunteers balanced by age and educational level. Later, these tasks were implemented as fMRI paradigms to explore CCC language activation of 20 patients with potential diagnosis of brain tumors. Results: The performance of the verbal fluency task was affected by age. The CCC language activation was reproducible with the semantic and phonological tasks. The combination of the tasks determined typical and atypical language lateralization in 60% and 40% of our patients, respectively. Conclusions: The verbal fluency task must be implemented with care as a clinical fMRI paradigm. Our results suggest that semantic and phonological tasks can be a good alternative for brain tumor patients with language deficits.

High incidence of Zika virus infection detected in plasma and cervical cytology specimens from pregnant women in Guayaquil, Ecuador.

Zika virus (ZIKV) infection during pregnancy has been linked to severe birth defects, and the epidemiologic situation of the ZIKV epidemic in Ecuador is poorly understood. Guayaquil, Ecuador, has a tropical climate and experiences frequent outbreaks of dengue and chikungunya virus, and in December 2015, ZIKV was identified. Given the well-documented effects of ZIKV in pregnancy, including microcephaly, we tested for the presence of ZIKV in both plasma and cervical cytology of pregnant women. We report the identification of a population of pregnant women with a high incidence of ZIKV infection detected in the plasma and lower reproductive tract. A case-control study was performed to determine the incidence of ZIKV infection among low-income, pregnant women at risk for preterm delivery compared to matched controls. Plasma and cervical cytology specimens were tested for ZIKV by rRT-PCR. Fifty-nine pregnant women were enrolled. The incidence of ZIKV was 54% (32/59) overall: 18/31 (58.1%) in cases and 14/28 (50.0%) in controls. ZIKV detection in plasma and cervical cytology specimens demonstrated good agreement. Overall, outcomes for neonates born to ZIKV-positive and ZIKV-negative mothers were similar. However, two neonates were born with microcephaly to case mothers who were ZIKV positive. We report a high incidence of ZIKV infection (54%) in a distinctive population in Guayaquil, Ecuador. We identify ZIKV in cervical samples that correlates with ZIKV in the plasma. These data raise concerns regarding the breadth of the ZIKV epidemic in Ecuador and demonstrate the utility of cervical cytology specimens for ZIKV testing.

Removal of carbamates and detoxification potential in a biomixture: Fungal bioaugmentation versus traditional use.

The use of fungal bioaugmentation represents a promising way to improve the performance of biomixtures for the elimination of pesticides. The ligninolyitc fungus Trametes versicolor was employed for the removal of three carbamates (aldicarb, ALD; methomyl, MTM; and methiocarb, MTC) in defined liquid medium; in this matrix ALD and MTM showed similar half-lives (14d), nonetheless MTC exhibited a faster removal, with a half-life of 6.5d. Then the fungus was employed in the bioaugmentation of an optimized biomixture to remove the aforementioned carbamates plus carbofuran (CFN). Bioaugmented and non-bioaugmented systems removed over 99% ALD and MTM after 8d of treatment, nonetheless a slight initial delay in the removal was observed in the bioaugmented biomixtures (removal after 3d: ALD 87%/97%; MTM 86%/99%, in bioaugmented/non-bioaugmented systems). The elimination of the other carbamates was slower, but independent of the presence of the fungus: >98% for MTM after 35d and >99.5% for CFN after 22d. Though the bioaugmentation did not improve the removal capacity of the biomixture, it favored a lower production of transformation products at the first stages of the treatment, and in both cases, a marked decrease in the toxicity of the matrix was swiftly achieved along the process (from 435 to 448 TU to values <1TU in 16d).

Síndrome nefrótico corticorresistente: 15 años de experiencia en el Hospital de Pediatría, Centro Médico Nacional Siglo XXI / Steroid-resistant nephrotic syndrome: 15 years experience from the Hospital de Pediatría, Centro Médico Nacional Siglo XXI

Introducción. Desde 1997 se estableció la clínica de síndrome nefrótico en el Hospital de Pediatría del Centro Médico Nacional Siglo XXI. Del 30 al 50% de los niños con síndrome nefrótico corticorresistente evolucionan a insuficiencia renal crónica, y 60-85% remiten con ciclosporina. El objetivo de este estudio fue reportar la respuesta al tratamiento y el pronóstico con este esquema en un grupo de pacientes con síndrome nefrótico corticorresistente. Métodos. Se realizó un estudio retrospectivo, longitudinal en niños con síndrome nefrótico corticorresistente. Se determinaron los resultados de la remisión y la supervivencia renal. Resultados. Se incluyeron 156 pacientes. El 66.7% de sexo masculino, la edad media al diagnóstico fue de 5.9 ± 4.2 años. La biopsia inicial resultó con cambios mínimos en 33 pacientes (21.9%), proliferación mesangial difusa en 74 (49%) y glomeruloesclerosis focal y segmentaria en 44 (29.1%). El promedio de seguimiento fue de 59.3 meses (mín 3 y máx 178 meses). Recibieron ciclosporina 59%; ciclofosfamida, 17.3% y 26 pacientes recibieron secuencialmente ambos esquemas. Remitieron 78.2% de ellos, requirieron diálisis 5.8% y fallecieron 1.9%. La supervivencia renal a 5 años fue de 92.9% y a 10 años, de 80%. La remisión en cambios mínimos y proliferación mesangial difusa fue de 79.8% y 86.5%, respectivamente y en glomeruloesclerosis focal y segmentaria 59.1%. La insuficiencia renal fue más frecuente en glomeruloesclerosis focal y segmentaria (20.4%). El riesgo de desarrollar insuficiencia renal con glomeruloesclerosis focal comparado con proliferación mesangial difusa fue 4.7 veces mayor, y comparado con cambios mínimos, el riesgo fue 8.72 veces mayor. Conclusiones. En este estudio se encontró remisión similar y frecuencia de progresión a insuficiencia renal mejor a lo que se ha reportado en la literatura.

Background. In 1997, the Clinic for Nephrotic Syndrome was established at the Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (Mexico City); 30-50% of children with steroid-resistant nephrotic syndrome develop chronic renal failure and 60-80% achieve remission with cyclosporine. The objective of the study was to report treatment response and prognosis using the described scheme in a group of patients with steroid-resistant nephrotic syndrome. Methods. Retrospective study in children with steroid-resistant nephrotic syndrome was done. Remission frequency and renal survival were measured. Results. One-hundred fifty seven patients were studied; 66.7% were male. Mean age at diagnosis was 5.9 ± 4.2 years. Biopsies showed 33 results (21.9%) with minimal changes (MC), 74 (49%) with diffuse mesangial proliferation (DMP) and 44 (29.1%) with focal segmental glomerulosclerosis (FSGS). Mean follow-up time was 59.3 months (minimum 3 months, maximum 178 months); 59% were on cyclosporine and 17.3% cyclophosphamide. Twenty six patients received both treatments and six patients received all three medications; 78.2% entered remission, 5.8% were on dialysis and 1.9% died. Five-year renal survival was 92.9% and 10-year survival was 80%. Remission in patients with MC and DMP was 79.8% and 86.5%, respectively and in FSGS was 59.1%. Chronic renal failure was found more often in FSGS (20.4%). Risk of developing renal failure with FSGS compared with DMP was 4.7 times and FSGS compared with MC risk was 8.7 times greater. Conclusions. Similar rates of remission and better renal survival were found compared with the literature.

Enteritis por Clostridium difficile / Clostridium difficile enteritis

La afectación del intestino delgado por Clostridium difficile constituye una entidad clínica infrecuente.MétodoSe presenta el primer caso de enteritis por C. difficile diagnosticado en España y se realiza una revisión de la literatura médica.ResultadosVarón de 30 años de edad intervenido por recidiva de un tumor germinal retroperitoneal. Siete días después presentó vómitos, diarrea y, finalmente, obstrucción intestinal por seudomembranas originadas por enteritis por C. difficile. En la literatura médica han sido descritos otros 57 casos de enteritis por C. difficile. La edad media era de 52±17 años con un rango desde 18 a 86 años. Veintinueve pacientes (50%) presentaban enfermedad inflamatoria intestinal. Cuarenta y siete (81%) tenían antecedentes de cirugía de colon o intestino delgado. La mortalidad fue más acusada en pacientes de mayor edad y en los que no presentaban enfermedad inflamatoria intestinal.ConclusiónLa enteritis por C. difficile se caracteriza por su elevada gravedad y morta(AU)

A 30-year-old man underwent surgery for recurrence of a retroperitoneal germ cell tumor. Seven days later the patient developed vomiting, diarrhea and, finally, intestinal obstruction due to pseudomembranes caused by CDE. Only 57 cases of CDE have been reported in the literature. The mean age was 52±17 years with a range of 18 to 86 years. Twenty-nine patients (50%) had inflammatory bowel disease. Forty-seven (81%) had a history of colon or small intestine surgery. Mortality was higher in older patients and in those without inflammatory bowel disease (AU)

[Clostridium difficile enteritis]. / Enteritis por Clostridium difficile.

INTRODUCTION: Clostridium difficile infection of the small intestine is infrequent. METHOD: We present the first case of C. difficile enteritis (CDE) diagnosed in Spain and provide a review of the literature. RESULTS: A 30-year-old man underwent surgery for recurrence of a retroperitoneal germ cell tumor. Seven days later the patient developed vomiting, diarrhea and, finally, intestinal obstruction due to pseudomembranes caused by CDE. Only 57 cases of CDE have been reported in the literature. The mean age was 52±17 years with a range of 18 to 86 years. Twenty-nine patients (50%) had inflammatory bowel disease. Forty-seven (81%) had a history of colon or small intestine surgery. Mortality was higher in older patients and in those without inflammatory bowel disease. CONCLUSION: CDE is characterized by high severity and mortality.

Functional properties of corn, banana and potato starch blends

Potato, corn and banana starches were blended in various combinations and ratios. Stability and clarity, freeze-thaw stability, water retention capacity and apparent viscosity of the pastes (prepared with a hydrothermic treatment using 100 C for 30 min) were evaluated. In general, the samples stored at room temperature (28 C) presented stability as well as low retrogradation rate. However, in the samples stored at 4 ÆC the propagation and maturation of crystals in the amylopectin component were favored, increasing sample retrogradation. A synergistic effect was shown in some starch blends. The blends had poor stability to freeze-thaw cycle, but a high synergestic effect was presented in water retention capacity. Potato: banana and corn: potato blends showed a synergistic effect in the apparent viscosity and in general, starch blends had stability during the 30-min test.