Effects of Alternative Cassava and Taro Feed on the Carcass and Meat Quality of Fattening Pigs Reared under Ecuadorian Backyard Systems.

Ecuadorian small producers use crossbred animals with a low level of genetic improvement, which are fed with alternative feeds to decrease production costs. The objective of this study was to evaluate the effects of geographical location and three diets according to the amount of cassava and taro incorporated into the feed (T1 conventional feed; T2 and T3 with 32% and 42% of cassava and taro, respectively) in pigs reared under the backyard system. The results did not show many differences between the treatments for morphological traits; however, between geographical locations, significant differences were evidenced. The fat content from the first rib was higher in the T1 group. The intramuscular fat percentage was higher in the T1 group, contrary to the protein levels, which were higher in the T3 group in Esmeraldas and the T2 group in Ro Chico. In the gastrointestinal tract (GIT) and its attached organs, differences were found in the empty stomach weight, full and empty small intestine weight, liver weight, and total GIT weight, with the T2 and T3 groups having the largest and heaviest. Cassava and taro did not affect the morphometric behavior and quality of the carcass but increased the amount of protein in the meat and the weight of the GIT. Geographical location was also observed to have a significant effect.

What do molecular data and vibrational communication tell us about the taxonomy of the genus Tyrrhenoleuctra Consiglio, 1957 (Plecoptera: Leuctridae) in Spain?

In this paper we present the results of a study of different populations of the genus Tyrrhenoleuctra, which includes morphologically cryptic species, in the Iberian Peninsula. A total of six populations were analysed from a molecular point of view and a behavioural study was conducted on three of them. Two phylogenetic trees, maximum likelihood (ML) and neighbour joining (NJ), were constructed using both new COI sequences and COI sequences already available in GenBank. Furthermore, intra- and interspecific p-distances were calculated within and between sequences of the different populations. As regards behavioural analyses, the male call of individuals from three of the studied populations was recorded, analysed and described. Both phylogenetic approaches used, ML and NJ, were congruent in discriminating five well-defined clusters, representing the four known Iberian Tyrrhenoleuctra species and a previously unknown taxon. The sequences from the six studied populations produced in this study fell within two clades: T. lusohispanica (four populations) and the new taxon (two populations). These results were supported also by the behavioral study, in which the drumming calls of individuals belonging to the two clades differed in some important parameters such as the number of sequences, intersequence interval and interbeat interval. The obtained results expand the previously known distribution of T. lusohispanica and show the existence of a new species (Tyrrhenoleuctra hynesi sp. n.) within this genus from a more restricted area, that will be described in this paper.

An Inexpensive Unmanned Aerial Vehicle-Based Tool for Mobile Network Output Analysis and Visualization.

Usage of Unmanned Aerial Vehicles (UAVs) for different tasks is widespread, as UAVs are affordable, easy to manoeuvre and versatile enough to execute missions in a reliable manner. However, there are still fields where UAVs play a minimal role regardless of their possibilities. One of these application domains is mobile network testing and measurement. Currently, the procedures used to measure the main parameters of mobile networks in an area (such as power output or its distribution in a three-dimensional space) rely on a team of specialized people performing measurements with an array of tools. This procedure is significantly expensive, time consuming and the resulting outputs leave a higher degree of precision to be desired. An open-source UAV-based Cyber-Physical System is put forward that, by means of the Galileo satellite network, a Mobile Data Acquisition System and a Graphical User Interface, can quickly retrieve reliable data from mobile network signals in a three-dimensional space with high accuracy for its visualization and analysis. The UAV tested flew at 40.43 latitude and -3.65 longitude degrees as coordinates, with an altitude over sea level of around 600-800 m through more than 40 mobile network cells and signal power displayed between -75 and -113 decibels.

Computational study of a novel catheter for liver radioembolization.

Radioembolization (RE) is a medical treatment for primary and secondary liver cancer that involves the transcatheter intraarterial delivery of micron-sized and radiation-emitting microspheres, with the goal of improving microsphere deposition in the tumoral bed while sparing healthy tissue. An increasing number of in vitro and in silico studies on RE in the literature suggest that the particle injection velocity, spatial location of the catheter tip and catheter type are important parameters in particle distribution. The present in silico study assesses the performance of a novel catheter design that promotes particle dispersion near the injection point, with the goal of generating a particle distribution that mimics the flow split to facilitate tumour targeting. The design is based on two factors: the direction and the velocity at which particles are released from the catheter. A series of simulations was performed with the catheter inserted at an idealised hepatic artery tree with physiologically realistic boundary conditions. Two longitudinal microcatheter positions in the first generation of the tree were studied by analysing the performance of the catheter in terms of the outlet-to-outlet particle distribution and split flow matching. The results show that the catheter with the best performance is one with side holes on the catheter wall and a closed frontal tip. This catheter promotes a flow-split-matching particle distribution, which improves as the injection crossflow increases.

Optimization of Deep Architectures for EEG Signal Classification: An AutoML Approach Using Evolutionary Algorithms.

Electroencephalography (EEG) signal classification is a challenging task due to the low signal-to-noise ratio and the usual presence of artifacts from different sources. Different classification techniques, which are usually based on a predefined set of features extracted from the EEG band power distribution profile, have been previously proposed. However, the classification of EEG still remains a challenge, depending on the experimental conditions and the responses to be captured. In this context, the use of deep neural networks offers new opportunities to improve the classification performance without the use of a predefined set of features. Nevertheless, Deep Learning architectures include a vast number of hyperparameters on which the performance of the model relies. In this paper, we propose a method for optimizing Deep Learning models, not only the hyperparameters, but also their structure, which is able to propose solutions that consist of different architectures due to different layer combinations. The experimental results corroborate that deep architectures optimized by our method outperform the baseline approaches and result in computationally efficient models. Moreover, we demonstrate that optimized architectures improve the energy efficiency with respect to the baseline models.

A proof-of-concept study of the in-vivo validation of a computational fluid dynamics model of personalized radioembolization.

Radioembolization (RE) with yttrium-90 (90Y) microspheres, a transcatheter intraarterial therapy for patients with liver cancer, can be modeled computationally. The purpose of this work was to correlate the results obtained with this methodology using in vivo data, so that this computational tool could be used for the optimization of the RE procedure. The hepatic artery three-dimensional (3D) hemodynamics and microsphere distribution during RE were modeled for six 90Y-loaded microsphere infusions in three patients with hepatocellular carcinoma using a commercially available computational fluid dynamics (CFD) software package. The model was built based on in vivo data acquired during the pretreatment stage. The results of the simulations were compared with the in vivo distribution assessed by 90Y PET/CT. Specifically, the microsphere distribution predicted was compared with the actual 90Y activity per liver segment with a commercially available 3D-voxel dosimetry software (PLANET Dose, DOSIsoft). The average difference between the CFD-based and the PET/CT-based activity distribution was 2.36 percentage points for Patient 1, 3.51 percentage points for Patient 2 and 2.02 percentage points for Patient 3. These results suggest that CFD simulations may help to predict 90Y-microsphere distribution after RE and could be used to optimize the RE procedure on a patient-specific basis.

Dyslexia Diagnosis by EEG Temporal and Spectral Descriptors: An Anomaly Detection Approach.

Diagnosis of learning difficulties is a challenging goal. There are huge number of factors involved in the evaluation procedure that present high variance among the population with the same difficulty. Diagnosis is usually performed by scoring subjects according to results obtained in different neuropsychological (performance-based) tests specifically designed to this end. One of the most frequent disorders is developmental dyslexia (DD), a specific difficulty in the acquisition of reading skills not related to mental age or inadequate schooling. Its prevalence is estimated between 5% and 12% of the population. Traditional tests for DD diagnosis aim to measure different behavioral variables involved in the reading process. In this paper, we propose a diagnostic method not based on behavioral variables but on involuntary neurophysiological responses to different auditory stimuli. The experiments performed use electroencephalography (EEG) signals to analyze the temporal behavior and the spectral content of the signal acquired from each electrode to extract relevant (temporal and spectral) features. Moreover, the relationship of the features extracted among electrodes allows to infer a connectivity-like model showing brain areas that process auditory stimuli in a synchronized way. Then an anomaly detection system based on the reconstruction residuals of an autoencoder using these features has been proposed. Hence, classification is performed by the proposed system based on the differences in the resulting connectivity models that have demonstrated to be a useful tool for differential diagnosis of DD as well as a method to step towards gaining a better knowledge of the brain processes involved in DD. The results corroborate that nonspeech stimulus modulated at specific frequencies related to the sampling processes developed in the brain to capture rhymes, syllables and phonemes produces effects in specific frequency bands that differentiate between controls and DD subjects. The proposed method showed relatively high sensitivity above 0.6, and up to 0.9 in some of the experiments.

Deep learning for EEG-based Motor Imagery classification: Accuracy-cost trade-off.

Electroencephalography (EEG) datasets are often small and high dimensional, owing to cumbersome recording processes. In these conditions, powerful machine learning techniques are essential to deal with the large amount of information and overcome the curse of dimensionality. Artificial Neural Networks (ANNs) have achieved promising performance in EEG-based Brain-Computer Interface (BCI) applications, but they involve computationally intensive training algorithms and hyperparameter optimization methods. Thus, an awareness of the quality-cost trade-off, although usually overlooked, is highly beneficial. In this paper, we apply a hyperparameter optimization procedure based on Genetic Algorithms to Convolutional Neural Networks (CNNs), Feed-Forward Neural Networks (FFNNs), and Recurrent Neural Networks (RNNs), all of them purposely shallow. We compare their relative quality and energy-time cost, but we also analyze the variability in the structural complexity of networks of the same type with similar accuracies. The experimental results show that the optimization procedure improves accuracy in all models, and that CNN models with only one hidden convolutional layer can equal or slightly outperform a 6-layer Deep Belief Network. FFNN and RNN were not able to reach the same quality, although the cost was significantly lower. The results also highlight the fact that size within the same type of network is not necessarily correlated with accuracy, as smaller models can and do match, or even surpass, bigger ones in performance. In this regard, overfitting is likely a contributing factor since deep learning approaches struggle with limited training examples.

On the importance of spiral-flow inflow boundary conditions when using idealized artery geometries in the analysis of liver radioembolization: A parametric study.

In the last decades, the numerical studies on hemodynamics have become a valuable explorative scientific tool. The very first studies were done over idealized geometries, but as numerical methods and the power of computers have become more affordable, the studies tend to be patient specific. We apply the study to the numerical analysis of tumor-targeting during liver radioembolization (RE). RE is a treatment for liver cancer, and is performed by injecting radiolabeled microspheres via a catheter placed in the hepatic artery. The objective of the procedure is to maximize the release of radiolabeled microspheres into the tumor and avoid a healthy tissue damage. Idealized virtual arteries can serve as a generalist approach that permits to separately analyze the effect of a variable in the microsphere distribution with respect to others. However, it is important to use proper physiological boundary conditions (BCs). It is not obvious, the need to account for the effect of tortuosity when using an idealized virtual artery. We study the use of idealized geometry of a hepatic artery as a valid research tool, exploring the importance of using realistic spiral-flow inflow BC. By using a literature-based cancer scenario, we vary two parameters to analyze the microsphere distribution through the outlets of the geometry. The parameters varied are the type of microspheres injected and the microsphere injection velocity. The results with realistic inlet velocity profile showed that the particle distribution in the liver segments is not affected by the analyzed injection velocity values neither by the particle density. NOVELTY STATEMENT: In this article, we assessed the use of idealized geometries as a valid research tool and applied the use of an idealized geometry to the case of an idealized hepatic artery to study the particle-hemodynamics during radioembolization (RE). We studied three different inflow boundary conditions (BCs) to assess the usefulness of the geometry, two types of particle injection velocities and two types of commercially available microspheres for RE treatment. In recent years, the advent in computational resources allowed for more detailed patient-specific geometry generation and discretization and hemodynamics simulations. However, general studies based on idealized geometries can be performed in order to provide medical doctors with some basic and general guidelines when using a given catheter for a given cancer scenario. Moreover, using an idealized geometry can be a reasonable approach which allows us to isolate a given parameter and control other parameters, so that parameters can be independently assessed. Even though an idealized geometry does not match any patient's geometry, the use of an idealized geometry can be valid when drawing general conclusions that may be useful in patient-specific cases. However, we believe that even if an idealized hepatic artery geometry is used for the study, it is necessary to account for the upstream and downstream tortuosity of vessels through the BCs. In this work, we highlighted the need of modeling the tortuosity of upstream and downstream vasculatures through the BCs.

A Power-Performance Perspective to Multiobjective Electroencephalogram Feature Selection on Heterogeneous Parallel Platforms.

This article provides an insight on the power-performance issues related with the CPU-GPU (Central Processing Unit-Graphics Processing Unit) parallel implementations of problems that frequently appear in the context of applications on bioinformatics and biomedical engineering. More specifically, we analyze the power-performance behavior of an evolutionary parallel multiobjective electroencephalogram feature selection procedure that evolves subpopulations of solutions with time-demanding fitness evaluation. The procedure has been implemented in OpenMP to dynamically distribute either subpopulations or individuals among devices, and uses OpenCL to evaluate the fitness of the individuals. The development of parallel codes usually implies to maximize the code efficiency, thus optimizing the achieved speedups. To follow the same trend, this article extends and provides a more complete analysis of our previous works about the power-performance characteristics in heterogeneous CPU-GPU platforms considering different operation frequencies and evolutionary parameters, such as distribution of individuals, etc. This way, different experimental configurations of the proposed procedure have been evaluated and compared with respect to a master-worker approach, not only in runtime but also considering energy consumption. The experimental results show that lower operating frequencies does not necessarily mean lower energy consumptions since energy is the product of power and time. Thus, we have observed that parallel processing not only reduces the runtime, but also the energy consumed by the application despite a higher instantaneous power. Particularly, the workload distribution among both CPU and GPU cores provides the best runtime and very low energy consumption compared with the values achieved by the same alternatives executed by only CPU threads.

Eco tridimensional en la evaluación de la enfermedad degenerativa de la válvula mitral / Three-dimensional Echocardiography in Characterization of Degenerative Mitral Valve Disease

Introducción: La insuficiencia mitral de causa degenerativa es una enfermedad de alta prevalencia que, de hecho, constituye la causa más común de necesidad de cirugía sobre la válvula mitral y su resultado está en íntima relación con el tipo de procedimiento que se realice. El ecocardiograma transesofágico tridimensional (3D) permite determinar la complejidad y la extensión del proceso degenerativo y, de este modo, optimizar la estrategia terapéutica. Objetivos: Evaluar las características y las dimensiones del aparato valvular mitral en la insuficiencia mitral degenerativa grave con el propósito de reconocer pacientes con diferente complejidad y extensión de la enfermedad mediante ecocardiograma transesofágico 3D y, asimismo, compararlas con una población sin cardiopatía. Material y métodos: Se incluyeron prospectivamente 25 pacientes con insuficiencia mitral grave degenerativa y 26 pacientes sin enfermedad cardiovascular, a los que se estudió con ecocardiograma transesofágico en 2D y 3D. Con la mejor secuencia 3D se construyó un modelo tridimensional valvular del que se obtuvieron mediciones de las valvas y el anillo (indexadas por la superficie corporal). La población con insuficiencia mitral se dividió en dos grupos: grupo A, compuesto por 17 pacientes con prolapso de un solo segmento y grupo B, conformado por 8 pacientes con más de un segmento con prolapso. Ambas poblaciones se compararon entre sí. Posteriormente se compararon la morfología y las dimensiones del anillo mitral de los pacientes con insuficiencia mitral versus la población sin cardiopatía. Los datos se presentan como mediana con rango intercuartil. En la comparación de los grupos se empleó la prueba de Wilcoxon. Se consideró significativa una p < 0,05 a dos colas. Resultados: El 76% de los pacientes con insuficiencia mitral eran hombres. La edad promedio fue de 60,6 (53-73,2) años. Los pacientes del grupo B presentaron diámetro diastólico del ventrículo izquierdo y anillo mitral con área, circunferencia y diámetro intercomisural significativamente más grandes. El área de la valva anterior y el volumen del prolapso fueron significativamente mayores en el grupo B. Cuando se compararon todos los pacientes con insuficiencia mitral con los pacientes sin cardiopatía, no se observaron diferencias en la morfología del anillo valvular mitral. Conclusiones: En pacientes con insuficiencia mitral grave degenerativa, el ecocardiograma transesofágico 3D permite poner en evidencia diferencias notables entre poblaciones con desigual extensión del compromiso valvular. Los datos así obtenidos podrían tener valor agregado a la hora de decidir la conducta terapéutica.

Classification of motor imagery tasks for BCI with multiresolution analysis and multiobjective feature selection.

BACKGROUND: Brain-computer interfacing (BCI) applications based on the classification of electroencephalographic (EEG) signals require solving high-dimensional pattern classification problems with such a relatively small number of training patterns that curse of dimensionality problems usually arise. Multiresolution analysis (MRA) has useful properties for signal analysis in both temporal and spectral analysis, and has been broadly used in the BCI field. However, MRA usually increases the dimensionality of the input data. Therefore, some approaches to feature selection or feature dimensionality reduction should be considered for improving the performance of the MRA based BCI. METHODS: This paper investigates feature selection in the MRA-based frameworks for BCI. Several wrapper approaches to evolutionary multiobjective feature selection are proposed with different structures of classifiers. They are evaluated by comparing with baseline methods using sparse representation of features or without feature selection. RESULTS AND CONCLUSION: The statistical analysis, by applying the Kolmogorov-Smirnoff and Kruskal-Wallis tests to the means of the Kappa values evaluated by using the test patterns in each approach, has demonstrated some advantages of the proposed approaches. In comparison with the baseline MRA approach used in previous studies, the proposed evolutionary multiobjective feature selection approaches provide similar or even better classification performances, with significant reduction in the number of features that need to be computed.

Novel technologies for monitoring the in-line quality of virgin olive oil during manufacturing and storage.

The quality of virgin olive oil is related to the agronomic conditions of the olive fruits and the process variables of the production process. Nowadays, food markets demand better products in terms of safety, health and organoleptic properties with competitive prices. Innovative techniques for process control, inspection and classification have been developed in order to to achieve these requirements. This paper presents a review of the most significant sensing technologies which are increasingly used in the olive oil industry to supervise and control the virgin olive oil production process. Throughout the present work, the main research studies in the literature that employ non-invasive technologies such as infrared spectroscopy, computer vision, machine olfaction technology, electronic tongues and dielectric spectroscopy are analysed and their main results and conclusions are presented. These technologies are used on olive fruit, olive slurry and olive oil to determine parameters such as acidity, peroxide indexes, ripening indexes, organoleptic properties and minor components, among others. © 2016 Society of Chemical Industry.

Análisis de las características de la válvula mitral en ecocardiograma tridimensional / Three-Dimensional Echocardiographic Analysis of Mitral Valve Characteristics

Introducción El ecocardiograma transesofágico en tres dimensiones (ETE 3D) es una herramienta especialmente útil en el estudio de la patología de la válvula mitral. En la bibliografía existe poca información, ninguna de nuestro país, acerca de los valores normales a partir de los cuales se pueda definir la enfermedad. Objetivo Definir los valores normales de las medidas del anillo y de las valvas de la válvula mitral a través del estudio de una población sin cardiopatía utilizando el ETE 3D. Material y métodos Se incluyeron prospectivamente 26 pacientes sin patología cardiovascular que fueron estudiados con ETE en dos y tres dimensiones. Con el mejor volumen 3D adquirido se construyó un modelo tridimensional de la válvula mitral del que se obtuvieron las medidas de las valvas y del anillo (indexadas por superficie corporal). Los datos se presentan como mediana con rango intercuartil. Resultados La edad fue de 64,5 años (39,1-69,7), el 46% eran hombres. Las medidas del anillo mitral fueron: diámetro intercomisural 18,7 mm (16,5-19,9), diámetro anteroposterior 16,4 mm (15,1-17,8), altura 4,4 mm (3,6-5,4), circunferencia en un plano 55,1 mm (52,2-60), circunferencia en 3D 57,8 mm (55,5-64,1), área en un plano 433,9 mm² (405,3-489) y área en 3D 457,8 mm² (431,2-515,8). Las medidas de las valvas fueron: longitud de la valva anterior 13,4 mm (12,4-14), área de la valva anterior 328,6 mm² (297-359,8), longitud de la valva posterior 7,8 mm (7,1-8,3) y área de la valva posterior 242 mm² (214,3-265,5). Se evaluó la reproducibilidad de las mediciones del anillo mitral en 3D y se observó muy buena concordancia tanto intraobservador como interobservador. Conclusiones Los resultados muestran los valores de referencia de las valvas y del anillo de la válvula mitral en una población sin cardiopatía estudiada con ETE 3D. Sientan las bases para futuros estudios que, asociando mediciones similares en todo el rango de gravedad de la patología mitral, permitan definir prospectivamente la sensibilidad y la especificidad del estudio para enfermedad mitral.

Introduction Three-dimensional transesophageal echocardiography (3D TEE) is a useful tool, particularly for the evaluation of mitral valve disease. There are few reports in the literature, none of our country, about the normal values in order to define the disease. Objective The aim of this study was to define the normal values of the mitral valve annulus and leaflets in a population without heart disease using 3D TEE. Methods Twenty-six patients without heart disease were prospectively included and underwent two-dimensional and 3D TEE. The best 3D volume acquired was used to construct a three dimensional model of the mitral valve to measure the mitral valve leaflets and annulus (indexed for body surface area). Data are presented as median with interquartile range. Results Age was 64.5 years (39.1-69.7) and 46% were men. Mitral annulus measurements were: intercommissural diameter 18.7 mm (16.5-19.9), anteroposterior diameter 16.4 mm (15.1-17.8), height 4.4 mm (3.6-5.4), circumference in projection plane 55.1 mm (52.2-60), 3D circumference 57.8 mm (55.5-64.1), area in projection plane 433.9 mm² (405.3-489) and 3D area 457.8 mm² (431.2-515.8). The leaflets measurements were: anterior leaflet length 13.4 mm (12.4-14), anterior leaflet area 328.6 mm² (297-359.8), posterior leaflet length 7.8 mm (7.1-8.3) and posterior leaflet area 242 mm² (214.3-265.5). The reproducibility of mitral annulus measurements in 3D was evaluated and showed good intraobserver and interobserver agreement. Conclusions Results show reference values of the mitral valve leaflets and annulus estimated by 3D TEE in a population without heart disease. These data lay the foundations for future studies which, by associating similar measurements across all the ranges of severity of mitral valve disease, may prospectively define the sensitivity and specificity of the method for mitral valve assessment.

Análisis de las características de la válvula mitral en ecocardiograma tridimensional / Three-Dimensional Echocardiographic Analysis of Mitral Valve Characteristics

Introducción El ecocardiograma transesofágico en tres dimensiones (ETE 3D) es una herramienta especialmente útil en el estudio de la patología de la válvula mitral. En la bibliografía existe poca información, ninguna de nuestro país, acerca de los valores normales a partir de los cuales se pueda definir la enfermedad. Objetivo Definir los valores normales de las medidas del anillo y de las valvas de la válvula mitral a través del estudio de una población sin cardiopatía utilizando el ETE 3D. Material y métodos Se incluyeron prospectivamente 26 pacientes sin patología cardiovascular que fueron estudiados con ETE en dos y tres dimensiones. Con el mejor volumen 3D adquirido se construyó un modelo tridimensional de la válvula mitral del que se obtuvieron las medidas de las valvas y del anillo (indexadas por superficie corporal). Los datos se presentan como mediana con rango intercuartil. Resultados La edad fue de 64,5 años (39,1-69,7), el 46% eran hombres. Las medidas del anillo mitral fueron: diámetro intercomisural 18,7 mm (16,5-19,9), diámetro anteroposterior 16,4 mm (15,1-17,8), altura 4,4 mm (3,6-5,4), circunferencia en un plano 55,1 mm (52,2-60), circunferencia en 3D 57,8 mm (55,5-64,1), área en un plano 433,9 mm² (405,3-489) y área en 3D 457,8 mm² (431,2-515,8). Las medidas de las valvas fueron: longitud de la valva anterior 13,4 mm (12,4-14), área de la valva anterior 328,6 mm² (297-359,8), longitud de la valva posterior 7,8 mm (7,1-8,3) y área de la valva posterior 242 mm² (214,3-265,5). Se evaluó la reproducibilidad de las mediciones del anillo mitral en 3D y se observó muy buena concordancia tanto intraobservador como interobservador. Conclusiones Los resultados muestran los valores de referencia de las valvas y del anillo de la válvula mitral en una población sin cardiopatía estudiada con ETE 3D. Sientan las bases para futuros estudios que, asociando mediciones similares en todo el rango de gravedad de la patología mitral, permitan definir prospectivamente la sensibilidad y la especificidad del estudio para enfermedad mitral.(AU)

Introduction Three-dimensional transesophageal echocardiography (3D TEE) is a useful tool, particularly for the evaluation of mitral valve disease. There are few reports in the literature, none of our country, about the normal values in order to define the disease. Objective The aim of this study was to define the normal values of the mitral valve annulus and leaflets in a population without heart disease using 3D TEE. Methods Twenty-six patients without heart disease were prospectively included and underwent two-dimensional and 3D TEE. The best 3D volume acquired was used to construct a three dimensional model of the mitral valve to measure the mitral valve leaflets and annulus (indexed for body surface area). Data are presented as median with interquartile range. Results Age was 64.5 years (39.1-69.7) and 46% were men. Mitral annulus measurements were: intercommissural diameter 18.7 mm (16.5-19.9), anteroposterior diameter 16.4 mm (15.1-17.8), height 4.4 mm (3.6-5.4), circumference in projection plane 55.1 mm (52.2-60), 3D circumference 57.8 mm (55.5-64.1), area in projection plane 433.9 mm² (405.3-489) and 3D area 457.8 mm² (431.2-515.8). The leaflets measurements were: anterior leaflet length 13.4 mm (12.4-14), anterior leaflet area 328.6 mm² (297-359.8), posterior leaflet length 7.8 mm (7.1-8.3) and posterior leaflet area 242 mm² (214.3-265.5). The reproducibility of mitral annulus measurements in 3D was evaluated and showed good intraobserver and interobserver agreement. Conclusions Results show reference values of the mitral valve leaflets and annulus estimated by 3D TEE in a population without heart disease. These data lay the foundations for future studies which, by associating similar measurements across all the ranges of severity of mitral valve disease, may prospectively define the sensitivity and specificity of the method for mitral valve assessment.(AU)

Infecciones respiratorias agudas bajas virales en pediatría: hayasgos clínicos predictores de severidad y factores asociados / Viral Lower Respiratory Tract Infection in Children: Clinical Findings that Predict Severity and Associated Factors

Las infecciones respiratorias agudas bajas (IRAB) son la principal causa de morbimor- talidad de los ni ños en el mundo y costituyen un problema de alto costo a nivel de salud p ública. Los virus son la causa principal y m últiples circunstancias modifican su evolu ción por lo que se busc ó factores asociados a la severidad y factores predictores de riesgo asequibles. Se encontr ó que el VSR es el principal virus detectado (62%) y tiene 10 veces m ás riesgo de severidad en comparaci ón con otros virus (OR 10; IC 95% 1.16 91.07). Entre los halla zgos cl ínicos y curso de la enfermedad: la radiologí a anormal, la oximetr ía de pulso menor a 92% y frecuen cias respiratorias mayores a 60 tienen 10, 27 y 42 veces mayor riesgo respectiva mente. Teniendo estas dos últimas, una sensibilidad de 69% en ambas y una especificidad de 92 y 96%, un valor predic -tivo negativo de 85 y 86 % y valor predictivo positivo de 82 y 90%, por lo que se puede concluir que son hallazgos cl ínicos que predicen severidad...(AU)

Tiroides lingual una forma de patologia tiroidea amenazante de la vida / Lingual thyroid a life threatening form of thyroid pathology

Latiroides lingual es lavariante más común de tiroides ectópica benigna. Suele manifestarse en la infancia con hipotiroidismo o síntomas locales, como tos crónica y disfagia. Se diagnostica durante la niñez tras el comienzo de síntomas obstructivos, como la disfagia y disfonías progres ivas, obst rucción respiratoria intermitente, disnea, estridor laríngeo o sensación de cuerpo extraño. El diagnóstico por imagen ideal es la resonancia magnética. El objetivo de este artículo es presentar el caso de una lactante menor de 46 días, presentando estridor laríngeo, cianosis, disnea, secundaria a una disgenesia de tiroides debido a tiroides lingual, la cual la llevó a un hipotiroidismo secundario...(AU)

Obstrucción súbita de la vía aérea superior secundaria a carcinoma tiroideo. presentación de un caso / Sudden obstruction of the upper airway secondary to thyroid carcinoma. presentation of a case

La obstrucci ón s úbita de la v ía aérea superior puede ser manifestaci ón de factores o condiciones tanto intr ínsecas como extr ínsecas. Como causa extr ínseca raramente asociada se encuentra el Carci - noma Papilar de Tiroides CPT, siendo este el subtipo m ás frecuente de Carcinoma de Tiroides que representa el 75 - 80% de los casos 1 . Se revisa un caso interesante de un paciente masculino de 13 a ños que se recibe en la emergencia del Hospital Mario Catarino Rivas con cuadro de dificultad respiratoria importante y estridor audible a distancia, que amerit ó intubaci ón inmediata y traslado a Unidad de Cuidados Intensivos Pedi átricos (UCIP). Con antecedentes de cuadro similar pero de menor intensidad 2 meses atr ás; tratado en su momento como sospecha fundada de Tuberculosis Pulmo- nar dado los hallazgos cl ínicos, antece dentes epidemiol ógicos de contacto con adulto en tratamiento antif ímico y hallazgos radiol ógicos de infiltrados miliares carac ter ísticos, en UCI P se complementan estu dios con TAC de Cuello que muestra cre cimiento Tiroideo con compresi ón de Tr áquea por lo que se programa para cirugí a ( Tiroidectom ía ) con estudio anato -mopatol ógico trans y postoperatorio el cual reporta Carcinoma Papilar de Tiroi des. Actualmente paciente en control con servi cio de Endocrinologí a y Hematoncologí a, en plan de recibir lodo Radioactivo...(AU)

Comparación de la eficacia y seguridad de dos combinaciones nebulizadas; sulfato de magnesio mas salbutamol versus salbutamol mas solucion salina normal, en el tratamiento del sindrome bronquial obstructivo en pediatría / Comparison of efficacy and safety of two nebulised combinations: magnesium sulfate more salbutamol versus salbutamol more normal saline solution in the treatment of obstructive bronchial syndrome In a pediatric populación

Los síndromes bronquiales obstructivos constituyen una patología muy frecuente y recurrente en la población pediátrica. El tratamiento convencional, incluye el uso de beta dos agonistas nebulizados de corta acción y esteroides sistémicos. Sin embargo existe una proporción de pacientes que no responden a ésta terapia por lo que son justificadas la utilización de otras medidas como ser la combinación nebulizada de sulfato de magnesio más salbutamol el cuál será el objetivo a investigar desde el punto de vista de eficacia y seguridad en comparación a la combinación nebulizada de salbutamol más solución salina normal, con el propósito de sugerir - sí resultase útil - una nueva alternativa de tratamient o. Se estudiaron 100 pacientes, 44 recibieron la combinación de magnesio con salbutamol y el resto salbutamol con solución salina; el 93% del grupo inicial presentó resolución total de su cuadro en las primeras 12 horas en comparación al 63% del grupo con la segunda combinación (p=0.003). Ambas combinaciones fueron seguras...(AU)

Hernia diafragmática postraumática: reporte de un caso / Posttraumatic diaphragmatic hernia: report of a case

La hernia diafragmática traumática es poco frecuente en niños y aún continúa siendo una patología de difícil diagnóstico siendo un desafío para cirujanos y radiólogos, diagnosticándose tardíamente hasta en más de la mitad de los casos, dejando una hernia diafragmática latente, que puede manifestarse con síntomas que varían desde inespecíficos hasta la estrangulación de un asa intestinal. - Es considerada un indicador de gravedad del trauma y presenta una elevada tasa de morbilidad y mortalidad. - El objetivo de esta publicación es presentar un caso de hernia diafragmática secundario a un trauma toracoabdominal cerrado. Reportamos el caso de un niño de 4 años atropellado que presentó una hernia diafragmática derecha, Con una excelente evolución clínica...(AU)