Fractal Electronics for Stimulating and Sensing Neural Networks: Enhanced Electrical, Optical, and Cell Interaction Properties.

Imagine a world in which damaged parts of the body - an arm, an eye, and ultimately a region of the brain - can be replaced by artificial implants capable of restoring or even enhancing human performance. The associated improvements in the quality of human life would revolutionize the medical world and produce sweeping changes across society. In this chapter, we discuss several approaches to the fabrication of fractal electronics designed to interface with neural networks. We consider two fundamental functions - stimulating electrical signals in the neural networks and sensing the location of the signals as they pass through the network. Using experiments and simulations, we discuss the favorable electrical performances that arise from adopting fractal rather than traditional Euclidean architectures. We also demonstrate how the fractal architecture induces favorable physical interactions with the cells they interact with, including the ability to direct the growth of neurons and glia to specific regions of the neural-electronic interface.

Impact of maternal social vulnerability and timing of prenatal care on outcome of prenatally detected congenital heart disease.

OBJECTIVES: Early prenatal detection of congenital heart disease (CHD) allows mothers to plan for their pregnancy and delivery; however, the effect of certain sociodemographic and fetal factors on prenatal care has not been investigated thoroughly. This study evaluated the impact of maternal and fetal characteristics on the timing of prenatal diagnosis of CHD and fetal and postnatal outcomes. METHODS: This retrospective multicenter cohort study included women with a fetal echocardiographic diagnosis of CHD between 2010 and 2019. Women were grouped into quartiles of social vulnerability (quartiles 1-4; low-high) using the 2014 social vulnerability index (SVI) provided by the Centers for Disease Control and Prevention. A fetal disease severity score (range, 1-7) was calculated based on a combination of CHD severity (mild = 1; moderate = 2; severe, two ventricles = 3; severe, single ventricle = 4 points) and prenatally diagnosed genetic abnormality, non-cardiac abnormality and fetal hydrops (1 point each). Late diagnosis was defined as a fetal echocardiographic diagnosis of CHD after 24 weeks' gestation. Univariate and multivariable regression analyses were used to identify factors associated with late diagnosis, termination of pregnancy (TOP), postnatal death, prenatal-postnatal discordance in CHD diagnosis and severity and, for liveborn infants, to identify which prenatal variables were associated with postnatal death or heart transplant. RESULTS: Among 441 pregnancies included, 94 (21%) had a late diagnosis of CHD. Late diagnosis was more common in the most socially vulnerable quartile, 38% of women in this group having diagnosis > 24 weeks, compared with 14-18% in the other three quartile groups. Late diagnosis was also associated with Catholic or other Christian religion vs non-denominational or other religion and with a lower fetal disease severity score. There were 93 (21%) TOP and 26 (6%) in-utero fetal demises. Factors associated with TOP included early diagnosis and greater fetal disease severity. Compared with the other quartiles, the most socially vulnerable quartile had a higher incidence of in-utero fetal demise and a lower incidence of TOP. Among the 322 liveborn infants, 49 (15%) died or underwent heart transplant during the follow-up period (range, 0-16 months). Factors associated with postnatal death or heart transplant included longer delay between obstetric ultrasound examination at which CHD was first suspected and fetal echocardiogram at which CHD was confirmed and greater fetal disease severity. CONCLUSIONS: High social vulnerability, Catholic or other Christian religion and low fetal disease severity are associated with late prenatal CHD diagnosis. Delays in CHD diagnosis are associated with fewer TOPs and worse postnatal outcome. Therefore, efforts to expedite fetal echocardiography following abnormal obstetric screening, particularly for at-risk women (e.g. those with high SVI), have the potential to impact pregnancy and postnatal outcome among the prenatally diagnosed CHD population. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

The influence of host tissue on M. gallisepticum vlhA gene expression.

Mycoplasma gallisepticum, a significant poultry pathogen, has evolved rapidly in its new passerine host since its first reported isolation from house finches in the US in 1994. In poultry, M. gallisepticum infects the upper respiratory tract, causing tracheal mucosal thickening and inflammation, in addition to inflammation of the reproductive tract. However, in house finches M. gallisepticum primarily causes inflammation of the conjunctiva. Given that different tissues are primarily affected by the same pathogen in different hosts, we have compared the early changes in gene expression of the phase-variable lipoproteins (vlhA) gene family of M. gallisepticum collected directly from target tissues in both hosts. Previous data have demonstrated that vlhA genes may be related to virulence, exhibiting changes in expression in a non-stochastic, temporal progression and we hypothesize that this may be influenced by differences in the target host tissue. If this is true, we would expect M. gallisepticum to display a different vlhA gene expression pattern in the chicken trachea compared to its expression pattern in house finch conjunctiva. Here we report significant differences in vlhA gene expression patterns between M. gallisepticum collected from chicken tracheas compared to those collected from house finch conjunctiva. While many of the predominant vlhA genes expressed in the input population showed an increase in expression in the chicken trachea at day one postinfection, those same vlhA genes decreased in expression in the house finch. These data suggest that discrete suites of vlhA genes may be involved in M. gallisepticum pathogenesis and tropism for unique tissues in two disparate avian hosts.

[Quality of life and associated characteristics of restless legs syndrome in the adult population of Burgos, Spain]. / Calidad de vida y caracteristicas asociadas del sindrome de piernas inquietas en la poblacion adulta de Burgos, España.

INTRODUCTION: Restless legs syndrome (RLS) is a neurological disorder with a prevalence of up to 15%, although little is known about its impact upon quality of life. AIM: To analyse the impact of RLS on health-related quality of life. SUBJECTS AND METHODS: A descriptive cross-sectional study. A random sample of 1,275 subjects over 18 years old, stratified by age, was taken from the urban area of Burgos, with an estimated prevalence, 10%; alpha, 5%; accuracy, 3%; and losses, 70%, using a two-phase study (screening and diagnosis of cases of RLS and non-cases confirmed by a doctor). The clinical and sociodemographic data were collected by means of semi-structured questionnaires, the European Quality of Life-5 Dimensions, the Restless Legs Syndrome Quality of Life Questionnaire, the Epworth Scale, the Goldberg Scale, the Sleep Scale and the International Restless Legs Syndrome Rating Scale. RESULTS: The prevalence of RLS was 5.6% (CI 95%: 2.5-8.7%). Of the total number of cases, 79.4% were women and only 7% had been previously diagnosed with RLS. Intense pain, insomnia and depression-anxiety were more frequent among the cases of RLS than in the controls (p < 0.001 in the three cases). The quality of life among the cases of RLS, especially in women, was poorer than among the controls (p < 0.001). For 11.7% of the cases, RLS made it difficult for the patients to work. CONCLUSIONS: RLS is associated with depression-anxiety, with a significant impact on sleep, on social and work relationships, and on the health-related quality of life.

TITLE: Calidad de vida y caracteristicas asociadas del sindrome de piernas inquietas en la poblacion adulta de Burgos, España.Introduccion. El sindrome de piernas inquietas (SPI) es un trastorno neurologico con una prevalencia de hasta un 15%, cuyo impacto sobre la calidad de vida resulta poco conocido. Objetivo. Analizar el impacto del sindrome de piernas inquietas (SPI) en la calidad de vida relacionada con la salud. Sujetos y metodos. Estudio descriptivo transversal. Se incluyo una muestra aleatoria, estratificada por edad, de 1.275 sujetos mayores de 18 años en el area urbana de Burgos, con las estimaciones de prevalencia, 10%; alfa, 5%; precision, 3%; y perdidas, 70%, usando un estudio en dos fases (cribado y confirmacion diagnostica de casos de SPI y no casos por un medico). Los datos clinicos y sociodemograficos se recogieron usando cuestionarios semiestructurados: European Quality of Life-5 Dimensions, Restless Legs Syndrome Quality of Life Questionnaire, escala de Epworth, escala de Goldberg, escala del sueño y cuestionario internacional del sindrome de piernas inquietas. Resultados. La prevalencia del SPI fue del 5,6% (IC 95%: 2,5-8,7%). El 79,4% de los casos eran mujeres; solo el 7% tenia un diagnostico previo de SPI. El dolor intenso, el insomnio y la depresion-ansiedad fueron mas frecuentes en los pacientes con SPI que en los controles (p < 0,001 en los tres casos). La calidad de vida entre los pacientes con SPI, especialmente en las mujeres, fue peor que en los controles (p < 0,001). En el 11,7% de los casos, el SPI produjo dificultades para trabajar. Conclusiones. El SPI esta asociado con ansiedad-depresion, con un significativo impacto en el sueño, en las relaciones sociales y laborales, y en la calidad de vida relacionada con la salud.

Knowledge of asthma and anaphylaxis among teachers in Spanish schools.

INTRODUCTION: Allergic diseases affect 15-20% of the paediatric population in the industrialised world. Most educational centres in Spain do not have health professionals among their staff, and the teachers are in charge of child care in school. The advisability of specific training of the teaching staff should be considered, with the introduction of concrete intervention plans in the event of life-threatening emergencies in schools. MATERIAL AND METHODS: Evaluation of the training needs constitutes the first step in planning an educational project. In this regard, the Health Education Group of the Spanish Society of Clinical Immunology, Allergology and Paediatric Asthma (Grupo de Educación Sanitaria de la Sociedad Española de Inmunología Clínica, Alergología y Asma Pediátrica [SEICAAP]) assessed the knowledge of teachers in five Spanish Autonomous Communities, using a self-administered questionnaire specifically developed for this study. The data obtained were analysed using the SPSS statistical package. RESULTS: A total of 2479 teachers completed the questionnaire. Most of them claimed to know what asthma is, and almost one half considered that they would know how to act in the event of an asthma attack. This proportion was higher among physical education teachers. Most would not know how to act in the case of anaphylaxis or be able to administer the required medication. In general, the teachers expressed interest in receiving training and in having an interventional protocol applicable to situations of this kind. DISCUSSION: It is important to know what the training requirements are in order to develop plans for intervention in the event of an emergency in school. Teachers admit a lack of knowledge on how to deal with these disorders, but express a wish to receive training.

[Maternal serum 25-hydroxy vitamin D levels in the first trimester and adverse gestational outcomes]. / Concentraciones séricas maternas de 25-hidroxivitamina D en el primer trimestre y resultados adversos gestacionales.

BACKGROUND: Some disorders of pregnancy and newborn have been associated with vitamin D deficiency (25 (OH) D) in maternal serum. The pathophysiology of this relationship is unknown today. OBJECTIVE: The aim of this study was to determine whether serum levels of vitamin D at the beginning of pregnancy are associated with gestational diabetes, hypertensive disorders of pregnancy, preterm birth and fetal growth restriction. MATERIAL AND METHOD: We conducted a prospective cohort study in 370 pregnant women at low obstetric risk randomly selected in our area (latitude 42 ° 20'N). The level of 25-hydroxy vitamin D was determinate between 8 and 14 weeks of pregnancy. We studied the relationship between the status of vitamin D and gestational diabetes, preeclampsia, preterm birth, intrauterine growth restriction and small for gestational age. The statistic analysis was performed using SPSS 15.0 and 3.1 Epidat programs. RESULTS: The prevalence of vitamin D deficiency in pregnant women in this serie was 96.8%, 34.6% had severe deficiency. After adjusting for maternal and seasonal variables, we haven't found association between first trimester maternal serum vitamin D levels and pregnancy outcomes studied. CONCLUSIONS: The pregnancy outcome was independent of the first trimester maternal serum 25(OH)D status.

Causes for revision surgery in total hip replacement. A retrospective epidemiological analysis. / Causas de cirugía de revisión en artroplastia total de cadera. Análisis epidemiológico retrospectivo.

OBJECTIVE: To determine the impact of each cause of revision surgery in total hip arthroplasty during the period 2009-2013. To analyse the relationship between these causes with different variables. MATERIALS AND METHODS: A study was conducted on 127 patients who had hip replacement revision surgery in our hospital during this period. Parameters, such as age, sex, date of primary arthroplasty, prosthetic replacement date, and main cause of the revision were recorded. Those revisions performed within 5 years after the primary arthroplasty were considered as early rescue. RESULTS: The most common cause of rescue was aseptic loosening in 38 (30%) followed by instability in 30 (24%). In terms of age at the time of rescue, statistically significant differences were found, with it being significantly higher in patients re-operated for a fracture. Differences in age at first surgery were found to be 7 years younger than those with late rescue (63.40) with respect to early (70.21). DISCUSSION: Similar results to ours have been observed in other published series, except for the higher incidence of instability in early rescue. CONCLUSIONS: This study demonstrates aseptic loosening and instability as the most frequent causes of revision surgery in our hospital. Age is a very influential factor in relation to longevity of primary arthroplasty. Complications were higher in when the primary hip replacement is implanted in older patients.

Validez de un método fotométrico de medición de partículas en aire para el control de quirófanos y otras salas de ambiente controlado en los hospitales / Validity of a photometric method of counting particles in air for control of operating rooms and clean rooms in hospitals

Objetivo: Validar un sistema de medici¨®n fotom¨¦trica de part¨ªculas en aire para realizar los controles de bioseguridad ambiental de quir¨®fanos y otras salas de ambiente controlado en los hospitales. Material y m¨¦todos: Se realizaron un total de 144 mediciones pareadas de aire, 88 en ocho quir¨®fanos con sistemas de ventilaci¨®n convencional y tres niveles de filtraci¨®n y 56 en nueve habitaciones sin instalaciones de ventilaci¨®n. Se midieron part¨ªculas de entre 0,1 a 10 ¦Ìm en mg/m3 por m¨¦todo fotom¨¦trico. Simult¨¢neamente, en cada sala se realiz¨® impacto de aire en placas de Petri con medio de cultivo mediante aparato aspirador de cabezal perforado, obteniendo tras cinco d¨ªas de incubaci¨®n recuento de unidades formadoras de colonias (UFC)/1000L. Finalmente se realiz¨® el c¨¢lculo de los puntos de corte ¨®ptimos para la medici¨®n de part¨ªculas mediante Curvas ROC para discriminar tres niveles de contaminaci¨®n. Resultados: El coeficiente de correlaci¨®n entre las dos mediciones fue 0,779 (p<0,001). Los puntos de corte fueron para 0 UFC. 0,015, para >=10 UFC, 0,037, y para >=100 UFC, 0,053. La sensibilidad para estos puntos fue de 95,83%,100% y 100%, y los ¨ªndices Kappa registraron 0,51, 0,88 y 0,75 respectivamente. Conclusi¨®n: En nuestro estudio la correlaci¨®n entre las medidas es notable; la medici¨®n fotom¨¦trica de part¨ªculas puede ser una alternativa para llevar a cabo alguno de los controles rutinarios de bioseguridad (AU)

Objective: Validate a photometric on-air particle measurement system in order to perform ambient bio-security checks in operating rooms and other clean rooms within hospitals. Material and methods: A total of 144 coupled air samples were performed, 88 in 8 different operating rooms with conventional ventilation systems and 3-level filtering and 56 in 9 different rooms without specific ventilation systems. Particles were measured in size between 0,1 to 10 ¦Ìm with the photometric system in mg/m3. Simultaneously in the rooms are performed the sampling air method with impact on culture media. Incubation period is 5 days and count is performed in colony-forming units (CFU/1000L). Finally, optimal cut-points in particles measure were calculated using ROC curves in order to discriminate the three different contamination levels. Results: Spearma´s correlation coefficient was 0,779 p<0,001. Sensitivity for cut-points in particle counting for the different contamination levels was 95,83% ,100% and 100% respectively, and the corresponding Kappa indexes were 0,51; 0,88 and 0,75. Conclusion: Correlation among measurements is notable. Particle measurement can be a worthy alternative for some of the routine bio-security checks (AU)

Suicidal traits in Marilyn Monroe's Fragments: an LIWC analysis.

BACKGROUND: Linguistic inquiry and word count (LIWC), a computerized method for text analysis, is often used to examine suicide writings in order to characterize the quantitative linguistic features of suicidal texts. AIMS: To analyze texts compiled in Marilyn Monroe's Fragments using LIWC, in order to explore the use of different linguistic categories in her narrative over the years. METHOD: Selected texts were grouped into four periods of similar word count and processed with LIWC. Spearman's rank correlation was used to assess changes in language use across the documents over time. The Kruskal-Wallis test was applied to compare means between periods and for each of the 80 LIWC output scores. RESULTS: Significant differences (p < .05) were found in 11 categories, the most relevant being a progressive decrease in the use of negative emotion words, a reduction in the use of long words in the third period, and an increase in the proportion of personal pronouns used as Monroe approached the time of her death. CONCLUSIONS: The consistently elevated usage of first-person personal singular pronouns and the consistently diminished usage of first-person personal plural pronouns are in line with previous studies linking this pattern with a low level of social integration, which has been related to suicide according to different theories.

Malestar en una mujer anciana: a propósito de un caso / Malaise in an elderly woman: presentation of a case

Presentamos el caso de una paciente anciana que acude a la consulta por malestar general. La evolución tórpida y el empeoramiento progresivo nos llevan a un estudio más profundo de la situación de la paciente con el hallazgo de un absceso hepático que pudo ser tratado satisfactoriamente (AU)

We report on an elderly patient who came to the clinic due to general malaise. The complicated progress and gradual worsening led us to conduct a deeper study of the status of the patient, finding a liver abscess that could be satisfactorily treated (AU)

[Malaise in an elderly woman: presentation of a case]. / Malestar en una mujer anciana: a propósito de un caso.

We report on an elderly patient who came to the clinic due to general malaise. The complicated progress and gradual worsening led us to conduct a deeper study of the status of the patient, finding a liver abscess that could be satisfactorily treated.

[Metabolic syndrome and its components in patients with sleep apnea syndrome]. / Síndrome metabólico y sus componentes en pacientes con síndrome de apnea-hipoapnea del sueño.

BACKGROUND: Sleep Apnea Syndrome (SAHS) represents a significant risk factor for the development of cardiovascular disease and evidence suggests a relation with Metabolic Syndrome (MS). The aim of this study was to determine the prevalence of individual components of MS and of MS as an entity, in patients with clinical suspicion of SAHS, and their relation to central obesity. METHODS: We examined the records of 486 consecutive patients, 359 (73.9%) men, with a mean age of 57.3 ± 13.5 years and a mean body mass index (BMI) of 32.1 ± 6.5 kg/m(2)), with clinical suspicion of SAHS. SAHS was diagnosed from the nocturnal register. An Apnea-Hipopnea Index (AHI) > 5 was considered SAHS. MS was evaluated according to the diagnostic criteria of the International Diabetes Federation. RESULTS: Three hundred and twenty-five (66.9%) of the entire group were moderate-severe SAHS. The mean of AHI was 30.2 ± 23.8. We had sufficient data available on 456 patients (93.8%) for MS diagnosis and its prevalence was 64.7% (295 patients). Multivariate analysis showed that age and abdominal perimeter were predictors of SAHS and MS (p<0.05). CONCLUSIONS: Patients with SAHS have a high prevalence of MS and their prevalence is greater in patients with major levels of SAHS. The rate of central obesity, measured by abdominal perimeter, predicts SAHS and MS.

Lentiviral vector-mediated gene transfer in adult mouse photoreceptors is impaired by the presence of a physical barrier.

Gene transfer offers a substantial promise for the therapy of degenerative ocular diseases. Lentiviral vectors have the ability to efficiently transduce murine photoreceptors during the first days of life, but they are poorly effective on photoreceptors during adulthood. Here, we studied whether a physical barrier was responsible for this impairment. Previous studies have described the capacity of enzymes, such as chondroitinase ABC and neuraminidase X, to modify the structure of the interphotoreceptor matrix (IPM) when subretinally injected. Considering the IPM as a physical barrier that may decrease photoreceptor transduction, we injected different enzymes into the subretinal space of the adult mouse simultaneously with the lentiviral vector preparation, to increase viral transduction by fragilizing the IPM. Subretinal injection of neuraminidase X and chondroitinase ABC induces modifications in the IPM by, respectively, revealing or decreasing peanut agglutinin sites on photoreceptors. The simultaneous subretinal injection of neuraminidase X with a lentiviral vector driving the expression of a reporter gene in the photoreceptors increases the number of transduced cells significantly (around five-fold). After the enzyme treatment, the diffusion of the vector between the pigmented epithelium and the photoreceptors appears to facilitate the lentiviral vector transduction. Such approach targeting the IPM may help to design new strategies to improve gene delivery into the adult photoreceptors.

Sexual transmission of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus type 1 infections among male transvestite comercial sex workers in Montevideo, Uruguay.

Prostitution may constitute a risk behavior for infection with hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). We conducted a seroepidemiologic study among 200 male transvestite commercial sex workers (CSWs) in Montevideo, Uruguay in 1999. Evidence of exposure to HBV, HCV, and HIV was found in 101 (50.5%), 13 (6.5%), and 43 (21.5%) individuals, respectively. Positivity for HIV was correlated with both HBV (odds ratio [OR] = 2.15, 95% confidence interval [CI] = 1.01-4.67) and HCV (OR = 3.47, 95% CI = 0.90-12.79) infection. Predictors of infection were older age (> or = 26 years; P < 0.01) for all 3 viruses and time in CSW (> or = 5 years; P < 0.05) for HBV and HIV. Prior history of use of drugs (OR = 3.54, 95% CI = 1.09-11.52) and sexual contact with foreigners (OR = 9.2, 95% CI = 1.16-73.12) were found to be associated only with HCV infection. Sexual transmission of these viruses constitutes a significant problem among male transvestite CSWs.

Lesiones gastroduodenales y "Helicobacter pylori": nuestra experiencia / Gastroduodenal lesions and "Helicobacter pylori": our experience

Objetivo: La enfermedad péptica en la infancia es infrecuente y su incidencia exacta es desconocida. El uso de la endoscopia ha hecho conocer que su prevalencia es mayor de la sospechada, y se ha facilitado la demostración de la asociación entre lesión gastroduodenal y Helicobacter pylori (HP). Con los datos obtenidos en nuestra revisión, se ha querido contribuir a la descripción de las lesiones encontradas y los factores concomitantes relacionados con la enfermedad gastroduodenal primaria. Material y métodos: Revisión de la historia clínica de 28 pacientes evaluados en nuestra sección, que fueron diagnosticados de lesión gastroduodenal macro o microscópica, por endoscopia aisladamente o por endoscopio con biopsia. Se excluyeron los pacientes con lesiones secundarias. Resultados: El 46 por ciento de los pacientes presentó gastritis y/o duodenitis; el 28,5 por ciento no presentó lesión anatómica macroscópica por endoscopia, pero sí microscópica; el 24,9 por ciento manifestó úlcera duodenal o gástrica. El síntoma guía fue epigastralgia en el 64 por ciento. Se encontró positividad de ureasa en el 86 por ciento y visualización del germen en el 71 por ciento de los casos. El tratamiento más frecuentemente pautado fue omeprazol, claritromicina y amoxicilina. Se erradicó HP en el 77 por ciento de los casos. Cuando no se consiguió, se realizó una segunda pauta de tratamiento distinta, que tampoco consiguió la erradicación del germen. Conclusiones: La endoscopio con múltiples biopsias es una exploración necesaria en el diagnóstico del paciente con sospecha de enfermedad ulcerosa o síntomas crónicos de abdomen superior. Aunque los cultivos de HP no son necesarios para el diagnóstico de la enfermedad, pueden ser de gran ayuda cuando falla el tratamiento empírico inicial (AU)

Estudio de diferentes aspectos de la mortalidad en un departamento de pediatría durante 15 años (1985-1999) / Study of some aspects of the mortality in a pediatric department over a fifteen-year period (1985-1999)

Objetivos: Estudiar diferentes aspectos acerca de la mortalidad hospitalaria, excluida la neonatal, en un departamento de pediatría durante un periodo de 15 años (1985-1999). Pacientes y métodos: Estudio retrospectivo y descriptivo de los pacientes que fallecieron desde un mes de vida hasta los 18 años de edad, entre 1985-1999. Se estudió el número total de defunciones, y su distribución por sexos, grupos de edad y años. También se tuvieron en cuenta las principales enfermedades que determinaron la muerte y las causas inmediatas que la condicionaron, además de la tasa de mortalidad bruta hospitalaria (TMBH) y la referida a la población pediátrica de nuestro área en 1998. Los datos se han expresado como estadística básica. Resultados: Los pacientes fallecidos fueron 125 (62 hombres y 63 mujeres); anualmente falleció una media de 8,3 ± 2,5 (14 y 5). La TMBH del grupo total fue de 0,47 ± 0,17 (0,87 y 0,23%), la de los hombres de 0,40 ± 0,19 (0,75 y 0,10%) y la de las mujeres de 0,57 ± 0,34 (1,46 y 0,21%). La mortalidad para el conjunto de la población pediátrica del área fue del 0,17 por mil; para las mujeres del 0,07 y para los hombres del 0,25. Del total de pacientes fallecidos, el 38% (47; 29 mujeres y 18 hombres) fue a causa de tumores, el 27% (34; 19 mujeres y 15 hombres) por enfermedades neurológicas, el 11% (14; 5 mujeres y 9 hombres) por infecciones, el 10% (12; 4 mujeres y 8 hombres) por accidentes y traumatismos, y el 8% (10; 3 mujeres y 7 hombres) a causa de un grupo heterogéneo compuesto por enfermedades diversas. Finalmente, el 3% (4; 1 mujer y 3 hombres) murieron por enfermedad pulmonar primaria y otro 3% más (4; 2 mujeres y 2 hombres) en el postoperatorio de cuadros quirúrgicos. El 49% falleció entre los 0 y los 5 años de edad, el 18% entre los 5 y los 10 años, el 21% entre los 10 y los 15 años y el 15% eran mayores de 15 años. La causa inmediata del fallecimiento de los pacientes con tumores fue debida, principalmente, a fallos multisistémicos o muerte cerebral por progresión de la enfermedad, mientras que los pacientes que fallecieron por enfermedades neurológicas lo hicieron por neumonías aspirativas. Ingresaron cadáveres en la Unidad de Urgencias 13 pacientes, de los cuales 7 eran mujeres y 6 hombres. Conclusiones: Nuestras tasas de mortalidad son bajas en todos los grupos de pacientes, aunque sean algo más elevadas en las mujeres y en los grupos extremos de las edades pediátricas. La primera causa de muerte fue por tumores y la segunda por enfermedades neurológicas. Casi el 50% de los fallecimientos se produjeron en niños menores de 5 años. El 10% de los pacientes habían fallecido antes de ingresar en el servicio de Urgencias (AU)

Objective. The objective of this study is to describe different aspects of hospital mortality in pediatric patients (excluding newborns) in our department over a period of fifteen years (1985-1999). Patients and methods. A retrospective and descriptive study was carried out in patients between one month and eighteen years of age, discharged from our department between January 1985 and December 1999. We examined the cases of those who had died and their distribution according to sex and age group. The most common diseases and the immediate causes of death were also analyzed. The overall hospital mortality and that corresponding to the pediatric population of our health area were assessed. The results are expressed as the mean, standard deviation and maximum and minimum values. Results: One hundred twenty-five patients, 62 boys and 63 girls, died during the time period analyzed. Each year, there were 8.3 ± 2.5 (14 y 5) deaths. The pediatric hospital mortality rate was 0.47 ± 0.17% (0.87%, 0.23%): 0.40 ± 0.19% (0.75%, 0.10%) for boys and 0.57 ± 0.34% (1.46%, 0.21%) for girls. The overall pediatric mortality in our health area was 0.17/1000 (0.07/1000 for girls and boys, respectively). Thirty-eight percent of the patients, (n= 47, 29 girls and 18 boys) died of tumors, 27% (n=34, 19 girls and 15 boys) of neurological disorders, 11% (n=14, 5 girls and 9 boys) of infectious diseases, 10% (n=12, 4 girls and 8 boys) due to accidents or traumatic causes, and 8% (n=10, 3 girls and 7 boys) of a miscellaneous group of diseases. Three percent of the patients (n=4, 1 girl and 3 boys) died of primary lung disease and another 3% (n=4, 2 girls and 2 boys), following a surgical procedure. Forty-nine percent were between 0 and 5 years old at the time of death, 18% were between 5 and 10 years old, and 15% were more than 15 years old. The major immediate causes of death were multiorgan dysfunction and brain death due to treatment failure in the tumor group, and aspiration pneumonia in the neurological disorder group. Thirteen patients (7 girls and 6 boys) died before admission to the emergency room: 4 of them due to sudden infant death syndrome, 3 due to accidents, 2 due to multiple malformation syndromes and 1 of an unknown disease. Conclusions. The mortality rates in our department were very low in all groups. They were higher in girls than in boys, and in infants and adolescents as compared to children in the middle of the age range. The major causes of death were tumors and neurological disorders. Nearly 50% of the deaths occurred before the patients had reached the age of 5 years. Ten percent of the patients died before their arrival at the hospital (AU)

Hydrolysis of lactose by free and immobilized beta-galactosidase from Thermus sp. strain T2.

The hydrolysis of lactose by a beta-galactosidase from the thermophilic microorganism Thermus sp. strain T2, both in solution and immobilized on a commercial silica-alumina, has been studied. The enzyme has been previously produced by Escherichia coli JM101 harboring the plasmid pBGT1, which contains the codifying gene under the promoters lpp(P) and lac(PQ). The enzyme was immobilized on the support activated with tris-hydroxymethylphosphine (THP). Activity and stability of the free and the immobilized enzyme towards pH and temperature were tested. To study the activity at different pH and temperature values, lactose was used as substrate. To check the stability, the enzyme was incubated either in buffer BP or in a solution of lactose in buffer BM at different pH and temperatures, being the remaining activity tested by withdrawing samples and determining their activity toward ONPG at 70 degrees C in buffer BP. Afterward, runs were performed to obtain kinetic models adequate for the description of the hydrolysis of lactose by the free and the immobilized enzyme. These data were fitted to the kinetic models proposed (all based on the Michaelis-Menten mechanism) by non-linear regression, being the models and their parameters compared to determine the effect of the immobilization on the kinetic behavior of the enzyme. Both the free and the immobilized enzyme are competitively inhibited by galactose, while glucose inhibited only the action of the free enzyme, in an uncompetitive way. The immobilization step seems to eliminate the inhibition by glucose. Moreover, the immobilization reduced to a half the inhibitory action of galactose. In general, the immobilization reduced the activity of the enzyme, but increased its thermal stability. Finally, a comparison between the kinetic behavior of this thermophilic enzyme and enzymes of mesophile microorganisms previously studied by us (E. coli and K. fragilis) and by other authors (Aspergillus niger) is performed.