Inducing perceived group variability triggers the incorporation of counter-stereotypic information into a generalized stereotype change.

Perceived variability is the extent to which individuals perceive group members as being similar to one another. Previous research has focused on how: group variability is perceived (and measured); information indicative of group heterogeneity can lead to reductions in stereotypicality; or how stereotype-inconsistent information can result into increased perceived variability. The present combines the three lines of research into a single research venue. In previous studies the stereotypicality of a group representation was influenced by priming stereotype-unrelated traits in an unrelated-context, prior to stereotype measurement; but priming counter-stereotypic traits had no effect on stereotypicality, although it boosted perceptions of group's variability. The present study examines whether highlighting dissimilarities among members of the same professional groups results in subsequent changes in the reported stereotype for a, not yet mentioned, group. The more the dissimilarity among group members, the more likely individuals were to incorporate counter-stereotypic information into the targeted-group, described as less stereotypic, even in central tendency measures. Importantly, the generating mechanism may involve a modification of participants' overall perception of variability. When members within professional groups are perceived as dissimilar, the well-known resistance of stereotypes to counter-stereotypic information is lessened making the group representations more flexible and less biased.

The effect of brine pumping on the natural hydrodynamics of the Salar de Atacama: The damping capacity of salt flats.

The Salar de Atacama is used as a case study to analyse and quantify coupled natural (evaporation and recharge) and anthropogenic processes (pumping of lithium-rich brine) to abstract their patterns to other salt flats using a three-dimensional groundwater flow model. Important changes in the dynamics of the water table between the pre-operational period (1986-1994) and operational period (1994-2015) are observed. The water table exhibited a gradual drawdown during the pre-operational period because the evaporation was greater than the recharge for most of these periods. This negative balance was counteracted by some sharp rises that were produced by direct rainfall events on the salt flat. The deep lateral recharge that arrived from the mountains did not produce abrupt changes in the water table because the rainfall events in the mountains were damped by the distance of the recharge zone and great thickness of the unsaturated zone. The natural evolution of the water table was modified by the intensive brine pumping that was performed in the south-western Salar de Atacama during the operational period. As evaporation depends on the water table depth, the pumping caused a drawdown of the water table, resulting in an evaporation rate reduction that partially compensated for the pumped brine in the water balance of the basin. This effect is defined as the damping capacity of salt flats. Thus, salt flats have a high capacity for dampening oscillations in their water table in response to both natural and anthropogenic disturbances which is of great importance for the management of lake and wetland ecosystems and brine exploitation. The limit of the dampening capacity of salt flats is defined by the evaporation extinction depth, which is in the range of 0.5-2 m.

Hydrodynamics of salt flat basins: The Salar de Atacama example.

The Salar de Atacama is one of the most well-known saline endorheic basins in the world. It accumulates the world main lithium reserves and contains very sensitive ecosystems. The objective of this work is to characterize the hydrodynamics of the Salar de Atacama, and to quantify its complex water balance prior to the intense brine extraction. The methodology and results can be extrapolated to the groundwater flow and recharge of other salt flats. A three-dimensional groundwater flow model using low computational effort was calibrated against hundreds of hydraulic head measurements. The water infiltrated from the mountains ascends as a vertical flux through the saline interface (mixing zone) produced by the density contrast between the recharged freshwater and the evaporated brine of the salt flat nucleus. This water discharges and is largely evaporated from lakes or directly from the shallow water table. On the other hand, the very low hydraulic gradients, coupled with the presence of the mixing zone that operates as barrier, leads the salt flat nucleus to act as a hydrodynamically quasi-isolated area. The computed water table shows the lowest hydraulic head in the salt flat nucleus near the discharge at the mixing zone. The groundwater balance of the Salar de Atacama in its natural regime was quantified resulting in an inflow/outflow of 14.9 m3·s-1. This balance considers the basin as an endorheic system. The very low infiltration values that are generally assumed for hyperarid basins are not consistent with the hydrogeology of the Salar de Atacama. Indeed, very high infiltration rates (up to 85% of rainfall) occur because of the high degree of fracturing of rocks and the scarce vegetation. This high infiltration is consistent with the light isotopic composition of the water from the recharge area (Altiplano). Therefore, the existence of additional inflows outside the basin is unlikely.

Xanthan and κ-carrageenan based alkaline hydrogels as electrolytes for Al/air batteries.

Xanthan and κ-carrageenan were used to prepare alkaline hydrogels to be used as electrolytes in aluminium air primary batteries. Two pasty gels were obtained starting from xanthan and KOH solutions (1M and 8M), while only the 8M KOH solution permitted the formation of a stable, elastic and gumminess hydrogel with κ-carrageenan. Discharge tests, performed on three Al/air cells assembled with Al anodes, electrolyte gels and Pt based cathodes, evidenced that all hydrogels exhibited appreciable properties of Al ion conductivities, according to the following performance order: xanthan with KOH 1M

Pax8 has a critical role in epithelial cell survival and proliferation.

The transcription factor Pax8, a member of the Paired-box gene family, is a critical regulator required for proper development and differentiation of thyroid follicular cells. Despite being Pax8 well characterized with respect to its role in regulating genes responsible for thyroid differentiation, its involvement in cell survival and proliferation has been hypothesized but remains unclear. Here, we show that Pax8 overexpression significantly increases proliferation and colony-forming efficiency of Fischer rat thyroid line 5 epithelial cells, although it is not sufficient to overcome their hormone dependence. More interestingly, we show that Pax8-specific silencing induces apoptosis through a p53-dependent pathway that involves caspase-3 activation and cleavage of poly(ADP)ribose polymerase. Our data indicate that tumor protein 53 induced nuclear protein 1 (tp53inp1), a positive regulator of p53-dependent cell cycle arrest and apoptosis, is a transcriptional target of Pax8 and is upregulated by Pax8 knockdown. Remarkably, tp53inp1 silencing significantly abolishes Pax8-induced apoptosis thus suggesting that tp53inp1 may be the mediator of the observed effects. In conclusion, our data highlight that Pax8 is required for the survival of differentiated epithelial cells and its expression levels are able to modulate the proliferation rate of such cells.

Qué síntomas presentan los niños con cáncer avanzado en cuidados paliativos? / Symptoms in childrens with advanced cancer who were attended by the palliative care

El dolor es el síntoma más frecuente y que genera más temor en los pacientes y sus cuidadores en la etapa avanzada de la enfermedad oncológica. Estos niños también presentan otros síntomas que pueden provocar importante malestar y empeorar la sensación dolorosa. En nuestro medio no contamos con información en este ámbito, que permita optimizar el tratamiento de estos pacientes. Objetivo. Caracterizar síntomas distintos del dolor en pacientes con cáncer avanzado, controlados por el equipo de cuidado paliativo (CP) del Hospital Roberto del Río. Pacientes y método. Se revisaron 71 fichas clínicas de pacientes ingresados a CP entre abril de 2002 y diciembre de 2010. Se registraron las características demográficas y los diagnósticos fueron clasificados en leucemia aguda, tumores sólidos y tumores del sistema nervioso central (SNC). Se evaluó un listado de síntomas y sus frecuencias. Resultados. El síntoma más frecuente en los pacientes con leucemia aguda fue fiebre (15 por ciento), al igual que los pacientes con tumores sólidos (16 por ciento). En los pacientes con tumores SNC la alteración de conciencia fue el más frecuente (19 por ciento). Sobre el 70 por ciento de los pacientes tuvieron hasta cuatro síntomas y la evaluación de intensidad en la mayoría fue cualitativa. Conclusiones. Síntomas distintos del dolor son frecuentes y pueden producir gran incomodidad. Evaluarlos objetivamente permitiría un mejor manejo, favoreciendo con esto el control del dolor.

Pain is the most common symptom which generates most fear in patients and their caregivers in the advanced stage of cancer. These children also have other symptoms that can cause significant discomfort and exacerbate the sensation of pain. In Chile, there has been no evaluation of the intensity of these symptoms and their effect on pain, and relevant knowledge could improve patient treatment. Objective: Describe symptoms other than pain in patients with advanced cancer who were attended by the palliative care (PC) team at the Roberto del Rio Hospital. Patients and methods: We reviewed medical records of 71 patients admitted to PC between April 2002 and December 2010. We recorded demographic characteristics and diagnoses were classified into acute leukemia, solid tumors and tumors of the central nervous system (CNS). We evaluated a list of symptoms and their frequencies. Results: The most common symptom in patients with acute leukemia was fever (15 percent) as well as in patients with solid tumors (16 percent). In patients with CNS tumors alteration of consciousness was the most frequent (19 percent). Over 70 percent of patients had four or more symptoms and intensity assessment was mostly qualitative. Conclusions: Besides pain, other symptoms are common and can cause great discomfort. Objective assessment of these symptoms would allow better management of children and also optimize pain control.

Correlación entre la edad y los síntomas de vejiga hiperactiva en mujeres jóvenes en Brasil / Correlation Between Age and Overactive Bladder Symptoms in Young Women in Brazil

El síndrome de vejiga hiperactiva (SVH) está definido por la Sociedad Internacional de Continencia (SIC) como urgencia urinaria, con o sin incontinencia de urgencia y con frecuencia asociado con un aumento de la frecuencia y de la nicturia. Propósito: El objetivo del estudio fue establecer una correlación entre los síntomas de SVH y la edad en mujeres de entre 20 y 45 años. Materiales y métodos: Entrevistamos a 1.050 mujeres de entre 20 y 45 años en el área de Campinas, Brasil, para investigar la prevalencia de síntomas de vejiga hiperactiva. En este estudio utilizamos el cuestionario ICIQ-SVH (estándar de la SIC), en su versión portuguesa validada y un cuestionario específico para la demografía. Resultados: En general, las mujeres de 35-45 años mostraron puntuaciones significativamente más altas en el cuestionario ICIQ-SVH que todos los demás grupos (p<0,001). Las mujeres mayores (35-45) presentaron una puntuación significativamente más alta que las mujeres más jóvenes (todos los demás grupos) (p<0,0001) con respecto a la frecuencia urinaria. En cuanto a la frecuencia hubo una diferencia significativa entre el grupo de edad 35-45 (mayor puntuación) y los grupos de edad 20-22 y 23-27 (p<0,0001). Las mujeres de 35-45 presentaron significativamente más nicturia que las mujeres en los grupos de edad de 28-34, 23-27 y 20-22. Las mujeres en el grupo de 28-34 también presentaron más nicturia que las mujeres de edades comprendidas entre los 20-22 (p<0,0001). Las mujeres de 35-45 experimentaron más urgencia que las de los grupos de edad de 28-34 y 23-27 (p<0,0001). Las mujeres de 35-45 tuvieron significativamente más incontinencia de urgencia que todos los demás grupos y las mujeres en el grupo de 20-22 también presentaron más incontinencia que las de 23-27 (p<0,0001). También se encontraron diferencias significativas en cuanto a la molestia de los síntomas; las mujeres en el grupo de 35-45 años de edad presentaron puntuaciones más altas que los demás grupos con respecto a la frecuencia (p<0,0001), nicturia (p=0,0011), urgencia (p=0,0015) e incontinencia de urgencia (p<0,0001). Conclusiones: En conclusión, las mujeres mayores presentan más síntomas de SVH y, por lo tanto, una puntuación mayor que las mujeres más jóvenes (AU)

Overactive Bladder Syndrome (OAB) is defined by the ICS (International Continence Society) as urinary urgency, with or without urgency incontinence and frequently associated with increase of frequency and nocturia. Purpose: The aim of the study was to establish a correlation between OAB symptoms and Age in women aged 20-45. Materials and methods: We interviewed 1050 women aged 20-45 in the area of Campinas, Brazil, to investigate the prevalence of Overactive Bladder Symptoms. In this study we used the ICIQ-OAB questionnaire (ICS standard), in its validated Portuguese version and a specific questionnaire for the demographics. Results: Overall, women aged 35-45 years showed significantly higher scores in the ICIQ-OAB questionnaire than all other groups (P<0.001). Older women (35-45) presented a significantly higher score than younger women (all other groups) (P<0.0001) regarding urinary frequency. Regarding frequency, there was a significant difference between the age group 35-45 (higher score) and the age groups 20-22 and 23-27 (P<0.0001). Women aged 35-45 presented significantly more nocturia than women in the age groups of 28-34, 23-27 and 20-22. Women in the group of 28-34 also presented more nocturia than women aged 20-22 (P<0.0001). Women aged 35-45 experienced more urgency than those in the age groups of 28-34 and 23-27 (P<0.0001). Women aged 35-45 had significantly more urgency incontinence than all the other groups, and women in group of 20-22 also presented more incontinence than those aged 23-27 (P<0.0001). Significant differences were also found regarding symptom bother, women in group 35-45 years old presented higher scores than the other groups regarding frequency (P<0.0001), nocturia (P=0.0011), urgency (P=0.0015) and urgency incontinence (P<0.0001). Conclusions: In conclusion, older women present more OAB symptoms and therefore a higher score than younger women (AU)

[Correlation between age and overactive bladder symptoms in young women in Brazil]. / Correlación entre la edad y los síntomas de vejiga hiperactiva en mujeres jóvenes en Brasil.

UNLABELLED: Overactive Bladder Syndrome (OAB) is defined by the ICS (International Continence Society) as urinary urgency, with or without urgency incontinence and frequently associated with increase of frequency and nocturia. PURPOSE: The aim of the study was to establish a correlation between OAB symptoms and Age in women aged 20-45. MATERIALS AND METHODS: We interviewed 1050 women aged 20-45 in the area of Campinas, Brazil, to investigate the prevalence of Overactive Bladder Symptoms. In this study we used the ICIQ-OAB questionnaire (ICS standard), in its validated Portuguese version and a specific questionnaire for the demographics. RESULTS: Overall, women aged 35-45 years showed significantly higher scores in the ICIQ-OAB questionnaire than all other groups (P<.001). Older women (35-45) presented a significantly higher score than younger women (all other groups) (P<.0001) regarding urinary frequency. Regarding frequency, there was a significant difference between the age group 35-45 (higher score) and the age groups 20-22 and 23-27 (P<.0001). Women aged 35-45 presented significantly more nocturia than women in the age groups of 28-34, 23-27 and 20-22. Women in the group of 28-34 also presented more nocturia than women aged 20-22 (P<.0001). Women aged 35-45 experienced more urgency than those in the age groups of 28-34 and 23-27 (P<.0001). Women aged 35-45 had significantly more urgency incontinence than all the other groups, and women in group of 20-22 also presented more incontinence than those aged 23-27 (P<.0001). Significant differences were also found regarding symptom bother, women in group 35-45 years old presented higher scores than the other groups regarding frequency (P<.0001), nocturia (P=.0011), urgency (P=.0015) and urgency incontinence (P<.0001). CONCLUSIONS: In conclusion, older women present more OAB symptoms and therefore a higher score than younger women.

Unusual endotracheal and breast metastasis from renal clear cell carcinoma: a case report.

We report a case of a woman affected by a metastatic renal clear cell carcinoma who showed unusual metastasis into the trachea and in the right breast 17 years and 21 years after nephrectomy respectively. Two endotracheal metastasis were identified during rigid bronchoscophy and were treated with endotracheal electro-surgery. Solitary metastasis in the right breast was identified by a mammography that revealed a dense mass of 1.5 cm at lower outer quadrant and she underwent to a right breast quadrantectomy. Histological examination showed a clear cell renal carcinoma metastasis as for the trachea as for the breast mass.

[A new experimental model for inducing interstitial cystitis by oxidative stress using bladder instillation of a nitric oxide donor gel]. / Un nuevo modelo experimental de inducción de cistitis intersticial mediante estrés oxidativo empleando instilación vesical de un gel donante de óxido nítrico.

PURPOSE: The aim of this study is to develop a new experimental model of inducing interstitial cystitis (IC) through vesical instillation of a polymeric solution containing the NO donor S-nitrousglutathione (GSNO) and to compare it to the experimental interstitial cystitis induced by vesical instillation of protamine and potassium chloride. MATERIAL AND METHOD: For that purpose 40 female Wistar rats were used, divided in four groups: 1. saline solution + GSNO; 2. saline solution + polymeric solution (without GNSO); 3. protamine sulphate + KCl; 4. protamine sulphate + GSNO. The rats received one application (5 animals) or 3 applications (5 animals) of the corresponding substance through intravesical instillation, and after 6 days (5 animals) or 9 days (5 animals) they were euthanized and their bladders were removed for macroscopic evaluation and histological study. RESULTS: In the macroscopic evaluation we observed edema and hyperemia of the mucosa in 2 (22%) of the animals in group 1, in 0 (0%) of the animals in group 2, in 10 (100%) of the animals in group 3, and in 5 (50%) of the animals in group 4. In the protamine + KCl group and in saline + GSNO similar effects were observed on the bladder wall. The animals in group 2 (saline + polymeric) showed vascular congestion, significantly smaller than the rest after 9 days instillations (p=0.0035). Significant increased fibrosis was observed after instillations in groups 3 and 4, after 6 days (p=0.3781) and 9 days (p=0.0459) respectively, when compared to control (group 2). All groups presented neutrophilic infiltrate of variable intensity 6 days after instillations (p=0.7277). After 9 days, there was a regression of the infiltrate, with no evidence of accentuated neutrophilic reaction in all the groups (p=0.2301). CONCLUSION: The inflammatory response to bladder instillation of an aqueous solution of S-nitrousglutathione was very similar to that induced by bladder instillation of protamine and KCl. Instillation of an aqueous solution of GSNO can be considered a new model for experimental induction of interstitial cystitis.

Impacto en la administración de un donante de óxido nítrico en gel en el flujo sanguíneo clitoridiano, medido por eco-Doppler / Impact of topic administration of nitric oxide donor gel in the clitoridian blood flow, assessed by Doppler ultra-sound

Objetivo: Evaluar el impacto de las moléculas del donante de óxido nítrico (NO) en el gel F-127 plurónico, aplicado tópicamente en el clítoris, sobre el flujo sanguíneo clitoridiano de mujeres jóvenes voluntarias, usando eco-Doppler. Método: Veinte mujeres sanas mayores de edad, sexualmente activas y sin alteraciones sexuales en su historia clínica fueron enroladas para la medición mediante eco-Doppler de la velocidad del pico sistólico, velocidad diastólica y tasa de resistencia en las arterias clitoridianas previo a la aplicación del donante del NO en gel, a fin de observar los valores basales del flujo en ellas y comparar los valores pre y post. Resultados: Las velocidades sistólica, diastólica y resistencia de base, y 15min posterior a la aplicación del gel, fueron significativamente diferentes (p=0,002, p=0,043, p=0,005, respectivamente). Los resultados muestran el aumento de las velocidades sistólicas y diastólicas a nivel de las arterias clitoridianas en casi 2,5 veces después de 15min de la administración del gel, lo que traduce un aumento en el flujo sanguíneo clitoridiano. Conclusión: El uso del donante de NO en gel S-nitrosoglutation aumenta, significativamente, el flujo sanguíneo del clítoris. Esto podría ser usado terapéuticamente en algunos casos de disfunción sexual(AU)

Objective: This study aims to evaluate of the impact of NO molecules in Pluronic F-127 gel, applied topically in the clitoris, on the clitoridian blood flow of healthy volunteer women, using the Doppler ultra-sound. Method: A total of 20 healthy women over 18 years old and sexually active with no sexual hormones alteration were enrolled. The Doppler ultra-sound procedure was performed on the artery of the clitoris in patients without the NO donor gel, and then after fifteen minutes of its application the same procedure was done again, to compare the values. Results: The hemodynamic results showed, that this formulation was responsible for the increase of the systolic and diastolic speeds in about 2,5 times after 15min of the administration of the gel. The initial resistance index was increased in 1.2 due to the local venous congestion in only 15min after the administration of gel. Indicating that this product can be used to promote the dilatation of the artery of the clitoris to treat women with sexual dysfunction. Conclusion: The use of topic hidrogel as a donor drug in the clitoris of women resulting in a local vasodilatation, without systemic effects. These findings suggest that this preparation may be useful in the management of selected cases of female sexual dysfunction(AU)

[Impact of topic administration of nitric oxide donor gel in the clitoridian blood flow, assessed by Doppler ultra-sound]. / Impacto en la administración de un donante de óxido nítrico en gel en el flujo sanguíneo clitoridiano, medido por eco-Doppler.

OBJECTIVE: This study aims to evaluate of the impact of NO molecules in Pluronic F-127 gel, applied topically in the clitoris, on the clitoridian blood flow of healthy volunteer women, using the Doppler ultra-sound. METHOD: A total of 20 healthy women over 18 years old and sexually active with no sexual hormones alteration were enrolled. The Doppler ultra-sound procedure was performed on the artery of the clitoris in patients without the NO donor gel, and then after fifteen minutes of its application the same procedure was done again, to compare the values. RESULTS: The hemodynamic results showed, that this formulation was responsible for the increase of the systolic and diastolic speeds in about 2,5 times after 15 min of the administration of the gel. The initial resistance index was increased in 1.2 due to the local venous congestion in only 15 min after the administration of gel. Indicating that this product can be used to promote the dilatation of the artery of the clitoris to treat women with sexual dysfunction. CONCLUSION: The use of topic hidrogel as a donor drug in the clitoris of women resulting in a local vasodilatation, without systemic effects. These findings suggest that this preparation may be useful in the management of selected cases of female sexual dysfunction.

Physiology and experimental medicine: translational research at the Toronto Hospital For Sick Children.

Physiology and Experimental Medicine at The Hospital For Sick Children (Toronto, ON, Canada) is a multidisciplinary program that brings together significant interdisciplinary and interprofessional activity from different study areas such as: lung and cardiovascular physiology; imaging; metabolism and nutrition; pharmacology; and experimental medicine. The program is comprised of researchers, clinicians, and educators who focus on the study of complex, integrated bodily systems. Special emphasis is placed on investigations which bridge in vitro and in vivo approaches, basic science with clinical applications, experimental models with human disease, and human subject research.

[NPT (near patient test) in the pharmacy: document and practice guidelines 2008]. / Screening nelle farmacia: documento e linee guida 2008.

NPT tests in the pharmacy. Blood testing can be made with NPT (near patient testing) directly in the pharmacy. Most tests can be made with a single drop of blood (i.e. from a finger) and results are comparable with results from blood test obtained with standard vein blood samples. NPT is basically used for: 1 - evaluating the risk of a disease. 2 evaluating or confirming the presence of a disease. 3 to manage and monitor treatments. The social role of the pharmacy in NPT (particularly in cardiovascular screening) is very important as the pharmacy is an institution with capillary diffusion in the territory. The pharmacy often constitutes an important, first-level consultancy point for the population, particularly where health institutions are far away (small villages) or not easily accessible. Rules for NPT. Guidelines for NPT testing in the pharmacy have been proposed and discussed in a consensus meeting (Spoleto, 2007). NPT guidelines suggest operating management and technical procedures and indicate prospective lines of action defining new roles for the pharmacy. Coagulation tests can be now made in the pharmacy at a very low cost and with an efficacy comparable to blood tests obtained with a vein sample. Results can be read in seconds. This test is also available for personal use and home testing. NPT: The Clinical Study. The evaluation of the results of a clinical study (patients with venous thrombosis/pulmonary embolisation, patients with fibrillation and patients with artificial cardiac valves) indicates that costing is very favourable for NPT which may reduce costs and improve management of many clinical conditions and their monitoring. Training and control systems help NPT testing to be reliable and useful to screen and manage most clinical and risk conditions. The clinical study also shows the positive correlation between NPT tests and standard' tests. In conclusion NPT tests are now very reliable and cost-effective and can be used for screening, diagnosis and to monitor treatments.

Cefalea en paciente con neurofibromatosis tipo I / Headache in patient with neurofibromatosis type 1

Introducción. La neurofibromatosis tipo I (NF-1) es unsíndrome neurocutáneo autosómico dominante resultantede una mutación en el cromosoma 17 (17q11.2). La asociaciónde la NF-1 con la malformación de Arnold-Chiari tipo Iya ha sido descrita. Caso clínico. Mujer de 23 años de edad diagnosticadade NF-1 en base a la presencia de lesiones cutáneas e historiafamiliar compatible. Enviada a consulta de neurologíapor cefalea de más de 1 año de evolución, frontooccipitalbilateral y con irradiación hacia los hombros, opresiva, y quese agravaba con el esfuerzo físico y la maniobra de Valsalva.La exploración física mostró múltiples manchas café con lecheen el tronco y neurofibromas cutáneos en la región cervicodorsal,junto con baja estatura y ligera escoliosis dorsal.Neurológicamente presentaba reflejos osteotendinososaumentados en los miembros inferiores respecto a los superiores,con discreta hipoestesia tactoalgésica en el brazo izquierdo.La resonancia magnética craneocervical mostróuna malformación de Chiari tipo I con una cavidad siringomiélicaasociada cervical, sin otras alteraciones a nivel delsistema nervioso central. Sometida a cirugía de la mencionadamalformación, experimentó mejoría parcial de los síntomas. Conclusión. La asociación de NF-1 y la malformaciónde Chiari tipo I no parece casual. Las alteraciones del desarrolloembrionario secundarias a la NF-1 condicionarían lahipoplasia de la fosa posterior subyacente a la malformaciónde Chiari. Nuestro caso refuerza la propuesta de que lamalformación de Chiari tipo I sea incluida en la lista de malformacionesque caracterizan a la NF-1

Introduction. Neurofibromatosis type 1 (NF-1) is anautosomal dominant neurocutaneous syndrome due to amutation in chromosome 17 (at 17q11.2). The associationof NF-1 with Arnold-Chiari I malformation has beenpreviously described. Case report. A 23 year-old woman diagnosed ofNF-1 based on the presence of cutaneous lesions and afamiliar background consistent with this was referred tothe neurologist due to oppressive frontooccipital bilateralheadache that irradiated to both shoulders. It worsenedon physical effort and Valsalva maneuver and hadmore than one year of evolution. Physical examinationshowed multiple «café au lait» spots in the trunk and cutaneousneurofibromas in the cervico-dorsal region, aswell as short height and mild dorsal scoliosis. Neurologicalexamination showed hyperreflexia in both legs andslight light touch and pinprick hyposthesia in the left arm.The magnetic resonance findings suggested Arn o l d -Chiari I malformation with associated cervical syrinx, withoutany other abnormalities in the central nervous system.She underwent surgery, with partial improvementof the symptoms. Conclusion. The association between NF-1 and Arnold-Chiari I malformation seems to be more than coincidental.The abnormalities of the embrionary developmentsecondary to NF-1 would be responsible for theposterior fossa hypoplasia found in Arnold-Chiari malformation.Our case focuses on the idea that Arnold-Chiari malformation should be included in the list ofabnormalities reported in NF-1

[Headache in patient with neurofibromatosis type 1]. / Cefalea en paciente con neurofibromatosis tipo I.

INTRODUCTION: Neurofibromatosis type 1 (NF-1) is an autosomal dominant neurocutaneous syndrome due to a mutation in chromosome 17 (at 17q11.2). The association of NF-1 with Arnold-Chiari I malformation has been previously described. CASE REPORT: A 23 year-old woman diagnosed of NF-1 based on the presence of cutaneous lesions and a familiar background consistent with this was referred to the neurologist due to oppressive frontooccipital bilateral headache that irradiated to both shoulders. It worsened on physical effort and Valsalva maneuver and had more than one year of evolution. Physical examination showed multiple café au lait spots in the trunk and cutaneous neurofibromas in the cervico-dorsal region, as well as short height and mild dorsal scoliosis. Neurological examination showed hyperreflexia in both legs and slight light touch and pinprick hyposthesia in the left arm. The magnetic resonance findings suggested Arnold - Chiari I malformation with associated cervical syrinx, without any other abnormalities in the central nervous system. She underwent surgery, with partial improvement of the symptoms. CONCLUSION: The association between NF-1 and Arnold- Chiari I malformation seems to be more than coincidental. The abnormalities of the embrionary development secondary to NF-1 would be responsible for the posterior fossa hypoplasia found in Arnold-Chiari malformation. Our case focuses on the idea that Arnold- Chiari malformation should be included in the list of abnormalities reported in NF-1.

Clinical significance of subcortical vascular disease in patients with mild cognitive impairment.

Patients with mild cognitive impairment (MCI) typically present with memory complaints. Some of these patients have subcortical vascular disease on computed tomography (CT) scan, namely white matter changes and lacunar infarcts, however it is not known whether these findings are associated with more pronounced cognitive deficits. In the present study we compare demographic, clinical and neuropsychological characteristics of MCI patients according to the presence or the absence of subcortical vascular disease. Forty consecutive patients with memory complaints, at least one neuropsychological memory test below 1 SD the normal for age and education, and maintained activities of daily living, were included. Patients with dementia, history of stroke or transient ischemic attack, or other brain disorders, were excluded. Twenty-five (62.5%) patients with MCI had no ischemic lesions on CT scan, and 15 (37.5%) were found to have subcortical vascular changes. MCI patients with subcortical vascular changes were older (77.1 +/- 6.8 vs. 70.8 +/- 7.5 years old), and more often males. The number of vascular risk factors, the frequency of neurological signs, the Hachinski score and the neuropsychological tests scores were not significantly different. The presence of subcortical vascular disease on CT scan is frequent in older patients with MCI, but does not appear to be associated with the severity of cognitive deficits.

A novel biweekly pancreatic cancer treatment schedule with gemcitabine, 5-fluorouracil and folinic acid.

Pancreatic adenocarcinoma is a common disease considered to be poorly responsive to antiblastic treatment. Recent clinical and preclinical results suggest that a combined treatment of gemcitabine (GEM), 5-flurouracil (5-FU) and folinic acid (FA) offers a clinical benefit in patients with advanced pancreas adenocarcinoma. The aim of this phase II clinical trial was to evaluate the antitumour activity and toxicity of a novel biweekly schedule of this combination in patients with pancreatic adenocarcinoma. A total of 42 patients received a 30 min infusion of FA (100 mg m(-2)) and 5-FU (400 mg m(-2)) (FUFA) on days 1-3, and GEM 1000 mg m(-2) on day 1 every 15 days. We observed 13 objective responses (two complete, 11 partial) and 23 stable diseases. The median time to progression was 9.75 months (95% Confidence Interval (CI), 6.88-12.62) and the median overall survival was 13.10 months (95% CI 9.64-16.56). There were seven cases of each grade III gastroenteric and haematological toxicity. The GEM plus FUFA combination appears to be well tolerated and very active in patients with pancreatic carcinoma.