Impact of Clostridioides difficile infection in patients admitted with ulcerative colitis.

BACKGROUND: Patients with ulcerative colitis (UC) are at increased risk of Clostridioides difficile infection (CDI), which is the principal causative agent of nosocomial diarrhoea in western countries. This has been related to complications such as need of colectomy and mortality among these patients. The aim of this study was to assess the incidence and impact of CDI in patients hospitalised with UC. METHODS: Case-control retrospective study including patients admitted due to a UC flare from January 2000 to September 2018. Porpensity score matching (PSM) was performed to minimise selection bias taking into account the small number of cases compared to controls. RESULTS: 339 patients were included; CDI in 35 (10.3%) patients. After PSM, 35 (33.33%) cases and 70 (66.67%) controls were analysed. Patients with CDI presented higher rates of readmission (52.9% vs. 21.4%, p = .001), increased mortality within the first 3 months post-discharge (5.9% vs. 0%, p = .042) and increased need of therapy intensification in the first year after admission (20.7% vs. 12.5%, p = .001). No risk factors for CDI were identified. Multivariable cox regression showed that treatment with 5-aminosalycilates at baseline (HR 0.42, 95% CI 0.18-0.92) and albumin <3.5 g/dL (HR 3.11, 95% CI 1.21-8.03) were associated with worse outcomes. CONCLUSIONS: CDI is a prevalent situation in hospitalised UC patients related to higher mortality within the first 3 months after the infection, need for therapy intensification within the first year and readmission. Our results underline the importance of CDI detection in patients with a flare of UC.

[Ibero-latinamerican clinical practical guidelines on pediatric caustic esophagitis: Physiopathology and clinical-endoscopic diagnosis (1st Part)]. / Guía de práctica clínica Ibero-Latinoamericana sobre la esofagitis cáustica en Pediatría: Fisiopatología y diagnóstico clínico-endoscópico (1a Parte).

Caustic ingestion represents a serious social-medical problem due to the devastating and irreversible consequences it can produce in the upper digestive tract. In Ibero-America, there are no published reliable data on the incidence or prevalence of caustic-induced injuries, and most of the available information on clinical presentation, diagnosis, treatment, and prognosis is based on retrospective clinical series and, indeed, its clinical management is often based primarily on expert opinion. Re cently as an initiative of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) and with the cooperation of the Spanish Society for Pediatric Gastroente rology, Hepatology and Nutrition (SEGHNP), we have designed a Clinical Practice Guideline that include a series of statements and recommendations aimed at optimizing patient medical care which is based on the systematic review of evidence. Two (2) successive papers focused on the evaluation of physiopathological and clinical-endoscopic diagnostic features of caustic esophagitis in children (1st. Paper) and, on the other hand, the most relevant therapeutic considerations (2nd. Paper). We expect this guideline to become a useful tool for the physician in the difficult decision-making process when assessing patients after caustic ingestion.

[Ibero-Latinamerican Clinical Practical Guidelines on pediatric caustic esophagitis: Therapeutical aspects (Part 2)]. / Guía de práctica clínica Ibero-Latinoamericana sobre la esofagitis cáustica en Pediatría: Aspectos terapéuticos (2a. Parte).

Caustic ingestion represents a serious social-medical problem due to the devastating and irreversible consequences it can produce in the upper digestive tract. In Ibero-America, there are no published reliable data on the incidence or prevalence of caustic-induced injuries, and most of the available information on clinical presentation, diagnosis, treatment, and prognosis is based on retrospective clinical series and, indeed, its clinical management is often based primarily on expert opinion. Re cently as an initiative of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) and with the cooperation of the Spanish Society for Pediatric Gastroente rology, Hepatology and Nutrition (SEGHNP), we have designed a Clinical Practice Guideline that include a series of statements and recommendations aimed at optimizing patient medical care which is based on the systematic review of evidence. Two (2) separate papers focused on the evaluation of physiopathological and clinical-endoscopic diagnostic features of caustic esophagitis in children (1st. Paper) and, on the other hand, the most relevant therapeutic considerations (2nd. Paper). We expect this guideline to become a useful tool for the physician in the difficult decision-making process when assessing patients after caustic ingestion.

Guía de práctica clínica Ibero-Latinoamericana sobre la esofagitis cáustica en Pediatría: aspectos terapéuticos (2a. Parte) / Ibero-Latinamerican Clinical Practical Guidelines on pediatric caustic esophagitis: therapeutical aspects (Part 2)

Resumen: La ingestión de cáusticos representa un grave problema médico-social por las consecuencias devastadoras e irreversibles que puede producir en el tracto digestivo superior. En Iberoamérica no se han publicado datos fidedignos sobre la incidencia o la prevalencia de lesiones inducidas por cáusticos. La información disponible sobre la presentación clínica, diagnóstico, tratamiento y pronóstico se basa en series retrospectivas de casos y, de hecho, su manejo clínico se sustenta en muchos casos fundamentalmente en la opinión de expertos. Recientemente como una iniciativa de la Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica (SLAGHNP) y con la co laboración de colegas de la Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediá trica (SEGHNP), hemos diseñado una Guía de Práctica Clínica (GPC) la cual incluye una serie de enunciados y recomendaciones dirigidos a optimizar la atención a los pacientes y que se basan en la revisión sistemática de la evidencia. En dos (2) manuscritos sucesivos nos hemos enfocado primero, en los aspectos fisiopatológicos y de diagnóstico clínico-endoscópico de la esofagitis cáustica en niños (1a. Parte) y en segundo lugar, en los aspectos más relevantes del tratamiento (2a. Parte). Esperamos esta guía se convierta en una herramienta útil para el clínico en el difícil proceso de toma de decisio nes a la hora de evaluar un paciente posterior a la ingesta de una sustancia cáustica.

Abstract: Caustic ingestion represents a serious social-medical problem due to the devastating and irreversible consequences it can produce in the upper digestive tract. In Ibero-America, there are no published reliable data on the incidence or prevalence of caustic-induced injuries, and most of the available information on clinical presentation, diagnosis, treatment, and prognosis is based on retrospective clinical series and, indeed, its clinical management is often based primarily on expert opinion. Re cently as an initiative of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) and with the cooperation of the Spanish Society for Pediatric Gastroente rology, Hepatology and Nutrition (SEGHNP), we have designed a Clinical Practice Guideline that include a series of statements and recommendations aimed at optimizing patient medical care which is based on the systematic review of evidence. Two (2) separate papers focused on the evaluation of physiopathological and clinical-endoscopic diagnostic features of caustic esophagitis in children (1st. Paper) and, on the other hand, the most relevant therapeutic considerations (2nd. Paper). We expect this guideline to become a useful tool for the physician in the difficult decision-making process when assessing patients after caustic ingestion.

Joint attention and vocabulary development in toddlers with Down syndrome and their peers with typical development: The role of maternal interactive style.

PURPOSE: Joint attention is considered a prerequisite for language development. Although language is one of the most impaired domains in Down syndrome (DS), few studies have examined the relationship between caregiver behavior during episodes of joint attention and vocabulary development in these children. Consequently, our primary aim was to analyze the behaviors of caregivers of children with DS and of children with typical development (TD) in the early stages of vocabulary development. A second objective was to examine the kind of words that caregivers use to refer to the object that is the focus of attention. We also consider the concurrent relationship between joint attention and vocabulary development in both groups of children. METHOD: We studied 28 children with DS and 28 children with TD, individually matched on mental age and gender, and their respective caregivers. The mean mental age for children with DS and children with TD was around 12 months. The mean chronological age of caregivers of children with DS and children with TD was around 35 years. Each child and his or her caregiver were video-recorded during a free-play session involving different objects. RESULTS: Although the total time engaged in joint attention was greater among caregivers of children with DS, caregivers of both groups of children were more likely to direct than follow their child's attentional focus. The caregivers of children with DS used a greater number of appropriate terms to refer to the object of attention. We found no significant correlation in either group of children between vocabulary development and joint attention behaviors. CONCLUSIONS: The results may be due to the fact that the children studied are still very young in developmental terms and have yet to develop all the skills required for joint attention. At this early stage, directing the child's attention would promote the development of joint attention. A possible explanation for the lack of a correlation between vocabulary development and joint attention is that children may use an associative mechanism in the early stages of lexical learning, and hence the learning of new words is a slow process.

Guía de práctica clínica Ibero-Latinoamericana sobre la esofagitis cáustica en Pediatría: fisiopatología y diagnóstico clínico-endoscópico (1a Parte) / Ibero-latinamerican clinical practical guidelines on pediatric caustic esophagitis: physiopathology and clinical-endoscopic diagnosis (1st Part)

Resumen: La ingestión de cáusticos representa un grave problema médico-social por las consecuencias devastadoras e irreversibles que puede producir en el tracto digestivo superior. En Iberoamérica no se han publicado datos fidedignos sobre la incidencia o la prevalencia de lesiones inducidas por cáusticos. La información disponible sobre la presentación clínica, diagnóstico, tratamiento y pronóstico se basa en series retrospectivas de casos y, de hecho, su manejo clínico se sustenta en muchos casos fundamentalmente en la opinión de expertos. Recientemente como una iniciativa de la Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica (SLAGHNP) y con la co laboración de colegas de la Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediá trica (SEGHNP), hemos diseñado una Guía de Práctica Clínica (GPC) la cual incluye una serie de enunciados y recomendaciones dirigidos a optimizar la atención a los pacientes y que se basan en la revisión sistemática de la evidencia. En dos (2) manuscritos sucesivos nos hemos enfocado primero, en los aspectos fisiopatológicos y de diagnóstico clínico-endoscópico de la esofagitis cáustica en niños (1a. Parte) y en segundo lugar, en los aspectos más relevantes del tratamiento (2a. Parte). Esperamos esta guía se convierta en una herramienta útil para el clínico en el difícil proceso de toma de decisio nes a la hora de evaluar un paciente posterior a la ingesta de una sustancia cáustica.

Abstract: Caustic ingestion represents a serious social-medical problem due to the devastating and irreversible consequences it can produce in the upper digestive tract. In Ibero-America, there are no published reliable data on the incidence or prevalence of caustic-induced injuries, and most of the available information on clinical presentation, diagnosis, treatment, and prognosis is based on retrospective clinical series and, indeed, its clinical management is often based primarily on expert opinion. Re cently as an initiative of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) and with the cooperation of the Spanish Society for Pediatric Gastroente rology, Hepatology and Nutrition (SEGHNP), we have designed a Clinical Practice Guideline that include a series of statements and recommendations aimed at optimizing patient medical care which is based on the systematic review of evidence. Two (2) successive papers focused on the evaluation of physiopathological and clinical-endoscopic diagnostic features of caustic esophagitis in children (1st. Paper) and, on the other hand, the most relevant therapeutic considerations (2nd. Paper). We expect this guideline to become a useful tool for the physician in the difficult decision-making process when assessing patients after caustic ingestion.

The Composition of Early Vocabulary in Spanish Children With Down Syndrome and Their Peers With Typical Development.

Purpose: There are very few studies, and at present none in Spanish, on vocabulary composition in children with Down syndrome (DS). Nor has the topic been widely assessed in Spanish-speaking children with typical development (TD). This study analyzed the composition of early vocabularies in a large sample of Spanish-speaking children with DS and compared it with that of children with TD. Method: We studied 108 children with DS and 108 children with TD with mental ages between 8 and 29 months, matched for size of productive vocabulary and gender. The MacArthur-Bates Communicative Development Inventories (Fenson et al., 1993, 2007), adapted to the language development profile of children with DS, were used. The categories examined were nouns, predicates, closed-class words, and social words. Results: The performance of children with DS was similar to that of children with TD with the same vocabulary size. The only significant difference was the larger production of nouns by children with DS. The trends of development in the different classes of words were also similar. Conclusions: The strategies used by children with DS to learn vocabulary may be similar to those used by children with TD in the first stages of language learning.

Adaptation of the MacArthur-Bates Communicative Development Inventories for Spanish Children With Down Syndrome: Validity and Reliability Data for Vocabulary.

PURPOSE: The MacArthur-Bates Communicative Development Inventories are widely used to study early language and communicative development. We recently developed a Spanish version for children with Down syndrome (the CDI-Down) adapted to their particular profile of linguistic and communicative development. The principal aims of this study are to assess the concurrent validity and test-retest reliability of the vocabulary section of this adaptation. METHOD: Validation for productive vocabulary (Study 1) was achieved by correlating CDI-Down scores on expressive vocabulary and measures on the basis of spontaneous speech samples (n = 29). Validation for receptive vocabulary (Study 2) was achieved by correlating CDI-Down scores on receptive vocabulary and measures derived from language items of the Brunet-Lézine Scale (Josse, 1997; n = 70). Reliability (Study 3) was measured with a subset of parents who completed the same inventory 4 months after the original sampling (n = 26). RESULTS: CDI-Down expressive and receptive vocabulary scores showed a significant positive relationship with their comparison measures, thereby demonstrating convergent validity. A significant positive relationship was also found between test-retest measures for productive and receptive vocabularies, thus supporting the reliability of the adaptation. CONCLUSION: The results demonstrate that the CDI-Down is a valid and reliable tool that could be useful for parents, teachers, clinicians, and researchers.

Early grammatical development in Spanish children with Down syndrome.

The objective of this work was to analyze morphosyntactic development in a wide sample of children with Down syndrome (DS) (n = 92) and children with typical development (TD) (n = 92) with a mental age (MA) of 20 to 29 months. Children were individually matched for gender and MA (Analysis 1) and for vocabulary size (Analysis 2). Information about morphosyntax was obtained using an adaptation of the CDI for children with DS. In both analyses, the number of children with DS and with TD who combined words was similar. Analysis 1 showed that children with DS produced shorter utterances, with less morphosyntactic complexity and less morphological suffixes than children with TD, despite having the same mental age. The developmental pattern was similar, although slower in children with DS. Analysis 2 showed that the performance of children with DS was lower than the performance of children with TD in relation to morphosyntactic complexity and morphological suffixes.

[Refractory status epilepticus in children: characterisation of epilepsies, continuous electroencephalographic monitoring and response to treatment]. / Estado epileptico refractario en ninos: caracterizacion de las epilepsias, monitorizacion electroencefalografica continua y respuesta al tratamiento.

INTRODUCTION: Patients with refractory status epilepticus (RSE) have high morbidity and mortality rates, are hospitalised for longer periods of time, suffer greater neurological damage and progress to symptomatic epilepsy. Continuous electroencephalogram (cEEG) monitoring is a valuable aid in the early detection of RSE, especially in the case of non-convulsive status epilepticus (NCSE). In this study we describe the clinical characteristics, treatment and use of cEEG in paediatric patients with RSE. PATIENTS AND METHODS: A retrospective study was conducted at the Hospital Clinico de la Pontificia Universidad Catolica de Chile between November 2005 and March 2011 in patients aged between 1 month and 15 years diagnosed with RSE and cEEG. Demographic characteristics, baseline and final conditions, and therapy were recorded. RESULTS: A total of 15 patients, 12 of whom were males, with a mean age of 4 years (1.5 months-13 years) were identified. Eight patients had a history of epilepsy. The most frequent aetiologies were progressive symptomatic and acute symptomatic. Convulsive epileptic status (CSE) was present in 11 patients and NCSE in the other four. During the cEEG, six of the 11 patients with CSE later progressed to NCSE. The mean amount of time with RSE was 10.2 days. Of the 15 patients, 13 responded to anticonvulsive drugs and the main secondary complications were respiratory depression and hypotension. Patients with CSE tended to evolve in a more torpid manner than patients with NCSE. On discharge from hospital, 13 patients (86.6%) presented new neurological deficit or difficult-to-manage epilepsy, one still had RSE and one died (6%). CONCLUSIONS: The aggregate neurological morbidity and mortality rates of RSE were high. The use of cEEG monitoring should be considered for use in the management of such cases of status epilepticus.

Estado epiléptico refractario en niños: caracterización de las epilepsias, monitorización electroencefalográfica continua y respuesta al tratamiento / Refractory status epilepticus in children: characterisation of epilepsies, continuous electroencephalographic monitoring and response to treatment

Introducción. Los pacientes con estados epilépticos refractarios (EER) tienen alta morbimortalidad, hospitalizaciones más prolongadas, mayor daño neurológico y evolución a epilepsia sintomática. La monitorización mediante electroencefalograma continuo (EEGc) es útil en la detección precoz del EER, especialmente el estado epiléptico no convulsivo (EENC). En este trabajo describimos las características clínicas, el tratamiento y el uso del EEGc en pacientes pediátricos con EER. Pacientes y métodos. Es un estudio retrospectivo realizado en el Hospital Clínico de la Pontificia Universidad Católica de Chile entre noviembre de 2005 y marzo de 2011, en pacientes de 1 mes a 15 años de edad, con diagnóstico de EER y EEGc. Se registraron características demográficas, condición basal y a la salida, y terapia. Resultados. Se identificaron 15 pacientes, 12 varones, con una edad promedio de 4 años (1,5 meses-13 años). Ocho pacientes tenían antecedente de epilepsia. Las etiologías más frecuentes fueron sintomática progresiva y sintomática aguda. Presentaron estado epiléptico convulsivo (EEC) 11 pacientes, y EENC, cuatro. Durante el EEGc, seis de los 11 pacientes con EEC evolucionaron posteriormente a EENC. El tiempo promedio de EER fue 10,2 días. De los 15 pacientes, 13 respondieron al uso de anticonvulsionantes, y las principales complicaciones secundarias fueron depresión respiratoria e hipotensión. Los pacientes con EEC tendieron a evolucionar más tórpidamente que los pacientes con EENC. En el momento del alta, 13 pacientes (86,6%) presentaron nuevo déficit neurológico o epilepsia de difícil manejo, uno persistió con EER y uno falleció (6%). Conclusiones. La morbilidad neurológica agregada y la mortalidad de los EER fueron altas. Debería considerarse el uso de la monitorización del EEGc en el manejo de estos estados epilépticos (AU)

Introduction. Patients with refractory status epilepticus (RSE) have high morbidity and mortality rates, are hospitalised for longer periods of time, suffer greater neurological damage and progress to symptomatic epilepsy. Continuous electroencephalogram (cEEG) monitoring is a valuable aid in the early detection of RSE, especially in the case of nonconvulsive status epilepticus (NCSE). In this study we describe the clinical characteristics, treatment and use of cEEG in paediatric patients with RSE. Patients and methods. A retrospective study was conducted at the Hospital Clínico de la Pontificia Universidad Católica de Chile between November 2005 and March 2011 in patients aged between 1 month and 15 years diagnosed with RSE and cEEG. Demographic characteristics, baseline and final conditions, and therapy were recorded. Results. A total of 15 patients, 12 of whom were males, with a mean age of 4 years (1.5 months-13 years) were identified. Eight patients had a history of epilepsy. The most frequent aetiologies were progressive symptomatic and acute symptomatic. Convulsive epileptic status (CSE) was present in 11 patients and NCSE in the other four. During the cEEG, six of the 11 patients with CSE later progressed to NCSE. The mean amount of time with RSE was 10.2 days. Of the 15 patients, 13 responded to anticonvulsive drugs and the main secondary complications were respiratory depression and hypotension.Patients with CSE tended to evolve in a more torpid manner than patients with NCSE. On discharge from hospital, 13 patients (86.6%) presented new neurological deficit or difficult-to-manage epilepsy, one still had RSE and one died (6%). Conclusions. The aggregate neurological morbidity and mortality rates of RSE were high. The use of cEEG monitoring hould be considered for use in the management of such cases of status epilepticus (AU)

The development of vocabulary in Spanish children with Down syndrome: comprehension, production, and gestures.

BACKGROUND: Our main purpose was to compare the lexical development of Spanish children with Down syndrome (DS) and children with typical development (TD) to investigate the relationship between cognitive and vocabulary development in comprehension and oral and gestural production. METHOD: Participants were 186 children with DS and 186 children with TD, with a mental age (MA) of 8-29 months and matched on gender and MA. Information about vocabulary was obtained using a new Spanish adaptation of the MacArthur-Bates CDI for children with DS. RESULTS: No significant differences in oral production were found. Lexical comprehension and gestural production of children with DS were superior. Similar to children with TD, gestural production in children with DS decreased as oral production increased. CONCLUSION: Our study provides evidence to support that lexical comprehension and gesture production are strengths in children with DS. With respect to oral production, our results do not support a specific dissociation between cognitive and lexical development.

Incidencia de los factores de riesgo en mujeres cubanas con diagnóstico de lesiones oncológicas de cérvix / Incidence of risk factor in Cuban women diagnosed with cervical oncologic lesions

Se estudió la incidencia de los principales factores de riesgo como: edad de inicio de las relaciones sexuales, promiscuidad, enfermedades de transmisión sexual y otros, en la aparición de lesiones neoplásicas de cuello uterino, iniciadas en mujeres infectadas por el virus del papiloma humano. Se incluyeron 230 mujeres; 93 con diagnóstico de neoplasias intraepiteliales (NIC) y 137 con carcinomas establecidos. Se halló un pico de incidencia entre 25 y 35 años, la edad de inicio de las relaciones sexuales y del primer embarazo fue 17 años, con 4 embarazos como promedio y que el 70 por ciento tuvo al menos una interrupción. El número de parejas osciló de 1 a 8 compañeros. El método anticonceptivo de elección fue el de los intrauterinos. Todas las pacientes mostraron niveles elevados de hormonas sexuales, el aumento de progesterona fue paralelo al avance de la enfermedad. La incidencia de enfermedades de transmisión sexual resultó mayor en las pacientes con NIC, igualmente estas fumaban más, pero consumían menos alcohol que aquellas con carcinomas establecidos. Se concluyó que los factores de riesgo podrían estar implicados en la progresión de lesiones iniciadas por la infección con el VPH(AU)

Authors studied incidence of main risk factors including age at first sexual intercourse, promiscuity, sexual communicable diseases, etc related to appearance of cervical neoplasia lesions present in women infected by human papilloma virus (HPV). Study included 230 women; 93 diagnosed with intra-epithelial neoplasia (IEN), and 137 with established carcinoma. We found a peak incidence between 25 and 35 years, the age at first sexual intercourse and of the first pregnancy was at 17 years old, with 4 pregnancies as average, and that 70 percent has at least an interruption of them. Number of pairs fluctuated between one up to 8 partners. The contraceptive method chosen were the intrauterine ones. All patients showed high levels of sexual hormones, increase of progesterone was in parallel with the progression of disease. Incidence of sexual communicable diseases was higher in patients with IEN, they were strong smokers, but with a consumption lower than those with established carcinoma. We conclude that risk factors could be involved in progression of lesions started by HPV(AU)

Incidencia de los factores de riesgo en mujeres cubanas con diagnóstico de lesiones oncológicas de cérvix / Incidence of risk factor in Cuban women diagnosed with cervical oncologic lesions

Se estudió la incidencia de los principales factores de riesgo como: edad de inicio de las relaciones sexuales, promiscuidad, enfermedades de transmisión sexual y otros, en la aparición de lesiones neoplásicas de cuello uterino, iniciadas en mujeres infectadas por el virus del papiloma humano. Se incluyeron 230 mujeres; 93 con diagnóstico de neoplasias intraepiteliales (NIC) y 137 con carcinomas establecidos. Se halló un pico de incidencia entre 25 y 35 años, la edad de inicio de las relaciones sexuales y del primer embarazo fue 17 años, con 4 embarazos como promedio y que el 70 por ciento tuvo al menos una interrupción. El número de parejas osciló de 1 a 8 compañeros. El método anticonceptivo de elección fue el de los intrauterinos. Todas las pacientes mostraron niveles elevados de hormonas sexuales, el aumento de progesterona fue paralelo al avance de la enfermedad. La incidencia de enfermedades de transmisión sexual resultó mayor en las pacientes con NIC, igualmente estas fumaban más, pero consumían menos alcohol que aquellas con carcinomas establecidos. Se concluyó que los factores de riesgo podrían estar implicados en la progresión de lesiones iniciadas por la infección con el VPH.

Authors studied incidence of main risk factors including age at first sexual intercourse, promiscuity, sexual communicable diseases, etc related to appearance of cervical neoplasia lesions present in women infected by human papilloma virus (HPV). Study included 230 women; 93 diagnosed with intra-epithelial neoplasia (IEN), and 137 with established carcinoma. We found a peak incidence between 25 and 35 years, the age at first sexual intercourse and of the first pregnancy was at 17 years old, with 4 pregnancies as average, and that 70 percent has at least an interruption of them. Number of pairs fluctuated between one up to 8 partners. The contraceptive method chosen were the intrauterine ones. All patients showed high levels of sexual hormones, increase of progesterone was in parallel with the progression of disease. Incidence of sexual communicable diseases was higher in patients with IEN, they were strong smokers, but with a consumption lower than those with established carcinoma. We conclude that risk factors could be involved in progression of lesions started by HPV.

The acquisition of productive vocabulary in Spanish children with Down syndrome.

BACKGROUND: It is generally assumed that children with Down syndrome (DS) present a deficit in lexical production relative to their cognitive abilities. However, the literature on this topic has recently shown several contradictory results. In addition, most studies only consider vocabulary production in its vocal modality. However it is also necessary to take into account gesture production, since this is a strength in children with DS. Our main purpose in this study, therefore, was to investigate the relationship between cognitive development and vocabulary size in both its vocal and gestural modalities in a broad sample of Spanish children with DS. METHOD: Participants in the study were 66 children with DS and 66 children with typical development (TD), with a mental age (MA) of 14-28 months (divided into five groups with a MA of 14-16, 17-19, 20-22, 23-25 and 26-28 months). Children were matched on the basis of their gender and MA. Productive vocabularies were collected using an adaptation of the MacArthur-Bates CDI for children with DS. RESULTS: In vocal modality, the number of words produced by children with DS and children with TD is similar. As in previous studies, our data confirmed that gestural communication is superior in children with DS. However, when words and gestures are combined, the performance of both groups of children is practically equal. CONCLUSION: Our results do not support a specific dissociation between cognitive and lexical development in children with DS.

Obtaiment of Pudu (Pudu pudu) deer embryos by the somatic nuclear transfer technique

RESUMEN: Los objetivos de este trabajo fueron los de producir embriones de pudú, obtenidos por la transferencia de núcleos de fibroblastos de la oreja de pudú en ovocitos de un rumiante domésticos que es el bovino. Para posteriormente en un trabajo futuro proceder a la transferencia de embriones de pudú, al útero de hembras receptoras sincronizadas de otra especie. Se obtuvieron biopsias de 1 mm aproximadamente del borde externo de la orejas de dos ciervos pudu machos del jardín zoológico Buin-Zoo, Santiago de Chile. Las líneas celulares han sido establecidas y conservadas según los protocolos utilizados para las bovinos. Los ovocitos son obtenidos por punción del complejo cúmulos-ovocito (COC).desde ovarios de vacas recuperados del matadero. Cada ovocito es enucleado y fusionado con un fibroblasto aislado insertado bajo la zona pelúcida. La fusión de membranas celulares es obtenida por choques eléctricos. En cuanto a la cronología, observamos que al segundo día se forma una etapa de dos blastómeras, al tercer día mórulas de 8 a 16 células, y desde el cuarto día se ha diferenciado como blastocisto, el cuál al séptimo día termina por eclosionar de la zona pelúcida.La obtención de blastocistos embrionarios indica que es posible obtener embriones de pudú mediante clonaje heteroespecífico, aunque, el porcentaje de éxito obtenido es relativamente bajo. Queda aun por verificar la viabilidad de los embriones así obtenidos después de la transferencia in útero.

Un nuevo instrumento para evaluar el desarrollo comunicativo y lingüístico de niños con síndrome de Down / No disponible

Los Inventarios de Desarrollo Comunicativo MacArthur-Bates (CDI) han demostrado ser un instrumento válido y fiable para evaluar el desarrollo comunicativo y lingüístico en niños pequeños. Sin embargo, requieren ser adaptados para su uso en poblaciones de niños con distintos discapacidades y problemas de desarrollo. Un caso particular lo constituyen los niños con síndrome de Down. Estos niños presentan un perfil de desarrollo del lenguaje particular con una serie de disociaciones (mejor actuación en léxico que morfo-sintaxis, mejor comprensión que producción, etc), que es necesario tener en cuenta. El objetivo del presente trabajo consiste en presentar la adaptación de dichos inventarios para la evaluación y el estudio del desarrollo del lenguaje de los niños con síndrome de Down. Se trata de la primera adaptación específica para evaluar a estos niños teniendo en cuenta su perfil evolutivo de desarrollo comunicativo y lingüístico. En la actualidad, estamos aplicando el inventario a una muestra amplia de niños con síndrome de Down. Ello nos permitirá ofrecer datos normativos sobre el desarrollo lingüístico y comunicativo de estos niños que pueden ser de utilidad para padres, educadores, clínicos e investigadores (AU)

No disponible