Prevalence and clinical presentation of molar incisor hypomineralisation among a population of children in the community of Madrid.

OBJECTIVE: The main objective of this study was to estimate the prevalence of molar incisor hypomineralisation (MIH), an alteration of tooth enamel with an estimated worldwide prevalence rate of 14%, among children using primary care services in the Community of Madrid, Spain. MATERIALS AND METHODS: This was a descriptive, cross-sectional and multicentre study. After calibrating all researchers and following the diagnostic criteria of the European Academy of Paediatric Dentistry (EAPD), children aged between 8 and 16 years who were users of the dental services at 8 primary oral health units of the Madrid Health Service (SERMAS) were included. The children underwent a dental examination, and the parents were asked to complete a questionnaire. RESULTS: The prevalence of MIH was 28.63% (CI: 24.61-32.65%). The age cohorts most affected by MIH were 8 years (21.4%) and 11 years (20.7%). The presence of MIH was greater among girls (85; 60.71%) than among boys (55; 39.28%). The mean number of affected teeth per patient was 4.46 ± 2.8. The most frequently affected molar was the upper right first molar (74.3%), and the upper left central incisor was the most affected incisor (37.85%). Opacities were the defects most frequently recorded (63.57%). CONCLUSIONS: The prevalence of MIH in this study is the highest of all relevant studies conducted in Spain.

Importance of Desensitization for Autistic Children in Dental Practice.

OBJECTIVES: Dental treatment in special needs patients, including children with autism, can be accomplished by reducing the behaviors that can reduce fear, as it has been demonstrated in other studies. The present study aims to examine the influence of the latency time elapsing between desensitization and the real dental situation on facilitating the access of children with autism to dental treatment. STUDY DESIGN: Nineteen patients with autism, who were aged 3-14 years and attended the Special Education Center in Madrid but were living with their parents at home, were selected for the study. All children in the sample were subjected to a desensitization process before attending the real dental office. Two study groups were established: the latency period between the last desensitization and the real situation was one day for the first group and seven days for the second group. An experimental study was conducted to assess the child's cooperation in the dental chair; the dental examination was divided into several steps and the highest step reached by each child was recorded. RESULTS: There is a statistical difference in the number of steps reached between the children who received the information just before the examination date and the children who experienced a longer latency period between receiving the information and experiencing the examination. CONCLUSIONS: We would like to emphasize the importance of providing information in advance when dealing with autistic children; this information should be as close as possible to the real situation. Additionally, we would like to stress the importance of inter-cooperation between parents, educators, and pediatric dentists in order to guarantee adequate oro-dental care for autistic children. Further studies with larger sample sizes and a control group are recommended.

Judicialización en cardiología y cirugía cardiovascular: estudio observacional transversal en materia de responsabilidad patrimonial en la sanidad pública española / Litigation in cardiology and cardiovascular surgery: A cross-sectional observational study of liability in the spanish public healthcare system

Introducción: la sobrestimación por los facultativos del riesgo a una demanda judicial tiene, entre otras consecuencias, la intensificación de la medicina defensiva. El objetivo del trabajo fue analizar las características de las sentencias sobre la responsabilidad médica en España en la asistencia sanitaria pública en las especialidades de cardiología y cirugía cardiovascular.Material y métodos: estudio observacional transversal cuyo objetivo fue analizar las sentencias dictadas en la jurisdicción contencioso-administrativa por los Tribunales Superiores de Justicia entre el período 2008-2020, en las especialidades de cardiología y cirugía cardiovascular. Las variables fueron administrativas, clínicas, judiciales e indemnizatorias.Resultados: se analizaron 1.015 sentencias, de las cuales 47 (4,63%) se refirieron a las especialidades de cardiología y cirugía cardiovascular. Ambas obtuvieron porcentajes de frecuencia similares, cardiología 22 (2,16%) y cirugía cardiovascular 25 (2,46%). El 74,1% de las sentencias fueron desestimatorias en primera instancia y el 75% en segunda instancia. Los 2 motivos de sentencia estimatoria más frecuentes fueron la pérdida de oportunidad 6 (42,85%) y la mala praxis diagnóstica y/o terapéutica 5 (35,71%). Los daños reclamados fueron: fallecimiento 21 (44,68%) y secuelas 26 (55,32%). La mediana de las indemnizaciones fue 30.000 euros.Conclusiones: la baja frecuencia de las demandas en cardiología y cirugía cardiovascular indica que se trata de especialidades de «bajo riesgo» de litigiosidad. La inmensa mayoría de las sentencias son, además, desestimatorias de la pretensión de los pacientes. Los datos contribuyen a estructurar el papel de las demandas judiciales y a aumentar el conocimiento de los profesionales en la dimensión médico-legal de la asistencia sanitaria. (AU)

Introduction: The overestimation by physicians of the risk of a lawsuit has, among other consequences, the stepped-up of defensive medicine. To analyze the characteristics of medical liability rulings in Spain in public health care in the specialties of cardiology and cardiovascular surgery.Materials and methods: Cross-sectional observational study analyzing the rulings handed down in the contentious-administrative jurisdiction by the High Courts of Justice in the period 2008-2020, in the specialties of cardiology and cardiovascular surgery. The variables were administrative, clinical, judicial, and compensatory.Results: A total of 1015 rulings were analyzed; 47 (4.63%) involved to the specialties of cardiology and cardiovascular surgery. Both obtained similar frequency percentages, cardiology 22 (2.2%) and cardiovascular surgery 25 (2.5 %). A total of 74.1 % of the rulings were dismissed in the first instance and 75% in the second instance. The two grounds for finding against the defendent were loss of chance 6 (42.85%) and diagnostic and/or therapeutic malpractice 5 (35.71%). Damages were usually claimed: death 21 (44.68%) and sequelae 26 (55.32%). The median award was 30,000 euros.Conclusions: The low frequency of claims in cardiology and cardiovascular surgery indicates that these are “low risk” specialties for litigation. The vast majority of the rulings are, moreover, dismissive of the patients' claims. The data help to structure the role of lawsuits and to increase professionals' knowledge of the medical-legal dimension of health care. (AU)

Empirical analysis of medical malpractice litigation involving urgent-care settings in the Spanish national health service. / Análisis empírico de la litigiosidad judicial por responsabilidad médica en la asistencia sanitaria pública urgente en España.

OBJECTIVES: To analyze the characteristics of superior court decisions in litigation or administrative procedures for medical malpractice claims involving urgent care settings in the Spanish national health service. MATERIAL AND METHODS: Observational cross-sectional study of judicial rulings handed down between 2008 and 2020 in cases involving urgent care. We analyzed administrative, clinical, and judicial variables as well as the amounts of compensation awarded. RESULTS: A total of 1015 rulings were analyzed; 243 cases (23.9%) involved urgent medical care. Most cases (223 [91.8%]) involved elderly patients. The largest proportion of defendants (97 [39.9%]) were emergency physicians, and the most common setting was a hospital emergency department (211 [86.8%]). The grounds for finding against the defendant were most often diagnostic or therapeutic error (40 [46.0%] cases) and lost opportunity (35 [40.2%] cases). Damages were usually claimed for sequelae (122 [50.2%] cases) and death (112 [46.1%] cases). The median award was €46 000, the minimum was €1300, and the maximum was €974 849. CONCLUSION: In medical and other health-care malpractice cases, the majority of claims (about 64%) are dismissed. This finding, unreported until now, may help to contain the overestimation of risk of liability in urgent medical care. It also reinforces the need to provide medical practitioners with more training regarding the legal aspects of health care.

OBJETIVO: Analizar las características de las sentencias sobre responsabilidad médica en España en la asistencia sanitaria pública urgente, dictadas en la jurisdicción contencioso-administrativa por los Tribunales Superiores de Justicia. METODO: Estudio observacional transversal que analizó las sentencias entre 2008 y 2020 en la asistencia urgente. Se incluyeron variables administrativas, clínicas, judiciales y de cuantía indemnizatoria. RESULTADOS: Se analizaron 1.015 sentencias, de las que 243 (23,9%) se refirieron a una asistencia urgente. La mayoría se refería a pacientes mayores de edad, 223 (91,8%). La especialidad más implicada fue Medicina de Urgencias y Emergencias 97 (39,9%) y el ámbito más frecuente fue el hospitalario 211 (86,8%). El 64,6% de las sentencias fueron íntegramente desestimatorias. Los motivos de sentencia condenatoria más habituales fueron la mala praxis diagnóstica o terapéutica 40 (46,0%), y la pérdida de oportunidad 35 (40,2%). Los daños más reclamados fueron secuelas 122 (50,2%) y fallecimiento 112 (46,1%). La mediana de las indemnizaciones fue 46.000 euros, intervalo: 1.300-974.849. CONCLUSIONES: La mayoría de las sentencias recaídas en la resolución de reclamaciones profesionales médico-sanitarias son íntegramente desestimatorias. Este dato, que era desconocido hasta el momento en la medicina pública, puede contribuir a enmarcar la sobrestimación del riesgo legal en la asistencia urgente. Así mismo, refuerza la idea de la necesidad de aumentar la formación de los profesionales en los aspectos médico-legales de la asistencia sanitaria.

Análisis empírico de la litigiosidad judicial por responsabilidad médica en la asistencia sanitaria pública urgente en España / Empirical analysis of medical malpractice litigation involving urgent-care settings in the Spanish national health service

Objetivo. Analizar las características de las sentencias sobre responsabilidad médica en España en la asistencia sanita- ria pública urgente, dictadas en la jurisdicción contencioso-administrativa por los Tribunales Superiores de Justicia. Método. Estudio observacional transversal que analizó las sentencias entre 2008 y 2020 en la asistencia urgente. Se incluyeron variables administrativas, clínicas, judiciales y de cuantía indemnizatoria. Resultados. Se analizaron 1.015 sentencias, de las que 243 (23,9%) se refirieron a una asistencia urgente. La mayoría se refería a pacientes mayores de edad, 223 (91,8%). La especialidad más implicada fue Medicina de Urgencias y Emergencias 97 (39,9%) y el ámbito más frecuente fue el hospitalario 211 (86,8%). El 64,6% de las sentencias fueron íntegramente desestimatorias. Los motivos de sentencia condenatoria más habituales fueron la mala praxis diagnóstica o terapéutica 40 (46,0%), y la pérdida de oportunidad 35 (40,2%). Los daños más reclamados fueron secuelas 122 (50,2%) y fallecimiento 112 (46,1%). La mediana de las indemnizaciones fue 46.000 euros, intervalo: 1.300-974.849. Conclusiones. La mayoría de las sentencias recaídas en la resolución de reclamaciones profesionales médico-sanitarias son íntegramente desestimatorias. Este dato, que era desconocido hasta el momento en la medicina pública, puede con- tribuir a enmarcar la sobrestimación del riesgo legal en la asistencia urgente. Así mismo, refuerza la idea de la necesidad de aumentar la formación de los profesionales en los aspectos médico-legales de la asistencia sanitaria.

Background and objective. To analyze the characteristics of superior court decisions in litigation or administrative procedures for medical malpractice claims involving urgent care settings in the Spanish national health service. Methods. Observational cross-sectional study of judicial rulings handed down between 2008 and 2020 in cases involving urgent care. We analyzed administrative, clinical, and judicial variables as well as the amounts of compensation awarded. Results. A total of 1015 rulings were analyzed; 243 cases (23.9%) involved urgent medical care. Most cases (223 [91.8%]) involved elderly patients. The largest proportion of defendants (97 [39.9%]) were emergency physicians, and the most common setting was a hospital emergency department (211 [86.8%]). The grounds for finding against the defendant were most often diagnostic or therapeutic error (40 [46.0%] cases) and lost opportunity (35 [40.2%] cases). Damages were usually claimed for sequelae (122 [50.2%] cases) and death (112 [46.1%] cases). The median award was €46 000, the minimum was €1300, and the maximum was €974 849. Conclusions. In medical and other health-care malpractice cases, the majority of claims (about 64%) are dismissed. This finding, unreported until now, may help to contain the overestimation of risk of liability in urgent medical care. It also reinforces the need to provide medical practitioners with more training regarding the legal aspects of health care.

Persistent mycotic superficial femoral artery pseudoaneurysm after endovascular treatment: a case report.

Mycotic pseudoaneurysms of the superficial femoral artery (SFA) are rare and are usually secondary to colonization of an atherosclerotic plaque during an episode of bacteremia. We describe the case of a 68 year-old diabetic male who presented to the Emergency Department with pyrexia and a painful expanding mass in the left thigh. He had a history of diarrhea and had been treated 16 days earlier for an SFA pseudoaneurysm that had been excluded with a covered stent with no adjunctive antibiotic therapy. Angio CT showed an abscess surrounding femoral vessels and stent thrombosis. Under general anesthesia, we performed extensive debridement, removal of the endovascular material, SFA ligation, and empirical antibiotic therapy. Blood and tissue cultures were positive for Escherichia coli. At the 3-months follow up visit, the patient reported he had no claudication. In selected patients, mycotic pseudoaneurysms can be treated by SFA ligation.

Pseudoaneurismas micóticos da artéria femoral superficial (AFS) são raros, e geralmente são secundários à colonização de uma placa aterosclerótica durante bacteremia. Relatamos o caso de um paciente masculino diabético de 68 anos que chegou ao Serviço de Emergência com pirexia e massa expansiva dolorosa na coxa esquerda. Apresentava histórico de diarreia e havia sido tratado 16 dias antes para pseudoaneurisma da AFS, que foi excluído com stent coberto e sem antibioticoterapia adjuvante. A angiotomografia computadorizada demonstrou um abscesso ao redor dos vasos femorais e trombose do stent. Sob anestesia geral, realizamos desbridamento extenso, remoção do material endovascular, ligadura de AFS e antibioticoterapia empírica. Culturas de sangue e tecidos foram positivas para Escherichia coli. Na consulta de seguimento aos 3 meses, o paciente negou claudicação. Em pacientes selecionados, pseudoaneurismas micóticos podem ser tratados com ligadura de AFS.

Persistent mycotic superficial femoral artery pseudoaneurysm after endovascular treatment: a case report / Pseudoaneurisma micótico persistente da artéria femoral superficial após tratamento endovascular: relato de caso

Abstract Mycotic pseudoaneurysms of the superficial femoral artery (SFA) are rare and are usually secondary to colonization of an atherosclerotic plaque during an episode of bacteremia. We describe the case of a 68 year-old diabetic male who presented to the Emergency Department with pyrexia and a painful expanding mass in the left thigh. He had a history of diarrhea and had been treated 16 days earlier for an SFA pseudoaneurysm that had been excluded with a covered stent with no adjunctive antibiotic therapy. Angio CT showed an abscess surrounding femoral vessels and stent thrombosis. Under general anesthesia, we performed extensive debridement, removal of the endovascular material, SFA ligation, and empirical antibiotic therapy. Blood and tissue cultures were positive for Escherichia coli. At the 3-months follow up visit, the patient reported he had no claudication. In selected patients, mycotic pseudoaneurysms can be treated by SFA ligation.

Resumo Pseudoaneurismas micóticos da artéria femoral superficial (AFS) são raros, e geralmente são secundários à colonização de uma placa aterosclerótica durante bacteremia. Relatamos o caso de um paciente masculino diabético de 68 anos que chegou ao Serviço de Emergência com pirexia e massa expansiva dolorosa na coxa esquerda. Apresentava histórico de diarreia e havia sido tratado 16 dias antes para pseudoaneurisma da AFS, que foi excluído com stent coberto e sem antibioticoterapia adjuvante. A angiotomografia computadorizada demonstrou um abscesso ao redor dos vasos femorais e trombose do stent. Sob anestesia geral, realizamos desbridamento extenso, remoção do material endovascular, ligadura de AFS e antibioticoterapia empírica. Culturas de sangue e tecidos foram positivas para Escherichia coli. Na consulta de seguimento aos 3 meses, o paciente negou claudicação. Em pacientes selecionados, pseudoaneurismas micóticos podem ser tratados com ligadura de AFS.

IL-17-Mediated Immunity Controls Skin Infection and T Helper 1 Response during Experimental Microsporum canis Dermatophytosis.

Despite worldwide prevalence of superficial mycoses, the immune response in dermatophytosis has scarcely been investigated. In this study, we developed a model of superficial skin infection in C57BL/6 mice with Microsporum canis, a highly prevalent human pathogen. This model mimics mild inflammatory human dermatophytosis, characterized by neutrophil recruitment and fungal invasion limited to the epidermis and exhibits the establishment of a specific T helper type 17 immune response during infection. By using IL-17RA- or IL-17A/F-deficient mice we showed that, in the absence of a functional IL-17 pathway, M. canis extensively colonizes the epidermis and promotes an exaggerated skin inflammation and a shift to an IFN-γ-mediated (T helper type 1) response. IL-17 signaling was not involved in neutrophil influx to skin or fungal invasion to deeper tissues. Finally, this study shows that skin langerin-expressing cells contribute to the antifungal T helper type 17 response in vivo. In conclusion, these data directly show a dual function of IL-17 cytokines in dermatophytosis by controlling superficial infection and down-modulating a T helper type 1 antifungal response.

[Essential mixed cryoglobulinemia type II: case report.] / Crioglobulinemia mixta esencial tipo II: presentación de un caso.

The cryoglobulinemic syndrome is produced by precipitating immunoglobulins at low temperatures. Its production is associated with several causes, such as lymphoproliferative disorders, chronic infections and autoimmune disorders. However, the etiology is unknow. There are three types of cryoglobulins. Type II and III are the mixed. Type III produce a systemic vasculitis with diverse clinical manifestations. Palpable purpura is the most common, accompanied by arthralgia, neuropathy and type I membranoproliferative glomerulonephritis. We present a case of a 71 years old male patient with renal failure, nephritic syndrome, arterial hypertension and palpable purpuric skin lesions in members, thorax and abdomen. During hospitalization essential mixed cryoglobulinemia associated with cutaneous leukocytoclastic vasculitis and type I membranoproliferative glomerulonephritis was diagnosed. Complementary methods, treatment instituted and the patient's clinical course are described.

El síndrome crioglobulinémico es producido por inmunoglobulinas que precipitan reversiblemente a bajas temperaturas, llamadas crioglobulinas. Su producción se asocia a varias causas, como desórdenes linfoproliferativos, infecciones crónicas y trastornos autoinmunitarios. No obstante, en muchos casos la etiología no logra determinarse. Existen tres tipos, siendo las de tipo II y III las que forman parte de las denominadas crioglobulinemias mixtas. Estas últimas producen un cuadro de vasculitis sistémica con manifestaciones clínicas diversas. La púrpura palpable es la más frecuente, acompañada en forma variable por artralgias, neuropatía y afección renal en forma de glomerulonefritis membranoproliferativa de tipo I. Presentamos el caso clínico de un paciente de sexo masculino de 71 años de edad con insuficiencia renal, síndrome nefrítico, hipertensión arterial y lesiones cutáneas purpúricas palpables ambos miembros, tórax y abdomen. Durante la internación se diagnostica crioglobulinemia mixta esencial asociada a vasculitis leucocitoclástica cutánea y glomerulonefritis membranoproliferativa tipo I. Describimos los métodos complementarios utilizados para llegar al diagnóstico, el tratamiento instituido y la evolución clínica del paciente.

[Kaposi's Sarcoma in patients with late HIV diagnosis. Case report and review of literature.] / Sarcoma de Kaposi en paciente con diagnóstico tardío de VIH. Presentación de un caso y revisión.

Kaposi's sarcoma is a limphoangioproliferous tumor described for the first time in the year 1872 by Moritz Kaposi. There are four clinical variants, the classical form, the endemic, the iatrogenic associated to transplantation or immunosuppression and the epidemic associated with AIDS, which will be referred in this publication. In this research,(case, paperwork, investigation) a 31 year old male patient, who was diagnosed AIDS and Kaposi's sarcoma at the same time while in hospital, is described.

El sarcoma de Kaposi es un tumor linfoangioproliferativo descripto por primera vez en el año 1872 por Moritz Kaposi. Hay cuatro variantes clínicas, la forma clásica, la endémica, la iatrogénica asociada a trasplante o inmunosupresión y la epidémica asociada a SIDA, de la cual se hará referencia en esta publicación. Se describe un paciente varón de 31 años, al cual durante la misma internación se hace el diagnóstico de SIDA y de sarcoma de Kaposi.

Anomalías dentarias de unión: A propósito de un caso y posibilidades de tratamiento / Union dental anomalies: a case report and treatment possibilities

El objetivo del presente artículo es describir las anomalías de unión, y para ello presentamos un raro caso de fusión - geminación y sus consecuencias tanto a nivel estético, pulpar así como las posibilidades de tratamiento

The aim of this article is to discuss the union anomalies and we present a rare case of a fusion - germination, the consequences in the aesthetic level as pulp level and treatment possibilities

Hemangioma verrugoso: comunicación de un caso / Verrucous hemangioma: case report

El hemangioma verrugoso es una anomalía vascular poco frecuente, de aspecto verrugoso, que puede estar presente desde el nacimiento yquese caracteriza histopatológicamente por estar compuestapor capilares dilatados y vasos de tamaño venular dispuestos en la dermis y el tejido celular subcutáneo. Secomunicael caso de un niño de 7 años de edad, cuya enfermedad estaba presente desde el nacimiento en la cara anterior de la pierna izquierda.

Verrucous hemangioma is rare vascular anomaly with verrucous aspect, that may be present since birth, and consists of dilated capillary and venular vessels that occupy the dermis and hypodermis. We report a 7-year-old boy whose disease appeared at birth and was located at the anterior side of his left leg.

Revascularización con pasta tri-antibiótica. Revisión bibliográfica / Revascularization with tri-antibiotic paste. Literature review

Se presenta una revisión bibliográfica sobra la revascularización con pasta tri-antibiótica. Se analizan los diferentes protocolos y los resultados obtenidos en la literatura, comparándolos y eligiendo los materiales y protocolos más actuales. Definimos un protocolo de actuación frente al tratamiento de dientes inmaduros no vitales. Se comparan la apexificación con la revascularización, definiendo las ventajas y las desventajas de ambos tratamientos (AU)

We are presenting a bibliografic review about tri-antibiotic revascularization. We have analized different protocols and results in the literature, comparing them and chosing the best and the newest tecniques, and finally we defined an ultimate treatment of necrotic immature teeth. We compared apexification and revascularization, stating their advantages and disadvantages of both treatments (AU)

Naturalez neuronal de los neuroblastomas de la clasificación de la Río Hortega del sistema nervioso central: estudio con técnicas argénticas e inmunohistoquímicas / Neuroblastomas neuronal nature of the classification of the Hortega River of the central nervous system. Argénticas study and immunohistochemical techniques

El objetivo fue demostrar que los llamados meduloblastomas del Sistema Nervioso Central son neuroblastomas, tumores de origen neural con identidad propia. Siguiendo a Del Río Hortega y Polak se estudiaron 33 meduloblastomas cerebelares clínica y anatomopatológicamente demostrados. Se utilizaron técnicas de anilinas, impregnación argéntica y de inmunohistoquímica. Se analizó extensamente la bibliografía haciendo énfasis en el origen e histogénesis de las neuronas. Se tuvo en cuenta un principio básico que para reconocerlas se debe teñir el núcleo, el citoplasma y sus prolongaciones. Con las técnicas habituales de hematoxilina- eosina se observa sólo el núcleo y citoplasma, con la inmunohistoquímica se caracteriza la estirpe y con las técnicas argénticas las prolongaciones, con las que Cajal, Del Río Hortega, Golgi y otros estudiaron y descubrieron las células del SNC normal y patológico, cuya teoría de la neurona de Cajal no fue superada hasta la actualidad.

SUMMARY: The purpose of this study was to demonstrate that the called meduloblastoma of the central nervous system, are neuroblastomas, tumors of neural origin with its own identity .Following the published studies from Del Rio Hortega and Pollak, we studied 33 cerebellar medulloblastoma, clinically and pathologically demonstrated We used silver, aniline stains and immunohistochemestry. A comprehensive literature review was conducted, with emphasis on the origin and histogenesis of neurons. A basic principle was considered to recognize a neuron, the nucleus, the cytoplasm and the neuronal extensions must be stained. With standard hematoxilin and eosin techniques we only observed the nucleus and the cytoplasm. The immunohistochemestry showed the cell line origin and the silver stain make evident the neuronal extensions. Del Rio Hortega, Cajal, Golgi and others discovered and studied the normal and pathological central nervous system cell. The Cajal’s neuron theory was unsurpassed even today.

Influence of controlled inoculation of malolactic fermentation on the sensory properties of industrial cider.

Given the lack of research in the traditional cider making field when compared to the efforts devoted to winemaking, this work focused on the effects of controlled inoculation of the malolactic fermentation (MLF) on the sensory properties of cider. MLF develops spontaneously in cider making at industrial level. In this work, industrial cider samples were inoculated with selected indigenous Oenococcus oeni strains and the benefits on the aroma and flavour in cider production compared to non-inoculated ciders were evaluated. Randomly amplified polymorphic DNA PCR was used to monitor strain colonization ability, outnumbering the indigenous microbiota, after completion of the alcoholic fermentation at industrial scale (20,000 l). Aroma-active compounds of experimentally inoculated ciders were analysed by HPLC and GC-MS, and sensory profiles were determined by fractioning aroma extracts using reversed-phase HPLC. Principal component analysis allowed the identification of relationships and differences among ciders with or without inoculation, including several highly appreciated commercial ones obtained under spontaneous conditions. Under controlled inoculation conditions, not only could MLF be shortened by half but, interestingly, enhancement of aroma complexity and flavour resulted in ciders enriched with a higher fruity note. In addition, important aromatic groups analysed here had not been previously described, thus affording deeper knowledge on aroma characterization of apple cider.

Fusariosis presentación de un caso en paciente con leucemia mieloide aguda / Fusarium: presentation of a patient case's with acute myeloid leukemia

Estudio de caso: Paciente de sexo femenino de 22 años con diagnóstico de leucemia mieloide aguda (LMA) en mayo de 2013. Presenta una recaída refractaria al tratamiento enenero de 2014. En el transcurso de su internación presenta síndrome febril con lesiones en piel de tipo nódulos y placas infiltradas eritematovioláceas, dolorosas a la palpación en tronco y miembros (fig.1). Se toma biopsia cutánea con diagnósticos presuntivos de leucemide y Sarcoma de Kaposi.

Case Study: Female patient of 22 years with diagnosis acute myeloid leukemia (AML) in May 2013. It presents a relapse refractory to treatment January 2014. During his internment presents feverish syndrome with skin lesions in lymph type and infiltrated erythematous plaques, painful to palpation trunk and limbs (Figure 1). Biopsy is taken with presumptive diagnosis of cutaneous and leucemide Kaposi sarcoma.