Rainfall and sea level drove the expansion of seasonally flooded habitats and associated bird populations across Amazonia.

Spatial arrangement of distinct Amazonian environments through time and its effect on specialized biota remain poorly known, fueling long-lasting debates about drivers of biotic diversification. We address the late Quaternary sediment deposition that assembled the world's largest seasonally flooded ecosystems. Genome sequencing was used to reconstruct the demographic history of bird species specialized in either early successional vegetation or mature floodplain forests. Sediment deposition that built seasonally flooded habitats accelerated throughout the Holocene (last 11,700 years) under sea level highstand and intensification of the South American Monsoon, at the same time as global increases in atmospheric methane concentration. Bird populations adapted to seasonally flooded habitats expanded due to enlargement of Amazonian river floodplains and archipelagos. Our findings suggest that the diversification of the biota specialized in seasonally flooded habitats is coupled to sedimentary budget changes of large rivers, which rely on combined effects of sea level and rainfall variations.

Canopy cover negatively affects arboreal ant species richness in a tropical open habitat / A cobertura de dossel afeta negativamente a riqueza de formigas arborícolas em um hábitat tropical aberto

Abstract We tested the hypothesis of a negative relationship between vegetation characteristics and ant species richness in a Brazilian open vegetation habitat, called candeial. We set up arboreal pitfalls to sample arboreal ants and measured the following environmental variables, which were used as surrogate of environmental heterogeneity: tree richness, tree density, tree height, circumference at the base of the plants, and canopy cover. Only canopy cover had a negative effect on the arboreal ant species richness. Vegetation characteristics and plant species composition are probably homogeneous in candeial, which explains the lack of relationship between other environmental variables and ant richness. Open vegetation habitats harbor a large number of opportunistic and generalist species, besides specialist ants from habitats with high temperatures. An increase in canopy cover decreases sunlight incidence and may cause local microclimatic differences, which negatively affect the species richness of specialist ants from open areas. Canopy cover regulates the richness of arboreal ants in open areas, since only few ant species are able to colonize sites with dense vegetation; most species are present in sites with high temperature and luminosity. Within open vegetation habitats the relationship between vegetation characteristics and species richness seems to be the opposite from closed vegetation areas, like forests.

Resumo Nós testamos a hipótese de que há uma relação negativa entre as características da vegetação e a riqueza de espécies de formigas em habitats abertos como o candeial. Para isto, nós instalamos pitfalls arborícolas para a captura de formigas e mensuramos as seguintes variáveis ambientais: riqueza de árvores, densidade de árvores, altura de árvores, circunferência basal das plantas e cobertura de dossel. Somente a cobertura de dossel apresentou efeito negativo na riqueza de formigas arborícolas. Provavelmente, as características da vegetação e a composição de espécies de plantas são mais homogêneas no candeial, o que explica a ausência de relação entre a riqueza de formigas e as outras variáveis ambientais. Formações abertas abrigam um grande número de espécies oportunistas e generalistas, além de formigas especialistas de climas quentes. O aumento na cobertura de dossel diminui a incidência solar o que pode causar diferenças microclimáticas que afetam negativamente as espécies de formigas especialistas de hábitats abertos. A cobertura de dossel regula a riqueza de espécies de formigas arborícolas em áreas abertas e poucas espécies nestes locais estão aptas a colonizar locais com a vegetação densa. Assim, a maioria das espécies estão presentes em locais com alta temperatura e luminosidade. Em outras palavras, em hábitats de vegetação aberta a relação entre características da vegetação e a riqueza de espécies pode ser oposta em comparação ao que é encontrado em áreas que apresentam a vegetação mais fechada, como florestas.

Canopy cover negatively affects arboreal ant species richness in a tropical open habitat.

We tested the hypothesis of a negative relationship between vegetation characteristics and ant species richness in a Brazilian open vegetation habitat, called candeial. We set up arboreal pitfalls to sample arboreal ants and measured the following environmental variables, which were used as surrogate of environmental heterogeneity: tree richness, tree density, tree height, circumference at the base of the plants, and canopy cover. Only canopy cover had a negative effect on the arboreal ant species richness. Vegetation characteristics and plant species composition are probably homogeneous in candeial, which explains the lack of relationship between other environmental variables and ant richness. Open vegetation habitats harbor a large number of opportunistic and generalist species, besides specialist ants from habitats with high temperatures. An increase in canopy cover decreases sunlight incidence and may cause local microclimatic differences, which negatively affect the species richness of specialist ants from open areas. Canopy cover regulates the richness of arboreal ants in open areas, since only few ant species are able to colonize sites with dense vegetation; most species are present in sites with high temperature and luminosity. Within open vegetation habitats the relationship between vegetation characteristics and species richness seems to be the opposite from closed vegetation areas, like forests.

Prevalence and Causes of Normal Exercise Oximetry in the Calf in Patients with Peripheral Artery Disease and Limiting Calf Claudication.

OBJECTIVE: In patients with claudication, an ankle brachial index (ABI) under 0.90 is considered to be abnormal and a sufficient argument for the arterial origin of exercise induced pain. Exercise transcutaneous oxygen pressure (Ex-tcpO2) can provide evidence of exercise induced regional blood flow impairment (RBFI) and confirm the arterial origin of walking induced pain. The frequency with which calf Ex-tcpO2 remains apparently normal in patients with claudication and abnormal ABI is unknown. Causes of these discrepant results have yet to be analysed. METHODS: A retrospective analysis of 4575 Ex-tcpO2 tests performed on 3,281 patients was conducted. The focus was on patients with a history of calf claudication and ABI under 0.90. Duplicate or non-standard tests were excluded, as were patients with no pain or those able to walk more than 15 minutes (on a treadmill). Searches were conducted for possible explanations of normal calf Ex-tcpO2 in the selected patients. RESULTS: Cardiorespiratory limitation was identified in 50 patients and isolated non-calf ischemia in 36 of the 106 patients selected. There was no obvious explanation during Ex-tcpO2, but clinical improvement after non-vascular treatment or total absence of improvement after a technically successful revascularisation was noted in 12 patients. Four patients were lost on follow up. Four patients improved after revascularisation, which suggests that the Ex-tcpO2 result was false negative. CONCLUSIONS: Ex-tcpO2 is negative in more than 20% of tests performed in patients with an ABI under 0.90 and a history of calf claudication. In most cases, when excluding re-tests and non-limiting or non-calf claudication on the treadmill, non-calf ischemia or a non-vascular limitation occurring during the test were observed. This observation supports both the value of treadmill testing in patients with calf claudication assumed to be of arterial origin (ABI<0.90) and the use of Ex-tcpO2 to detect non-calf ischemia.

Test-retest Reliability of GPS derived Measurements in Patients with Claudication.

OBJECTIVE: In patients with peripheral artery disease (PAD), the different distances between stops and the stop durations recorded with Global Positioning System (GPS) during a 1 hour stroll in the community are highly variable. Nevertheless, the reliability of the greatest community walk distance (greatest distance), the average of walking speeds (average speed) and the durations of stops (average stop durations) have not been studied. DESIGN: Seventeen PAD patients performed two series of evaluations (T1 and T2) within a 1 month period. METHODS: Each series included: a 1 hour stroll in the community with the calculation of the walking impairment questionnaire (WIQ) scores, the measurement of maximal walking distance on a treadmill (MWD on treadmill) and a 1 hour stroll in the community with GPS. The Garmin GPS-60 (Garmin Ltd, Olathe, Kan) receiver was used for all patients. Test-retest reliability of MWD on treadmill, WIQ, and GPS parameters were assessed with intraclass coefficient of correlation (ICC). RESULTS: ICCs are almost perfect between T1 and T2 for greatest distance (ICC = 0.911), average speed (ICC = 0.905), and MWD on treadmill (ICC = 0.992), and substantial for the average WIQ (ICC = 0.794). Correlation of average stop durations was considered substantial (ICC = 0.691). CONCLUSIONS: Despite the previously reported "within stroll" variability of walking bouts for distances, speeds, and stop durations, GPS derived greatest distance and average speed are reliable in PAD patients in test-retest experiments. The GPS appears to be a new tool to assess walking limitation and allows objective clinical investigation.

The clinical course of pulmonary embolism patients anticoagulated for 1 year: results of a prospective, observational, cohort study.

BACKGROUND: Few studies have examined the clinical course of pulmonary embolism (PE) in patients anticoagulated continuously for 1 year. OBJECTIVE: We sought to determine the incidence of death, recurrent PE and bleeding during anticoagulation in the first year after acute PE, and to assess associated risk factors. METHODS: All consecutive PE patients who were referred to our center in Pisa, Italy between 2001 and 2005 received a conventional initial treatment, followed by vitamin K antagonists [international normalized ratio (INR), 2.0-3.0] for 1 year. They were followed-up at scheduled times at the study center. The development of recurrent PE was objectively documented and recorded. RESULTS: Out of 497 patients, 48 (9.6%) developed recurrent PE, which was fatal in 36. Of these 48 events, 39 occurred within 10 days of diagnosis and only two patients had a non-fatal recurrent PE between 6 and 12 months. Risk factors associated with the risk for overall recurrent PE were persistent severe dyspnoea (P = 0.007), a high perfusion defect score index (PDI) (P = 0.003) and cardiopulmonary co-morbidities (P = 0.005). Unprovoked presentation (P = 0.030), persistent severe dyspnoea (P = 0.011) and a high PDI (P = 0.001) predicted the risk for fatal PE. Overall bleeding incidence was 3.4%, no cases of bleeding occurred between 180 and 360 days post-diagnosis. CONCLUSIONS: In spite of conventional anticoagulation, a proportion of patients with PE experience both a fatal and non-fatal recurrent embolism within the first year. The large majority of these occur within the days proceeding diagnosis, with only a small minority occurring in the last 6 months. No bleeding was observed after 6 months. Therefore, prolonging anticoagulation for 1 year represents both a safe and effective treatment.

Comunicación en salud como una herramienta más en la lucha contra los helmintos intestinales / Health communication as another tool in the fight against intestinal helminths

Las helmintiasis intestinales continúan siendo un problema de salud para una gran parte del mundo. La quimioterapia antihelmíntica aplicada en las comunidades logra disminuir la prevalencia e intensidad de estas infecciones; sin embargo, las cifras suelen regresar a valores similares poco tiempo después. Un enfoque integral en la lucha contra los helmintos intestinales con intervenciones que involucren a las comunidades, los sectores y a los decisores de salud ayudará a hacer decrecer la transmisión de los geohelmintos. Una estrategia de comunicación social, donde se tome en consideración a la audiencia, el mensaje que se llevará a esta, la fuente de procedencia del mensaje y el canal por el cual llegará a la audiencia propicia que el público conozca de las amenazas de estas infecciones y que aumente el nivel de percepción y su participación. La presente revisión aborda aspectos relacionados con la importancia de la capacitación de los trabajadores de la salud en comunicación social en salud y en la identificación de los problemas relacionados con el control de las helmintiasis intestinales en su comunidad. El uso de los métodos de comunicación puede influir positivamente en las decisiones individuales y comunitarias para disminuir el impacto de este problema en la salud de las poblaciones.

[Dose intensity received in breast cancer treatment with chemotherapy]. / Intensidad de dosis recibida en el tratamiento quimioterápico del cáncer de mama.

OBJECTIVE: To know relative dose intensity (RDI) in patients with breast cancer treated with chemotherapy. To determine the number of patients where RDI was < 85% of that programmed and the possible cause. METHOD: Retrospective study, four-month selection period. The following were recorded: age, body surface, protocol applied, intention of treatment, frequency of administration of cycles, number of cytostatic treatments previously received and filgrastim administration. The average RDI per patient and protocol was calculated. RESULTS: 110 patients were analysed, the average age of them being 55.4 years (interval: 31-84), average body surface 1.7 m2 (1.3-2.4). Overall average RDI was 91.0% (SD 10.7). 93.8% (10.6), 95.8% (6.3) and 81.9% (18.5) in neoadjuvant, adjuvant and palliative treatments, respectively. 20% of the patients did not reach a RDI = 85% of that programmed, average RDI 69.5% (3.29). A delay in the administration of chemotherapy equal or greater than seven days occurred in 45.4% of the cases, average RDI 80.7% (16.0). In the episodes where the dose was reduced because of toxicity, the RDI was 75.6% (13.6). Significant inverse ratios were obtained with age (p = 0.02) and line of treatment (p = 0.03) with the RDI. In 36.8%, dose reduction was caused by neutropenia; 52.9% received filgrastim. CONCLUSIONS: Most patients received the appropriate RDI. Age, previous treatments and intention of treatment were the variables with the greatest impact on the dose received. The delay in administering the cycle was the most frequent act minimising the toxicity and which least affected the treatment.

Intensidad de dosis recibida en el tratamiento quimioterápico del cáncer de mama / No disponible

Objetivo: Conocer las intensidades de dosis relativas (IDR) enpacientes con cáncer de mama y tratamiento quimioterápico.Determinar el número de pacientes donde la IDR fue < 85% de laprogramada y posible causa.Método: Estudio retrospectivo, periodo de selección de 4 meses.Se registraron: edad, superficie corporal, protocolo administrado,intención de tratamiento, frecuencia de administración de ciclos,número de tratamientos citostáticos recibidos anteriormente y administraciónde filgrastim. Se calculó la IDR media por paciente y protocolo.Resultados: Se analizaron 110 pacientes, edad media 55,4años (intervalo: 31-84), superficie corporal media 1,7 m2 (1,3-2,4). La IDR media global fue 91,0% (DE 10,7). Del 93,8%(10,6), 95,8% (6,3) y 81,9% (18,5) en neoadyuvancia, adyuvanciay tratamiento paliativo, respectivamente. El 20% de pacientesno alcanzó una IDR >= 85% de la programada, IDR media 69,5%(3,29). Un retraso en la administración de quimioterapia igual osuperior a 7 días ocurrió en un 45,4% de los casos, IDR media80,7% (16,0). En los episodios donde se disminuyó la dosis portoxicidad la IDR media fue 75,6% (13,6). Se obtuvieron relacionesinversas significativas de la edad (p = 0,02) y línea de tratamiento(p = 0,03) con la IDR. En un 36,8% la reducción de dosisfue por neutropenia, recibiendo filgrastim el 52,9%.Conclusiones: La mayoría de pacientes recibió una IDR adecuada.La edad, tratamientos anteriores e intención de tratamientofueron las variables que más afectaron a la dosis recibida. Elretraso en la administración del ciclo fue la actuación más frecuentepara minimizar la toxicidad y que menos afectó al tratamiento

Objective: To know relative dose intensity (RDI) in patientswith breast cancer treated with chemotherapy. To determine thenumber of patients where RDI was < 85% of that programmedand the possible cause.Method: Retrospective study, four-month selection period.The following were recorded: age, body surface, protocol applied,intention of treatment, frequency of administration of cycles,number of cytostatic treatments previously received and filgrastimadministration. The average RDI per patient and protocol was calculated.Results: 110 patients were analysed, the average age of thembeing 55.4 years (interval: 31-84), average body surface 1.7 m2(1.3-2.4). Overall average RDI was 91.0% (SD 10.7). 93.8%(10.6), 95.8% (6.3) and 81.9% (18.5) in neoadjuvant, adjuvantand palliative treatments, respectively. 20% of the patients did notreach a RDI >= 85% of that programmed, average RDI 69.5%(3.29). A delay in the administration of chemotherapy equal orgreater than seven days occurred in 45.4% of the cases, averageRDI 80.7% (16.0). In the episodes where the dose was reducedbecause of toxicity, the RDI was 75.6% (13.6). Significant inverseratios were obtained with age (p = 0.02) and line of treatment(p = 0.03) with the RDI. In 36.8%, dose reduction was caused byneutropenia; 52.9% received filgrastim.Conclusions: Most patients received the appropriate RDI.Age, previous treatments and intention of treatment were thevariables with the greatest impact on the dose received. The delayin administering the cycle was the most frequent act minimisingthe toxicity and which least affected the treatment

Analysis of polymorphism at site -174 G/C of interleukin-6 promoter region in multiple myeloma.

It is well established that interleukin-6 (IL-6) is an essential growth factor for multiple myeloma (MM) and patients with increased IL-6 levels have a poor prognosis. In healthy subjects, the presence of the C allele at a polymorphic site (-174 G/C) of the IL-6 gene is related to low IL-6 levels. In view of the potential association of this particular polymorphism with IL-6 concentration, and the relevance of IL-6 in MM pathogenesis, the objective of the present study was to investigate the prevalence of IL-6 (-174 G/C) promoter polymorphism and its association with development of MM in Brazilian individuals. We investigated the prevalence of these alleles in 52 patients and 60 healthy subjects (matched by age, sex, and race) of a Brazilian population. Thirty patients were male (42.4%), 24 (46.2%) were white and the median age at diagnosis was 58.5 years (range: 28 to 84 years). To determine the IL-6 (-174 G/C) polymorphism, molecular analysis was performed by polymerase chain reaction followed by endonuclease restriction digestion. The genotype distributions observed in the group of patients were 4% CC, 42% GC and 54% GG. The C allele frequency was 0.25. These results were similar to the control group, suggesting no impact of this polymorphism on the susceptibility to MM.

Analysis of polymorphism at site -174 G/C of interleukin-6 promoter region in multiple myeloma

It is well established that interleukin-6 (IL-6) is an essential growth factor for multiple myeloma (MM) and patients with increased IL-6 levels have a poor prognosis. In healthy subjects, the presence of the C allele at a polymorphic site (-174 G/C) of the IL-6 gene is related to low IL-6 levels. In view of the potential association of this particular polymorphism with IL-6 concentration, and the relevance of IL-6 in MM pathogenesis, the objective of the present study was to investigate the prevalence of IL-6 (-174 G/C) promoter polymorphism and its association with development of MM in Brazilian individuals. We investigated the prevalence of these alleles in 52 patients and 60 healthy subjects (matched by age, sex, and race) of a Brazilian population. Thirty patients were male (42.4 percent), 24 (46.2 percent) were white and the median age at diagnosis was 58.5 years (range: 28 to 84 years). To determine the IL-6 (-174 G/C) polymorphism, molecular analysis was performed by polymerase chain reaction followed by endonuclease restriction digestion. The genotype distributions observed in the group of patients were 4 percent CC, 42 percent GC and 54 percent GG. The C allele frequency was 0.25. These results were similar to the control group, suggesting no impact of this polymorphism on the susceptibility to MM.

Hydrogen peroxide impairs GRK2 translation via a calpain-dependent and cdk1-mediated pathway.

Oxidative mechanisms of injury are involved in many neurodegenerative diseases such as stroke, ischemia-reperfusion injury and multiple sclerosis. G protein-coupled receptor kinase 2 (GRK2) plays a key role in G protein-coupled receptor (GPCR) signaling modulation, and its expression levels are decreased after brain hypoxia/ischemia and reperfusion as well as in several inflammatory conditions. We report here that hydrogen peroxide downregulates GRK2 expression in C6 rat glioma cells. The hydrogen peroxide-induced decrease in GRK2 is prevented by a calpain protease inhibitor, but does not involve increased GRK2 degradation or changes in GRK2 mRNA level. Instead we show that hydrogen peroxide treatment impairs GRK2 translation in a process that requires Cdk1 activation and involves the mTOR pathway. This novel mechanism for the control of GRK2 expression in glial cells upon oxidative stress challenge may contribute to the modulation of GPCR signaling in different pathological conditions.

[Nasal potential difference test to diagnose cystic fibrosis]. / Prueba de la diferencia de potencial nasal para el diagnóstico de la fibrosis quística.

Cystic fibrosis is usually diagnosed based on suspicion arising from a typical clinical picture and must be confirmed by either a finding of high chloride concentrations in sweat tests on 2 separate days or detection of 2 gene mutations. The nasal potential difference (NPD) test has been proposed to provide evidence of abnormal function of the cystic fibrosis transmembrane conductance regulator (CFTR), a receptor that forms a chloride ion channel. The test is especially useful for patients who have normal chloride concentrations in sweat tests and in whom 2 gene mutations related to cystic fibrosis have not been detected. The NPD test requires 2 electrodes connected to a voltmeter (a Tholy-Medicap device). One is placed on the nasal mucosa of the inferior turbinate and the other is placed subcutaneously on the forearm. A reading less than -40 mV is considered abnormal, as values under that cut point are never found in healthy individuals. Two abnormal NPD findings on separate days are required for a diagnosis of CFTR dysfunction. False negatives arise when the integrity of the epithelium is altered. After application of amiloride, NPD decreases more markedly in cystic fibrosis patients than in healthy individuals and applying isoproterenol or fenoterol after amiloride provokes no response in patients with the genetic defect that prevents chloride ion channel activation.

Prueba de la diferencia de potencial nasal para el diagnóstico de la fibrosis quística / Nasal potencial difference test to diagnose cystic fibrosis

En la gran mayoría de los pacientes con fibrosis quística (FQ), el diagnóstico se sospecha por unos síntomas clínicos típicos y debe confirmarse mediante la determinación en sudor de una concentración de cloro elevada en 2 días separados o mediante la identificación de 2 mutaciones en un estudio genético. Para evidenciar el anormal comportamiento de la proteína de membrana CFTR (cystic fibrosis transmembrane conductance regulator), encargada del transporte de cloro, se ha ideado la prueba de la diferencia de potencial nasal (DPN), especialmente útil en pacientes con concentraciones de cloro normales y en los que no se identifican las 2 mutaciones del gen de la FQ. Para la realización de la DPN se requieren 2 electrodos conectados a un voltímetro (dispositivo de medida Tholy-Medicap®), uno colocado sobre la mucosa nasal del cornete inferior, y otro en el tejido celular subcutáneo del antebrazo. Un valor inferior a -­40 mV se considera patológico. Los valores obtenidos en sujetos sanos no sobrepasan nunca este valor. Se precisan 2 determinaciones anormales de DPN registradas en 2 días separados para aceptar la disfunción de la CFTR. Pueden observarse falsos negativos cuando la integridad del epitelio está alterada. En la FQ, tras la aplicación de amilorida la diferencia de potencial se reduce de modo más llamativo que en sanos, y la aplicación de isoproterenol o fenoterol después de amilorida no provoca respuesta debido al defecto genético que impide la activación de los canales de cloro

Cystic fibrosis is usually diagnosed based on suspicion arising from a typical clinical picture and must be confirmed by either a finding of high chloride concentrations in sweat tests on 2 separate days or detection of 2 gene mutations. The nasal potential difference (NPD) test has been proposed to provide evidence of abnormal function of the cystic fibrosis transmembrane conductance regulator (CFTR), a receptor that forms a chloride ion channel. The test is especially useful for patients who have normal chloride concentrations in sweat tests and in whom 2 gene mutations related to cystic fibrosis have not been detected. The NPD test requires 2 electrodes connected to a voltmeter (a Tholy-Medicap® device). One is placed on the nasal mucosa of the inferior turbinate and the other is placed subcutaneously on the forearm. A reading less than -40 mV is considered abnormal, as values under that cut point are never found in healthy individuals. Two abnormal NPD findings on separate days are required for a diagnosis of CFTR dysfunction. False negatives arise when the integrity of the epithelium is altered. After application of amiloride, NPD decreases more markedly in cystic fibrosis patients than in healthy individuals and applying isoproterenol or fenoterol after amiloride provokes no response in patients with the genetic defect that prevents chloride ion channel activation

Plasmablastic multiple myeloma is associated with increased vascular endothelial growth factor immunoexpression.

The biologic basis of the negative prognosis of plasmablastic myeloma is not fully understood. To determine whether histologically aggressive multiple myeloma (MM) is associated with a more angiogenic marrow environment, bone marrow samples from 50 recently diagnosed MM patients were evaluated. Twelve percent (6/50) of patients presented plasmablastic MM, and this feature correlated with moderate/strong intensity of vascular endothelial growth factor staining of plasma cells (P = 0.036). Although plasmablastic MM was not associated with increasing of microvessel density, this new evidence of increased expression of vascular endothelial growth factor on plasmablasts suggests that the adverse prognosis conferred by plasmablastic disease may be due, at least in part, to secretion of this angiogenic cytokine, also suggesting that the subset of MM patients with plasmablastic features may derive particular benefit from antiangiogenic therapies.

Plasmablastic multiple myeloma is associated with increased vascular endothelial growth factor immunoexpression

The biologic basis of the negative prognosis of plasmablastic myeloma is not fully understood. To determine whether histologically aggressive multiple myeloma (MM) is associated with a more angiogenic marrow environment, bone marrow samples from 50 recently diagnosed MM patients were evaluated. Twelve percent (6/50) of patients presented plasmablastic MM, and this feature correlated with moderate/strong intensity of vascular endothelial growth factor staining of plasma cells (P = 0.036). Although plasmablastic MM was not associated with increasing of microvessel density, this new evidence of increased expression of vascular endothelial growth factor on plasmablasts suggests that the adverse prognosis conferred by plasmablastic disease may be due, at least in part, to secretion of this angiogenic cytokine, also suggesting that the subset of MM patients with plasmablastic features may derive particular benefit from antiangiogenic therapies.

[Diagnosis and treatment of a case of benign paroxysmal posture vertigo of the horizontal canal]. / Diagnóstico y tratamiento de un caso de vértigo posicional paroxístico benigno del canal horizontal.

Ahorizontal canal positional vertigo with apogeotropic and persistent directional changing nystagmus is reported. A new procedure consisting in cervical hiperflexion was used to determine the affected side in order to perform a particle repositioning manoeuvre.

Diagnóstico y tratamiento de un caso de vértigo posicional paroxístico benigno del canal horizontal / Diagnosis and treatment of a case of horizontal canal positional vertigo

Presentamos un caso de vértigo posicional paroxístico benigno (VPPB) del canal horizontal que presentaba un nistagmo ageotrópico de dirección cambiante, en el que empleamos una prueba diagnóstica consistente en la hiperflexión cervical que nos orientó sobre el lado en que realizar la maniobra de recolocación de partículas específica (AU)

A horizontal canal positional vertigo with apogeotropic and persistent directional changing nystagmus is reported. A new procedure consisting in cervical hiperflexion was used to determine the affected side in order to perform a particle repositioning manoeuvre (AU)

[Video-nystagmography findings in healthy elderly subjects]. / Resultados videonistagmográficos en un grupo de sujetos sanos de edad avanzada.

This study investigated 44 healthy elderly subjects aged between 64 and 87, who were analysed with videonystagmoscopy and quantitative videonystagmography, for establishing new standards for normal limits into this new diagnostic tool. 15.9% of the subjects were found to have spontaneous and provoked nystagmus at least in one position studied. Vertical nystagmus in head hanging position was the most frequent finding. In the Dix-Hallpike test we found one case of torsional nystagmus. No subject had seated position nystagmus. Nystagmus after head shaking and evoked nystagmus were not found.

Resultados videonistagmográficos en un grupo de sujetos sanos de edad avanzada / Videonystagmographics finding in healthy elderly subjects

Se presentan los resultados obtenidos en una muestra de 44 sujetos sanos de edades comprendidas entre 64 y 87 años, estratificados en sexo y edad que fueron sometidos a un estudio protocolizado, utilizando como herramienta la videonistagmoscopia y su estudio cuantitativo mediante videonistagmografía, para buscar valores normales en ese grupo de población. En el 15,9 por ciento de los sujetos (7/44) se encuentran nistagmo espontáneo y provocado en alguna de las posiciones estudiadas. El nistagmo encontrado con más frecuencia fue el vertical, seguido del horizontal y la posición en la que aparecieron correspondió a la hiperextensión cervical y la prueba de Dix-Hallpike, en donde sólo encontramos un nistagmo torsional. En ninguno de los sujetos detectamos nistagmo en posición sentada, ni nistagmo evocado por la mirada, ni en la maniobra de agitación cefálica (AU)

This study investigated 44 healthy elderly subjects aged between 64 and 87, who were analysed with videonystagmoscopy and quantitative videonystagmography, for establishing new standards for normal limits into this new diagnostic tool. 15.9% of the subjects were found to have spontaneous and provoked nystagmus at least in one position studied. Vertical nystagmus in head hanging position was the most frequent finding. In the Dix-Hallpike test we found one case of torsional nystagmus. No subject had seated position nystagmus. Nystagmus after head shaking and evoked nystagmus were not found (AU)