Prevalence of ankylosing spondylitis in Spain: EPISER2016 Study.

Objective: The aim of this study was to estimate the prevalence of ankylosing spondylitis (AS) in Spain.Method: This is a cross-sectional, population-based study of people aged 20 years or older in Spain. Randomly selected individuals were contacted by telephone and rheumatic disease screening was performed. If the first screening was positive, medical records were then reviewed and/or a telephone questionnaire was conducted by a rheumatologist, followed by an appointment if necessary. Cases had to fulfil the modified New York (mNY) criteria.Results: In total, 4916 individuals were included, of whom 355 had a positive screening result for AS. Of these, 11 were classified as AS. An additional individual who reported a prior diagnosis of rheumatoid arthritis had a diagnosis of AS confirmed on review of the medical records. Estimated prevalence was 0.26% (95% CI 0.14-0.49).Conclusion: EPISER2016 is the first population-based study to estimate the prevalence of AS in Spain, which has been estimated as being similar to that in other European countries.

A little garbage in, lots of garbage out: Assessing the impact of careless responding in personality survey data.

In self-report surveys, it is common that some individuals do not pay enough attention and effort to give valid responses. Our aim was to investigate the extent to which careless and insufficient effort responding contributes to the biasing of data. We performed analyses of dimensionality, internal structure, and data reliability of four personality scales (extroversion, conscientiousness, stability, and dispositional optimism) in two independent samples. In order to identify careless/insufficient effort (C/IE) respondents, we used a factor mixture model (FMM) designed to detect inconsistencies of response to items with different semantic polarity. The FMM identified between 4.4% and 10% of C/IE cases, depending on the scale and the sample examined. In the complete samples, all the theoretical models obtained an unacceptable fit, forcing the rejection of the starting hypothesis and making additional wording factors necessary. In the clean samples, all the theoretical models fitted satisfactorily, and the wording factors practically disappeared. Trait estimates in the clean samples were between 4.5% and 11.8% more accurate than in the complete samples. These results show that a limited amount of C/IE data can lead to a drastic deterioration in the fit of the theoretical model, produce large amounts of spurious variance, raise serious doubts about the dimensionality and internal structure of the data, and reduce the reliability with which the trait scores of all surveyed are estimated. Identifying and filtering C/IE responses is necessary to ensure the validity of research results.

Lead(ii) soaps: crystal structures, polymorphism, and solid and liquid mesophases.

The long-chain members of the lead(ii) alkanoate series or soaps, from octanoate to octadecanoate, have been thoroughly characterized by means of XRD, PDF analysis, DSC, FTIR, ssNMR and other techniques, in all their phases and mesophases. The crystal structures at room temperature of all of the members of the series are now solved, showing the existence of two polymorphic forms in the room temperature crystal phase, different to short and long-chain members. Only nonanoate and decanoate present both forms, and this polymorphism is proven to be monotropic. At higher temperature, these compounds present a solid mesophase, defined as rotator, a liquid crystal phase and a liquid phase, all of which have a similar local arrangement. Since some lead(ii) soaps appear as degradation compounds in oil paintings, the solved crystal structures of lead(ii) soaps can now be used as fingerprints for their detection using X-ray diffraction. Pair distribution function analysis on these compounds is very similar in the same phases and mesophases for the different members, showing the same short range order. This observation suggests that this technique could also be used in the detection of these compounds in disordered phases or in the initial stages of formation in paintings.

First Report of Ilyonectria macrodidyma Associated with Black Foot Disease of Grapevine in Brazil.

Cultivated grapevine (Vitis labrusca and V. vinifera) is of considerable economic importance to the Brazilian fruit industry for both fresh market consumption and for the production of wines, sparkling beverages, and juices. Black foot disease is caused by fungi of the genera Ilyonectria P. Chaverri & C. Salgado (anamorph: Cylindrocarpon Wollew.), Campylocarpon Halleen, Schroers & Crous, and Cylindrocladiella Boesew. In 2012, 4- to 40-year-old grapevines (Vitis spp.) showing reduced vigor, vascular lesions, necrotic root lesions, delayed budding, vine decline, and death were collected from seven locations at Rio Grande do Sul state, Brazil. Fungal isolations were made from root fragments and crown lesions (at least 2 cm above the bottom) on potato dextrose agar (PDA) medium added with 0.5 g L-1 streptomycin sulfate. Eight isolates were obtained and identified on the basis of morphological features and multi-gene analysis (rDNA-ITS, ß-tubulin, and histone H3) as Ilyonectria macrodidyma (Halleen, Schroers & Crous) P. Chaverri & C. Salgado. One representative isolate (Cy5UFSM) was used for more detailed morphological and molecular characterization, and pathogenicity confirmation. When incubated in the dark at 20°C for 7 to 10 days, colonies of felty straw-colored mycelium (3) 4.79 cm diameter on average were observed. No sporodochia or other fruiting bodies were produced on carnation leaf agar (CLA) medium after 30 days. Microconidia that were produced after 5 weeks on spezieller nährstoffarmer agar (SNA) medium with addition of two pieces of 1 cm2 filter paper showed ovoid and ellipsoid shape (6.4 × 3.6 µm) and one-septate macroconidia (17.3 × 4.1 µm). To confirm the species, primer pairs ITS1 and ITS4 (4); Bt2a and Bt2b; and H3-1a and H3-1b (2) were used to amplify the ITS1-5.8S rRNA-ITS2, part of the ß-tubulin and histone H3 genes, respectively. Sequences of these three regions showed 99, 100, and 100% of homology with I. macrodidyma, respectively. To confirm pathogenicity, 4-month-old rooted cuttings of V. labrusca cv. Bordô were inoculated by immersing them in a conidial suspension of the isolate (106 conidia ml-1) for 60 min (1). Thirty days later, inoculation was performed again by drenching the crown with 40 ml of 106 conidia ml-1 suspension to ensure infection of the roots. In the control treatment, plants were inoculated with sterile distilled water. Plants inoculated with I. macrodidyma showed necrosis of the leaf ribs, reduction in root mass, root and crown necrosis, browning of vessels, drying of shoots, and death. I. macrodidyma was re-isolated from the crown necrosis and vascular lesions, confirming Koch's postulates. To our knowledge, this is the first report of I. macrodidyma associated with black foot disease of grapevine in Brazil, which poses considerable threat to the industry unless management options are realized. References: (1) A. Cabral et al. Phytopathol. Mediterr. 51:340, 2012. (2) N. L. Glass et al. Appl. Environ. Microbiol. 61:1323, 1995. (3) R. W. Rayner. A Mycological Colour Chart. Commonwealth Mycological Institute and British Mycological Society, 1970. (4) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, CA, 1990.

First Report of "Cylindrocarpon" pauciseptatum Associated with Black Foot Disease of Grapevine in Brazil.

Since 1999, the decline of American grapevines (Vitis labrusca L.) has been common in Rio Grande do Sul, Brazil (1). In August 2012, V. labrusca with black foot symptoms were collected in vineyards in the Serra Gaúcha Region. Symptomatic plants had low vigor, vascular lesions, delayed budding, and decline and death of vines. Symptomatic roots had necrotic lesions and reduced biomass. Fungal isolations were made from necrotic root and crown fragments (own-rooted cultivar) on potato dextrose agar (PDA) medium amended with 0.5 g L-1 streptomycin sulfate. Putative colonies of "Cylindrocarpon" pauciseptatum Schroers & Crous were obtained from single macroconidia isolations. Two isolates were used to confirm the identity of isolated colonies: Cy12UFSM and Cy13UFSM. After incubation in the dark for 10 days at 20°C, the isolated mycelial colonies, which were cottony white to felty in texture, became dark orange to brown. Both isolates produced chlamydospores in chains at 40 days. Chlamydospores of Cy12UFSM and Cy13UFSM were 9 to 12 µm and 5 to 11.5 µm in diameter. Sporodochia formation on carnation leaf agar (CLA) medium was observed after 30 days. To encourage development of conidia, the isolates were grown on spezieller nährstoffarmer agar (SNA) medium for five weeks at 20°C with addition of two pieces of 1 cm2 filter paper. Microconidia of Cy12UFSM were 4 to 8.5 × 3.5 to 5 µm and those of Cy13UFSM were 3.5 to 7.5 × 3 to 5 µm. Macroconida were predominantly 3-septate (Cy12UFSM was 36 to 45 × 7.5 to 9 µm and Cy13UFSM was 30 to 38 × 7.5 to 8 µm), but 1-, 2- septate macroconidia were observed. The sizes of the three spore types and colony morphology for our isolates were similar to those described by Schroers et al. (3) for "C." pauciseptatum. To further confirm the identity of Cy12UFSM and Cy13UFSM, multi-gene DNA sequence analysis (rDNA-ITS, ß-tubulin, and histone H3) was conducted using primer pairs ITS1 and ITS4 (4), Bt2a and Bt2b, and H3-1a and H3-1b (2), which amplify the ITS1-5.8S rRNA-ITS2 genes, part of the ß-tubulin gene, and the histone H3 gene, respectively. Sequences of these three regions had 99, 99, and 97% similarity with references sequences of "C." pauciseptatum (isolate Cy238; accessions ITS [JF735307]; ß-tubulin [JF735435], and histone H3 [JF735582], respectively). To evaluate pathogenicity, 4-month-old rooted cuttings of V. labrusca cv. Bordô were inoculated with two isolates by immersing them in a conidial suspension (106 conidia ml-1) for 60 min. Ten single-vine replicates were used for each isolate, and 10 water-inoculated vines were included as controls. Thirty days after inoculation, vines were re-inoculated with 40 ml of a 106 conidia ml-1 suspension to ensure root infection. After 4 months, the inoculated plants had reduced root mass relative to controls (39.18% for Cy12UFSM and 18.27% for Cy13UFSM). Inoculated plants also had root and crown necrosis, vascular lesions, shoot decline, and vine mortality (60 and 80% mortality for Cy12UFSM and Cy13UFSM, respectively). All water-inoculated control plants remained symptomless. The fungi Cy12UFSM and Cy13UFSM were re-isolated from infected woody tissues, confirming Koch's postulates. To our knowledge, this is the first report of "C." pauciseptatum associated with black foot disease of grapevine in Brazil, which may potentially impact the sustainability of grapevine nurseries and vineyard productivity. References: (1) L. R. Garrido et al. Fitopatol. Brasil. 29:548, 2004. (2) N. L. Glass et al. Appl. Environ. Microbiol. 61:1323, 1995. (3) H. J. Schoers et al. Mycol. Res. 112:82, 2008. (4) T. J. White et al. Amplification Pages 315-322 in: PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, CA, 1990.

An analysis of the bacterial community in a membrane bioreactor fed with photo-Fenton pre-treated toxic water.

A photo-Fenton-membrane bioreactor (MBR) coupled system is an innovative tool for the treatment of wastewater containing high quantities of contaminants. In this paper, wastewater with 200 mg l(-1) of dissolved organic carbon (DOC) of a selected mixture of five commercial pesticides: Vydate®, Metomur®, Couraze®, Ditimur-40®, and Scala® was treated by combining photo-Fenton and MBR. The effect of photo-treated pollutants on MBR operation was investigated by studying the population changes that occurred with time in the activated sludge of the biological system. Pre-treatment with photo-Fenton was carried out (only up to 34% of mineralization of DOC) and, after MBR treatment, 98% of biodegradation efficiency was obtained. During the biological treatment, little changes in the activated sludge population were detected by DGGE analysis, maintaining acceptable biodegradation efficiency, which points out the robustness of the MBR treatment versus changes in feed composition.

[Impact of resistive therapy on gait parameters in children with cerebral palsy: systematic review and meta-analysis]. / Impacto de la terapia resistida sobre los parametros de la marcha en niños con paralisis cerebral: revision sistematica y metaanalisis.

INTRODUCTION: Cerebral palsy is one of the main causes of disability in childhood. Resistive therapy has proved to be beneficial in increasing strength and motor function in these patients, but its impact on gait is not yet clear. AIM: To analyse the impact of resistive therapy on improving gait through a systematic review and meta-analysis. PATIENTS AND METHODS: A search was conducted in Medline, ISI Web of Knowledge and PEDro for clinical trials in which resistive therapy was used and at least one gait parameter was assessed. RESULTS: Nine controlled studies and one single-arm study were identified. In terms of pre-post difference, the overall intragroup effect was in favour of the intervention, with null heterogeneity (standardised mean difference: 0.32; 95% CI: 0.19-0.44). The standardised mean differences were also positive as they restricted each of the gait parameters analysed: 0.36, 0.35 and 0.22 for step cadence, gait speed and step length, respectively. As regards the difference between groups, the results showed high heterogeneity, and the mean difference was also favourable, especially for speed (7.3 cm/s; 95% CI: 2.67-11.92), cadence (5.66 steps; 95% CI: 1.86-9.46) and, to a lesser extent, step length (3.25 cm; 95% CI: -1.69 to 8.19). CONCLUSION: The results support the impact of resistive therapy on gait improvement, especially in terms of the gait speed and step cadence parameters.

TITLE: Impacto de la terapia resistida sobre los parametros de la marcha en niños con paralisis cerebral: revision sistematica y metaanalisis.Introduccion. La paralisis cerebral es una de las principales causas de discapacidad en la infancia. La terapia resistida ha demostrado beneficio en el aumento de la fuerza y la funcion motora de estos pacientes, pero su impacto en la marcha aun no esta claro. Objetivo. Analizar el impacto de la terapia resistida sobre la mejora en la marcha, mediante una revision sistematica y metaanalisis. Pacientes y metodos. Se realizo una busqueda en Medline, ISI Web of Knowledge y PEDro de ensayos clinicos en los que se intervino con terapia resistida y se evaluo al menos un parametro de marcha. Resultados. Se identificaron nueve estudios controlados y uno de un solo brazo. En cuanto a la diferencia pre-post, el efecto global intragrupo fue a favor de la intervencion, con una heterogeneidad nula (diferencia estandarizada de medias: 0,32; IC 95%: 0,19-0,44). Las diferencias estandarizadas de medias fueron asimismo positivas al restringir a cada uno de los parametros de marcha analizados: 0,36, 0,35 y 0,22 para la velocidad de la marcha, la cadencia del paso y la longitud del paso, respectivamente. En relacion con la diferencia entre grupos, los resultados mostraron una heterogeneidad elevada y la diferencia de medias tambien fue favorable, especialmente para la velocidad (7,3 cm/s; IC 95%: 2,67-11,92) y la cadencia (5,66 pasos; IC 95%: 1,86-9,46), y en menor medida para la longitud del paso (3,25 cm; IC 95%: -1,69 a 8,19). Conclusion. Los resultados apoyan el impacto de la terapia resistida en la mejora en la marcha, especialmente en cuanto a los parametros de velocidad de la marcha y cadencia del paso.

Facial expression recognition as a candidate marker for autism spectrum disorder: how frequent and severe are deficits?

Background: Impairments in social communication are a core feature of Autism Spectrum Disorder (ASD). Because the ability to infer other people's emotions from their facial expressions is critical for many aspects of social communication, deficits in expression recognition are a plausible candidate marker for ASD. However, previous studies on facial expression recognition produced mixed results, which may be due to differences in the sensitivity of the many tests used and/or the heterogeneity among individuals with ASD. To ascertain whether expression recognition may serve as a diagnostic marker (which distinguishes people with ASD from a comparison group) or a stratification marker (which helps to divide ASD into more homogeneous subgroups), a crucial first step is to move beyond identification of mean group differences and to better understand the frequency and severity of impairments. Methods: This study tested 46 individuals with ASD and 52 age- and IQ-matched typically developing (TD) participants on the Films Expression Task, which combines three key features of real-life expression recognition: naturalistic facial expressions, a broad range of simple and complex emotions, and short presentation time. Test-retest reliability was assessed in 28 individuals who did not participate in the main study and revealed acceptable reliability (ICC r = .74). Results: Case-control comparisons showed highly significant mean group differences for accuracy (p = 1.1 × 10- 10), with an effect size (Cohen's d = 1.6), more than twice as large as the mean effect size reported in a previous meta-analysis (Uljarevic and Hamilton, 2012, J Autism Dev Disord). The ASD group also had significantly increased mean reaction times overall (p = .00015, d = .83) and on correct trials (p = .0002, d = .78). However, whereas 63% of people with ASD showed severe deficits (they performed below two standard deviations of the TD mean, a small subgroup (15.3%) performed normally (within one standard deviation of the mean). Conclusion: These findings indicate that the majority of people with ASD have severe expression recognition deficits and that the Films Expression Test is a sensitive task for biomarker research in ASD. Future work is needed to establish whether ASD subgroups with and without expression recognition deficits differ from one another in terms of their symptom profile or neurobiological underpinnings.

Satisfaction with a therapeutic sleeve for arm lymphedema secondary to breast cancer treatment: Controlled crossover trial.

HIGHLIGHTS: Secondary lymphedema is a late iatrogenic side effect of breast cancer treatment.Despite multimodal decongestive therapy in their daily life breast cancer survivors with lymphedema have few alternatives but to use a compressive sleeve.Concerned with the well-known low compliance to the daily use of traditional sleeves, we conducted a comparative study to evaluate the subjective assessment of an innovative class 1 compression sleeve.We concluded that the PRADEX® sleeve, not being worse in its compressive efficacy, is much better with regard to patient comfort. ABSTRACT: Secondary arm lymphedema is a feared late iatrogenic side effect of breast cancer survivors with a negative impact on patient's self-image and quality of life. Its reported incidence is extremely variable, from 6% to 80%, as well as the effectiveness of the multimodal decongestive lymphedema therapy.In their daily life breast cancer survivors with lymphedema have few alternatives but to use a compressive sleeve. Concerned with the well-known low compliance to the daily use of traditional sleeves, we conducted a comparative study in a subgroup of our patients with lymphedema secondary to breast cancer treatment for the subjective assessment of PRADEX®, an innovative class 1 compression sleeve. Secondarily, we aimed to assess the non-inferiority of PRADEX® regarding subjective and objective measures of the severity of lymphedema.We studied 46 women with grade 1 secondary arm lymphedema, who used their usual sleeve and PRADEX® daily for 2 weeks each, in a crossover design.The new therapeutic sleeve was classified as having a better design and a better usability and comfort (more comfortable, thinner, fresher, softer, more flexible, comfortable, resistant to dirt and easier to dress and to wear). Women's subjective opinion about the severity of lymphedema favored their usual sleeve in detriment of PRADEX®, but this subjective feeling was contradicted by objective measurements of different perimeters of the arm at the beginning and at the end of the study.We concluded that the PRADEX® sleeve, not being worse in its compressive therapeutic efficacy, is much better with regard to patient comfort.

A comprehensive profiling of sulfatides in myelin from mouse brain using liquid chromatography coupled to high-resolution accurate tandem mass spectrometry.

Sulfatides are sulfoglycolipids found in the myelin sheath. The composition ratio of sulfatide molecular species changes with age, and it has also been associated with the pathogenesis of various human central nervous system diseases. However, profiling sulfatides in biological samples is difficult, due to the great variety of molecular species. In this work, a new, easy and reliable liquid chromatography-electrospray tandem mass spectrometry (LC-ESI(+)-MS/MS) method has been developed to profile sulfatide content in biological samples of myelin. The 'wrong-way-round' ionization effect has been described for this type of molecules for the first time, making it possible to correctly identify as many as 37 different sulfatides in mouse brain myelin samples, including molecules with different fatty acid chain lengths and varying degrees of unsaturation and hydroxylation. A chemometric analysis of their relative abundances showed that the main difference among individuals of different ages was the content of sulfatides with odd-numbered fatty acid chains, in addition to hydroxylated species.

Diferencias de género en la titulación de fármacos de pacientes con insuficiencia cardiaca y fracción de eyección reducida del ensayo ETIFIC / Gender differences in drug titration among heart failure patients with reduced ejection fraction in the ETIFIC trial

Introducción y objetivos El tratamiento óptimo disminuye la mortalidad y hospitalizaciones por insuficiencia cardiaca (IC) en pacientes con IC y fracción de eyección reducida. En los ensayos clínicos las mujeres estuvieron infrarrepresentadas y no fueron evaluadas específicamente. Este estudio buscó comparar la seguridad y efectividad de titulación (ajuste de dosis) de fármacos en mujeres y varones. Métodos Estudio post hoc de género del ensayo aleatorizado multicéntrico ETIFIC. Se incluyeron pacientes hospitalizados con IC de novo y fracción de eyección reducida. Proceso estructurado de titulación en unidades de IC. Objetivo principal: la dosis relativa media de bloqueadores beta (% de la dosis objetivo) alcanzada por mujeres frente a varones. Objetivos secundarios: dosis relativas medias de otros fármacos de IC, eventos adversos y resultados clínicos a 6 meses. Resultados Se incluyeron 320 pacientes, 83 (25,93%) mujeres y 237 (74,06%) varones. (76 frente a 213 analizados). Media±desviación estándar de dosis relativa de bloqueadores beta mujeres frente a varones: 62,08±30,72% frente a 64,4±32,77%; diferencia −2,32%; IC95%, −10,58-5,94; p=0,580, antagonistas del receptor de mineralocorticoides 79,85±27,72% comparado con 67,29±31,43%; p=0,003, sin diferencias significativas en dosificación de otros fármacos. El análisis multivariante no encontró diferencias significativas. Mortalidad cardiovascular 1 (1,20%) frente a 3 (1,26%), p=1 y 0 hospitalizaciones por IC (0,00%) frente a 10 (4,22%), p=0,125. Conclusiones En un análisis post hoc del ensayo ETIFIC de titulación en IC no encontramos diferencias de género significativas en dosificación, mortalidad cardiovascular y hospitalizaciones por IC (AU)

Introduction and objectives Optimal medical therapy decreases mortality and heart failure (HF) hospitalizations in HF patients with reduced left ventricular ejection fraction. Women have been underrepresented in clinical trials and not specifically evaluated. This study aimed to compare the safety and effectiveness of drug titration in women vs men. Methods This post hoc gender study of the ETIFIC multicenter randomized trial included hospitalized patients with new-onset HF with reduced ejection fraction and New York Heart Association II-III and no contraindications to beta-blockers. A structured 4-month titration process was implemented in HF clinics. The primary endpoint was the mean relative dose (% of target dose) of beta-blockers achieved by women vs men. Secondary endpoints included the mean relative doses of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and mineralocorticoid receptor antagonists, adverse events, and other clinical outcomes at 6 months. Results A total of 320 patients were included, 83 (25.93%) women and 237 (74.06%) men (76 vs 213 analyzed). The mean±standard deviation of the relative doses achieved by women vs men were as follows: beta-blockers 62.08%±30.72% vs 64.4%±32.77%, with a difference of−2.32% (95%CI,−10.58-5.94), P = .580; and mineralocorticoid receptor antagonists 79.85%±27.72% vs 67.29%±31.43%, P =.003. No other differences in drug dosage were found. Multivariate analysis showed nonsignificant differences. CV mortality was 1 (1.20%) vs 3 (1.26%), P=1, and HF hospitalizations 0 (0.00%) vs 10 (4.22%), P=.125. Conclusions In a post hoc analysis from the HF-titration ETIFIC trial, we found nonsignificant gender differences in drug dosage, cardiovascular mortality, and HF hospitalizations (AU)

Reporte de caso: manejo multidisciplinario en gestante con embarazo de 31 semanas y COVID-19 positivo con evolución grave / Case report: multidisciplinary management in case of 31 weeks pregnant woman and COVID 19 infection with severe disease presentation

INTRODUCCIÓN: En diciembre de 2019 se reporta un brote de neumonía atípica causada por un nuevo coronavirus: SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus-2), cuya enfermedad se denomina COVID-19 (Coronavirus Disease 2019). Desde entonces su distribución se ha ampliado mundialmente causando una emergencia en los sistemas de salud. MÉTODO: Corresponde al reporte de caso clínico. Este estudio es descriptivo y se basa en el manejo realizado a paciente embarazada con COVID-19 confirmado. Esta publicación cuenta con la autorización del comité de ética local para la revisión de ficha clínica. CASO: Mujer de 40 años con un embarazo de 31 semanas, se le diagnostica COVID-19 tras contacto estrecho con caso confirmado. Evoluciona con disnea y por posibilidad de interrupción del embarazo se traslada a centro de mayor complejidad. Allí se pesquisa compromiso de función pulmonar, uso de musculatura accesoria y alteración sensorial, requiriendo oxigenoterapia. Se evalúa interdisciplinariamente decidiendo intubar y realizando manejo en unidad de cuidados intensivos (UCI). Se realiza cesárea de urgencia a las 31+4 semanas debiendo realizarse histerectomía total por inercia uterina. Tras el procedimiento evoluciona tórpidamente con deterioro de función pulmonar, describiéndose un pronóstico catastrófico con probabilidad de fallecer por insuficiencia respiratoria. Un mes después despierta con una mejoría en su función pulmonar, sin otra falla orgánica. Actualmente se encuentra en buenas condiciones y es tratada multidisciplinariamente para lograr una rehabilitación integral. DISCUSIÓN: En epidemias pasadas, las embarazadas mostraron altas tasas de letalidad y riesgo de ingreso a UCI. Basados en una revisión de reportes de casos, parece ser que COVID-19 durante el embarazo se asocia a morbilidad materna severa, riesgo que aumenta en mujeres con comorbilidades, lo cual hace cuestionarnos si la infección por COVID-19 intensifica el riesgo materno o estos casos ya eran embarazos de riesgo. Se necesitan futuras investigaciones al respecto.

INTRODUCTION: The coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, was first reported in december 2019 in China as an atypipical pneumonia. Since then its distribution has globally expanded causing a public health emergency. METHOD: Corresponds to a case report. A descriptive study about the management of a pregnant woman whith COVID-19. CASE: A 40 year old pregnant woman, 31 weeks gestational age, was admitted with a diagnosis of COVID-19. She developed dyspnea and preterm birth risk that needed a more complex hospital level. Thereafter, the patient developed respiratory distress, use of accessory breathing muscles and neurological alteration, requiring oxygen therapy. An interdisciplinary medical team evaluation decided to manage her condition at intensive care unit (ICU). Cesarean delivery was performed at 31+4 weeks. After the procedure, the pulmonary function declined to a life threatening condition. A month later, the patient woke up with improved pulmonary function, without any organ failure. Currently the patient is in a good general condition with a multidisciplinary rehabilitation treatment ongoing. DISCUSSION: In previous epidemic outbrakes, pregnant women presented high fatality rates and intensive care tratment risk. Based on a case report review, COVID-19 in pregnancy is associated with severe maternal morbidity, specially in women with associated comorbidities. This situation raises the question whether the COVID-19 infection intensifies the maternal risk or whether these cases were already a high risk pregnancies. Additional studies are needed to answer this issue.

Pharmacologic reversal of acute changes in diffusion-weighted magnetic resonance imaging in focal cerebral ischemia.

Recently, diffusion-weighted magnetic resonance imaging (DWI) has been shown to visualize acute ischemic lesions in the brain before changes are observable with conventional magnetic resonance imaging. However, the underlying mechanisms of these acute DWI changes are unclear and may include both reversible and irreversible damage. In this study, we demonstrate that acute DWI lesions may be reversed with MK801 therapy postischemia. Sprague-Dawley rats (n = 12) were subjected to middle cerebral artery occlusion and DWI scans were obtained beginning 60 min postocclusion. Distinct regions of hyperintensity were observed in the basal ganglia and cortex, corresponding with the expected distribution of ischemia in this model. After the first scan, animals were treated with MK801 (0.5 mg/kg i.v.) or normal saline and subsequently scanned again 30 and 60 min after treatment. In the control group, the area of hyperintense lesions continued to increase, by 55% in the cortex and 57% in the basal ganglia. MK801 therapy significantly (p < 0.01) reduced the area of damage by the third DWI scan at 60 min posttreatment (-50% cortex, -22% basal ganglia, -41% total hemisphere) compared to pretreatment scans. Tetrazolium (TTC) stains at 24 h confirmed that MK801 significantly reduced the volumes of infarction (p < 0.05). These results demonstrate that significant portions of the acute ischemic lesion on DWI are reversible with pharmacologic intervention.

Biodegradation of polysiloxanes in lymph nodes of rats measured with 29Si NMR.

Linear and cyclic polysiloxanes and extracts (free polymer) from a silicone gel-filled implant are used to investigate the reactivity of silicones in vivo. Aqueous emulsions of polysiloxanes and controls (without polysiloxanes) are injected once (day 0, approximately 10% w/v) or six times (starting at day 0, every 14 days, approximately 3% w/v) in the right thigh of rats and the popliteal and lumbar lymph nodes are harvested (3 rats per time point and compound investigated) at 2, 16, 30, 44, 58 and 72 days after the injection. 29Si NMR spectroscopy is used to detect and evaluate the presence of polysiloxanes and their metabolites in the lymph nodes. In addition to the resonance associated with the polysiloxane injected (approximately -20 ppm), the NMR spectra of lymph nodes show new resonances that are attributed to partially hydrolyzed polysiloxanes (-5 to -15 ppm) and silica (-90 to - 120 ppm). These resonances are not present in polysiloxanes emulsions before injection or in the lymph nodes of controls. Our results demonstrate that all polysiloxanes and extracts from silicone gel-filled implants are biotransformed in the lymph nodes, but high molecular weight polymer degrades at a slower rate than oligomers.

Tetrode technology: advances in implantable hardware, neuroimaging, and data analysis techniques.

The technical advances in hardware and software for multiunit recordings have made it easier to gather data from a large number of neurons for behavioral correlations. This paper discusses several such advances in implantable hardware, magnetic resonance imaging of electrodes in situ, and data analysis software for multiple simultaneous signals.

Role of vasogenic edema and tissue cavitation in ischemic evolution on diffusion-weighted imaging: comparison with multiparameter MR and immunohistochemistry.

PURPOSE: To examine the mechanisms of further evolution that occurs from the early to late phase after initial changes in diffusion-weighted imaging after cerebral ischemia. METHODS: Sprague-Dawley rats were subjected to middle cerebral artery occlusion. Diffusion-, proton density-, T1- and T2-weighted imaging were performed on days 0, 2, and 6. Histologic examination (IgG, glial fibrillary acidic protein, and cresyl violet staining) was done after scanning. RESULTS: Apparent diffusion coefficients (ADCs) in the ischemic hemisphere were significantly decreased on day 0. Thereafter, ADCs increased over time and became significantly higher than the contralateral side by day 6. Changes in basal ganglia occurred more rapidly than in cortex. Proton density-, T1-, and T2-weighted scans showed maximal changes on day 2. From day 0 to day 2, there are significant correlations between changes in ADC and changes in T1-weighted signals and T2-weighted signals. Histologic exam showed early neuronal injury on day 0, intense gliotic activity and protein leakage associated with infarction and edema on day 2, and cavitation in severely infarcted areas on day 6. CONCLUSION: After initial reduction of ADC, the subsequent increase in ADC values on day 2 may be associated with vasogenic edema and cell lysis. Later elevations in ADC may be related to cavitation of infarcted tissue.

Isolation and structure elucidation of new cytotoxic steroids from the gorgonian Leptogorgia sarmentosa.

The gorgonian Leptogorgia sarmentosa contains three new steroids, (20S)-20-hydroxycholestane-3,16-dione (1), (16S, 20S)-16,20-dihydroxycholestan-3-one (2), and (20S)-20-hydroxycholest-1-ene-3,16-dione (3) together with a known related compound (4). Their structures were defined by spectroscopic analysis. The new steroids exhibited significant cytotoxicity against four tumor cell lines (ED50 = 1 microg/ml).

Immunoreactivity of the ets-1 transcription factor correlates with areas of epithelial-mesenchymal transition in the developing avian heart.

Cardiac morphogenesis involves substantial remodeling processes that include cell transdifferentiation and migration. The c-ets-1 protooncogene codes for a transcription factor that can transactivate a number of genes involved in developmental processes such as degradation of extracellular matrices and cell migration. We have immunolocated the ets-1 protein in the heart of quail and chick embryos between the Hamburger and Hamilton stages HH16 and HH37. In HH16-17 embryos, the ets-1 transcription factor was only detected in some endocardial cells and in most mesothelial and mesenchymal cells of the proepicardium. Ets-1 immunoreactivity increased markedly in the developing endocardial cushions, myocardium, epicardium and early subepicardial mesenchyme of HH18-19 embryos. By HH20-24 the immunoreactivity was found throughout the heart, with a stronger intensity in the areas of epithelial-mesenchymal transition of the endocardium and epicardium. In embryos between HH26 and HH33, ets-1 immunoreactivity increased in the cushion mesenchyme, atrioventricular endocardium, ventricular epicardium and subepicardial mesenchyme cells, but not in other areas of the heart. The immunoreactivity declined in the innermost part of the endocardial cushions. The subepicardial mesenchyme was particularly immunoreactive in these stages, coinciding with the development of the subepicardial vascular network. In fact, ets-1 colocalized with the quail vascular marker QH1 in the subepicardial mesenchymal cells. Ets-1-negative cells were abundant in the subepicardium and valvuloseptal tissue of the HH37 embryos. The results suggest that ets-1, probably through transactivation of genes such as urokinase-type plasminogen activator and matrix metalloproteinases, might play a crucial role in the differentiation of the cushion and subepicardial mesenchyme, the formation of the intratrabecular sinusoids and the early development of the cardiac vessels.

Immunolocalization of the transcription factor Slug in the developing avian heart.

Slug is a transcription factor involved in processes such as the formation of mesoderm and neural crest, two developmental events that imply a transition from an epithelial to a mesenchymal phenotype. During late cardiac morphogenesis, mesenchymal cells originate from two epithelia--epicardial mesothelium and cushion endocardium. We aimed to check if Slug is expressed in these systems of epithelial-mesenchymal transition. We have immuno-located the Slug protein in the heart of quail embryos between Hamburger and Hamilton stages HH16 and HH30. In the proepicardium (the epicardial primordium), Slug was detected in most cells, mesothelial as well as mesenchymal. Slug immunoreactivity was strong in the mesenchyme of the endocardial cushions and subepicardium from its inception until HH24, but the immunoreactivity disappeared in later embryos. Only a small portion of the endocardial cells located in the areas of epithelial-mesenchymal transition (atrioventricular groove and outflow tract) were immuno-labelled, mainly between HH16 and HH20. Endocardial cells from other cardiac segments were always negative, except for a transient, weak immunoreactivity that coincided with the development of the intertrabecular sinusoids of the ventricle. In contrast, virtually all cells of the epicardial mesothelium were immunoreactive until stage HH24. The mesenchymal cells that migrate to the heart through the spina vestibuli were also conspicuously immunoreactive. The myocardium was not labelled in the stages studied. Our results stress the involvement of Slug in the epithelial to mesenchymal transition. We suggest that Slug can constitute a reliable marker of the cardiac epithelial cells that are competent to transform into mesenchyme as well as a transient marker of the epithelial-derived mesenchymal cells in the developing heart.

Echo-planar chemical shift imaging of silicone gel prostheses.

We have developed an echo-planar (EP) proton chemical shift imaging (CSI) MR technique that allow us to discriminate the polydimethylsiloxane (PDMS, silicone) proton MR signal from that of the fat and water protons found in tissues, in order to map the distribution of PDMA in humans who have silicone gel prostheses. Silicone gel-filled prosthetic implants induce histologic changes in the surrounding tissue which are attributed to the leakage of free PDMS from the prosthesis. The T2 relaxation measurements of three silicone gels show that there are two components in them, each with a different degree of molecular mobility. The presence of free silicone is confirmed by chloroform extraction, which removed 14-28% of the material. This free polymer present in the gel can pass through the intact or ruptured membrane of the implant into the surrounding tissue. Our preliminary imaging results indicate that EP-CSI MR might be useful as a diagnostic technique for implant malfunction.