Stent Graft Placement by Pseudoaneurysm of the Hepatic Arteries: Efficacy and Patency Rate in Follow-up.

PURPOSE: To investigate efficacy and patency status of stent graft implantation in the treatment of hepatic artery pseudoaneurysm. MATERIALS AND METHODS: A retrospective analysis of patients who had undergone endovascular treatment of hepatic artery pseudoaneurysms between 2011 and 2020 was performed. Medical records were examined to obtain patients' surgical histories and to screen for active bleeding. Angiographic data on vascular access, target vessel, material used and technical success, defined as the exclusion of the pseudoaneurysm by means of a stent graft with sufficient control of bleeding, were collected. Vessel patency at follow-up CT was analyzed and classified as short-term (< 6 weeks), mid-term (between 6 weeks and 1 year), and long-term patency (> 1 year). In case of stent occlusion, collateralization and signs of hepatic hypoperfusion were examined. RESULTS: In total, 30 patients were included and of these, 25 and 5 had undergone stent graft implantation and coiling, respectively. In patients with implanted stent grafts, technical success was achieved in 23/25 patients (92%). Follow-up CT scans were available in 16 patients, showing stent graft patency in 9/16 patients (56%). Short-term, mid-term, and long-term short-term stent patency was found in 81% (13/16), 40% (4/10), and 50% (2/4). In patients with stent graft occlusion, 86% (6/7) exhibited maintenance of arterial liver perfusion via collaterals and 14% (1/7) exhibited liver abscess during follow-up. CONCLUSION: Stent graft provides an effective treatment for hepatic artery pseudoaneurysms. Even though patency rates decreased as a function of time, stent occlusion was mainly asymptomatic due to sufficient collateralization.

Dynamic evaluation of neutrophil-to-lymphocyte ratio as prognostic factor in stage III non-small cell lung cancer treated with chemoradiotherapy.

PURPOSE: Locally advanced non-small cell lung cancer (LA-NSCLC) is frequently treated with chemoradiotherapy (CRT). Despite the efforts, long-term outcomes are poor, and novel therapies have been introduced to improve results. Biomarkers are needed to detect early treatment failure and plan future follow-up and therapies. Our aim is to evaluate the role of dynamics of neutrophil-to-lymphocyte ratio (NLR) in patients with locally advanced NSCLC treated with CRT. METHODS: We retrospectively reviewed patients diagnosed with LA-NSCLC receiving definitive CRT at our center from 2010 to 2015. Baseline and post-treatment NLR were collected from our center database. NLR was dichotomized (threshold = 4) and patients were divided into two groups based on the variation from baseline to post-treatment NLR. The prognostic role and association with response were examined with logistic regression and multivariate Cox regression model, respectively. RESULTS: Ninety-two patients were included. Our analysis shows that NLR after treatment is associated with response to treatment [OR in the multivariate analysis 4.94 (1.01-24.48); p value = 0.048]. Furthermore, NLR and ECOG are independent prognostic factors for progression-free survival (PFS) and overall survival (OS). Specifically, PFS was 25.79 months for the good prognosis group and 12.09 for the poor prognosis group [HR 2.98 (CI 95% = 1.74-5.10), p < 0.001]; and OS was 42.94 months and 18.86 months, respectively [HR 2.81 (CI 95% = 1.62-4.90), p < 0.001]. CONCLUSION: Dynamics of NLR have a prognostic value in stage III NSCLC treated with definitive CRT. Pre- and post-CRT NLR should be evaluated in prospective clinical trials involving consolidation treatment with immunotherapy.

ERCC1, XPF and XPA-locoregional differences and prognostic value of DNA repair protein expression in patients with head and neck squamous cell carcinoma.

OBJECTIVES: Nucleotide excision repair protein expression has been claimed to be responsible for platinum-based chemotherapy resistance. ERCC1, XPF and XPA, core proteins in DNA repair, were evaluated regarding their prognostic value in patients with head and neck squamous cell carcinoma by looking at overall survival and time to recurrence. MATERIALS AND METHODS: Tissue microarrays were constructed from 453 cases of HNSCC, including 222 oral (49%), 126 oropharyngeal (27.8%) and 105 laryngeal (23.2%) tumours. There were 284 XPF, 293 XPA and 294 ERCC1 specimens evaluable for protein expression analysis after immunohistochemical workup. Expression levels were dichotomised into high- and low-expressing groups. Outcomes for overall survival (OS) and time to recurrence (TTR) were analysed using the Kaplan-Meier method. RESULTS: No correlation between ERCC1, XPA and XPF expression and OS was found by looking at the overall patient cohort. However, subsite analysis revealed that high ERCC1 expression was associated with a significantly inferior OS in patients with SCC of the oral cavity (p = 0.028) and showed an independent predictive value in multivariate analysis (p = 0.0123). High XPA expression showed a significantly increased OS in patients with oropharyngeal SCC (p = 0.0386). Regarding XPF, no impact on OS in any subsite could be shown. CONCLUSIONS: While high ERCC1 expression functions as a predictive marker with decreased OS in patients with squamous cell carcinoma of the oral cavity, high XPA expression shows an inverse effect in the subsite of the oropharynx, which has not been described previously. CLINICAL RELEVANCE: ERCC1 and XPA might be candidates to overcome chemotherapy resistance in subtypes of HNSCC.

Molecular subtypes in early colorectal cancer associated with clinical features and patient prognosis

Purpose: After surgical resection, an ample prognosis variability among stages is observed. Multiple prognostic factors are individually studied and some CRC classifiers have been proposed. Not one have been implemented into clinical practice. Methods/patients: We classified 105 patients with resected CRC (stage I-III) into five molecular subtypes using BRAFV600E and RAS (KRAS; NRAS) status, and the expression of DNA mismatch repair (MMR) proteins (MLH1 and MSH2). Clinicopathological features and DFS) of distincts groups were evaluated. Results and conclusions: RAS and BRAFV600E mutations were detected in 43.8 and 11.4% of patients, respectively. 19% of tumours had lack of expression of any MMR proteins reflecting a system deficiency (dMMR). Patients with any RAS mutation had lower DFS that patients with RAS wild type (wt) (40.23 vs 45.26 months; p value = 0.035). Of a total of five molecular subtypes, three were MMR proficient (pMMR): RAS mutated (39%), BRAFV600E mutated (6.7%) and RAS/BRAFV600E wt (35.2%); and two were dMMR: BRAFV600E mutated (4.8%) and BRAFV600E wt (14.3%). Left side tumours were more frequently observed in pMMR/RAS and BRAFV600E wt subtype, and right side tumours in dMMR subtypes. Among the three pMMR subtypes, a benefit survival was observed for patients without any mutation in BRAFv600E or RAS oncogenes (median of DFS = 45.5 vs 40.98 months in RAS mutated group; p = 0.084 and vs 34.13 in BRAFv600E mutated group; p = 0.031). Molecular classification using these biomarkers can be useful to identify groups with differences in prognosis

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Molecular subtypes in early colorectal cancer associated with clinical features and patient prognosis.

PURPOSE: After surgical resection, an ample prognosis variability among stages is observed. Multiple prognostic factors are individually studied and some CRC classifiers have been proposed. Not one have been implemented into clinical practice. METHODS/PATIENTS: We classified 105 patients with resected CRC (stage I-III) into five molecular subtypes using BRAFV600E and RAS (KRAS; NRAS) status, and the expression of DNA mismatch repair (MMR) proteins (MLH1 and MSH2). Clinicopathological features and DFS) of distincts groups were evaluated. RESULTS AND CONCLUSIONS: RAS and BRAFV600E mutations were detected in 43.8 and 11.4% of patients, respectively. 19% of tumours had lack of expression of any MMR proteins reflecting a system deficiency (dMMR). Patients with any RAS mutation had lower DFS that patients with RAS wild type (wt) (40.23 vs 45.26 months; p value = 0.035). Of a total of five molecular subtypes, three were MMR proficient (pMMR): RAS mutated (39%), BRAFV600E mutated (6.7%) and RAS/BRAFV600E wt (35.2%); and two were dMMR: BRAFV600E mutated (4.8%) and BRAFV600E wt (14.3%). Left side tumours were more frequently observed in pMMR/RAS and BRAFV600E wt subtype, and right side tumours in dMMR subtypes. Among the three pMMR subtypes, a benefit survival was observed for patients without any mutation in BRAFv600E or RAS oncogenes (median of DFS = 45.5 vs 40.98 months in RAS mutated group; p = 0.084 and vs 34.13 in BRAFv600E mutated group; p = 0.031). Molecular classification using these biomarkers can be useful to identify groups with differences in prognosis.

Polyamines in human breast milk for preterm and term infants.

Maternal milk is the first source of exogenous polyamines for the newborn. Polyamines modulate gut maturation in neonates, but no studies are available on polyamine concentration in human milk of preterm babies, even though they could be important for their immature gut. The present study aimed to determine polyamine concentration in human breast milk of mothers with preterm or term infants during the first month of lactation. Human milk samples were obtained during the first month of lactation from twenty-seven mothers with preterm babies and twelve mothers with babies born at term. The polyamine concentration in human milk was quantified by HPLC. During the first month of lactation, the total polyamine concentration was significantly higher in preterm milk than in term milk samples (7590 (SD 4990) v. 4660 (SD 4830) nmol/l, respectively (P » 0·034)), as well as individual polyamine concentrations. Polyamine concentration in mature milk for preterm babies was significantly higher than that in mature milk for babies at term, and a similar trend was observed in colostrum and transition human milk. The spermidine/spermine ratio was higher in transition milk in preterm v. term samples, while in mature milk, the ratio was significantly lower in preterm than in term babies. In conclusion, the polyamine concentration was significantly higher in human milk for preterm than for term infants. This and the different spermidine/spermine ratios could influence the gut development of premature babies.

Diferencias de estado nutricional, control metabólico y tratamiento de la diabetes tipo 1 en dos décadas / Changes in nutritional state, metabolic control and treatment of type 1 diabetes in the last 20 years

Objetivo: Describir los cambios en las características antropométricas, control metabólico, tratamiento y prevalencia de sobrepeso en los niños diabéticos en los últimos 20 años. Pacientes y métodos: Estudio observacional retrospectivo de dos grupos de niños diagnosticados de DM1 (n=90) realizado en dos cortes transversales, 1986 y finales del año 2007. Las variables estudiadas fueron: edad, años de DM1, sexo; peso, talla, IMC y sus valores Z; HbA1c, unidades NGSP/DCCT (%) e IFCC (mmol/mol), y el tratamiento con insulina (tipo, número de dosis, U/día y U/kg/día). Resultados: En relación con el grupo de 1986, en el grupo de 2007 hay un incremento significativo (p=0,001) en las variables Z-peso y Z-IMC. Hay una relación negativa entre los años de DM1 y la talla (Z-talla) en el grupo de 1986 (p<0,05). La HbA1c es menor en el grupo 2007 (p=0,001), pero la dosis de insulina (U/día y U/kg/día) es similar en ambos grupos. El número de dosis diarias de insulina es mayor en el grupo 2007 (p<0,001) y predomina el uso de análogos de la insulina. No se encontró una relación estadísticamente significativa entre la HbA1c y el tratamiento insulínico (dosis, número de inyecciones y tipo de insulina). La prevalencia de sobrepeso (14,6% vs 2,4%) es significativamente mayor en el grupo de 2007 (p=0,001). Conclusiones: El control metabólico ha mejorado y el uso de múltiples dosis diarias de insulina se ha convertido en la norma, pero ha aumentado la prevalencia de sobrepeso que puede incrementar el riesgo cardiovascular de los niños diabéticos (AU)

Objective: The aim of this study is to describe changes in anthropometric characteristics, metabolic control, treatment and prevalence of overweight in diabetic children (DM1) from 2007 compared with another similar group from 1986. Patients and methods: Observational retrospective study of two groups of diabetic children (n=90). The collection of variables has been made at two cross-sections, 1986 and 2007. The studied variables were: age, years of DM1, sex, weight, height, BMI (and their Z values), HbA1c and treatment with insulin (type, number of doses, IU/day and IU/kg/day). Results: In 2007 group there is a significant increase in Z-weight and Z-BMI (P=0.001) when compared with the 1986 group. There was a negative relationship between the years with DM1 and Z-height (P=0.05) in the 1986 group. The value of HbA1c was lower in the 2007 group (P=0.001), but the dose of insulin (IU/day and IU/kg/day) was similar in both groups. The number of daily doses of insulin was higher in the 2007 group (P<0.001), the use of insulin analogues dominated overall. A statistically significant relationship between HbA1c and treatment with insulin (dose injections, insulin type) was not found. The prevalence of overweight (14.6% vs 2.4%) was significantly higher in the 2007 Group (P=0.001). Conclusions: The metabolic control (HbA1c) had improved and the use of multiple daily doses of insulin has been become the standard, but the prevalence of overweight has increased. We must monitor the emergence of insulin resistance and cardiovascular risk factors in this sensitive population to prevent early cardiovascular disease (AU)

[Changes in nutritional state, metabolic control and treatment of type 1 diabetes in the last 20 years]. / Diferencias de estado nutricional, control metabólico y tratamiento de la diabetes tipo 1 en dos décadas.

OBJECTIVE: The aim of this study is to describe changes in anthropometric characteristics, metabolic control, treatment and prevalence of overweight in diabetic children (DM1) from 2007 compared with another similar group from 1986. PATIENTS AND METHODS: Observational retrospective study of two groups of diabetic children (n=90). The collection of variables has been made at two cross-sections, 1986 and 2007. The studied variables were: age, years of DM1, sex, weight, height, BMI (and their Z values), HbA(1c) and treatment with insulin (type, number of doses, IU/day and IU/kg/day). RESULTS: In 2007 group there is a significant increase in Z-weight and Z-BMI (P=.001) when compared with the 1986 group. There was a negative relationship between the years with DM1 and Z-height (P=.05) in the 1986 group. The value of HbA(1c) was lower in the 2007 group (P=.001), but the dose of insulin (IU/day and IU/kg/day) was similar in both groups. The number of daily doses of insulin was higher in the 2007 group (P<.001), the use of insulin analogues dominated overall. A statistically significant relationship between HbA(1c) and treatment with insulin (dose injections, insulin type) was not found. The prevalence of overweight (14.6% vs 2.4%) was significantly higher in the 2007 Group (P=.001). CONCLUSIONS: The metabolic control (HbA(1c)) had improved and the use of multiple daily doses of insulin has been become the standard, but the prevalence of overweight has increased. We must monitor the emergence of insulin resistance and cardiovascular risk factors in this sensitive population to prevent early cardiovascular disease.

Predicting the duration of chemotherapy-induced neutropenia: new scores and validation.

BACKGROUND: the objective of this study was to develop predictive models to classify febrile neutropenic patients into two groups, according to a prediction of the duration of the chemotherapy-induced neutropenia episode. PATIENTS AND METHODS: for this retrospective analysis, 106 patients with solid tumours and an episode of febrile neutropenia (FN) were eligible. A score was attributed to each chemotherapy treatment drug according to its expected toxicity. Three new scores were proposed based only on this classification. Two of them are a combination of the individual drug scores and the third one was built using statistical techniques such as cluster analysis and classification trees. RESULTS: statistical techniques produced the best score, distinguishing two groups of patients with statistically different neutropenia durations, with median durations until haematological recovery of absolute neutrophil count 2 × 10(9)/l of 4 versus 2 days (P < 0.001). CONCLUSIONS: our methodological approach based on statistical techniques identifies the patients who will need the longest times to recover from FN. The input of this predictive system is only the aggressiveness of the cytotoxic agents in a chemotherapy regimen. Our proposal succeeded in distinguishing two groups of patients and the results show better performance than other scores in previous studies.

Validity, reliability, and responsiveness of a new short Visual Simplified Respiratory Questionnaire (VSRQ) for health-related quality of life assessment in chronic obstructive pulmonary disease.

The Visual Simplified Respiratory Questionnaire (VSRQ) was designed to assess health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD). It contains eight items: dyspnea, anxiety, depressed mood, sleep, energy, daily activities, social activities and sexual life. Psychometric properties were assessed during a clinical trial that evaluated the impact of tiotropium on HRQoL of COPD patients. These included the determination of structure, internal consistency reliability, concurrent validity with the St George's Respiratory Questionnaire (SGRQ), test - retest reliability, clinical validity and responsiveness to change over two weeks. Minimal important difference (MID) was calculated; cumulative response curves (CRC) were based on the dyspnea item. Psychometric analyses showed that VSRQ structure was unidimensional. The questionnaire demonstrated good internal consistency reliability (Cronbach's alpha = 0.84), good concurrent validity with SGRQ (Spearman = -0.70) and clinical validity, good test-retest reproducibility (ICC = 0.77), and satisfactory responsiveness (standardized response mean = 0.57; Guyatt's statistic = 0.63). MID was 3.4; CRC median value of the 'minimally improved' patients was 3.5. In conclusion, VSRQ brevity and satisfactory psychometric properties make it a good candidate for large studies to assess HRQoL in COPD patients. Further validation is needed to extend its use in clinical practice.

[Retinopathy of prematurity in the Murcia region of Spain. Incidence and severity]. / Retinopatía del prematuro en la región de Murcia (España). Incidencia y gravedad.

OBJECTIVE: To determine the incidence and severity of Retinopathy of Prematurity (ROP) in the Murcia region of Spain. METHODS: This was a retrospective study of all infants born preterm in the Murcia region during 2004, who were screened for ROP. Our screening criteria were: Infants with a gestational age

Retinopatía del prematuro en la región de Murcia (España). Incidencia y gravedad / Retinopathy of prematurity in the Murcia region of (Spain). Incidence and severity

Objetivo: Conocer la incidencia actual y gravedad de la Retinopatía del Prematuro (ROP) en la región de Murcia. Método: Estudio retrospectivo de todos los prematuros nacidos en la región de Murcia durante 2004y que fueron sometidos a cribado ROP. Los criterios de cribado fueron: Recién nacidos pretérmino (RNPT) con £ 32 semanas de edad gestacional(EG) o RNPT con £ 1.500 g de peso al nacer (PN).Se registró sexo, EG, PN, paridad y evaluación oftalmológica. Se realizó un estudio descriptivo y analítico. Resultados: La muestra la forman 115 prematuros con una EG media de 29,67 semanas y un PN medio de 1.325 g. La incidencia global de ROP fue del 32,1%, y de ROP grave del 15,6% del total de la muestra. El 88,8% de los prematuros con ROP gravetenía £ 29 semanas EG o £ 1000 g PN. Estadísticamente existían diferencias significativas, (p <0,001) para la EG y el PN, entre los prematuros con ROP y sin ROP. Conclusiones: Un tercio de los prematuros cribados para ROP en la región de Murcia desarrolla la enfermedad y el 50% de ellos precisa tratamiento. Los resultados también indican que los criterios de cribado actuales son adecuados para nuestra población. Con criterios más restrictivos no se detectarían todos los pacientes con ROP grave. Para modificar el protocolo de cribado ROP precisamos más estudios

Objective: To determine the incidence and severity of Retinopathy of Prematurity (ROP) in the Murcia region of Spain. Methods: This was a retrospective study of all infants born preterm in the Murcia region during2004, who were screened for ROP. Our screening criteria were: Infants with a gestational age ² 32weeks (GA) or with a birth weight ² 1500 g (BW).We evaluated sex, GA, BW, parity and ophthalmologic evaluation. We then performed a descriptive study and a statistical analysis. Results: The study sample involved 115 infants with an average GA of 29.67 weeks and BW of 1325 g. The incidence of ROP and severe ROP was32.1% and 15.6% respectively. The likelihood of the premature infant developing severe ROP was found to be 88.8% if it was born before 29 weeks GA or weighed less than 1000g BW. Significant differences (p < 0.001), in terms of GA and BW between infants with and without ROP, were found. Conclusions: A third of the preterm infants screened for ROP in the Murcia region developed the disease, and the 50% of these required treatment. The current screening criteria used in our region are appropriate. If more restrictive criteria were used, some severe ROP cases would not be detected. In order to be able to modify the current guidelines for screening for ROP, further studies are required

Funciona el tejido adiposo marrón como un depósito de acidos grasos poliinsaturados de cadena larga durante el desarrollo postnatal del cerebro? / [Is brown adipose tissue a store of long chain polyunsaturated fatty acids during postnatal developing brain?]

Mammals along their early postnatal period develop a substantial amount of a very active brown adipose tissue (BAT). Through this work we explored the possibility that BAT may function as a long chain polyunsaturated fatty acids reservoir (LC-PUFA) during the rapid growth of brain structures. In new born rats 1, 6, 12 and 20 days old, we analyzed fatty acid percentage of triglycerides (TG) and phospholipid fractions, and the absolute amount of TG. In 6 day old rats we also evaluated the extend of further desaturation of 1-14C linoleic acid administered by intraperitoneal injection. Results demonstrated a drastic increase of TG concentration during experimental period (1,5; 40; 118; 120 mg/g wet weight) and LC-PUFA percentage was higher in [quot ]1 and 6[quot ] than [quot ]12 and 20[quot ] days old rats (16-17% vs 5%). Our results showed that BAT stored important amounts of LC-PUFA. On the other hand, 1-14C linoleic acid incorporation was higher in liver than BAT. In contrast, the desaturated products of 1-14C linoleic acid /1-14C linoleic acid ratio was greater in BAT than liver (>4). This could indicate that BAT synthesizes LC-PUFA in addition to store it. In summary we demonstrated than BAT is an important reservoir of LC-PUFA during postnatal brain growth.

Los mamíferos como el hombre y la rata, poseen durante su desarrollo postnatal temprano un tejido adiposo marrón (TAM) muy activo. En este trabajo se exploró la posibilidad de que el TAM funcione como un depósito de ácidos grasos poliinsaturados de cadena larga (AGPI-CL), durante el período de máximo crecimiento postnatal del cerebro de rata. En el TAM de ratas de 1, 6, 12 y 20 días de edad analizamos la concentración de triglicéridos (TG) y la composición de ácidos grasos en los TG y fosfolípidos (FL). Además, en ratas de 6 días de edad evaluamos la capacidad del TAM para desaturar 1- 14C ácido linoleico administrado por vía intraperitoneal. Los resultados mostraron un rápido incremento en la concentración de TG durante el período experimental (1,5; 40; 118; 120 mg /g de peso húmedo). El porcentaje de AGPI-CL fue mayor en las ratas de 1 y 6 días de edad que en las de 12 y 20 días (16-17% vs 5%). Por otra parte, la incorporación de 1-14C ácido linoleico fue más alta en el hígado que en el TAM, aunque la relación "productos desaturados de 1-14C ácido linoleico / 1-14C ácido linoleico" fue mayor en el TAM que en el hígado (>4), lo cual podría indicar que este tejido además de almacenar AGPI-CL los sintetiza. En resumen, nuestros resultados demuestran que el TAM es depósito importante de AGPICL durante el período de máximo desarrollo postnatal del cerebro.

Cytokines and Chemokines in physiopathological processes. IX Monographic Symposium of the Spanish Society for Immunology

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Cytokines and Chemokines in physiopathological processes. IX Monographic Symposium of the Spanish Society for Immunology

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Oxidación de las lipoproteínas de alta y baja densidad del plasma humano y su correlación con la composición de ácidos grasos de los fosfolípidos / Low and hight density lipoproteins oxidation of the human plasma and your correlacionated with fatty acids of the phospholipids

La modificación oxidativa de las lipoproteínas de baja densidad (LDL) está asociada con el desarrollo de la aterosclerosis. El propósito del presente estudio es investigar cual de los ácidos grasos (AG) componentes de los fosfolípidos (FL) de las LDL y de las lipoproteínas de alta densidad (HDL) está relacionado con su susceptibilidad de oxidación (SO). Las LDL y HDL fueron aisladas del plasma de 13 voluntarios e incubadas con CuSO45uM por 3 h. a 37 ºC. El grado de oxidación fue medido por la producción de sustancias reactivas con el ácido tiobarbitúrico (TBARS) y correlacionado con la relación por ciento AG respecto por ciento ácido palmítico de los FL. Encontrándose en la LDL una correlación estadísticamente significativa (p<0,05) para el C22:6 y C20:4 y en la HDL para el C22:6 y C20:5. En conclusión la SO de las LDL y HDL está correlacionada con ácidos grasos poliinsaturados de sus FL.

Aspectos epidemiólogicos de las cardiopatías congénitas: estudio sobre 1216 niños de Murcia / Epidemiological aspects of congenital heart malformations: a study of 1216 children of Murcia

Objetivos. Se pretende realizar una amplia revisión de la bibliografía para enumerar los principales factores, actualmente conocidos, relacionados con la etiología y otros aspectos epidemiológicos de las cardiopatías congénitas (CC). Posteriormente, se pretende valorar algunos de estos hallazgos, trasladándolos a una población geográficamente definida. Métodos. Se efectuó un estudio retrospectivo de todos los niños con cardiopatía congénita nacidos entre 1978-1990; y estudiados en el hospital de referencia, de la comunidad de Murcia, en lo que se refiere a la cardiología pediátrica. Los principales factores analizados se refieren a la distribución por municipios y áreas de salud, y algunos aspectos perinatales. Resultados. Había 525 niños y 477 niñas (H/M= 1:1), con predominio masculino en la estenosis aórtica e hipoplasia de cavidades izquierdas, y femenino en el conducto arterioso persistente. El 16 por ciento de niños presentó bajo peso al nacer. La incidencia por años osciló entre el 3,8 y el 6,4 por mil, y por áreas de salud también osciló entre el 3,8 y el 6,5 por mil. La edad de los progenitores era la siguiente: materna, en el momento del parto, entre 21-30 años en el 60 por ciento, y el 29 por ciento por encima de esta edad; paterna, entre 2130 años en el 53,1 por ciento, y el 43,1 por ciento superior a esa edad. Conclusiones 1. Existía un predominio masculino en la estenosis aórtica (p <0,001) y la hipoplasia de cavidades izquierdas (p <0,05), y femenino en el conducto arterioso permeable (p <0,05). 2. Fue estadísticamente significativo el menor peso entre los niños con CC y anomalías extracardiacas (2.902,20 ñ 624,69 g), que en aquellos con CC aisladas (3.228,86 641,28 g) (t= 7,823, p <0,0001). 3. Hubo mayor porcentaje de niños con peso <2.500 g entre los que tenían conducto arterioso permeable comparado con los niños con otras cardiopatías (aunque no se incluyeron los recién nacidos pretérmino con conducto arterioso patente) (AU)

LIPSIA--a new software system for the evaluation of functional magnetic resonance images of the human brain.

This paper describes the non-commercial software system LIPSIA that was developed for the processing of functional magnetic resonance images (fMRI) of the human brain. The analysis of fMRI data comprises various aspects including filtering, spatial transformation, statistical evaluation as well as segmentation and visualization. In LIPSIA, particular emphasis was placed on the development of new visualization and segmentation techniques that support visualizations of individual brain anatomy so that experts can assess the exact location of activation patterns in individual brains. As the amount of data that must be handled is enormous, another important aspect in the development LIPSIA was the efficiency of the software implementation. Well established statistical techniques were used whenever possible.