Bioaccumulation of heavy metals in Donax obesulus from the Lambayeque coast, Peru / Bioacumulación de metales pesados en Donax obesulus del litoral de Lambayeque, Perú

Donax obesulus is a bivalve widely mined collected and consumed widely by the local coastal population of the Lambayeque region, Peru. Donax obesulus lives in the coastal marine environment and presents anthropogenic disturbances, including pollutants such as heavy metals (cadmium, copper, and lead). The objectives were to quantify and evaluate the concentrations of copper, lead, and cadmium in edible tissues of Donax obesulus. The samples were collected from three different beaches on the Lambayeque coast (from south to north: Lagunas, San José, and El Gigante) between May and July 2013, and A physical-chemical treatment was performed to detect the heavy metal concentrations by inductively coupled plasma optical emission spectroscopy (ICP- OES). The results showed that copper presented a cumulative trend in tissues of Donax obesulus with the highest concentration collected at San José beach in July (10.1 µg g-1). In contrast, the concentrations of lead (> 0.3 µg g-1) and cadmium (> 0.2 µg g-1). Donax obesulus presents bioaccumulation of copper, lead, and cadmium. (AU)

Donax obesulus es un bivalvo ampliamente extraído, recolectado y consumido ampliamente por la población costera local de la región de Lambayeque, Perú. El ambiente costero-marino donde vive Donax obesulus presenta perturbaciones antropogénicas, incluyendo contaminantes como metales pesados ​​(cadmio, cobre y plomo). Los objetivos de esta investigación fueron cuantificar y evaluar las concentraciones de cobre, plomo y cadmio en tejidos comestibles de Donax obesulus. Donax obesulus las muestras fueron recolectadas en tres playas diferentes de la costa de Lambayeque (de sur a norte: Lagunas, San José y El Gigante) entre mayo y julio de 2013. Las muestras fueron sometidas a una prueba toxicológica Se les realizó un tratamiento fisicoquímico. realizado para obtener las concentraciones de metales pesados ​​mediante espectrometría de emisión óptica de plasma acoplado inductivamente (OES) (ICP). Los resultados mostraron que el cobre presentó una clara tendencia acumulativa en Donax obesulus con la mayor concentración en la playa de San José en julio (10.1 µg g-1). En cambio, las concentraciones de plomo (> 0,3 µg g-1) y cadmio (> 0,2 µg g-1) fueron escasas en todas las áreas de muestreo durante todo el curso de la investigación. a lo largo del tiempo que abarcó la investigación. La bioacumulación de cobre, plomo y cadmio que se encuentra en Donax obesulus podría NO vulnerar la seguridad alimentaria de sus consumidores. (AU)

Impact of pretransplant CMV-specific T-cell immune response in the control of CMV infection after solid organ transplantation: a prospective cohort study.

INTRODUCTION: Although solid organ transplant (SOT) recipients with pretransplant serology for cytomegalovirus (CMV-R+) are considered at intermediate risk for CMV infection post transplantation, CMV infection remains a major cause of morbidity in this population. We prospectively characterized whether having pretransplant CMV-specific cellular immunity is independently associated with controlling infection after transplantation in R + SOT recipients. METHODS: A prospective cohort of consecutive R + SOT recipients that received pre-emptive treatment for CMV infection was monitored after transplantation and variables were recorded during the follow-up. The cytomegalovirus-specific T-cell immune response was characterized by intracellular cytokine staining and viral loads determined using real-time PCR. RESULTS: One hundred and thirty-five R + SOT recipients were included (67 kidney, 64 liver, four liver-kidney). Only one-third of the patients (42; 31.85%) had CMV-specific T-cell immunity (CD8+CD69+INF-γ+ T cells >0.25%) before transplantation. Patients with negative pretransplant immunity had more CMV infection (49, 52.7% vs. 15, 35.7%; p 0.07) and received more antiviral therapy than those with immunity (32, 34.4% vs. 6, 14.3%, p 0.016). Having CMV specific immunity was an independent factor for protection from developing viraemia ≥2000 IU/mL (OR 0.276, 95% CI 0.105-0.725, p < 0.01) and lower administration of treatment (OR 0.398, 95% CI 0.175-0.905, p 0.028). Only patients with no pretransplant CMV-specific T-cell response were diagnosed with CMV-disease (8, 8.6% vs. 0, 0%, p 0.05). DISCUSSION: Our results show that having a pretransplant CMV specific T-cell response may be associated with a lower rate of CMV viraemia and less antiviral treatment after transplantation; however, more prospective studies are needed to confirm these findings.

Linfoma óseo primario / Primary bone lymphoma

La afectación esquelética en los pacientes con linfoma no hodgkiniano (LNH) no es infrecuente. Suele ser una manifestación tardía, y cuando aparece lo hace generalmente de forma secundaria por linfomas en estadio avanzado y con alta carga tumoral. Sin embargo, tan solo en contadas ocasiones la afectación esquelética se debe a un linfoma óseo primario y constituye, por tanto, la forma de presentación de esta enfermedad. Se describe el caso de un paciente con un linfoma óseo primario de estirpe B que debutó con lesiones vertebrales y compresión medular secundaria (AU)

Skeletal involvement in patients with non-Hodgkin's lymphoma (NHL) is not uncommon. It tends to be a late manifestation and usually occurs secondary to lymphomas in advanced stage, with high tumor burden. However, only in a few cases has skeletal involvement been attributed to a primary bone lymphoma and constitutes, therefore, the form of presentation of this disease. We describe the case of a patient with primary B-cell lymphoma of the bone that appeared with vertebral lesions and secondary spinal compression (AU)

Chimerism detection by short tandem repeat analysis when donor and recipient genotypes are not known.

BACKGROUNDS: The analysis of chimerism after bone marrow transplantation by STR-PCR is frequently carried out with commercial kits designed for forensic purposes and including too many non informative STR. Furthermore, in routine clinical practice it is not uncommon to lack the pre-transplant genotype of the recipient or the donor, thus making it difficult to identify both components in the post-transplant genotype. The objective of this paper is to overcome these drawbacks by analyzing the informativity of STR markers from a perspective which can be applied whether the pretransplant genotypes are available or not, and selecting a minimum STR panel that allows an effective direct detection of chimerism. METHODS: DNA extraction, STR-PCR and fragment analysis of 15 STR in 90 donor-recipient pairs, 60 of which were part of the discovery set and 30 in a validation set. Loci were considered as informative when there were 3 or 4 different alleles in the combined genotypes of the recipient and the donor. RESULTS: The informativity varied between 41.6 and 76.6. The 4 most informative loci were D2S1338, D21S11, D18S51 and FGA. We could select a minimum set of 8 markers (D2S1338, D21S11, D18S51, FGA, VWA, D19S433, TH01 and D3S1358) that provided at least 3 informative loci in 95% of cases. CONCLUSION: This minimum STR panel may be an efficient way to detect and quantitate donor-recipient chimerism after transplantation.

Pre-clinical studies of a new quinolone (UB-8902) against Acinetobacter baumannii resistant to ciprofloxacin.

The in vitro activity and in vivo efficacy of a new ciprofloxacin derivative (UB-8902) were evaluated. In vitro time-kill curves were performed for ciprofloxacin (CIP), moxifloxacin (MXF) and UB-8902 against CIP-susceptible (Ab58) and CIP-resistant (Ab661 and Ab33) Acinetobacter baumannii strains. UB-8902 showed similar bactericidal activity to CIP and MXF against these strains. In the in vivo experiments in mice, the toxicity of UB-8902, its 50% protective dose (PD(50)) (peritoneal sepsis model), its pharmacokinetic/pharmacodynamic (PK/PD) parameters and its efficacy in a pneumonia model were studied. The maximum tolerated dose of UB-8902 was 512 mg/kg. PD(50) values were 16, 128 and 32 mg/kg for Ab58, Ab661 and Ab33, respectively. Pharmacokinetic parameters of UB-8902 were similar to MXF and were lower than those for CIP, whilst pharmacodynamic parameters were better than CIP. In the pneumonia model, UB-8902 decreased the bacterial lung concentration [4.62 colony-forming units (CFU)/g and 4.15log(10)CFU/g] and positive blood cultures (60% and 62.5%) for Ab58 and Ab33, respectively, compared with the control. In conclusion, UB-8902 presents bactericidal activity against A. baumannii strains resistant to CIP. Moreover, it is effective at reducing mortality in a model of peritoneal sepsis with a dose lower than the toxic one, and it is efficacious in a murine pneumonia model.

Morphological and magnetic properties of superparamagnetic carbon-coated Fe nanoparticles produced by arc discharge.

Spherical carbon coated iron particles of nanometric diameter in the 5-10 nm range have been produced by arc discharge at near-atmospheric pressure conditions (using 5-8 x 10(4) Pa of He). The particles exhibit a crystalline dense iron core with an average diameter of 7.4 +/- 2.0 nm surrounded by a sealed carbon shell, shown by transmission electron microscopy (TEM), selected-area diffraction (SAED), energy-dispersive X-ray analysis (STEM-EDX) and electron energy loss spectroscopy (EELS). The SAED, EDX and EELS results indicate a lack of traces of core oxidized phases showing an efficient protection role of the carbon shell. The magnetic properties of the nanoparticles have been investigated in the 5-300 K temperature range using a superconducting quantum interference device (SQUID). The results reveal a superparamagnetic behaviour with an average monodomain diameter of 7.6 nm of the nanoparticles. The zero field cooled and field cooled (ZFC-FC) magnetization curves show a blocking temperature (T(B)) at room temperature very suitable for biomedical applications (drug delivery, magnetic resonance imaging, hyperthermia).

Retiro de ventilación mecánica prolongada: experiencia de seis años con la aplicación de protocolo especializado / Weaning of prolonged mechanical ventilation: specialized protocol

La Ventilación Mecánica Prolongada (VMP) ha sido definida como aquella mayor de 21 días por al menos 6 horas diarias. Este fenómeno es un creciente problema para las Unidades de Cuidados Intensivos (UCI) en todo el mundo. Los consensos internacionales señalan que los pacientes con VMP deben ser tratados en unidades diferentes a las UCI, con protocolos especializados multiprofesionales dedicados a intentar el retiro del respirador. En nuestro Centro hemos recibido desde el año 2002 a 31 pacientes con VMP y les hemos aplicado un Protocolo de Rehabilitación Respiratoria Integral para ese objetivo. Las patologías predominantes fueron neuromusculares. El protocolo tiene 4 etapas progresivas, las 2 primeras comprenden la evaluación general y el inicio de terapias multiprofesionales. Las 2 siguientes consisten en retiro progresivo del respirador y continuación de terapias. Se midió la presión inspiratoria, presión espiratoria espiratoria máximas (PImáx y PEmáx) y la presión inspiratoria máxima sostenida (PIms), también se evaluó la actividad muscular de cuello, tronco y extremidades, así como el estado general y nutritivo, el nivel de conciencia y la calidad del apoyo familiar. Se entra a etapa 3 cuando los valores de PImáx y PEmáx son 60 y 50 cmH2O, respectivamente. Fueron excluidos de llegar a las últimas 2 etapas 7 pacientes, quienes no lograron este nivel de presiones. Resultados: 19pacientes (61 por ciento) con promedio de edad de 44 años (16-77), fueron retirados del respirador, 5 están aún en etapas 2 y 3; el promedio de VMP fue de 238 días y de 74 días a contar desde el ingreso a etapa 3. El promedio de mejoría de PImax fue de 59 por ciento, la PEmáx 60 por ciento y la PIms 61 por ciento, todos valores con significación estadística (p <0,001). El control cefálico y de tronco mejoró con las terapias. También el daño cognitivo, la depresión y la alteración de la función deglutoria...

Prolonged mechanical ventilation (PMV) is defined as greater than 21 days of mechanical ventilation for at least 6hours per day and is an increasing problem for the Intensive Care Units in all over the world. Many expert consensus groups recommend that long-term facilities may be a useful resource of care to implement integrated and specialized protocols for weaning from PMV. Since 2002 our center admitted 31 patients in PMV who were included on an Integral Respiratory Rehabilitation Protocol that was applied for our primary outcome of weaning success. Neuromuscular diseases were the main cause requiring PMV. The protocol applied consists of 4 successive stages, the first two oriented to evaluation and initiation of multiprofessional therapies, the next two are dedicated to progressive weaning and continuation of therapy. Peak inspiratory and expiratory pressures, and maximal sustained inspiratory pressure (PImax, PEmax and PIms) were measured, additionally muscular activity from neck, trunk and legs, general and nutritional condition, conscience level and family support were evaluated. Entry to stage 3 was defined when the PImax and PEmax were 60 and 50 cmH2O. Seven patients who failed to achieve this pressure levels were excluded. Results: 19 patients (61 percent) with a mean age of 44 years (16-77) had successful weaning and 5 patients are still in stage 2 or 3. Mean duration of PMV was 238 days. Mean Time on Mechanical Ventilation from the beginning of stage3 until the final weaning was 74 days. PImax, PEmax and PIms increased in 59, 60 and 61 percent each, all with statistical significance p <0.001, cephalic and trunk muscle control was increased with integrated therapies. The cognitive impairment, depression and swallowing disorders were professionally treated. Conclusion: A specialized, multiprofessional integrated protocol for PMV in our center permitted a successful weaning rate comparable to the best international series.

Two chromosomally located qnrB variants, qnrB6 and the new qnrB16, in Citrobacter spp. isolates causing bacteraemia.

The objective of this study was to determine the prevalence of the plasmid-borne quinolone resistance genes qnrA, qnrB and qnrS in a collection of Enterobacteriaceae causing bacteraemia. The presence of the three genes was tested for using multiplex PCR in 306 clinical isolates. Plasmid analysis was performed using I-CeuI and S1 nuclease digestion and hybridization with specific probes for the qnr and 23S rRNA genes. Five strains were found to carry a qnr gene, one of which, qnrB16, a new variant of qnrB, was detected in a Citrobacter freundii isolate. The qnrB6 variant was found in two C. freundii isolates and in one Citrobacter werkmanii isolate. The qnrS2 gene was found in one Klebsiella pneumoniae isolate. The qnrA gene was not found in any of the isolates studied. The qnrS2 gene was located on a plasmid of c. 50 kb, whereas qnrB6 and qnrB16 were inserted in the chromosome between pspF and the orf2, which had previously been found in a complex integron. In the Hospital Clinic of Barcelona, Spain, the prevalence of qnrB was higher than that of qnrA and qnrS. The importance of the description of the new qnrB16 is emphasized.

[Intravenous colistin in the treatment of infections due to pan-resistant Gram negative bacilli]. / Colistín en infecciones nosocomiales por bacilos gramnegativos pan-resistentes.

UNLABELLED: Emergence of panresistant gram negative bacilli has lead to the progressive reintroduction of intravenous colistin. AIM: To describe the clinical experience observed with this compound. METHODOLOGY: A retrospective analysis was performed for all treatments lasting >/= 48 hours. Medical records were analyzed to obtain clinical parameters and microbiological data, evaluate clinical response and evolution until discharge. MAIN RESULTS: 24 treatments lasting >/= 48 hours were applied between June 2005 and September 2006. Intravenous colistin was indicated to treat cases of ventilator-associated (VA) pneumonia (n = 10; 41.7%), abscess or collections (12.5%), bloodstream infections, non-VA pneumonia or urinary tract infections (4.2% each one, respectively). Treatment was initiated on average at 3.2 days (+/- 2.85) from diagnosis of infection. All courses were microbiologically-guided, and involved P. aeruginosa or A. baumannii isolates. Susceptibility was evaluated by E-test in 11 isolates (MIC90 3.6 nicrog/mL, range 0.38 to 4 microg/mL). One isolate was resistant to colistin (9%). A favorable response was observed in 12 treatments (50%) with a relapse in 5 cases (41.7%). Being treated for pneumonia was the only factor associated to failure, (p = 0.04) Eradication was documented in 8 cases (33.3%) and persistence in 11 (45.8%). In 5 cases a microbiological follow-up was not available. Survival at time of discharge was 45.5%. (n = 10) None of the treatment courses was associated with nefrotoxicity. CONCLUSIONS: Intravenous colistin is a safe compound useful to treat various nosocomial infections due to pan-resistant gram negative bacilli. Nonetheless, its clinical efficacy is limited, especially among patients treated for nosocomial pneumonia.

Colistín en infecciones nosocomiales por bacilos gramnegativos pan-resistentes / Intravenous colistin in the treatment of infections due to pan-resistant Gram negative bacilli

La emergencia de bacilos gramnegativos pan-resistentes ha obligado a la reutilización progresiva de colistín. Objetivo: Describir la experiencia clínica con este compuesto. Metodología: Se efectuó un análisis retrospectivo de todos los tratamientos con colistín endovenoso administrados por más de 48 horas, analizando datos clínicos, microbiológicos, la respuesta terapéutica y evolución hasta el egreso. Resultados: Se aplicaron 24 tratamientos entre junio de 2005 y septiembre de 2006. Colistín endovenoso fue utilizado en eventos de neumonía asociada a VM (n = 10; 41,7 por ciento), colecciones o abscesos (12,5 por ciento), bacteriemias, neumonía no asociada a VM e infección urinaria (4,2 por ciento cada una, respectivamente). El tratamiento fue iniciado en promedio a 3,2 (± 2,85) días desde el diagnóstico de infección. Todos los pacientes tenían infecciones por Pseudomonas aeruginosa o Acinetobacter baumannii. Se evaluó la susceptibilidad por E-test en once aislados (CIM90 3,6 µg/mL, rango 0,38 a 4 µg/mL). Una cepa (9 por ciento) presentó resistencia. Se observó una respuesta favorable en 50 por cientoo de los casos (n = 12) con recaída en cinco de estos casos (41,7 por ciento). El único factor asociado a fracaso fue la presencia de neumonía (p = 0,04). Se observó erradicación en ocho casos (33,3 por ciento) y persistencia en once (45,8 por ciento). En cinco casos el resultado microbiológico no fue evaluable. Sobrevivió a la hospitalización 45,5 por ciento de los pacientes (n = 10). No se observó nefrotoxicidad. Conclusiones: Colistín endovenoso es un compuesto seguro para el tratamiento de infecciones por bacilos gramnegativos pan-resistentes. Sin embargo, su eficacia terapéutica es limitada, especialmente, entre aquellos pacientes tratados por neumonía.

Emergence of panresistant gram negative bacilli has lead to the progressive reintroduction of intravenous colistin. Aim: To describe the clinical experience observed with this compound. Methodology: A retrospective analysis was performed for all treatments lasting ≥ 48 hours. Medical records were analyzed to obtain clinical parameters and microbiological data, evaluate clinical response and evolution until discharge. Main results: 24 treatments lasting ≥ 48 hours were applied between June 2005 and September 2006. Intravenous colistin was indicated to treat cases of ventilator-associated (VA) pneumonia (n = 10; 41.7 percent), abscess or collections (12.5 percent), bloodstream infections, non-VA pneumonia or urinary tract infections (4.2 percent each one, respectively). Treatment was initiated on average at 3.2 days (± 2.85) from diagnosis of infection. All courses were microbiologically-guided, and involved P. aeruginosa or A. baumannii isolates. Susceptibility was evaluated by E-test in 11 isolates (MIC90 3.6 µg/mL, range 0.38 to 4 µg/mL). One isolate was resistant to colistin (9 percent). A favorable response was observed in 12 treatments (50 percent) with a relapse in 5 cases (41.7 percent). Being treated for pneumonia was the only factor associated to failure, (p = 0.04) Eradication was documented in 8 cases (33.3 percent) and persistence in 11 (45.8 percent). In 5 cases a microbiological follow-up was not available. Survival at time of discharge was 45.5 percent. (n = 10) None of the treatment courses was associated with nefrotoxicity. Conclusions: Intravenous colistin is a safe compound useful to treat various nosocomial infections due to pan-resistant gram negative bacilli. Nonetheless, its clinical efficacy is limited, especially among patients treated for nosocomial pneumonia.

[Organic personality disorder: conceptual review and research strategies]. / El trastorno orgánico de la personalidad: análisis conceptual y estrategias para la investigación.

The historical review of "psychiatric personality disorders" reveals the lack of convergence of those disorders with the organic personality disorder (OPD). Only the psychopathy concept has been used as a psychopathological phenotype for one of the groups of OPD, the so-called "pseudopsychopaths". These patients have been described from the beginning of the XXth century under the heading of "frontal lobe syndrome". It was only with the development of the psychiatric nosologies, towards the middle of the XXth century, that the term "organic personality disorder" started to be used. The accumulation of knowledge about the different prefrontal areas and the development of neuropsychological models that try to explain social behavior have opened new ways of understanding this syndrome. The orbitofrontal cortex has been identified as one of the key structures in behavioral and emotional regulation. Recognition of emotions in voices and faces, empathy, appreciation of humor, tasks that show "theory of mind" are some of the dimensions included in the examination of the non-cognitive functions of the prefrontal cortex

[Attentional impairment after traumatic brain injury: assessment and rehabilitation]. / Alteraciones de la atención tras daño cerebral traumático: evaluación y rehabilitación.

INTRODUCTION: Attention disorders are a major problem after traumatic brain injury underlying deficits in other cognitive functions and in everyday activities, hindering the rehabilitation process and the possibility of return to work. Functional neuroimaging and neuropsychological assessment have depicted theoretical models considering attention as a complex and non-unitary process. DEVELOPMENT: Although there are conceptual difficulties, it seems possible to establish a theoretical background to better define attentional impairments and to guide the rehabilitation process. The aim of the present study is to review some of the most important pieces involved in the assessment and rehabilitation of attentional impairments. We also propose an appropriate model for the design of individualized rehabilitation programs. Lastly, different approaches for the rehabilitation are reviewed. CONCLUSIONS: Neuropsychological assessment should provide valuable strategies to better design the cognitive rehabilitation programs. It is necessary to establish a link between basic and applied neuropsychology, in order to optimize the treatments for traumatic brain injury patients. It is also emphasized that well-defined cognitive targets and skills are required, given that an unspecific stimulation of cognitive processes (pseudorehabilitation) has been shown to be unsuccessful.

Cancer cells express aberrant DNMT3B transcripts encoding truncated proteins.

Cancer cells display an altered distribution of DNA methylation relative to normal cells. Certain tumor suppressor gene promoters are hypermethylated and transcriptionally inactivated, whereas repetitive DNA is hypomethylated and transcriptionally active. Little is understood about how the abnormal DNA methylation patterns of cancer cells are established and maintained. Here, we identify over 20 DNMT3B transcripts from many cancer cell lines and primary acute leukemia cells that contain aberrant splicing at the 5' end of the gene, encoding truncated proteins lacking the C-terminal catalytic domain. Many of these aberrant transcripts retain intron sequences. Although the aberrant transcripts represent a minority of the DNMT3B transcripts present, Western blot analysis demonstrates truncated DNMT3B isoforms in the nuclear protein extracts of cancer cells. To test if expression of a truncated DNMT3B protein could alter the DNA methylation patterns within cells, we expressed DNMT3B7, the most frequently expressed aberrant transcript, in 293 cells. DNMT3B7-expressing 293 cells have altered gene expression as identified by microarray analysis. Some of these changes in gene expression correlate with altered DNA methylation of corresponding CpG islands. These results suggest that truncated DNMT3B proteins could play a role in the abnormal distribution of DNA methylation found in cancer cells.

Alteraciones de la atención tras daño cerebral traumático: evaluación y rehabilitación / Attentional impairment after traumatic brain injury: assessment and rehabilitation

Introducción. Las alteraciones de la atención forman parte de los principales problemas que surgen tras un traumatismo craneoencefálico. Éstas pueden influir de forma directa en el funcionamiento de otros procesos cognitivos y en actividades de la vida diaria, y dificultar así el progreso de la rehabilitación y el retorno al trabajo. La evaluación neuropsicológica y la neuroimagen funcional están permitiendo el desarrollo de modelos teóricos que consideran la atención como un proceso complejo y no unitario. Desarrollo. A pesar de la dificultad conceptual, es posible establecer un marco teórico que permita delimitar las alteraciones de los pacientes y guiar el proceso de rehabilitación. El presente trabajo trata de recoger algunos de los aspectos básicos involucrados tanto en la evaluación como en la rehabilitación de las dificultades atencionales, y proponer un modelo que permite una aproximación a la elaboración de programas de evaluación y rehabilitación individualizados. Por último, se revisan distintos abordajes en la rehabilitación de los problemas de atención. Conclusión. La evaluación debe proporcionar bases explicativas y estrategias de utilidad para el desarrollo de programas de rehabilitación cognitiva. Es necesario establecer una relación entre una neuropsicología más orientada a proponer y verificar modelos cognitivos, y aquella dedicada a la aplicación de estos modelos en los programas de rehabilitación. Se pone de manifiesto la necesidad de programas dirigidos al entrenamiento de habilidades específicas, ya que una estimulación inespecífica y no dirigida (pseudorehabilitación) se ha mostrado inefectiva

Introduction. Attention disorders are a major problem after traumatic brain injury underlying deficits in other cognitive functions and in everyday activities, hindering the rehabilitation process and the possibility of return to work. Functional neuroimaging and neuropsychological assessment have depicted theoretical models considering attention as a complex and non-unitary process. Development. Although there are conceptual difficulties, it seems possible to establish a theoretical background to better define attentional impairments and to guide the rehabilitation process. The aim of the present study is to review some of the most important pieces involved in the assessment and rehabilitation of attentional impairments. We also propose an appropriate model for the design of individualized rehabilitation programs. Lastly, different approaches for the rehabilitation are reviewed. Conclusions. Neuropsychological assessment should provide valuable strategies to better design the cognitive rehabilitation programs. It is necessary to establish a link between basic and applied neuropsychology, in order to optimize the treatments for traumatic brain injury patients. It is also emphasized that well-defined cognitive targets and skills are required, given that an unspecific stimulation of cognitive processes (pseudorehabilitation) has been shown to be unsuccessful

Antibacterial evaluation of a collection of norfloxacin and ciprofloxacin derivatives against multiresistant bacteria.

The objective of this study was to analyse an array of ciprofloxacin and norfloxacin derivatives in order to determine those with good activity against bacteria that already present fluoroquinolone resistance associated with mutations in the gyrA and/or parC genes. Four norfloxacin and 20 ciprofloxacin derivatives were synthesised and tested against quinolone-susceptible and -resistant Escherichia coli, Acinetobacter baumannii, Stenotrophomonas maltophilia and Staphylococcus aureus strains using a microdilution test. Among the derivatives, the 4-methyl-7-piperazine ciprofloxacin derivative showed a minimum inhibitory concentration for 50% of the organisms that was 16- and 8-fold lower than ciprofloxacin for A. baumannii and S. maltophilia, respectively. When the methyl group at position 4 in the piperazine ring was substituted by ethyl, butyl or heptyl groups, activity against A. baumannii steadily decreased. The 7-(4-methyl)-piperazine ciprofloxacin derivative (UB-8902) showed very good activity against these multiresistant microorganisms including A. baumannii and S. maltophilia.

[Memory and the executive functions]. / Memoria y funciones ejecutivas.

INTRODUCTION: The terms 'executive functioning' or 'executive control' refer to a set of mechanisms involved in the improvement of cognitive processes to guide them towards the resolution of complex problems. Both the frontal lobes, acting as structure, and the executive processes, acting as function, work with memory contents, operating with information placed in the diencephalic structures and in the medial temporal lobe. Generally, we can state that many works find an association between frontal damage and specific memory shortages like working memory deficit, metamemory problems, source amnesia, or difficulties in the prospective memory. DEVELOPMENT: This paper is a critical review of the working memory concept and proposes a new term: the attentional operative system that works with memory contents. Concerning the metamemory, the frontal lobes are essential for monitoring processes in general and for 'the feeling of knowing' kind of judgements in particular. CONCLUSIONS: Patients suffering prefrontal damage show serious problems to remember the information source. Thus, the information is rightly remembered but the spatiotemporal context where that information was learned has been forgotten. Finally, the prospective memory deals with remembering to make something in a particular moment in the future and performing the plan previously drawn up.

Memoria y funciones ejecutivas / Memory and the executive functions

Introduction. The terms ‘executive functioning’ or ‘executive control’ refer to a set of mechanisms involved in the improvement of cognitive processes to guide them towards the resolution of complex problems. Both the frontal lobes, acting as structure, and the executive processes, acting as function, work with memory contents, operating with information placed in the diencefalic structures and in the medial temporal lobe. Generally, we can state that many works find an association between frontal damage and specific memory shortages like working memory deficit, metamemory problems, source amnesia, or difficulties in the prospective memory. Development. This paper is a critical review of the working memory concept and proposes a new term: the attentional operative system that works with memory contents. Concerning the metamemory, the frontal lobes are essential for monitoring processes in general and for ‘the feeling of knowing’ kind of judgements in particular. Conclusions. Patients suffering prefrontal damage show serious problems to remember the information source. Thus, the information is rightly remembered but the spatiotemporal context where that information was learned has been forgotten. Finally, the prospective memory deals with remembering to make something in a particular moment in the future and performing the plan previously drawed up (AU)

Introducción. ‘Funcionamiento ejecutivo’ o ‘control ejecutivo’ hacen referencia a una serie de mecanismos implicados en la optimización de los procesos cognitivos para orientarlos hacía la resolución de situaciones complejas. Los lóbulos frontales como estructura y los procesos ejecutivos como función operan con contenidos de la memoria, trabajando estratégicamente con información que se halla en estructuras diencefálicas y del lóbulo temporal medial. En términos generales podemos afirmar que múltiples trabajos relacionan el daño frontal con déficit de memoria específicos como la afectación de la memoria de trabajo, los problemas de metamemoria, la amnesia de la fuente o las dificultades en la memoria prospectiva. Desarrollo. Se plantea una revisión crítica del concepto de memoria de trabajo para proponer el de sistema atencional operativo que trabaja con contenidos de la memoria. En lo referente a la metamemoria los lóbulos frontales son fundamentales para los procesos de monitorización en general y para los juicios tales como los de ‘sensación de que se conoce’ en particular. Conclusiones. Los pacientes con daño prefrontal muestran una desproporcionada afectación en la memoria para recordar la fuente de la información. Así la información es correctamente recordada, pero el contexto espaciotemporal en el que dicha información se adquirió ha quedado olvidado. Para terminar, la memoria prospectiva hace referencia al recuerdo de hacer algo en un momento concreto del futuro y la ejecución del plan previamente formulado (AU)

Propuesta de un protocolo para la evaluación de las funciones ejecutivas / A proposal for a protocol for use in the evaluation of the executive functions

Introducción. Las funciones ejecutivas incluyen una serie de componentes como son la capacidad implicada en la formulación de metas, las facultades empleadas en la planificación de los procesos y las estrategias para lograr los objetivos pretendidos. En un trabajo anterior, en el que se tomaba como base los modelos que han intentado esclarecer los procesos implicados en las funciones ejecutivas, planteamos un modelo integrador. Desarrollo. A partir de este modelo, en este artículo proponemos un protocolo de evaluación. Así, las funciones ejecutivas entendidas como solución de problemas requieren, en términos genéricos, procesos de selección de objetivos, planificación y monitorización (torre de Hanoi y mapa del zoo). Cada uno de estos subprocesos opera a través de la memoria de trabajo, tanto con la agenda visuoespacial como con el bucle articulatorio. El sistema ejecutivo central o sistema atencional supervisor (SAS) actúa cuando no existe una solución conocida y debemos crear una posible alternativa. Conclusión. En este sentido, el SAS podría contener las siguientes funciones: ampliación de la capacidad del bucle fonológico y de la agenda viusoespacial (tareas tipo Sternberg), manipulación y actualización de la información (paradigma n-back), manipulación y mantenimiento de la información (letras y números de la escala de memoria de Wechsler), trabajar simultáneamente en dos tareas cognitivas (tareas de ejecución dual), inhibición (paradigma de Stroop y go-no go) y alternancia de sets cognitivos (tareas tipo clasificación de cartas de Wisconsin). Una vez que este proceso de planificación se ha llevado a cabo se precisa tomar decisiones (paradigma del juego de cartas) y es el marcador somático el encargado de tal proceso (AU)

Introduction. Executive functions include a variety of components such as the capacity implicated in goal formulation, the faculties employed in processes planning, and the strategies used to achieve the pretended objectives. In a previous work, taking as starting basis those models which have attempted to clarify those processes implicated in executive functions, we posed an integrative model. Development. Starting from this model, we now propose an assessment protocol. Thus, executive functions considered as problem solving, require in generic terms, objective selection, planning, and monitoring processes (tower of Hanoi and zoo map). Each of these sub-processes operate through the working memory both with the visospatial sketch and the phonological loop. The central executive system, or attentional supervisor system (ASS), acts when there is no known solution and we must create an alternative one. Conclusions. In this sense, the ASS could contain the following functions: amplification of the phonological loop and visospatial sketch capacity (Sternberg type tasks), information manipulation and actualisation (n-back paradigm), information manipulation and maintenance (Wechsler Memory Scale letters and numbers), simultaneously work in two cognitive tasks (dual execution tasks), inhibition (Stroop and go-no go paradigms), and cognitive sets alternation (Wisconsin Card Sorting Test). Once this planning process has been done, we must take a decision (gambling task paradigm), being the somatic marker in charge of this process (AU)