¿Es el estiramiento pasivo del cuádriceps igual de efectivo que el autoestiramiento en jugadores de fútbol? Ensayo clínico aleatorizado / Is quadriceps passive stretching as effective as self-stretching in soccer athletes? Randomized clinical trial

Objetivo Comparar los efectos de un estiramiento pasivo del músculo cuádriceps frente a un autoestiramiento en la flexibilidad de los músculos del muslo y el rango de movimiento (ROM) de la cadera en jugadores de fútbol. Métodos Se diseñó un ensayo clínico aleatorizado en el que se incluyeron 34 jugadores de fútbol amateur con déficit de flexibilidad en el músculo cuádriceps. Los jugadores fueron aleatorizados en dos grupos (grupo estiramiento o grupo autoestiramiento). Cada participante recibió una única sesión de estiramiento pasivo o autoestiramiento del cuádriceps en su pierna dominante. Se valoró la flexibilidad del cuádriceps mediante el test de Ely, la flexibilidad de los isquiotibiales mediante el Passive Knee Extension test, y ROM de flexión y extensión de la cadera. Resultados Ambos grupos mostraron un aumento estadísticamente significativo de la flexibilidad del cuádriceps, de la flexibilidad de los isquiotibiales y del ROM de extensión de la cadera sin diferencias significativas entre ellos (p>0,05). El grupo estiramiento mostró unos tamaños del efecto grandes en la flexibilidad y el ROM de extensión (d>0,8), siendo superiores a los registrados en el grupo autoestiramiento. Conclusiones La flexibilidad de los músculos cuádriceps e isquiotibiales, así como el ROM de extensión de cadera aumentaron tras el estiramiento y el autoestiramiento del músculo cuádriceps. Los tamaños del efecto mostrados por el grupo estiramiento fueron superiores a los del grupo autoestiramiento (AU)

Objective To compare the effects of quadriceps passive stretching or quadriceps self-stretching in muscle flexibility and hip range of motion (ROM) in football athletes. Methods A randomized clinical trial was carried out. Thirty-four football athletes with lack of flexibility in the quadriceps muscle were included and randomized in two groups (Stretching group or self-stretching group) and received a single session of quadriceps passive stretching or quadriceps self-stretching in the dominant lower limb. The outcome variables were: quadriceps flexibility measured with the Ely's test, hamstring flexibility measured with the Passive Knee Extension test and hip flexion and extension ROM. Results Both groups achieved a statistically significant improvement of quadriceps flexibility, hamstrings flexibility and hip extension ROM without statistically significant differences between them (p>0.05). The stretching group reported large effect sizes in muscle flexibility and hip extension ROM (d>0.8), and the effect sizes of the stretching group were higher than the self-stretching group. Conclusions Flexibility of the quadriceps and hamstring muscles as well as hip extension ROM increased after stretching and self-stretching of the quadriceps muscle. The effect sizes shown by the stretching group were higher than those of the self-stretching group (AU)

La osteonecrosis de maxilares: luces y sombras en el conocimiento de su fisiopatología / Osteonecrosis of the jaw: lights and shadows in the knowledge of its pathophysiology

No disponible

Análisis bibliométrico de los artículos originales publicados en la revista Ciencia & Trabajo: 1999-2015 / Bibliometric analysis of the original articles published in the journal Ciencia & Trabajo: 1999-2015

INTRODUCCIÓN: La Revista Ciencia y Trabajo (C&T) es editada por la Fundación Científica y Tecnológica de la Asociación Chilena de Seguridad desde 1999, publica trabajos científicos en temas relaciona dos con la seguridad e higiene industrial, salud ocupacional, calidad de vida laboral y otras disciplinas asociadas al trabajo y medio ambiente. OBJETIVO: Analizar la producción científica de los artículos originales publicados en C&T durante el periodo 1999-2015. MATERIAL Y MÉTODOS: Estudio bibliométrico descriptivo, longitudinal y retrospectivo. Se analizaron las características metodológicas y técnicas específicas en pre vención de riesgos laborales para cada uno de los artículos analizados, asimismo, la visibilidad en SciELO Analytics para los últimos años. RESULTADOS: Se publicaron un total de 430 artículos originales en 52 números con una media de 27 ± 8,8 artículos por año y 8 ± 2,6 artícu los por número. Los años con más artículos fueron 2009, 2010 y 2011. El número de autores por artículo oscila entre 1 a 4 (82%), en su mayo ría de universidades de Latinoamérica, destacando Chile, México y Brasil como los países de mayor contribución. La Psicosociología y Medicina del Trabajo son las temáticas más investigadas respecto a otras técnicas específicas en prevención de riesgos laborales como la Seguridad en el Trabajo y Ergonomía, predominando los estudios trans versales de carácter descriptivo-observacional en el idioma español. CONCLUSIONES: Se evidencia la consolidación de la revista a lo largo del tiempo. Por la antigüedad, publicación regular y demás atributos, la Revista C&T puede plantearse la posibilidad de ser indexada en la base de datos Scopus.

BACKGROUND: The journal Science and Work (C&T) has been pub lished by the Scientific and Technological Foundation of the Chilean Security Association since 1999, it publishes scientific papers on issues related to industrial safety and health, occupational health, quality of work life and other disciplines associated with Work and the environment. Objetive: To analyze the scientific production of the original articles published in C&T during the period 1999-2015. MATERIALS-METHODS: Descriptive, longitudinal and retrospective bibliometric study. We analyzed the specific methodological and technical characteristics in occupational risk prevention for each of the analyzed articles, as well as the visibility in SciELO Analytics for the last years. RESULTS: A total of 430 original articles were published in 52 numbers with an average of 27 ± 8.8 articles per year and 8 ± 2.6 articles per number, the years with the most articles were 2009, 2010 and 2011. The number of authors per article ranges from 1 to 4 (82%), mostly from Latin American universities, Chile, Mexico and Brazil being the countries with the highest contribution. Psychosociology and Occupational Medicine are the most researched topics in relation to other specific techniques in the prevention of occupational hazards such as Occupational Safety and Ergonomics, with cross - sectional descriptive - observational studies predominat ing in the spanish language. CONCLUSIONS: It is evident the consolida tion of the journal over time. Due to seniority, regular publication and other attributes, C&T can consider the possibility of being indexed in the Scopus database.

Determination of biofilm production by Candida tropicalis isolated from hospitalized patients and its relation to cellular surface hydrophobicity, plastic adherence and filamentation ability.

Candida tropicalis is an emerging virulent species. The aim of this study is to determine the biofilm-forming ability of 29 strains of C. tropicalis isolated from inpatients, and to examine its relation with other virulence factors such as cellular surface hydrophobicity (CSH), immediate (15 min, IA) and late (24 h, LA) plastic adherence and filamentation ability. The study was performed in parallel using two incubation temperatures - 37 and 22 °C - to determine the effect of growth temperature variations on these pathogenic attributes of C. tropicalis. Biofilm formation (BF) was measured by optical density (OD) and by XTT reduction (XTT); Slime index (SI), which includes growth as a correction factor in BF, was calculated in both methods. All strains were hydrophobic and adherent - at 15 min and 24 h - at both temperatures, with higher values for 22 °C; the adhered basal yeast layer appears to be necessary to achieve subsequent development of biofilm. Filamentation ability varied from 76.2% of strains at 37 °C to 26.6% at 22 °C. All C. tropicalis strains were biofilm producers, with similar results obtained using OD determination and XTT measurement to evaluation methods; SI is useful when good growth is not presented. BF at 37 °C was similar at 24 h and 96 h incubation; conversely, at 22 °C, the highest number of biofilm-producing strains was detected at 96 h. CSH is an important pathogenic factor which is involved in adherence, is influenced by the filamentation of yeast, and plays a critical role in BF.

Tumor de células gigantes en rótula: a propósito de un caso y revisión de la literatura / Patellar giant cell tumour: presentation of a case and a review of the literature

Los tumores en la rótula son poco frecuentes. Suelen afectar a pacientes jóvenes y se presentan como dolor inespecífico en la rodilla. El tumor de células gigantes (TCG) del hueso es un tumor benigno, pero localmente agresivo. Aunque la localización alrededor de la rodilla es muy frecuente, llegando a ser de hasta el 40-60%, la afectación de la rótula se ha descrito clásicamente en la literatura como casos aislados. Presentamos el caso de un varón de 19 años de edad, que acude a nuestra consulta presentando clínica meniscal. En el estudio radiológico se descubre de forma incidental una lesión lítica en la patela. Tras el estudio mediante resonancia magnética nuclear (RMN), se confirma el carácter benigno de la lesión, y en el mismo acto quirúrgico extraemos una biopsia incisional de la rótula. El estudio histológico confirma la sospecha de TCG, por lo que en un segundo tiempo quirúrgico se realiza el tratamiento definitivo. El paciente a los 56 meses de la intervención está asintomático y libre de enfermedad (AU)

Patellar tumours are rare. They typically appear in young patients, and present with a non-specific pain in the knee. Giant cell tumour (GCT) are benign, but locally aggressive. Although they are usually found around the knee (40-60%), those affecting the patella have been classically described in the literature as uncommon. We describe the case of a 19 year old male complaining of pain in his knee, whose clinical examination suggested a meniscal tear. Plain radiological examination, as well as MRI, revealed a well circumscribed lytic lesion within the patella. The patient underwent arthroscopic surgery, during which an incisional biopsy was performed. Following pathology reports, which confirmed the suspected GCT, definitive surgery was performed. At 56 months after the surgery the patient remains asymptomatic and free of disease (AU)

Estudio transversal para evaluar el riesgo cardiovascular en los hijos de padres con diabetes mellitus o hipertensión arterial / A cross-sectional study to assess cardiovascular risk in the children of parents with diabetes mellitus or arterial hypertension

Introducción. La enfermedad cardiovascular en adultos es la primera causa de muerte, en los menores de 15 años ocupa el tercer lugar. El propósito del estudio fue investigar qué factores de riesgo para enfermedad cardiovascular tienen los hijos de padres con diabetes o hipertensión arterial (HTA). Material y métodos. En un estudio transversal realizado en la Unidad de Medicina Familiar n.° 80 en Morelia, Michoacán, México, se incluyeron 156 pacientes con diabetes mellitus, HTA y sin diabetes ni hipertensión, hasta 10 años de evolución de la enfermedad y un hijo(a) biológico (edad 7-15 años) para formar binomios. Se conformaron 3 binomios: hijos-padres con diabetes, hijos-padres con HTA e hijos-padres sin diabetes ni HTA; se les realizó historia clínica, índice de masa corporal, glucemia, colesterol, triglicéridos, colesterol unido a las lipoproteínas de baja (c-LDL) y alta densidad (c-HDL) y síndrome metabólico. Resultados. La frecuencia de síndrome metabólico fue mayor en padres con diabetes (28,8%) o padres con HTA (25,0%) y en los hijos de padres sin diabetes ni HTA (11,5%). En el binomio hijo-padre con diabetes, la glucosa (OR=4,500; IC 95% 2,320-8,730, p<0,0001) resultó ser el factor de riesgo a tomar en cuenta para el desarrollo de enfermedad cardiovascular; en el binomio hijo-padre con HTA fue el colesterol total (OR=4,143; IC 95% 1,996-8,600, p<0,0001) y en el binomio hijo-padre sin diabetes ni HTA fue la circunferencia abdominal (OR=3,429; IC 95% 1,621-7,251, p<0,0001). Conclusiones. Los hijos de padres con y sin diabetes mellitus o HTA tienen un riesgo elevado para desarrollar enfermedad cardiovascular. Se requieren estudios prospectivos, longitudinales utilizando estrategias no farmacológicas y farmacológicas que impacten en los factores de riesgo en los hijos para evitar la enfermedad cardiovascular (AU)

Introduction. Cardiovascular disease in adults is the first cause of death, and in adolescents under 15 years old, it is the third cause of death. The purpose of this study was to investigate which risk factors for cardiovascular disease have the children of parents with diabetes or hypertension. Material and methods. In a cross-sectional study conducted in the Family Medicine Unit No. 80 in Morelia, Michoacán, Mexico, were included 156 patients with diabetes mellitus, hypertension and without diabetes or hypertension (10 years of disease progression), and a biological child (age 7-15 years) to form pairs. Three groups were formed: child-parent with Diabetes; child-parent with Hypertension and child-parent without Diabetes or Hypertension. Medical history, body mass index, blood glucose, cholesterol, triglycerides, c-LDL, c-HDL and signs of metabolic syndrome were recorded. Results. The frequency of signs of metabolic syndrome was higher in parents with Diabetes (28.8%), and in children of parents without either diabetes or hypertension (11.5%). In binomial children-parents with Diabetes, serum glucose (OR=4.50: 95% CI; 2.32-8.73, P<.0001) was the most important risk factor to develop cardiovascular disease; in binomial children-parents with Hypertension it was total cholesterol (OR=4.143: 95% CI; 1.996-8.60, P<.0001); and, in binomial children-parents without either Diabetes or Hypertension, the abdominal circumference (OR=3.429: 95% CI; 1.621-7.251, P<.0001) was the most important risk factor. Conclusions. We conclude that children of parents with or without diabetes mellitus or hypertension are at increased risk for developing cardiovascular disease. Longitudinal studies are required using non-pharmacological and pharmacological strategies that will have an impact on the most important risk factors for preventing cardiovascular disease (AU)

[Patellar giant cell tumour: presentation of a case and a review of the literature]. / Tumor de células gigantes en rótula: a propósito de un caso y revisión de la literatura.

Patellar tumours are rare. They typically appear in young patients, and present with a non-specific pain in the knee. Giant cell tumour (GCT) are benign, but locally aggressive. Although they are usually found around the knee (40-60%), those affecting the patella have been classically described in the literature as uncommon. We describe the case of a 19 year old male complaining of pain in his knee, whose clinical examination suggested a meniscal tear. Plain radiological examination, as well as MRI, revealed a well circumscribed lytic lesion within the patella. The patient underwent arthroscopic surgery, during which an incisional biopsy was performed. Following pathology reports, which confirmed the suspected GCT, definitive surgery was performed. At 56 months after the surgery the patient remains asymptomatic and free of disease.

A Case of Human Oral Myiasis by Lucilia sericata in a Hospitalized Patient in Extremadura, Spain.

Myiasis is the term used to describe infestations, both obligatory and accidental, in vertebrate animals and humans by dipteral larvae. The oral cavity is rarely affected by this infestation and the circumstances which can lead to oral myiasis include persistent mouth opening together with poor hygiene, or facial traumatism. We present a case of oral myiasis by larvae of Lucilia sericata, a species present in the Iberian Peninsula, in a hospitalized patient with surgical problems.

[A cross-sectional study to assess cardiovascular risk in the children of parents with diabetes mellitus or arterial hypertension]. / Estudio transversal para evaluar el riesgo cardiovascular en los hijos de padres con diabetes mellitus o hipertensión arterial.

INTRODUCTION: Cardiovascular disease in adults is the first cause of death, and in adolescents under 15 years old, it is the third cause of death. The purpose of this study was to investigate which risk factors for cardiovascular disease have the children of parents with diabetes or hypertension. MATERIAL AND METHODS: In a cross-sectional study conducted in the Family Medicine Unit No. 80 in Morelia, Michoacán, Mexico, were included 156 patients with diabetes mellitus, hypertension and without diabetes or hypertension (10 years of disease progression), and a biological child (age 7-15 years) to form pairs. Three groups were formed: child-parent with Diabetes; child-parent with Hypertension and child-parent without Diabetes or Hypertension. Medical history, body mass index, blood glucose, cholesterol, triglycerides, c-LDL, c-HDL and signs of metabolic syndrome were recorded. RESULTS: The frequency of signs of metabolic syndrome was higher in parents with Diabetes (28.8%), and in children of parents without either diabetes or hypertension (11.5%). In binomial children-parents with Diabetes, serum glucose (OR=4.50: 95% CI; 2.32-8.73, P<.0001) was the most important risk factor to develop cardiovascular disease; in binomial children-parents with Hypertension it was total cholesterol (OR=4.143: 95% CI; 1.996-8.60, P<.0001); and, in binomial children-parents without either Diabetes or Hypertension, the abdominal circumference (OR=3.429: 95% CI; 1.621-7.251, P<.0001) was the most important risk factor. CONCLUSIONS: We conclude that children of parents with or without diabetes mellitus or hypertension are at increased risk for developing cardiovascular disease. Longitudinal studies are required using non-pharmacological and pharmacological strategies that will have an impact on the most important risk factors for preventing cardiovascular disease.

Factores de riesgo de fracaso de la corrección quirúrgica de la incontinencia urinaria de esfuerzo mediante cinta suburetral transobturatriz / Risk Factors for Failure After Transobturator Vaginal Tape for Urinary Incontinence

Objetivos: Identificar factores que llevaron al fracaso del tratamiento quirúrgico en 302 mujeres con incontinencia urinaria de esfuerzo (IUE) tratadas mediante cinta suburetral transobturatriz (TOT) con seguimiento de 4 años (rango 1-6).Material y métodos302 mujeres incontinentes de 41-81 años fueron intervenidas mediante TOT entre abril de 2003 y noviembre de 2010. Los datos se recogieron mediante el cuestionario validado para incontinencia de orina, el International Consultation on Incontinence Questionnaire — Short Form (ICIQ-SF), y los registros clínicos de la historia. En 262 se consiguió continencia (grupo A) y 40 siguieron incontinentes (grupo B). Se investigó: edad, tiempo de evolución de IUE, tipo y número de partos (eutócicos, distócicos, nuliparidad, multiparidad) y antecedentes médicos y/ o quirúrgicos. Se empleó el cuestionario ICIQ-SF para asignar si los resultados de la cirugía fueron o no exitosos. Resultados: El grupo A presentó menor edad (p=0,0001), menos tiempo de evolución de IUE (p=0,017) y más partos eutócicos (p=0,00002). El grupo B presentó más partos distócicos (p=0,002), colocación previa de cinta vaginal libre de tensión (TVT) o TOT (p=0,03), tratamiento antidepresivo-ansiolítico (p=0,003), tratamiento antihipertensivo (p=0,0005), DMID (p=0.02), HTA (p=0,0007), trastornos respiratorios (p=0,025). No hubo diferencia en nuliparidad (p=0,7), multiparidad (p=0,4), obesidad (p=0,18), trastornos intestinales (p=0,59), anexectomía (p=0,19), cesárea (p=0,17), colposuspensión (p=0,29), histerectomía (p=0,57), alergias (p=0,48), artritis (p=0,22), artrosis (p=0,44), depresión (p=0,74), DMNID (p=0,44), tabaquismo (p=0,28) o fibromialgia (p=0,47). Conclusiones: Edad avanzada, largo tiempo de evolución de la incontinencia urinaria, antecedentes de partos distócicos y la colocación de TVT o TOT previamente aparecen como los factores independientes más asociados al fracaso del TOT, y pueden hacer aconsejable la indicación de otra técnica quirúrgica (AU)

Objective: To identify risk factors leading to treatment failure in a sample of 302 women with stress urinary incontinence (SUI) treated by transobturator vaginal tape (TOT) with a medium follow-up of 4 years (range 1-6). Material and Methods: A population based cohort study with prospectively data from 302 women, aged 41-81 years underwent TOT between April 2003-November 2010. Data were collected by validated questionnaire on urinary incontinence, the International Consultation on Incontinence Questionnaire — Short Form (ICIQ-SF), and clinical data-records. Continence was achieved in 262 (Group A) and 40 continued with incontinence (Group B). We investigated the relationship between age, SUI evolution time, type and number of childbirths (eutocic, dystocic, nulliparous, multiparous status) and medical and/or surgical backgrounds. The ICIQ-SF questionnaire was used to describe whether the surgery outcomes were successful or not. Results: Group A were younger (p=0.0001), had less SUI evolution time (p=0.017); more eutocic childbirths (p=0.000018). Group B had more dystocic childbirth (p=0.022), previous tension free vaginal tape (TVT) or TOT (p=0.03.), antidepressant-anxiolytic drugs (p=0.003), antihypertensive drugs (p=0.0005), type 1 diabetes (p=0.02), arterial hypertension (p=0.0007), respiratory diseases (p=0.025). Differences were not found with regard to nulliparous (p=0.701), multiparous status (p=0.42), obesity (p=0.18), intestinal disorders (p=0.59), oophorectomy (p=0.19), caesarean (p=0.17), prolapse surgery (p=0.29), hysterectomy (p=0.57), allergies (p=0.48), arthritis (p=0.22), arthrosis (p=0.44), depression (p=0.74), type 2 diabetes (p=0.44), smoking patterns (p=0.28), fibromyalgia (p=0.47). Conclusions: Elderly women, with long evolution SUI, dystocic delivery, previous TVT or TOT appear as independent risk factors associated to TOT failure. These factors may make the indication of another surgical approach recommendable (AU)

[Risk factors for failure after transobturator vaginal tape for urinary incontinence]. / Factores de riesgo de fracaso de la corrección quirúrgica de la incontinencia urinaria de esfuerzo mediante cinta suburetral transobturatriz.

OBJECTIVE: To identify risk factors leading to treatment failure in a sample of 302 women with stress urinary incontinence (SUI) treated by transobturator vaginal tape (TOT) with a medium follow-up of 4 years (range 1-6). MATERIAL AND METHODS: A population based cohort study with prospectively data from 302 women, aged 41-81 years underwent TOT between April 2003-November 2010. Data were collected by validated questionnaire on urinary incontinence, the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF), and clinical data-records. Continence was achieved in 262 (Group A) and 40 continued with incontinence (Group B). We investigated the relationship between age, SUI evolution time, type and number of childbirths (eutocic, dystocic, nulliparous, multiparous status) and medical and/or surgical backgrounds. The ICIQ-SF questionnaire was used to describe whether the surgery outcomes were successful or not. RESULTS: Group A were younger (p=0.0001), had less SUI evolution time (p=0.017); more eutocic childbirths (p=0.000018). Group B had more dystocic childbirth (p=0.022), previous tension free vaginal tape (TVT) or TOT (p=0.03.), antidepressant-anxiolytic drugs (p=0.003), antihypertensive drugs (p=0.0005), type 1 diabetes (p=0.02), arterial hypertension (p=0.0007), respiratory diseases (p=0.025). Differences were not found with regard to nulliparous (p=0.701), multiparous status (p=0.42), obesity (p=0.18), intestinal disorders (p=0.59), oophorectomy (p=0.19), caesarean (p=0.17), prolapse surgery (p=0.29), hysterectomy (p=0.57), allergies (p=0.48), arthritis (p=0.22), arthrosis (p=0.44), depression (p=0.74), type 2 diabetes (p=0.44), smoking patterns (p=0.28), fibromyalgia (p=0.47). CONCLUSIONS: Elderly women, with long evolution SUI, dystocic delivery, previous TVT or TOT appear as independent risk factors associated to TOT failure. These factors may make the indication of another surgical approach recommendable.

Detection of antibodies against Sarcocystis neurona, Neospora spp., and Toxoplasma gondii in horses from Costa Rica.

Serum samples from 315 horses from Costa Rica, Central America, were examined for the presence of antibodies against Sarcocystis neurona, Neospora spp., and Toxoplasma gondii by using the surface antigen (SAG) SnSAG2 enzyme-linked immunosorbent assay (ELISA), the NhSAG1 ELISA, and the modified agglutination test, respectively. Anti- S. neurona antibodies were found in 42.2% of the horses by using the SnSAG2 ELISA. Anti- Neospora spp. antibodies were found in only 3.5% of the horses by using the NhSAG1 ELISA, and only 1 of these horses was confirmed seropositive by Western blot. Antibodies to T. gondii were found in 34.0% of the horses tested, which is higher than in previous reports from North and South America. The finding of anti- S. neurona antibodies in horses from geographical areas where Didelphis marsupialis has wide distribution suggests that D. marsupialis is a potential definitive host for this parasite and a source of infection for these horses.

Aspartyl proteinase, phospholipase, hemolytic activities and biofilm production of Candida albicans isolated from bronchial aspirates of ICU patients.

A correlation between mucosal colonization by Candida albicans and the subsequent development of invasive respiratory infection has been previously described. The aim of this study was to evaluate different enzymatic activities in vitro and to determine the capacity to form biofilms by 17 C. albicans isolates from bronchial aspirates of mechanically ventilated patients hospitalized in intensive care units. All the C. albicans clinical isolates tested were biofilm producers and displayed detectable levels of proteinase and hemolytic activities, although phospholipase activity was not detected in one strain. The correlation noted among the virulence factors studied suggests that the presence of more than one concurrent factor could facilitate the spread of infection.

Validation of the Pascual Graphomotor Test in Cuban school children.

INTRODUCTION: The ability to draw is a complex perception and cognition function, which is acquired in infancy and is not usually investigated in the neuropaediatric clinic. OBJECTIVE: To validate the Pascual graphomotor test (PGT) in 5 to 11 year-old Cuban school children. PATIENTS AND METHODS: The PGT was performed on a total of 172 children from the city of Havana Círculo Infantil del Municipio Plaza nursery school and from the 1st to 5th year of a primary school in the same area. The sample was systematic. The test was repeated the following day. All the drawings were scored blind by a neurologist and neurology resident. RESULTS: For the validation of the test the differentiation with age and school year was taken as a validation criterion. A high correlation was obtained between the ages of the children and the scores obtained. The Spearman coefficient was -0.78 (P=0.01), and a there was a similar inverse correlation between the school year and the test scores (Spearman coefficient=-0.79, P=0.01). The test was very reliable, with an intraclass correlation coefficient (ICC) of 0.99 for inter-observer agreement and 0.97 for the test-retest. CONCLUSIONS: The test was valid according to the criterion employed, differentiation with age and school year. The PGT demonstrated good temporal and inter-observer stability. We believe that it is a very useful tool in the neurological examination of Cuban school children.

Enzymatic activities of Candida tropicalis isolated from hospitalized patients.

Secretion of hydrolytic enzymes is considered a virulence factor in Candida spp. Extracellular enzymatic activities in 29 clinical isolates of Candida tropicalis were analyzed by plate assays. C. tropicalis, similar to Candida albicans, showed elevated hemolytic and esterase activities. However, unlike C. albicans, low aspartyl protease and very low phospholipase activities were detected in C. tropicalis isolates.

Síndrome de dolor regional complejo sin causa aparente. A propósito de un caso / The complex regional pain syndrome with no apparent cause. A case report

El síndrome de dolor regional complejo (SDRC) es una entidad nosológica que cursa con dolor, inestabilidad vasomotora y limitación funcional, cuya etiología no está aún demostrada; con frecuencia se produce después de un traumatismo. Se caracteriza por dolor, y el cuadro se puede agravar con inflamación, tumefacción, alteraciones cutáneas, cambios de color y claudicación. La gammagrafía con tecnecio-99 es una prueba sensible, sin embargo no existe una prueba específica para el diagnóstico certero; hoy en día se han descrito numerosas escalas cuyos criterios permiten llegar a un diagnóstico probable. El tratamiento del SDRC debe ser introducido lo antes posible; se plantea en varios escalones: farmacológico, bloqueos nerviosos, simpatectomía, estimulación medular, infusión intratecal, acompañados de rehabilitación y en algunos casos de psicoterapia. Se describe el caso de una mujer de 38 años que sin causa previa desarrolla un SDRC. Asimismo se hace una revisión bibliográfica de esta enfermedad (AU)

TThe Complex Regional Pain Syndrome (CRPS) is a nosological entity characterized by the presence of pain, vasomotor instability and limitation of the normal function, whose etiology has still not been demonstrated, although it usually occurs after a traumatic injury. It is defined by the presence of pain and its picture may become worse with inflammation, swelling, skin abnormalities, changes in color and limp.The 99TC-scintigraphy is a sensitive diagnostic test. However, there is no specific test for its diagnosis. Nowadays, several scales have been described whose criteria make it possible to reach a probable diagnosis.Treatment of CRPS must be begun as soon as possible. Several steps are proposed: pharmacological treatment, neural blockade, sympathectomy, spinal cord stimulation, intrathecal drug delivery accompanied by rehabilitation and in some cases psychotherapy. We describe the case of a 38-year-old woman with no previous factors who develops CRPS.We present a bibliographic review on this disease (AU)

Neuromyelitis optica positive antibodies confer a worse course in relapsing-neuromyelitis optica in Cuba and French West Indies.

BACKGROUND: In Caucasian populations neuromyelitis optica (NMO-IgG) antibody has been detected in 27.1% / 78.2% of patients with relapsing-NMO (R-NMO). The prevalence reported for the disease in the Caribbean is 3.1/100,000 in the French West Indies (FWI) and 0.52 /100,000 in Cuba, but the NMO antibody status is unknown. OBJECTIVE: To assess the NMO-IgG antibody status of Cuban/FWI RNMO patients, comparing with European cases tested at the same laboratories. METHODS: Serum NMO-IgG antibodies were assayed in 48 R-NMO patients (Wingerchucks 1999 criteria): Cuba (24)/FWI (24), employing Lennon et als method. We compared the demographic, clinical, disability and laboratory data between NMO-IgG +/- patients. All the data were reviewed and collected blinded to the NMO-IgG status. RESULTS: Seropositivity of the NMO-IgG antibody demonstrated a lower rate in the Caribbean (33.3%), as compared with Caucasian patients from Spain/Italy (62.5%) and France (53.8%). Caribbean patients with NMO-IgG (+) displayed more attacks, more spinal attacks and a higher EDSS than NMO-IgG (-) cases, while brain and spinal cord MRI lesions were more frequent during remission, with more vertebral segments, more gray, white matter and holocord involvement. CONCLUSIONS: NMO IgG positive antibodies in NMO patients had a lower rate in the Caribbean area - where the population has a predominant African ancestry - than in Caucasian Europeans, suggesting the influence of a possible ethnic factor in the pathogenesis of the disease, but they confer a worse course with more attacks, more disability and MRI lesions.

Modification of adherence to plastic and to human buccal cells of Candida albicans and Candida dubliniensis by a subinhibitory concentration of itraconazole.

Exposure to subinhibitory concentrations of antifungal agents can influence the adherence of Candida spp. to the host cell. In this study the adherence of Candida albicans ATCC 10231 and Candida dubliniensis CECT 11455 to plastic and to human buccal epithelial cells was evaluated following pre-exposure to 0.5 x minimum inhibitory capacity (MIC) of itraconazole and compared with the corresponding cellular surface hydrophobicity. The yeasts were grown in Sabouraud broth or RPMI-1640 with itraconazole (0.5 x MIC) for 24-26 h at 37 degrees C and the drug was then removed. The adhesion capacity to plastic was studied by turbidimetry in a polystyrene microtiter plate. The adhesion of the yeast to buccal epithelial cells was determined using microscopy techniques. The cellular surface hydrophobicity levels were determined by the microbial adhesion hydrocarbons test. Pre-exposure to itraconazole decreased plastic adherence and cellular surface hydrophobicity in both species when grown in RPMI. When C. albicans was grown in Sabouraud broth, it was nonhydrophobic and did not adhere and therefore no change was detected with the antibiotic. Itraconazole increased adherence to buccal epithelial cells in both species and media studied, as compared to controls without antifungal agents. To study the effects of these antifungal agents on pathogenicity mechanisms, it will be necessary to standardize the methodology for evaluation to determine their in vivo therapeutic efficacy.

Exposure to therapeutic concentrations of ritonavir, but not saquinavir, reduces secreted aspartyl proteinase of Candida parapsilosis.

The effect of ritonavir and saquinavir, HIV proteinase inhibitors, on the secreted aspartyl proteinase (Sap) activity of Candida parapsilosis was studied. In a proteinase-inducing medium (yeast carbon base-bovine serum albumin), Sap activity in all clinical isolates of C. parapsilosis (n = 20) was observed at 37 degrees C but not at 22 degrees C. The presence of ritonavir at a concentration of 8 microg/ml produced an inhibition close to 50% albumin consumption and also delayed yeast growth; however, saquinavir did not have any effect on growth or on Sap activity. In Sabouraud broth, which does not induce Sap production, no effect was shown on yeast growth by either of the two HIV proteinase inhibitors studied.