Concordancia entre 2 sistemas de medición de movilidad articular de rodilla en sujetos jóvenes sanos: estudio transversal / Concordance between two knee joint mobility measurement systems in healthy young subjects: Cross-sectional study

Introducción: La valoración de los arcos de movilidad articular es uno de los elementos esenciales para determinar el inicio y la progresión en los tratamientos fisioterapéuticos. Objetivo: Analizar la concordancia del goniómetro universal y el goniómetro digital para medir los movimientos de flexión y extensión de la rodilla de manera bilateral, en sujetos jóvenes sanos. Métodos: Estudio descriptivo, analítico de corte transversal, que contó con la participación de 180 jóvenes sanos, seleccionados de manera aleatoria y voluntaria, con una edad media de 21,7 años, a quienes se les midió el movimiento de flexo-extensión de la rodilla de manera pasiva. El coeficiente de correlación intraclase (ICC) de acuerdo absoluto, se utilizó para medir el grado de concordancia entre las valoraciones cuantitativas realizadas. Se presentó anormalidad en la distribución de los datos de las mediciones de flexión-extensión de la rodilla, por lo que, las comparaciones se realizaron con la mediana de los datos. Resultados: Se encontró una muy buena concordancia en la utilización del goniómetro universal y el goniómetro digital, para los movimientos de la rodilla: flexión derecha ICC: 0,956, extensión derecha ICC: 0,936, flexión izquierda ICC: 0,933, y para la extensión izquierda ICC: 0,953. Conclusiones: El goniómetro universal y el goniómetro digital obtuvieron una muy buena correlación en la medición de la flexión y extensión de la rodilla. (AU)

Introduction: The assessment of joint mobility arches is one of the essential elements to determine the onset and progression in physiotherapeutic treatments. Objective: To analyze the concordance of the universal goniometer and the digital goniometer to measure the movements of flexion and extension of the knee bilaterally, in healthy young subjects. Methods: A descriptive, analytical cross-sectional study involved 180 healthy young people, randomly selected and voluntarily, with a mean age of 21.7 years, who were measured in the knee flexo-extension movement passively. The intraclass correlation coefficient (ICC) according to absolute, was used to measure the degree of agreement between the quantitative assessments made. There was an abnormality in the distribution of data from knee flexion–extension measurements, so comparisons were made with the median of the data. Results: A very good agreement was found in the use of the universal goniometer and the digital goniometer, for knee movements: right flexion ICC 0.956, right extension ICC 0.936, left flexion ICC 0.933, and for left extension ICC 0.953. Conclusions: The universal goniometer and the digital goniometer obtained a very good correlation in the measurement of knee flexion and extension. (AU)

SARS-CoV-2 en Pediatría: abordaje de la transmisión, fisiopatología ehipótesis de presentación clínica / Sars-cov-2 in pediatrics: transmission approach, pathophysiology and clinical presentation hypothesis

La pandemia de COVID-19 causada por el síndrome respiratorio agudo severo coronavirus 2 (SARS-CoV-2) es una infección producida por inhalación de gotas o contacto directo con superficies infectadas. Los síntomas clínicos son similares a cualquier infección viral respiratoria aguda; la enfermedad suele ser más leve en los niños. El objetivo fue describir el abordaje de la transmisión, la fisiopatología y las manifestaciones clínicas del SARS-CoV-2 en población pediátrica. Se realizó una revisión bibliográfica en bases de datos académicas PubMed, LILACS, OVID-MEDLINE usando términos DECS-LILACS, aplicando filtros de búsqueda y se seleccionaron textos científicos e información relevante para la investigación. Los resultados evidencian una menor incidencia, prevalencia, hospitalizaciones e ingreso a unidades de cuidados intensivos. Es necesario corroborar las hipótesis planteadas para fortalecer estos conocimientos y determinar las características que predominan en la lesión pulmonar por infección de SARS-CoV-2 en Pediatría.(UA)

The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an infection caused by inhalation of droplets or direct contact with infected surfaces. The clinical symptoms are similar to any acute respiratory viral infection; the disease is usually milder in children. The objective was to describe the transmission approach, pathophysiology and clinical manifestations of SARS-CoV-2 in the pediatric population. A bibliographic review was carried out in PubMed, LILACS, OVID-MEDLINE academic databases using DECS-LILACS terms, applying search filters and scientific texts and relevant information for the research were selected. The results show a lower incidence, prevalence, hospitalizations and admission to intensive care units. It is necessary to corroborate the hypotheses proposed to strengthen this knowledge and determine the characteristics that predominate in pulmonary injury due to SARS-CoV-2 infection in pediatrics.(AU)

First Report of 'Candidatus Phytoplasma asteris' Affecting Woody Hosts (Fraxinus uhdei, Populus nigra, Pittosporum undulatum, and Croton spp.) in Colombia.

Phytoplasmas of the 16SrVII group in ornamental Fraxinus uhdei trees (1) growing in different cities of the Colombian Andes have been reported (2). In surveys made in Bogotá during March and May 2011, symptoms suggestive of phytoplasma infection were observed in ornamental woody species: Croton spp. (Euphorbiaceae), Pittosporum undulatum (Pittosporaceae) and Populus nigra (Salicaceae) trees, growing close to infected F. uhdei (Oleaceae). Symptoms included witches' broom, yellowing, dieback, epicormic sprouts, tufted foliage, abnormal elongation or shortening of internodes, and deliquescent branching leading to dramatic changes in crown architecture. P. undulatum and F. uhdei are introduced species representing the second and third most abundant trees in the city. P. nigra is an introduced species and Croton spp. is an Andean genus. In order to screen for the presence of phytoplasmas in Croton spp., P. undulatum, and P. nigra, four individuals of each species and two F. uhdei trees were sampled. For DNA extraction, 1 g of vascular tissue from young stems was used. Samples were tested by nested PCR with primers P1A/P7A (4) followed by R16F2n/R16R2 (3). The frequency of phytoplasma detection varied among species; P. undulatum and Croton spp. had three positives each, while P. nigra had one positive. Both F. uhdei were positive. Sequences from the amplicons (three reads) were aligned. BLAST analysis of 16S rDNA sequences from the four species tested had 99.2 to 99.7% similarity to 16SrI group sequences. Phylogenetic analysis further confirmed this relationship. Virtual sequence analysis using the iPhyclassifier tool ( http://plantpathology.ba.ars.usda.gov/cgi-bin/resource/iphyclassifier.cgi ) showed that the sequence derived from P. undulatum (JQ730861) produced an identical RFLP pattern to group 16SrI-B (reference sequence NC_005303). RFLP similarity coefficients of the phytoplasmas from F. uhdei, Croton spp., and P. nigra (JQ730859, JQ730859 and JQ730861) were less than 0.97, suggesting the presence of a new subgroup within group 16SrI. The vectors of phytoplasmas are unknown in the region. Phytoplasma hosts previously reported in Colombia are: Solanum quitoense (16SrIII), Manihot esculenta (16SrIII), Liquidambar styraciflua (16SrI and 16SrVII), Elaeis guineensis (16SrI and 16SrIII), Coffea arabica (16SrIII), Cordia alliodora (16SrIII), Solanum tuberosum (16SrV and 16SrXII), and Zea mays (16SrI). To our knowledge, this is the first report of Croton spp. and P. undulatum as phytoplasma hosts. Phytoplasmas of group 16SrI are known to infect more than 100 species of different families worldwide. Detection of this group in several tree species and the observation of similar symptoms in other trees species raises concerns about a possible epidemic affecting plants in the Andean region. Implications are at several levels: i) epidemiological, with infected trees representing a potential inoculum source for other ornamental plants or crops growing in the agricultural surrounding areas; ii) economic, since eventually it will be necessary to replace diseased plants; and iii) environmental, because of the negative impact on the services provided by trees and green areas. References: (1) J. J. Filgueira et al. Plant Pathology 53:520, 2004. (2) L. Franco-Lara et al. Fitopatología Colombiana 29:32, 2005. (3) D. E Gundersen et al. Phytopathol. Mediterr. 35:144, 1996. (4) I-M. Lee et al. Int. J. Syst. Evol. Microbiol. 54:1037, 2004.

Neumonía fatal en una niña inmunocompetente, asociada a herpes simple tipo 1 / Fatal pneumonia associated to herpes simplex 1, in an immunocompetent girl

Most reported cases of lower respiratory tract infection due to herpes simplex virus type-1 (HSV-1) occurs in immunocompromised patients, however there are few cases of viral infection in inmunocompentes critically ill patients (1-3). Objective: Report the case of fatal VHS-1 pneumonia in an immunocompetent patient. Case: A ten year old girl, immunocompetent, who presents respiratory symptoms and progresses rapidly to severe hypoxemia, instability and death. Lung biopsy reported Cowdry type A inclusions and the polimerasa chain reaction (PCR) was positive for HSV-1. We discuss the clinical features, diagnosis, treatment and prognosis in critically ill immunocompetent patients with HSV-1 infection in lower respiratory tract.

La mayoría de los casos reportados de infección por el virus herpes simplex tipo-1 (VHS-1) en el tracto respiratorio inferior ocurren en pacientes inmunosuprimidos; sin embargo, se han reportado casos de aislamiento del virus en pacientes inmunocompentes en estado crítico. Objetivo: Reportar el caso de neumonía grave y fatal por VHS-1 en un paciente inmunocompetente. Caso Clínico: Paciente de 10 años, sexo femenino, inmu-nocompetente, que inicia síntomas respiratorios y progresa rápidamente a hipoxemia severa, inestabilidad y muerte. La biopsia pulmonar reportó inclusiones de Cowdry tipo A y una reacción en cadena de la polimerasa (PCR) positiva para VHS-1. Discusión: Se comenta el cuadro clínico, diagnóstico, tratamiento y pronóstico en pacientes inmunocompetentes críticamente enfermos con infección por VHS-1 en el tracto respiratorio inferior.

[Attention deficit hyperactivity behavioral phenotype dimensions of adults from Antioquian families using the Wender-Utah Scale -Spanish version]. / Dimensiones del fenotipo conductual del trastorno por déficit de atención/hiperactividad en adultos de familias antioqueñas utilizando la escala Wender-Utah en Español.

INTRODUCTION: The Wender-Utah Rating Scale (WURS) has been used for retrospective screening of attention deficit hyperactivity disorders (ADHD) symptoms and its comorbidities. AIM: To establish the ADHD behavioral phenotype dimensions of adults from 140 Antioquian families with genetic segregation for ADHD diagnosis, using the WURS -Spanish version. SUBJECTS AND METHODS: 392 adults from both genders, belonging to nuclear and multigenerational families with one or more ADHD affected members were selected. The Composite International Diagnostic Interview (CIDI) for mental disorder was administered to establish the gold standard diagnosis of ADHD through the long life. All participants fulfill the WURS. Exploratory and confirmatory factor analyses were done to determine the behavioral dimensions of the ADHD phenotype. RESULTS: A factor structure of four dimensions was derived, measuring behavioral decontrol, hyperactivity, inattention and anxiety, and which explained the 60% of the total variance. CONCLUSIONS: The behavioral adult ADHD phenotype in the Antioquian families was conformed by four dimensions, which could be used in heritability and linkage future studies.

Dimensiones del fenotipo conductual del trastorno por déficit de atención/hiperactividad en adultos de familias antioqueñas utilizando la escala Wender-Utah en español / Attention deficit hyperactivity behavioural phenotype dimensions of adults from antioquian families using the wender-utah scale-spanish version

Introducción. El cuestionario Wender-Utah (WURS) se ha empleado en la evaluación retrospectiva de los síntomas del trastorno por déficit de atención/hiperactividad (TDAH) y sus comorbilidades en adultos. Objetivo. Establecer las dimensiones del fenotipo de las conductas del TDAH y sus comorbilidades en adultos de 141 familias de Antioquia con segregación para el diagnóstico de TDAH, usando la WURS en español. Sujetos y métodos. Se tomaron 392 adultos de ambos sexos pertenecientes a las familias nucleares y multigeneracionales con uno o más miembros afectados de TDAH. A los participantes se les aplicó una entrevista psiquiátrica estructurada internacional (CIDI) para realizar el diagnóstico de referencia de TDAH a lo largo de la vida. Los participantes cumplimentaron, además, la WURS. Se hicieron análisis de factores exploratorios y confirmatorios para establecer las dimensiones del fenotipo de la conducta del TDAH. Resultados. Se encontró una estructura factorial de cuatro dimensiones que midieron descontrol conductual, hiperactividad, inatención y ansiedad, que explicaron el 60% de la variabilidad total. Conclusión. El fenotipo conductual de los adultos de familias antioqueñas con TDAH está formado por cuatro dimensiones, que podrían utilizarse en futuros análisis de heredabilidad y ligamiento (AU)

Introduction. The Wender-Utah Rating Scale (WURS) has been used for retrospective screening of attention deficit hyperactivity disorders (ADHD) symptoms and its comorbidities. Aim. To establish the ADHD behavioral phenotype dimensions of adults from 140 Antioquian families with genetic segregation for ADHD diagnosis, using the WURS –Spanish version. Subjects and methods. 392 adults from both genders, belonging to nuclear and multigenerational families with one or more ADHD affected members were selected. The Composite International Diagnostic Interview (CIDI) for mental disorder was administered to establish the gold standard diagnosis of ADHD through the long life. All participants fulfill the WURS. Exploratory and confirmatory factor analyses were done to determine the behavioral dimensions of the ADHD phenotype. Results. A factor structure of four dimensions was derived, measuring behavioral decontrol, hyperactivity, inattention and anxiety, and which explained the 60% of the total variance. Conclusions. The behavioral adult ADHD phenotype in the Antioquian families was conformed by four dimensions, which could be used in heritability and linkage future studies(AU)

[Specific impaired language development: a selective or generalised cognition problem]. / Trastorno específico del desarrollo del lenguaje: problema selectivo o generalizado de la cognición.

INTRODUCTION: Specific developmental language disorder (SDLD) is a diagnostic entity in which language is expected to be the only cognitive function that is affected. Nevertheless, difficulties in other cognitive functions may also appear, either because the language disorder is an expression of an underlying condition or because the retarded language development gives rise to cognitive deficits in general. AIM: To determine whether there are any differences in the cognitive performance of children with SDLD and that of children who have developed normally. SUBJECTS AND METHODS: The study involved a sample of 51 children with SDLD, aged between 6 and 16 years, and 49 children in a control group, who were paired by chronological age, sex and socioeconomic level. Verbal cognitive capacity, attention, memory, visual-constructional and executive functioning were all evaluated. RESULTS: Statistically and clinically significant differences were found in the verbal-type skills, such as language comprehension and verbal cognitive capacity, which showed effect sizes of -1.31 and -1.33, respectively. In the other functions that were assessed, the performance of the SDLD group was slightly lower than that of the control group, but with no clinically significant differences. CONCLUSION: These findings show that the group of children with SDLD was well selected, since the only differences between the two groups involve linguistic aspects; moreover, this evidence supports the idea that language and other cognitive functions are relatively independent and that a language disorder would only generate an unspecific general effect in the other cognitive functions.

Trastorno específico del desarrollo del lenguaje: problema selectivo o generalizado de la cognición / Specific impaired language development: a selective or generalised cognition problem

Introducción. El trastorno específico del desarrollo del lenguaje (TEDL) es una entidad diagnóstica en la que se espera que el lenguaje sea la única función cognitiva afectada. Sin embargo, es posible que se puedan presentar dificultades en otras funciones cognitivas, sea porque la alteración lingüística es expresión de una afección de base o porque el retraso lingüístico lleve a falencias cognitivas en general. Objetivo. Determinar si existen diferencias en el rendimiento cognitivo de niños con TEDL respecto a niños con un desarrollo normal. Sujetos y métodos. Participaron 51 niños con TEDL, con edades entre los 6 y 16 años, y 49 niños de un grupo control, pareados por edad cronológica, sexo y estrato socioeconómico. Se evaluó la capacidad cognitiva verbal, atención, memoria, praxia visuoconstruccional y función ejecutiva. Resultados. Se encontraron diferencias estadística y clínicamente significativas en las habilidades de tipo verbal, como son la comprensión lingüística y la capacidad cognitiva verbal, las cuales tuvieron un tamaño de efecto de –1,31 y –1,33, respectivamente. En las demás funciones evaluadas el rendimiento del grupo con TEDL fue levemente menor que el del grupo control, sin mostrar una diferencia clínicamente significativa. Conclusión. Estos hallazgos muestran que el grupo de niños con TEDL está muy bien seleccionado, ya que los dos grupos sólo se diferencian en aspectos lingüísticos; además, es una evidencia que apoya la concepción de que el lenguaje y otras funciones cognitivas son relativamente independientes, y que una alteración lingüística sólo generaría un efecto general inespecífico en las demás funciones cognitivas

Introduction. Specific developmental language disorder (SDLD) is a diagnostic entity in which language is expected to be the only cognitive function that is affected. Nevertheless, difficulties in other cognitive functions may also appear, either because the language disorder is an expression of an underlying condition or because the retarded language development gives rise to cognitive deficits in general. Aim. To determine whether there are any differences in the cognitive performance of children with SDLD and that of children who have developed normally. Subjects and methods. The study involved a sample of 51 children with SDLD, aged between 6 and 16 years, and 49 children in a control group, who were paired by chronological age, sex and socioeconomic level. Verbal cognitive capacity, attention, memory, visual-constructional and executive functioning were all evaluated. Results. Statistically and clinically significant differences were found in the verbal-type skills, such as language comprehension and verbal cognitive capacity, which showed effect sizes of –1.31 and –1.33, respectively. In the other functions that were assessed, the performance of the SDLD group was slightly lower than that of the control group, but with no clinically significant differences. Conclusion. These findings show that the group of children with SDLD was well selected, since the only differences between the two groups involve linguistic aspects; moreover, this evidence supports the idea that language and other cognitive functions are relatively independent and that a language disorder would only generate an unspecific general effect in the other cognitive functions

[Specific developmental language disorder: a theoretical approach to its diagnosis, aetiology and clinical symptoms]. / Trastorno específico del desarrollo del lenguaje: una aproximación teórica a su diagnóstico, etiología y manifestaciones clínicas.

AIM: This article presents an updated review about the definition, diagnostic criteria, classifications, etiology and the evolution of the specific language impairment (SLI). DEVELOPMENT: The specific language impairment is characterized by a developmental language delay and an impaired language, that persist over time and it is not explained by sensorial, motor and mental disabilities, neither by psycopathological disorders, socio-emotional deprivation, nor brain injury. The diagnosis is based on exclusional criteria. Some researchers propose different classifications considering the children performance in language comprehension and language production. Genetical linkage to the FOXP2 gen in the SPCH1 region of the chromosome 7 and to the chromosomes 13, 16 y 19 has been reported. The neuroimage studies have shown alterations in the volume and perfusion of some brain structures related to language. The manifestations of SLI may change during the development of the children and may disturb the self-esteem, the academic performance and the social abilities. CONCLUSIONS: The variability in the linguistic and cognitive performance, and the variety in the etiological findings in children with SLI, don't allow to settle the affected population as an homogeneous group. Different theoretical positions have emerged as a consequence of this condition.

Trastorno específico del desarrollo del lenguaje: una aproximación teórica a su diagnóstico, etiología y manifestaciones clínicas / Specific developmental language disorder: A theoretical approach to its diagnosis, aetiology and clinical symptoms

Objetivo. Se presenta una revisión teórica actualizada de la definición, los criterios diagnósticos, las propuestas de clasificación, la etiología y la evolución del trastorno específico del desarrollo del lenguaje (TEDL). Desarrollo. El TEDL, comúnmente conocido como SLI (del inglés specific language impairment) en la literatura inglesa, se determina por un retraso y una alteración del desarrollo del lenguaje que persisten en el tiempo y que no pueden explicarse por deficiencias sensoriales, motoras, mentales, trastornos psicopatológicos, deprivación socioafectiva, ni lesiones cerebrales evidentes. El diagnóstico se basa en criterios de exclusión. Algunos autores plantean propuestas de clasificación considerando las características del desempeño de los niños en cuanto a la comprensión y la expresión del lenguaje. Se ha encontrado una asociación genética con el gen FOXP2 de la región SPCH1 del cromosoma 7, y en los cromosomas 13, 16 y 19. Los estudios de neuroimagen muestran alteraciones en el volumen y la perfusión de estructuras relacionadas con el lenguaje. Las características semiológicas del TEDL pueden cambiar a medida que el niño crece y afectar a la autoestima, el rendimiento escolar y las habilidades sociales. Conclusiones. La variabilidad en los perfiles de desempeño lingüístico y cognitivo y los diversos hallazgos etiológicos de los niños con TEDL no permiten caracterizar la población afectada como un grupo homogéneo. Esto ha generado diferentes posicionamientos teóricos, que han enriquecido la comprensión del espectro de manifestaciones del TEDL (AU)

Aim. This article presents an updated review about the definition, diagnostic criteria, classifications, etiology and the evolution of the specific language impairment (SLI). Development. The specific language impairment is characterized by a developmental language delay and an impaired language, that persist over time and it is not explained by sensorial, motor and mental disabilities, neither by psycopathological disorders, socio-emotional deprivation, nor brain injury. The diagnosis is based on exclusional criteria. Some researchers propose different classifications considering the children performance in language comprehension and language production. Genetical linkage to the FOXP2 gen in the SPCH1 region of the chromosome 7 and to the chromosomes 13, 16 y 19 has been reported. The neuroimage studies have shown alterations in the volume and perfusion of some brain structures related to language. The manifestations of SLI may change during the development of the children and may disturb the self-steem, the academic performance and the social abilities. Conclusions. The variability in the linguistic and cognitive performance, and the variety in the etiological findings in children with SLI, don’t allow to settle the affected population as an homogeneous group. Different theorical positions have emerged as a consequence of this condition (AU)

Synthesis, testing, and characterization of a novel Nafion membrane with superior performance in photoassisted immobilized Fenton catalysis.

A new type of Nafion/Fe structured membrane ensuring faster kinetics, higher efficiency, and mechanical properties has been prepared and will be compared in its performance with the Fe-exchanged commercial Dupont 117 Nafion/Fe membrane during the abatement of model organic compounds. During the casting of the laboratory Nafion sample, the iron ions were introduced directly into the Nafion oligomer solution. This novel laboratory Nafion/Fe was tested as an immobilized catalyst in the degradation of several toxic pollutants showing a faster photoassisted degradation kinetics and a wider effective photocatalytic pH range compared to the Fe-exchanged commercial Dupont 117 Nafion/Fe membrane. When carrying out Ar ion sputtering of the 50 topmost catalyst layers, evidence is presented by X-ray photoelectron spectroscopy that Fe ions are found in the inner Nafion layers and seem to be responsible for the immobilized photoassisted Fenton processes leading to the degradation of 4-chorophenol (4-CP) taken as a model organic pollutant for the degradation process reported in this study. In the laboratory sample, the iron oxy/hydroxy Nafion moiety undergoes a transition to a more stable Nafion/Fe species during 4-CP degradation as determined by X-ray diffraction. This more stable form shows a higher iron dispersion and crystallinity compared to the fresh sample and is stabilized by the Nafion matrix avoiding the formation of separate iron phases. By infrared absorption (Fourier transform infrared), evidence is presented for the band of akaganeite-like species at 870 cm(-1) on the laboratory Nafion/Fe sample. This band disappears after 4-CP degradation because of the formation of the more highly dispersed iron species. Sputtering experiments show a decrease of F-containing groups in the laboratory Nafion/Fe samples closer to the catalyst upper layer while the amounts of Fe, C, and in particular O species increase in the topmost layer(s). In particular, the oxygenated species develop in the Nafion/Fe up to approximately 50 A below the catalyst surface. These species remain stable during the long-term Nafion/Fe degradation of 4-CP. Dynamo-mechanical analysis performed on laboratory Nafion/ Fe membrane samples revealed that these membranes possessed a greater mechanical modulus and resistance than the commercial Dupont 117 Nafion membrane.

[Spatial distribution of Cordyceps spp. (Ascomycotina: Clavicipitaceae) and its impact on the ants in forests of Amazonian Colombian foothill]. / Distribución espacial de Cordyceps spp. (Ascomycotina: Clavicipitaceae) y su impacto sobre las hormigas en selvas del piedemonte amazónico de Colombia.

Entomopathogenic fungi of the genus Cordyceps were sampled in the foothills of the Colombian Amazon region (450-600 msnm altitude. January and May, 1998, i.e. dry and wet seasons, respectively). Healthy and Cordyceps-parasitized ants from a nearly pristine, a naturally disturbed and a human-disturbed forests were collected on 100 quadrants (1 m2) per forest. Litter, shrubs and trunks were explored as substrates, and samples were gathered in vertical strata from 50 cm to 2 m high. Azteca was the predominant ant genus in near pristine forest whereas Camponotus, Pheidole and Crematogaster were dominant in disturbed forests. In the naturally disturbed forest we found 759 individuals of Cordyceps unilateralis and 69 of C. lloydii var. binata parasitizing Camponotus spp. (Formicidae: Formicinae), whereas C. kniphofioides var. ponerinarum and C. australis were found only in six cases infecting the ants Paraponera clavata and Pachycondila crassinoda (Formicidae: Ponerinae). In the human disturbed forest it were found 34 individuals of C. unilateralis on Camponotus. In the near pristine forest we did not find parasitized ants. The Camponotus spp. ants parasitized by C. unilateralis and C. lloydii var. binata were found predominantly in the substratum foliage up to 1 m. It was concluded that the incidence of Cordyceps-ant interactions is not influenced by the conservation status of the forest. Instead, relative humidity and presence/absence of host ants appear to be key factors. Also, the microspatial distribution of the interactions seems to follow a definite pattern. This work observations support the hypothesis on coevolution of dispersion mechanisms in Cordyceps and ant pheromonal codes.

Estudio multicentrico, abierto, no comparativo sobre la seguridad y eficacia de sulbactam cefoperazona en infecciones bacterianas moderadas y severas / Non comparative multicentric study over security and efficacy of sulbactam cefoperazone in moderate and severe in bacterials infections

La eficacia y seguridad de sulbactam/cefoperazona fue evaluada en un estudio multicéntrico, abierto, no comparativo, usado como monoterapia. Doscientos dieciseis pacientes entraron inicialmente al estudio, siendo excluidos 42, por haber recibido antibioticoterapia concomiante. Ciento setenta y cuatro pacientes adultos (99M, 75 F), con rango de edad de 13 a 83 años fueron tratados con sulbactam/cefoperazona como monoterapia, en proporción 1:2, vía endovenosa, presentando 102 (59 por ciento) pacientes infecciones severas, y, 72(41 por ciento) infecciones moderadas. La localización de las infecciones fueron: piel y tejidos blandos (n=54,31 por ciento), abdominales (n=54,31 por ciento), infecciones respiratorias bajas (n=40,23 por ciento), tracto biliar (n=9,5 por ciento), tracto urinario (n=9,5 por ciento), área ginecológica (n=3,2 por ciento) y otras (n=5,3 por ciento). Ciento sesenta y uno (93 por ciento) de las infecciones fueron agudas, nueve (5 por ciento) crónicas y, 4 (2 por ciento) recurrentes. Los gérmenes obtenidos con mayor frecuencia el cultivo inicial fueron P. aeruginosa (27,16 por ciento), E.coli (n=23,13 por ciento), E.cloacae (n=14,8 por ciento), S. aureus (n=7,4 por ciento). La dosis diaria administrada de sulbactam/cefoperazona osciló entre 3 y 9 gr/día (media 4,6g/día), durante 1-70 días (media 10 días). Ciento cuarenta y cuatro pacientes fueron evaluados clínicamente, obteniéndose curación en 112 pacientes (78 por ciento), mejoría en 24 (17 por ciento), y falla en 8 pacientes (5 por ciento). Se incluyeron 96 pacientes para evaluación bacteriológica, reportándose erradicación en 88 (91 por ciento) y, persistencia en 8 (9 por ciento). Se presentaron efectos adversos en 9 pacientes (5 por ciento): rash, prolongación del PTT, cefalea, escalofríos y diarrea. Con un 95 por ciento de respuesta clínica satisfactoria, 91 por ciento de erradicación bacteriológica y buena tolerancia concluimos que sulbactam/cefoperazona usado como monoterapia es una buena elección para el tratamiento de infecciones moderadas y severas.

Four chamber pacing in dilated cardiomyopathy.

A 54-year-old man received a four chamber pacing system for severe congestive heart failure (NYHA functional Class IV). His ECG showed a left bundle branch block (200-msec QRS duration) with 200-msec PR interval, normal QRS axis, and 90-msec interatrial interval. An acute hemodynamic study with insertion of four temporary leads was performed prior to the implant, which demonstrated a significant increase in cardiac output and decrease of pulmonary capillary wedge pressure. A permanent pacemaker was implanted based on the encouraging results of the acute study. The right chamber leads were introduced by cephalic and subclavian approaches. The left atrium was paced with a coronary sinus lead, Medtronic SP 2188-58 model. An epicardial Medtronic 5071 lead was placed on the LV free wall. The four leads were connected to a standard bipolar DDD pacemaker, Chorus 6234. The two atrial leads were connected via a Y-connector to the atrial channel of the pacemaker with a bipolar pacing configuration. The two ventricular leads were connected in a similar fashion to the ventricular channel of the device. The right chamber leads were connected to the distal poles. The left chamber leads were connected to the proximal poles of the pacemaker. Six weeks later, the patient's clinical status improved markedly with a weight loss of 17 kg and disappearance of peripheral edema. His functional class was reduced to NYHA II. Four chamber pacing is technically feasible. In patients with evidence of interventricular dyssynchrony, this original pacing mode probably provides a mechanical activation sequence closer to the natural one.(ABSTRACT TRUNCATED AT 250 WORDS)

Eficacia clinica de la cefoperazona: estudio multicentrico en infecciones variadas / Clinical efficacy of cefoperazone: multicenter study in different infections

Se evaluó, en infecciones mixta por microorganismos aerobios y anaerobios, la eficacia y tolerancia del tratamiento combinado de Cefoperazona(2g/dia) y tinidazol (0.8g/d), administrando por via intravenosa en 36 pacientes (rango de edad 13-65 anos, 20 mujeres y 16 hombres) durante 5-17 dias (promedio 7.8 dias) con las siguientes infecciones severas: peritonitis(n=18), sepsis(n=2) abceso de pared abdominal(n=3), enfermedades inflamatoria pelviana(n=3) neumonia (n=2) colecistitis(n=1), osteomielitis(n=1), abceso subfrenico(n=3), abceso hepatico, tubo-ovarico y gangrena de miembros inferiores(1caso c/u). Los microorganismos sensibles a cefoperazona y/o tinidazol aislados fueron: E. Coli, Acinetobacter, sp., Bacteroides, sp., P.aeruginosa, k. pneumoniae, peptoestreptococcus, Enterocoicos, P.vulgaris,

Effectiveness of cefotaxime in gram-negative meningitis.

We treated 12 adult patients who had gram-negative bacillary meningitis with cefotaxime administered intravenously at a dose of 2 g every 4 hours. The etiological organisms included Haemophilus influenzae (3 cases), Serratia marcescens (3 cases), Klebsiella pneumoniae (3 cases), Escherichia coli (2 cases), and Enterobacter (1 case). The infection followed a neurosurgical procedure in 6 cases. The mean inhibitory and bactericidal concentrations of cefotaxime for the isolates ranged from 0.125 to 0.25 microgram/ml. The cerebrospinal fluid (CSF) concentrations of cefotaxime ranged from 5.0 to 15.2 micrograms/ml, and the CSF bactericidal titers were 1:64 to 1:128. The CSF in all patients was sterilized within 96 hours. All 12 patients recovered, and there were no relapses.

Cefmenoxime. Clinical, bacteriologic, and pharmacologic studies.

Cefmenoxime, a new semisynthetic third-generation cephalosporin, was evaluated in 105 patients (45 men and 60 women) with the following infections: skin or skin structure (33), pulmonary (22), urinary tract (30), and septicemia (20). Forty-two infections were hospital-acquired, 85 patients had underlying diseases, 29 patients required concomitant surgery, and 32 patients had positive results of blood culture. Cefmenoxime dosages ranged from 4 to 12 g per day intravenously for one and a half to 51 days. Cultures revealed 183 organisms in the 105 patients. Minimal inhibitory concentrations were obtained for cefmenoxime, cefoperazone, cefotaxime, cefamandole, cefoxitin, and moxalactam. Cefmenoxime and cefotaxime exhibited nearly equivalent activities against all organisms tested and were the most active agents tested against all aerobic and facultative organisms except Staphylococcus aureus. Mean serum peak and trough levels obtained after 2 g every six hours were 84.1 micrograms/ml (peak), 8.3 micrograms/ml (trough); and after 2 g every four hours, 106 micrograms/ml (peak) and 10.9 micrograms/ml (trough). Of 105 infections, 86 were clinically cured, three were not cured, and 16 were not evaluable. Safety studies revealed 24 transient reactions in 23 patients including eosinophilia, diarrhea, leukopenia, rash, elevated liver enzyme levels, Antabuse effect, and phlebitis. On the basis of these clinical and in vitro results, cefmenoxime is a safe drug for the treatment of infections caused by gram-negative and gram-positive aerobic organisms.