Consumer insights into the at-home liking of commercial beers: Integrating nonvolatile and volatile flavor chemometrics.

Consumer acceptability of beers is influenced by product formulation and processing conditions, which impart unique sensory profiles. This study used multivariate techniques to evaluate at-home consumer sensory acceptability of six commercial beers considering their style, fermentation type, and chemical composition. Samples included top-fermented beers (American India Pale Ale and Stout) and bottom-fermented beers (Pilsner, zero-alcohol Pilsner, Vienna Lager, and Munich Dunkel). Beer consumers (n = 50) conducted sensory hedonic, check-all-that-apply (CATA) and just-about-right (JAR) tests. Chemometric variables included iso-alpha-acids, hordenine, and volatile aromatic compounds, quantified by chromatographic methods, whereas bitterness units (IBU) were determined spectrophotometrically. Lager beers had higher acceptability than top-fermented beer (p < .05) for all attributes. Light-colored beers and medium-height foams had the highest liking scores for visual sensory attributes. Higher concentrations of bitter-tasting molecules, hordenine, and acidity decreased the liking scores of top-fermented (Ale) beers, as a sensory penalty analysis suggested. In contrast, the most favored beers (Pilsners and Munich Dunkel) contained higher fusel alcohol esters linked to fruity aromatic notes. Although a low conversion rate of fatty acids into fruity esters was noted in nonalcoholic Pilsner, its overall liking score was not statistically different from the alcoholic version. However, consumers perceived the nonalcoholic Pilsner as less bitter than its alcoholic counterpart even when IBUs were nonsignificantly different. This study emphasized the significance of understanding beer chemometrics to comprehend consumer acceptability, highlighting the crucial role of bitter molecules. Hence, hordenine, acidity, and volatile contents provided additional and valuable insights into consumer preferences.

Intraplaque calcium and its relation with the progression of carotid atheromatous disease.

BACKGROUND: Calcification and progression of atheromatous disease (AD) both have been independently related with the risk of stroke. However, the link between the two phenomena is still unclear. The main objective of this study was to analyze the temporal evolution of Ca content of carotid atheromatous plaques and its relation with the progression of carotid AD using quantitative CT Angiography (CTA). METHODS: Forty-three asymptomatic patients with stenosis of the internal carotid artery (ICA)>50% completed the study. Contrast mold volume and calcium (Ca) content by quantitative CTA and Modified Agatston Score (Ca volume × radiological density) were assessed at baseline and after 12±2 months. Biochemical parameters, including main markers of Ca/Phosphorus (P) metabolism, were determined. RESULTS: CTA measurement showed an increase of volumetric stenosis (volume decrease of the contrast mold), compared to baseline (475.45 [155.6] mm3 × U.H vs. 501.3 [171.9] mm3 × U.H; P=0.04) as well as an increase of intraplaque Ca (64.58 [57.8] mm3 × U.H. vs. 56.8 [52.3] P=0.002). An inverse correlation between baseline Ca content and volumetric stenosis progression (r=-0.481; P<0.001), as well as between the increase of carotid Ca and plasma levels of vitamin D (r=0.4; P=0.025) were also found. Multiple regression analysis found a model with baseline intraplaque Ca, adjusted by Body Mass Index (BMI) as most predictive of carotid AD progression. CONCLUSIONS: These results suggest that a higher content of Ca confers greater stability against the progression of carotid AD and, eventually, its ability to generate symptomatology.

Insights into Drivers of Liking for Avocado Pulp (Persea americana): Integration of Descriptive Variables and Predictive Modeling.

Trends in new food products focus on low-carbohydrate ingredients rich in healthy fats, proteins, and micronutrients; thus, avocado has gained worldwide attention. This study aimed to use predictive modeling to identify the potential sensory drivers of liking for avocado pulp by evaluating acceptability scores and sensory descriptive profiles of two commercial and five non-commercial cultivars. Macronutrient composition, instrumental texture, and color were also characterized. Trained panelists performed a descriptive profile of nineteen sensory attributes. Affective data from frequent avocado adult consumers (n = 116) were collected for predictive modeling of an external preference map (R2 = 0.98), which provided insight into sensory descriptors that drove preference for particular avocado pulps. The descriptive map explained 67.6% of the variance in sensory profiles. Most accepted pulps were from Hass and Colin V-33; the latter had sweet and green flavor notes. Descriptive flavor attributes related to liking were global impact, oily, and creamy. Sensory drivers of texture liking included creamy/oily, lipid residue, firmness, and cohesiveness. Instrumental stickiness was disliked and inversely correlated to dry-matter and lipids (r = -0.87 and -0.79, respectively). Color differences (∆Eab*) also contributed to dislike. Sensory-guided selection of avocado fruits and ingredients can develop products with high acceptability in breeding and industrialization strategies.

Beer and Consumer Response Using Biometrics: Associations Assessment of Beer Compounds and Elicited Emotions.

Some chemical compounds, especially alcohol, sugars, and alkaloids such as hordenine, have been reported as elicitors of different emotional responses. This preliminary study was based on six commercial beers selected according to their fermentation type, with two beers of each type (spontaneous, bottom, and top). Chemometry and sensory analysis were performed for all samples to determine relationships and patterns between chemical composition and emotional responses from consumers. The results showed that sweeter samples were associated with higher perceived liking by consumers and positive emotions, which corresponded to spontaneous fermentation beers. There was high correlation (R = 0.91; R2 = 0.83) between hordenine and alcohol content. Beers presenting higher concentrations of both, and higher bitterness, were related to negative emotions. Further studies should be conducted, giving more time for emotional response analysis between beer samples, and comparing alcoholic and non-alcoholic beers with similar styles, to separate the effects of alcohol and hordenine. This preliminary study was a first attempt to associate beer compounds with the emotional responses of consumers using non-invasive biometrics.

Consenso para el diagnóstico y tratamiento de la esclerosis múltiple en pacientes del ISSSTE / Consensus for the diagnosis and treatment of multiple sclerosis in ISSSTE patients

Resumen: La esclerosis múltiple es una de las principales enfermedades desmielinizantes del sistema nervioso central, que repercute no solo en lo económico, sino también en lo social. El Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE) dispone de la mayor parte de los tratamientos que modifican la evolución de esta enfermedad y para optimizar su uso, un grupo de neurólogos de la institución se reunió para la realización de un documento sobre aspectos generales de diagnóstico y tratamiento denominado Consenso para el Diagnóstico y Tratamiento de la Esclerosis múltiple en pacientes del ISSSTE. El objetivo de este documento es dar recomendaciones de las diferentes alternativas terapéuticas contra la esclerosis múltiple.

Abstract: Multiple sclerosis is one of the main demyelinating diseases of the central nervous system, which impacts not only economically but also socially. The Mexican Institute of Security and Social Services of State Workers (ISSSTE) has most of the disease modifying treatments for this disease and to optimize its use, a group of neurologists from the institution met to make a document on general aspects of diagnosis and treatment called: Consensus for the diagnosis and treatment of multiple sclerosis in ISSSTE patients. The objective of this consensus is to give recommendations on the different therapeutic alternatives against multiple scle- rosis for adults and children.

Chemical Profile and Safety Assessment of a Food-Grade Acetogenin-Enriched Antimicrobial Extract from Avocado Seed.

Acetogenins are bioactive fatty acid derivatives found in avocado tissues. Their efficacy as antimicrobials has been documented and initiated interest to use them as replacements of synthetic food additives. The present work focused on evaluation of multiple analytical methodologies for detection and quantification of organic solids present in a food-grade acetogenin-enriched extract (Avosafe®), and on its safety evaluations using bacterial reverse mutation (AMES) tests and acute oral toxicity to rat assays. Results confirmed chemical structures of two acetogenins as present in Avosafe® (AcO-avocadyne-(0) and AcO-avocadiene B-(3)), and together with seven other previously known compounds, quantified 94.74 ± 5.77% w/w of its solids as acetogenins. Safety evaluations indicated that Avosafe® was non-mutagenic and had an acute median lethal oral dose (LD50) to rats higher than the maximum concentration tested (>2000 mg·kg-1), with no signs of macroscopic abnormalities in organs. Mean body weight and hematological and biochemical parameters were normal after 14 days of a single oral dose of 2000 mg·kg-1. The results advance scientific information on the safety of avocado seed acetogenins and also generate new knowledge on profiles and concentrations of individual acetogenins found in avocado tissues (seed, pulp, and leaves) and in Avosafe®.

Volumetric assessment of the carotid bifurcation: an alternative concept to stenosis grading.

BACKGROUND: To design a volumetric method for the assessment of carotid atheromatosis (CA) based on computed tomography (CT) angiography and three-dimensional (3D) reconstructions; to analyze the accuracy and optimal threshold values to differentiate between equivalent degrees of severity by duplex scanning and CT angiography (two-dimensional maximum intensity projection [2D MIP]; internal carotid artery stenosis [ICS] <50%; ICS >50%); and to assess the method's suitability to detect progression of CA. DESIGN: suitability and accuracy of a new diagnostic method. POPULATION: 90 carotid bifurcations (45 patients) were assessed with duplex scanning and CT angiography, and reevaluated after 12 ± 2 months follow-up. Determinations: Assessment of internal carotid artery (ICA) stenosis degree with duplex scanning and 2D MIP CT angiography projections. Volumetric assessment of carotid bifurcation by CT angiography (contrast volume [mm(3)] and density [Hounsfield units, H.U.] between 2-cm below and 1-cm above the anatomic bifurcation of the carotid artery [BifV], and its ratio with 1-cm segment of the common carotid artery [CCV]). STATISTICAL ANALYSIS: descriptive statistics; intraobserver and interobserver agreement (Bland-Altman plot and intraclass correlation coefficient [ICC], accuracy of 3D volumetry and duplex scanning as referred to MIP 2D CT angiography as gold standard: sensitivity (Sens), specificity (Sp), kappa index, and receiver operating characteristic curves (ROCs). RESULTS: Estimation of MIP 2D images (CT angiography) confirmed the findings of duplex scanning in 23 of 30 ICS <50% and 48 of 53 ICS >50% (Sens, 0.91; Sp, 0.77% kappa = 0.68). Three-dimensional volumetric assessment of carotid bifurcation showed an intraobserver and interobserver agreement with an ICC of 0.96 (95% confidence interval [CI], 0.904-0.985) and 0.94 (95% CI, 0.822-0.977), respectively. The BifV-to-CCV ratio was 5.2 ± 1.8 in the ICS <50% group versus 3.8 ± 1.3 in the ICS >50% group (P = 0.001). The optimal cutoff point of the BifV-to-CCV relationship was identified from the ROC curve in 4.1 (Sens, 0.75; Sp, 0.75; kappa, 0.46). At 12 months, a decrease of the average BifV with regard to the baseline value (475.45 [155.6] mm(3) × H.U. vs. 501.3 [171.9] mm(3) × H.U.; P = 0.04) was observed. CA progression was detected in 32 bifurcations (14 ICS <50%; 18 ICS> 50%), with a reduced bifurcation volume of 137.8 (71.4) mm(3) × H.U.; P < 0.001. CONCLUSIONS: Volumetric assessment of carotid bifurcation is a new concept based on assessing plaque burden rather than its hemodynamic effect or maximum stenosis; thus, justifying its moderate accuracy with regard to ICS conventional ICA grading based on biplanar images. This method can be especially useful in plaque progression studies given its accuracy to detect minor changes in the arterial lumen.

The tuberal lateral hypothalamus is a major target for GABAA--but not GABAB-mediated control of food intake.

The lateral hypothalamus (LH) is a site of integration for control mechanisms of feeding behavior as it has extensive reciprocal connections with multiple intrahypothalamic and extrahypothalamic brain areas. Evidence suggests that blockade of ionotropric gamma-aminobutyric acid (GABA) receptors in the LH elicits eating in satiated rats. To determine whether this GABA(A) receptor antagonist effect is specific to the LH, the antagonist picrotoxin was injected into one of six nearby sites and food intake was measured. Picrotoxin at 133 pmol elicited eating in the LH, but not in surrounding sites (thalamus, lateral preoptic area, ventral tegmental area, dorsomedial hypothalamus, and entopeduncular nucleus). More specifically, picrotoxin injected into the tuberal LH (tLH) elicited eating, but was ineffective when injected into the anterior or posterior LH. We also investigated whether GABA(B) receptors in the LH participated in the control of food intake and found that neither blockade nor activation of these receptors under multiple conditions changed food intake. Collectively, our findings suggest that GABA(A) but not GABA(B) receptors in the tLH act to suppress feeding behavior.

GABA(A) receptors in the lateral hypothalamus as mediators of satiety and body weight regulation.

In the lateral hypothalamus (LH), the inhibitory amino acid neurotransmitter, GABA, has had a long-standing presumptive role as an inhibitor of food intake. However, minimal investigation has been focused on GABA, especially as compared to the attention received by many peptide transmitters. To begin to address this deficiency in the understanding of the role of GABA in the LH and feeding, we report that antagonism of GABA(A) receptors in the rat LH elicits feeding, consistent with previous findings, and provide evidence for the behavioral selectivity of this effect. We extend previous findings that activation of LH GABA(A) receptors suppresses feeding, in particular by showing that nighttime and deprivation-induced eating are dramatically suppressed. Finally, we show that chronic activation, but not blockade, of the LH GABA(A) receptors leads to a reduction in 24 h food intake with concomitant body weight loss. These data collectively suggest that activation of GABA(A) receptors plays a fundamental role in controlling food intake and body weight, a role that has previously been somewhat underestimated.

Proposiçäo de técnica endocavitária para remodelamento ventricular esquerdo / An endocavitary technique for left ventricular surgical remodeling

O remodelamento do coraçäo mediante vesntriculectomia parcial esquerda é uma proposiçäo atual para o tratamento cirúrgico paliativo de pacientes com miocardiopatia dilatada e sem critérios de transplante cardíaco. Este procedimento acarreta morbi-mortalidade imediata elevada, por resultar em áreas de isquemia ou necrose miocárdica e pelo risco de arritmias. Nosso objetivo é apresentar um técnica de remodelamento ventricular endocavitário, caracterizada pela manutençäo da arquitetura anatomofuncional do coraçäo por näo incorrer em ressecçäo ventricular. A técnica foi utilizada em circulaçäo extracorpórea e com o coraçäo preservado por cardioplegia sangüínea hipotérmica. Após atriotomia esquerda, a cúspide anterior da valva mitral foi removida e um enxerto triangular de pericárdio bovino (medindo aproximadamente 2x6x6 cm) suturado no endocárdio ventricular por pontos de Polipropileno 3-0 ancorados em feltro de Dacron. As bordas ao longo do enxerto foram fixadas em duas linhas imaginárias que se estendiam da ponta do ventrículo esquerdo ao anel valvar mitral, passando uma delas pela metade do septo interventricular e outra junto à inserçäo do músculo papilar posterior mitral. A aproximaçäo destas linhas configurou uma plicadura interna e posterior na cavidade ventricular esquerda, que teve seu diâmetro reduzido. As estruturas musculares e a circulaçäo coronária foram preservadas. A base do triângulo foi fixada ao anel mitral mediante os pontos utilizados para implante da bioprótese mitral, necessário devido à remoçäo da cúspide anterior da valva. Oito pacientes com miocardiopatia dilatada, excluídos do programa de transplante cardíaco, foram submetidos à técnica proposta, no período de outubro a dezembro de 1996. Dois pacientes eram do sexo feminino e 6 masculinos e sua idade variava entre 24 e 58 anos. Cinco pacientes mostraram regurgitaçäo mitral. Todos os doentes estavam hospitalizados por insuficiência cardíaca congestiva quando da indicaçäo cirúrgica e classificados em classe funcional IV (New York Heart Association). Ocorreram dois óbitos na presente série: um no pós-operatório imediato e outro no 3§ mês, por razoes näo relacionadas à presente técnica. A técnica de remodelamento ventricular intracavitário mostrou um resultado satisfatório em termos de mortalidade e morbidade hospitalar e melhora funcional a curto prazo. Um maior tempo de acompanhamento será necessário para demonstrar o benefício real da técnica,...

Hemopatías malignas: análisis de la relación entre su tratamiento y desarrollo de neoplasias consideradas como secundarias / Malignant hemppathies. Analysis of the realationship between their treatment and the development of neoplasms of secondary nature

El desarrollo de neoplasias secundarias (NS) como complicación tardía en el tratamiento de las hemopatías malignas (HM) es un hecho de observación clínica cada vez más frecuente. En el presente estudio se informa la experiencia clínica en 17 casos documentados de HM y NS de 1967 a 1985. Hasta donde conocemos, éste es el primer informe de esta situación clínica en México. La mayoría de las HM estaban en estadios clínicos avanzados al ser diagnósticadas. El intervalo de aparición entre HM y NS varió de 0 a 180 meses. El estadio clínico de las HM al diagnosticar la NS fue de remisión completa en 12 casos (70.5 por ciento), y parcial en el resto. Se dividieron las NS en: neoplasias de tejidos hematopoyéticos (NTH) seis casos=35.3 por ciento y tumores sólidos (TS) 11 casos=64.7 por ciento. Todas las NTH fueron síndromes mieloproliferativos agudos y el dato clínico más común de presentación fue un síndrome anémico inexplicable. Todos los TS se desarrollaron en tejidos con alto índice de duplicación de DNA: piel, estómago, cervix, vejiga y próstata. Se encontró historia de quimioterapia y radioterapia en 12 pacientes (70.58 por ciento). La duración de la quimioterapia recibida varió de 0 a 60 meses (X=29,.2). Se identificaron factores de riesgo posibles en ocho casos (47 por ciento): historia familiar de carcinoma, pobre respuesta al tratamiento de las HM y factores de riesgo propios de las NS desarrolladas

La psicoterapia familiar en el tratamiento de la farmacodependencia / Family psycotherapy in the treatment of drugdependency

El autor anota: "La psicoterapia familiar es una técnica terapéutica, cada día más utilizada como respuesta a diversos problemas psicosociales. En lo que se refiere al tratamiento de enfermos farmacodependientes, durante los últimos años se ha evidenciado un creciente interés en el papel de la familia en la génesis y mantenimiento del problema del uso y abuso de drogas, así como en el tratamiento del mismo. Por ejemplo, en ciertos programas para el abatimiento del uso y abuso del alcohol se han empleado, con resultados efectivos, estrategias que incluyen la orientación y/o el tratamiento del núcleo familiar del enfermo alcoholico. Sin embargo, aun cuando en el tratamiento del alcoholismo se ha manejado desde hace algún tiempo la psicoterapia familiar, la intervención de la familia en el tratamiento del enfermo farmacodependiente es relativamente nueva, debido, probablemente, a que el problema del uso y abuso de drogas a nivel social puede considerarse, también, como relativamente nuevo" más adelante anota: "La terapia familiar puede ser una ayuda importante en el tratamiento de algunos tipos de desórdenes que se presentan en la adolescencia, siempre y cuando no se le considere como una terapia total. Los problemas de trastornos en la formación de la identidad; conflictos con los padres; cambios relacionados con las normas morales; y las dificultades para el `acting out', son algunos de los que pueden ser tratados con éxito mediante la terapia familiar; asimismo, ésta resulta útil en conflictos que tienen que ver con la imagen del `self' y la imagen de la familia y puede modelar al adolescente, permitiendole que cambie y crezca a su propio ritmo y de acuerdo con sus propios intereses. Cuando, como sucede con frecuencia, se utiliza el recurso del `chivo expiatorio' para mantener el precario equilibrio familiar, tal vez la única vía de acceso al adolescente sea el tratamiento del grupo familiar"

Valorizaçäo da valvuloplastia na correçäo da insuficiência mitral / Value of the valvoplasty in the correction of mitral insufficiency

Foram estudados 51 pacientes portadores de insuficiência mitral (IM) e operados pela técnica da anuloplastia, visando a avaliar a eficácia imediata e tardia do procedimento. O período de acompanhamento foi de 6 meses a 11 anos (m = 3,4 ñ 2,7 anos). Trinta e um pacientes eram femininos (60,8%) e 20 masculinos (39,2%), com idades de 3,3 a 51 anos (m = 26,7 ñ 13,4 anos). Houve uma reduçäo no número de casos em classes funcional (CF) III-IV (NYHA) em relaçäo ao pré-oporatório: 49(96,1%) VS, 7 (15,9%) pacientes (p < 0,001). Observou-se também uma diminuiçäo no índice cardiotorácico: 0,59 ñ 0,02 VS. 0,53 ñ 0,02 (p < 0,001, na dimensäo do átrio esquerdo: 9,9 ñ 0,3 VS. 8.9 ñ 0,4 cm (< 0,001) e no pedículo vascular: 5,0 ñ 0,1 VS. 4,9 ñ 0,2 cm (NS). Regurgitaçäo mitral residual e em 28 (54,9% na última avaliaçäo, estando todos em CFI ou II. A mortalidade foi nula no P.O. imediato, tendo ocorrido 8 óbitos (9,8%) num tempo médio de 21,3 ñ 17,3 meses de P.O., sendo 2 deles entre pacientes com prolapso mitral (50%) e os outros 3 entre 43 (7%) valvulopatia reumática. A probabilidade de sobrevida em 11 anos foi foi de 84 ñ 6%, com 62 ñ 4½ de chances de completar esses período sem disfunçäo valval. Concluímos que a anuloplastia simples constituiu-se um procedimento efetivo nos casos de IM por doença congênita ou reumática, sendo, contudo, fundamental a prevençäo de novos surtos reumáticos ou de episódios de endocardite infecciosa, causa mais freqüentes de insucesso a longo prazo

Reoperaçöes após cirurgia de Bentall-De Bono para ectasia ânulo-aórtica / Re-operations following Bentall-De Bono operation for anulo-aortic ectasia

Complicaçöes tardias após substituiçäo da aorta ascendente e valva aórtica pela técnica de enxerto valvulado de Bentall-De Bono podem constituir sério problema cirúrgico. Condutas nestas situaçöes näo estäo padronizadas. Entre 37 pacientes operados, no período de janeiro de 1976 e dezembro de 1986, ocorreram complicaçöes tardias necessitando tratamento cirúrgico em 5 (13,5%) casos. Alguns deles apresentaram mais de uma alteraçäo. Estas foram: rotura de válvula biológica (dura-máter), pertuito peritubular na anastomose proximal, pseudo aneurisma em sutura do óstio coronariano esquerdo, deiscência da sutura proximal do tubo, hemólise e endocardite infecciosa localizada no enxerto de Dacron. Um paciente apresentou embolizaçäo sistêmica por vegetaçäo. O tratamento cirurgico consistiu na substituiçäo do enxerto, preservando-se a prótese, nos 2 casos de endocardite infecciosa. As duas biopróteses de dura-máter rotas foram substituídas por próteses metálicas de disco, preservando-se o tubo implantado e abordando-se a prótese através de incisäo longitudinal no mesmo. As situaçöes de discência de sutura e pseudo-aneurisma foram corrigidas mediante sutura direta dos pertuitos localizados. Ocorreu 1 óbito (20%) no pós-operatório imediato à reoperaçäo, em paciente com endocardite infecciosa por fungo (Aspergillus), decorrente de sangramento incontrolável. Os demais 4 pacientes receberam alta hospitalar, após recuperaçäo sem intercorrências, no 9§ dia de pós-operatório, em 3 casos, e no 22§, no caso de endocardite. Como complicaçäo tardia, tivemos 1 caso de persistência de pertuito peritubular em comunicaçäo com o óstio coronariano esquerdo, causando insuficiência aórtica (IAo) e hemólise leve residuais. Houve 1 óbito tardio, por hemorragia, durante procedimento cirúrgico näo cardíaco. Complicaçöes relacionadas a infecçäo, deiscência de suturas, ou degeneraçäo de bioprótese ocorrem com certa freaqüência na evoluçäo a longo prazo deste tipo de correçäo cirúrgica. O tratamento pode ser realizado com risco aceitável e visar apenas à intervençäo sobre o defeito apresentado, conservando-se as demais estruturas. É recomendável a utilizaçäo de prótese metálica, como primeira opçäo, para evitar os problemas degenerativos dos materiais biológicos

Uma estratégia para a prevençäo da endocardite infecciosa / A strategy fot the prevention of infectious endocarditis

Säo apresentadas as indicaçöes médicas e os regimes terapêuticos para a prevençäo da endocardite infecciosa, baseados no último encontro do Comitê da American Heart Association adaptados à realidade do nosso país. Apresenta-se a estratégia utilizada no Instituto de Cardiologia do Rio Grande do Sul, enfatizando a importância de uma conduta uniformizada, assim também como a utilizaçäo de material impresso para ser fornecido aos pacientes

Nevomatosis pigmentaria cutáneo-mucosa ictiosiforme: a propósito de un caso / Pigmentary mucocutaneous ichthysiform nevomatosis: apropos of a case

Se presenta una niña de seis años con lesiones pigmentarias congénitas en piel, mucosas, semimucosas, plantas, palmas, hipertricosis e hiperqueratosis severa a manera de Ictiosis Histrix y proponemos el nombre tentativo de Nevomatosis Pigmentaria Cutáneo-mucosa generalizada, Ictiosiforme. La histología demostró: nevos celulares intradérmicos pigmentarios con hiperqueratosis y células névicas que invadían hasta el tejido celular subcutáneo. Creemos que con el devenir del tiempo la paciente podría presentar alguna lesión maligna, como melanoma, a partir de cualquiera de sus lesiones pigmentarias

Tratamento cirúrgico para ectasia ânulo-aórtica / Surgical treatment for annulo-aortic ectasia

Foram estudados 27 pacientes submetidos a implante de tubo de Dacron valvulado (segundo técnica de Bentall-De Bono), entre 1976 e 1985. Todos apresentavam ectasia ânulo-aórtica, que era devida a necrose cística da média em 23 pacientes (85,2%), dissecçäo crônica de aorta em 3 pacientes (11,1%) e aortite luética em 1 paciente (3,7%). A faixa etária foi de 29 a 64 anos (m = 48 anos). Três eram do sexo feminino e 24, do sexo masculino. Foi utilizado tubo de Dacron 28 ou 30 mm em todos. As válvulas utilizadas foram: de dura-máter em 7 pacientes, de aorta heteróloga em 9 e metálica em 11 pacientes. A classe funcional era I-II em 7 pacientes e III-IV em 19 pacientes (NYHA). Houve 1 óbito (3,7%) pós-operatório imediato, por sangramento incontrolável e insuficiência renal aguda. As complicaçöes mais freqüentes foram arritmias (13 pacientes, 48%) e hemorragia (3 pacientes, 11%). No pós-operatório tardio faleceram 9 pacientes, pelas seguintes causas: morte súbita (2 pacientes, 7,4%), insuficiência cardíaca aguda (2 pacientes, 7,4%), hemorragia após reoperaçäo (1 paciente, 3,7%), infecçäo hospitalar (1 paciente, 3,7%), endocardite infecciosa (1 paciente, 3,7%) e causa acidental (7,4%). Cinco pacientes (18,5%) foram reoperados no pós-operatório tardio, 2 por disfunçäo de prótese, 2 por endocardite infecciosa sobre tudo de Dacron e 1 por fístula perivalvular. A curva atuarial mostrou uma probabilidade de sobrevida de 83,7% até o 3ª anos, 61% aos 5 anos e 42,7% do 6ª ao 9ª ano. No fim do período, os 17 pacientes sobreviventes encontram-se em classe funcional I-II (p < 0,001), em relaçäo ao pré-operatório. Concluímos que a cirurgia de Bentall & De Bono, para ectasia ânulo-aórtica, está associada a uma mortalidade operatória baixa. Houve melhora significativa na capacidade funcional dos pacientes, após o tratamento, e a sobrevida a longo prazo foi satisfatória

Nevomatosis pigmentaria cutáneo-mucosa ictiosiforme: a propósito de un caso / Pigmentary mucocutaneous ichthysiform nevomatosis: apropos of a case

Se presenta una niña de seis años con lesiones pigmentarias congénitas en piel, mucosas, semimucosas, plantas, palmas, hipertricosis e hiperqueratosis severa a manera de Ictiosis Histrix y proponemos el nombre tentativo de Nevomatosis Pigmentaria Cutáneo-mucosa generalizada, Ictiosiforme. La histología demostró: nevos celulares intradérmicos pigmentarios con hiperqueratosis y células névicas que invadían hasta el tejido celular subcutáneo. Creemos que con el devenir del tiempo la paciente podría presentar alguna lesión maligna, como melanoma, a partir de cualquiera de sus lesiones pigmentarias (AU)