In-Hospital influenza vaccination to prevent cardiorespiratory events in the first 45 days after acute coronary syndrome: A prespecified analysis of the VIP-ACS trial.

BACKGROUND: Influenza vaccination prevents major cardiovascular events in individuals presenting a recent acute coronary syndrome (ACS), however the early effect of an in-hospital double-dose vaccination strategy remains uncertain. METHODS: The VIP-ACS was a randomized, pragmatic, multicenter, open-label trial with a blinded-adjudication endpoint. Patients with ACS ≤ 7 days of hospitalization were randomized to an in-hospital double-dose quadrivalent inactivated influenza vaccine (double-dose) or a standard-dose influenza vaccine at 30 days post-randomization. The primary endpoint was a hierarchical composite of death, myocardial infarction, stroke, hospitalization for unstable angina, hospitalization for heart failure, urgent coronary revascularization, and hospitalization for respiratory infections, analyzed with the win ratio (WR) method in short-term follow-up (45-days after randomization). RESULTS: The trial enrolled 1,801 patients (≥18 years old). Median participant age was 57 years, 70 % were male. There were no significant differences between groups on the primary hierarchical endpoint: there were 5.7 % wins in the double-dose in-hospital group and 5.5 % wins in the standard-dose delayed vaccination group (WR: 1.03; 95 % CI: 0.70---1.53; P = 0.85). In a sensitivity analysis including COVID-19 infection in the hospitalizations for respiratory infections endpoint, overall results were maintained (WR: 1.03; 95 % CI 0.71---1.51; P = 0.87). Results were consistent for major cardiovascular events only (WR: 0.82; 95 % CI: 0.48---1.39; P = 0.46). No serious adverse events were observed. CONCLUSION: In patients with recent ACS, in-hospital double-dose influenza vaccination did not significantly reduce cardiorespiratory events at 45 days compared with standard-dose vaccination at 30 days post-randomization.

Maize resistance to witchweed through changes in strigolactone biosynthesis.

Maize (Zea mays) is a major staple crop in Africa, where its yield and the livelihood of millions are compromised by the parasitic witchweed Striga. Germination of Striga is induced by strigolactones exuded from maize roots into the rhizosphere. In a maize germplasm collection, we identified two strigolactones, zealactol and zealactonoic acid, which stimulate less Striga germination than the major maize strigolactone, zealactone. We then showed that a single cytochrome P450, ZmCYP706C37, catalyzes a series of oxidative steps in the maize-strigolactone biosynthetic pathway. Reduction in activity of this enzyme and two others involved in the pathway, ZmMAX1b and ZmCLAMT1, can change strigolactone composition and reduce Striga germination and infection. These results offer prospects for breeding Striga-resistant maize.

Influenza vaccination strategy in acute coronary syndromes: the VIP-ACS trial.

AIMS: To evaluate whether a strategy of double-dose influenza vaccination during hospitalization for an acute coronary syndrome (ACS) compared with standard-dose outpatient vaccination (as recommended by current guidelines) would further reduce the risk of major cardiopulmonary events. METHODS AND RESULTS: Vaccination against Influenza to Prevent cardiovascular events after Acute Coronary Syndromes (VIP-ACS) was a pragmatic, randomized, multicentre, active-comparator, open-label trial with blinded outcome adjudication comparing two strategies of influenza vaccination following an ACS: double-dose quadrivalent inactivated vaccine before hospital discharge vs. standard-dose quadrivalent inactivated vaccine administered in the outpatient setting 30 days after randomization. The primary outcome was a hierarchical composite of all-cause death, myocardial infarction, stroke, unstable angina, hospitalization for heart failure, urgent coronary revascularization, and hospitalization for respiratory causes, analysed by the win ratio method. Patients were followed for 12 months. During two influenza seasons, 1801 participants were included at 25 centres in Brazil. The primary outcome was not different between groups, with 12.7% wins in-hospital double-dose vaccine group and 12.3% wins in the standard-dose vaccine group {win ratio: 1.02 [95% confidence interval (CI): 0.79-1.32], P = 0.84}. Results were consistent for the key secondary outcome, a hierarchical composite of cardiovascular death, myocardial infarction and stroke [win ratio: 0.94 (95% CI: 0.66-1.33), P = 0.72]. Time-to-first event analysis for the primary outcome showed results similar to those of the main analysis [hazard ratio 0.97 (95% CI: 0.75-1.24), P = 0.79]. Adverse events were infrequent and did not differ between groups. CONCLUSION: Among patients hospitalized with an ACS, double-dose influenza vaccination before discharge did not reduce cardiopulmonary outcomes compared with standard-dose vaccination in the outpatient setting. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov number: NCT04001504.

Joint Theoretical and Experimental Study on the La Doping Process in In2O3: Phase Transition and Electrocatalytic Activity.

In2O3 and La3+-doped In2O3 nanostructures were synthesized through a facile and fast chemical route based on the microwave-assisted hydrothermal method combined with rapid thermal treatment in a microwave oven. The presence of the La3+ doping process modifies the size and morphology of the In2O3 nanostructures and also stabilizes the rhombohedral (rh) In2O3 phase with respect to the most stable cubic (bcc) polymorph. X-ray diffraction (XRD) patterns and Rietveld refinements, Raman, UV-vis, and energy dispersive X-ray (EDX) spectroscopies, transmission electron (TEM) and field-emission scanning electron (FE-SEM) microscopies, as well as PL emissions have been performed. To complement and rationalize the experimental results, first-principle calculations, based on density functional theory, are carried out to obtain the formation energies of the In2O3 and bcc- and rh-In2O3-doped phases, their geometry and electronic properties. Theoretical results are able to explain the relative stabilization of the rh-phase with respect to the bcc-phase based on the analysis geometry changes and the electronic redistribution induced by the La3+ doping process. In addition, Wulff construction is employed to match the theoretical and experimental morphologies of the cubic phase. The synthesized samples were applied for the O2 evolution reaction (OER). The La3+-doped In2O3 film presents superior electrocatalytic activity, with an onset potential lower than the undoped In2O3 film that can be associated with the increase in electron density caused by the La3+ doping process. This study provides a versatile strategy for obtaining In2O3 and La3+-doped In2O3 nanostructures for practical applications.

A comparison study of cleanup techniques for oil spill treatment using magnetic nanomaterials.

Magnetic nanoparticles have been successfully used to recovery oil from oil spilled on water. Two different methods, floating and vortex, were employed to promote the interaction of four oil samples with different API (e.g., 10, 20, 28 and 45) spilled on seawater and deionized water with three magnetic materials, namely: magnetite nanoparticles (N); magnetic nanocomposites of yeast biomass provided by ethanol industry (Y); and magnetic nanocomposites of cork powder (C). The magnetic nanomaterials exposed to oil on water were taking out by a neodymium magnet, and the oil recoveries were determined by gravimetric analysis before and after lyophilization. The lyophilization was determinant to guarantee the accuracy of the experiments, and without this step, the masses of oil recovered would be overestimated due to the drag of water during the oil and magnetic material removal process. Three main factors, API, contact method and magnetic material, and two interactions (i.e., API × contact method, and contact method × magnetic material) presented a statistically significant effect on oil recovery. It was observed that oil recovery increases as API decreases, and it was possible to establish a model to predict the amount of recovered oil according to this effect. Higher oil recoveries were also obtained by magnetic nanocomposites of yeast biomass (Y), regardless of the contact method and type of water, recoveries of 23% and 100% for 45 and 10 API, respectively, employing around 20 mg of Y on 300 mg of spilled oil. These percentages correspond to 0.29 ±â€¯0.01 kg/kg and 15.98 kg/kg of recovering oil by the magnetic procedure. The increase of mass of magnetic material improved the recovery of oils with higher APIs. The reusability of the spent materials presents potential for its application in oil spill cleaning technologies.

Cytogenetic evaluation of tannery workers in the city of Teresina, northeastern Brazil.

Assessments of chromosomal integrity and structure enable the prevention of diseases associated with the work environment, with the frequencies of chromosomal aberrations and micronuclei often being used as markers in biomonitoring. Owing to their routine manipulation of potentially toxic chemicals, tannery workers as a group merit a more thorough evaluation and discussion. This study investigated chromosomal damage in 30 workers from a tannery in the city of Teresina, the state capital of Piauí, northeast Brazil, and a control group consisting of 30 employees from a nearby accounting firm. The frequencies of chromosomal aberrations (CAs) and binucleated cell micronuclei (MN) were assessed as a measure of damage. Means were compared using the Student t-test and ANOVA-Dunnett test. Our results indicated a higher number of CAs in exposed individuals compared to the control group, including dicentric (P < 0.0001) and tricentric chromosomes (P < 0.001), and those in ring (P < 0.0001) and acentric ring forms (P < 0.001). Assessment of MN frequency demonstrated a similar trend (exposed vs control, P < 0.0001). It was concluded that the tannery workers in this study exhibited a higher incidence of genetic damage than comparable unexposed individuals. However, further research on this subject is needed, particularly in regard to potentially clastogenic agents used in the tanning process.

Prevalencia de patología cardíaca en la enfermedad de Chagas: años 2004-2012. Programa y Red de Chagas de CABA / Prevalence of cardiac pathology in Chagas disease: 2004 -2012. Program and Chagas CABA network

El Instituto Universitario de Ciencias de las Salud ha mostrado un particular compromiso con la formación de sus estudiantes en la estrategia de Atención Primaria de la Salud, con las prácticas asistenciales dedicadas al 1er nivel de atención ambulatoria y a las patologías prevalentes en ese ámbito. Del mismo modo se han desenvuelto las actividades de formación en investigación. Como exponente de esa orientación, la revista Ciencias de la Salud publicó en el Vol. 2, N°1, 2011:4-9, el artículo “Prevalencia de la Enfermedad de Chagas” de Érica G. Morais, que había obtenido el premio “Futuros Líderes”, otorgado por el Curso Anual Internacional de Investigación en Ciencias de la Salud (IUCS-AMA, Prof. Carlos Álvarez Bermúdez). Aquella investigación formaba parte de un proyecto más amplio realizado en el Hospital Teodoro Álvarez entre 2004 y 2012, en el que participaron un conjunto de investigadores, que compartieron la autoría de la actual publicación. El Dr. Jorge Mitelman, Prosecretario de Ciencia y Técnica del IUCS e integrante de ese equipo, preparó además una reseña sobre la jornada del INCOSUR, realizada en abril del presente año, describiendo asimismo el proceso de desarrollo de la Ciudad de Buenos Aires, como área no endémica, para encarar las consecuencias de la enfermedad de Chagas

Diabetes and exercise in the elderly.

Type 2 diabetes mellitus is highly prevalent among the elderly. Age-associated changes in body composition, obesity and sedentary behavior are some of the main factors responsible for the increased prevalence of diabetes in this population. Elderly patients experience important and specific issues, including the association of comorbidities and geriatric syndromes, use of many medications, the presence of dependencies and frailty. Physical activity has been shown to be as effective for the treatment of diabetes in the elderly as in younger patients, so that its practice must be strongly encouraged. Resistive activities are preferable for the frail and vulnerable diabetic elderly. Aerobic activities should be prescribed whenever possible, and the association of both modalities is the best choice. Moderate- to high-intensity exercises are more effective for glycemic control and, unlike previously thought, are generally safe for the elderly population. The frequency of exercising should be at least 3 days/week for aerobic and 2 days/week for resistance activities. Balance exercises may be beneficial in special situations. In the elderly patient, special care must be taken for: the presence of contraindications for the practice of each exercise modality; the interactions and limitations imposed by medications, chronic comorbidities and geriatric syndromes; the higher possibility of developing hypoglycemia, especially if insulin is used for treatment, and the prevention of orthostatic hypotension that may be worsened by dehydration. The prescription of exercises tailored for each patient's preferences and limitations is highly effective not only for glycemic control, but also for improving independence, self-esteem and quality of life.

Spondylodiscitis in hemodialysis patients: a case series.

BACKGROUND: Although bacterial spondylodiscitis is one of the most serious complications in hemodialysis patients, it is often underdiagnosed, and few reports describe its course and clinical management. PATIENTS AND METHODS: We retrospectively reviewed 11 hemodialysis patients diagnosed with spondylodiscitis, during a 5-year period, and compared them with the general population followed at our center. Nine patients presented with fever on admission. Blood cultures were positive in all patients and Staphylococcus aureus was identified in 8. Ten patients had a central venous catheter as access for hemodialysis and the number of vascular accesses in the patients´ medical history was superior to the rest of our HD population. RESULTS: Four patients (36%) died during follow-up. None of the patients that underwent vancomycin and gentamicin antibiotic therapy died. CONCLUSION: Bacterial spondylodiscitis must be suspected whenever a patient on hemodialysis is admitted with fever and/or back pain. The presence of a central venous catheter and a history of multiple vascular accesses may be important risk factors. Prolonged antibiotic therapy with initial broad-spectrum coverage seems to be the best therapeutic approach.

Antifungal activity of the naphthoquinone beta-lapachone against disseminated infection with Cryptococcus neoformans var. neoformans in dexamethasone-immunosuppressed Swiss mice

The in vivo antifungal activity of the naphthoquinone beta-lapachone against disseminated infection by Cryptococcus neoformans was investigated. Swiss mice were immunosuppressed daily with dexamethasone (0.5 mg per mouse) intraperitoneally for 3 days, the procedure was repeated 4 days later, and the animals were then challenged intravenously with C. neoformans (10(6) CFU/mL) 1 week later. Seven days after infection, the mice were divided into groups and treated daily with beta-lapachone (10 mg/kg, iv) for 7 (N = 6) and 14 days (N = 10). Amphotericin B (0.5 mg/kg) was used as comparator drug and an additional group received PBS. Treatment with beta-lapachone cleared the yeast from the spleen and liver, and the fungal burden decreased approximately 10(4) times in the lungs and brain 14 days after infection when compared to the PBS group (P < 0.05). This result was similar to that of the amphotericin B-treated group. Protection was suggestively due to in vivo antifungal activity of this drug and apparently not influenced by activation of the immune response, due to similar leukocyte cell counts among all groups. This study highlights the prospective use of beta-lapachone for treatment of disseminated cryptococcosis.

Antifungal activity of the naphthoquinone beta-lapachone against disseminated infection with Cryptococcus neoformans var. neoformans in dexamethasone-immunosuppressed Swiss mice.

The in vivo antifungal activity of the naphthoquinone beta-lapachone against disseminated infection by Cryptococcus neoformans was investigated. Swiss mice were immunosuppressed daily with dexamethasone (0.5 mg per mouse) intraperitoneally for 3 days, the procedure was repeated 4 days later, and the animals were then challenged intravenously with C. neoformans (10(6) CFU/mL) 1 week later. Seven days after infection, the mice were divided into groups and treated daily with beta-lapachone (10 mg/kg, iv) for 7 (N = 6) and 14 days (N = 10). Amphotericin B (0.5 mg/kg) was used as comparator drug and an additional group received PBS. Treatment with beta-lapachone cleared the yeast from the spleen and liver, and the fungal burden decreased approximately 10(4) times in the lungs and brain 14 days after infection when compared to the PBS group (P < 0.05). This result was similar to that of the amphotericin B-treated group. Protection was suggestively due to in vivo antifungal activity of this drug and apparently not influenced by activation of the immune response, due to similar leukocyte cell counts among all groups. This study highlights the prospective use of beta-lapachone for treatment of disseminated cryptococcosis.

Fenótipo Pena-Shokeir. Caso clínico / Pena-Shokeir phenotype. Case report

O fenótipo Pena-Shokeir (PSP) é caracterizado porartrogripose, hipoplasia pulmonar e anomalias faciais. Foirecentemente sugerido que seria secundário à redução dosmovimentos in utero devido a uma patologia intrínseca,independentemente da causa (Sequência de Deformação daAcinésia Fetal - FADS). Os autores descrevem um casoclássico de PSP com uma primeira ecografia obstétrica às 21semanas de gestação revelando diminuição dos movimentosfetais, micrognatia, mãos cerradas e pés botos. Aamniocentese revelou um cariótipo 46,XY normal. Às 23semanas, a ecografia obstétrica mostrou um feto imóvel,com restrição do crescimento intra-uterino e morfologiasobreponível, a que se associava hidrâmnios. O prognósticofoi explicado aos pais que decidiram interromper a gravidez.O estudo anátomo-patológico post mortem revelouhipertelorismo, orelhas de implantação baixa, micrognatia,pescoço curto e largo, discreto pterigia axilar e inguinal,flexão rígida das articulações dos cotovelos e anca,hiperextensão rígida dos joelhos, camptodactilia, pés botos,diminuição da massa muscular e hipoplasia pulmonar. Comoem muitos outros casos de PSP, a etiologia não foiesclarecida(AU)

Pena-Shokeir Phenotype (PSP) is characterized byarthrogryposis, facial anomalies and pulmonary hypoplasia.It has recently been suggested that it is secondaryto the reduction of movements in the uterus dueto an intrinsic pathology regardless of the cause (FetalAkinesia Deformation Sequence). Authors describe acase of a classic PSP, with a first obstetric ultrasound at 21 weeks of gestational age revealing reduction of fetalmovements, micrognathia, limb abnormalities withclubbed feet and clenched hands. Amniocentesis revealeda normal 46,XY karyotype. At 23 weeks, obstetricultrasound revealed intra-uterine growth restriction withabnormal fetal movements profile, identical fetal morphologyplus hypertelorism and new-onset polyhydramnios.Prognosis was explained to the parents who decidedto terminate pregnancy. Pathological study foundhypertelorism, low-set ears, micrognathia, short largeneck, small axillary and inguinal pterigia, rigid flexionat the elbows and hips with hyperextended knees, camptodactyly,clubbed feet, diminished muscle bulk andpulmonary hypoplasia. As in many other cases of PSP,etiology was not clarified(AU)

Development of low-cost metal oxide pH electrodes based on the polymeric precursor method.

In this work, the polymeric precursor method was used to prepare low-cost solid-state sensors for pH determination based on iridium oxide as the main pH sensitive material. The iridium content was reduced with addition of TiO(2), forming the binary system IrO(x)-TiO(2), whose electroanalytical properties were evaluated in comparison with a commercial glass pH electrode. The minimum iridium content which gave suitable results was 30mol%, and the electrode presented Nernstian and fast response in the pH range from 1 to 13, with no hysteresis effect observed. Besides, the electrode showed high selectivity in the presence of alkali ions as Li(+), Na(+) or K(+). The amount of iridium in the prepared electrodes was very small (<0.1mg), supporting the efficiency of this method on the simple preparation of functional low-cost pH electrodes.

Primary endometrial B-cell lymphoma: case report.

The female genital tract is usually involved with lymphoma as part of disseminated disease. Primary lymphoid neoplasms of the female genital tract are rare; the frequency was reported to be 2% among extranodal lymphomas in women. Most of the time, primary female genital tract lymphoma occurs in the ovary and cervix, whereas endometrial lymphoma is extremely rare. The case of an 89-year-old patient that presented with postmenopausal bleeding is reported. An endometrial polypoid formation was found on hysteroscopic examination and the biopsy revealed a diffuse large B-cell lymphoma. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were surgically performed. The histologic diagnosis was primary diffuse large B-cell lymphoma of the endometrium. Adjuvant therapy was not performed. Five months after initial diagnosis, the patient died. Only a few case reports of primary endometrial lymphoma have been published; therefore, information concerning etiologic factors, histologic type, treatment and prognosis is limited.

Effect of pre-treatment and supporting media on Ni(II), Cu(II), Al(III) and Fe(III) sorption by plant root material.

In this work Paspalum notatum root material was used to elucidate the influence of acid leaching pre-treatment and of sorption medium on metal adsorption. Ground P. notatum root was leached with 0.14M HNO(3). Leached root material (LRM) and non-leached root material (NLRM) were employed to flow sorption of Ni(II), Cu(II), Al(III) and Fe(III) in 0.5M CH(3)COONH(4) medium at pH 6.5. For LRM the sorption was also studied in 0.5M KNO(3) medium. The acid pre-treatment increased the sorption capacity (SC) for all ions studied. For the KNO(3) medium, Cu(II) and Fe(III) sorption was higher than in CH(3)COONH(4) and the type of the Ni(II) isotherm's model changed. The Freundlich model was the most representative isotherm model to describe metallic ions sorption. The (1)H NMR spectra showed differences between LRM and NLRM and the acid-basic potentiometric titration elucidated that acid-leaching procedure affected the root material sorption sites once only two predominant sorption sites were found for LRM (phenolic and amine, both able cations sorption) and five sorption sites (two carboxylic, amine and two phenolic) were founded for NLRM.

Validez predictiva de la escala de síntomas prodrómicos (SOPS) / Predictive validity of the Scale of Prodromal Symptoms (SOPS)

Introducción. Se realiza un análisis factorial exploratorio de los ítems de la escala de síntomas prodrómicos (SOPS) para conocer sus propiedades psicométricas y su validez de constructo, así como para la validez de criterio o predictiva de las subescalas clínicas de la SOPS en la transición desde el estado prodrómico a la psicosis de los sujetos de riesgo durante el seguimiento de 1 año.Método. A partir de la administración de la entrevista estructurada de síndromes prodrómicos (SIPS), que incluye la SOPS, a 30 pacientes remitidos para evaluación por la sospecha de presentar signos prodrómicos de psicosis se realizó un análisis factorial con rotación varimáx, se obtuvieron índices de Cronbach de coherencia interna y se analizó, mediante regresión logística, la validez predictiva de las subescalas que componen este instrumento.Resultados. Se obtuvieron tres factores de primer orden, siendo el más homogéneo y coincidente con investigaciones anteriores el que incluye los síntomas negativos, y se observaron niveles más altos en los síntomas negativos, de desorganización y generales en los varones. Los índices α de Cronbach de la escala fueron 0,880 en la fase de captación de los pacientes de riesgo y 0,952 un año después. Con una tasa de incidencia de psicosis del 26,67 % en la muestra estudiada durante el seguimiento de 1 año se comprobó que las subescalas de la SOPS presentaron excelente valor predictivo positivo, siendo los síntomas negativos los que mostraron mejores índices de especificidad (95,5%) y de sensibilidad (100%).Conclusiones. Los criterios diagnósticos basados en la SIPS/SOPS permiten identificar a las personas de alto riesgo de psicosis y predecir con bastante precisión la aparición de episodios psicóticos a medio plazo, siendo un instrumento válido, económico y de fácil utilización en sistemas sanitarios de atención primaria

Introduction. We conduct an exploratory factor analysis with the Scale of Prodromal Symptoms (SOPS) items, to determine its psychometric characteristics and construct validity, as well as we analyze criterion or predictive validity of its clinical subscales in the conversion of high mental risk subjects from prodrome to psychosis in a 1 year follow-up period. Method. The subjects were 30 patients referred for evaluation with the Structured Interview of Prodromal Syndromes (SIPS), which includes the SOPS, because of a suspected psychosis prodromal syndrome, a factor analysis with varimax rotation was carried out: Cronbach internal coherence indices were obtained, and predictive validity of the subscales comprising this instrument were analyzed using logistic regression. Results. Three first-order factors were found, one of them was a homogeneous component made up of negative symptoms, consistent with previous studies, and higher scores were observed in negative, disorganized and general symptoms in males. Cronbach's alpha indices were 0.880, in the recruitment phase of risk patients, and 0.952 one year later. With an incidence rate of psychosis of 26.67 % in the sample studied, during the 1 year follow-up period, an excellent positive predictive value of the SOPS subscales was found, with negative symptoms having the best specificity (95.5 %) and sensitivity (100 %) indices. Conclusions. Diagnostic criteria based on the SIPS/ SOPS make it possible to identify persons at high risk of psychosis, and to make an accurate prediction of medium term psychotic episodes. It is a valid, economical and easy to use instrument in primary health care systems

[Predictive validity of the Scale of Prodromal Symptoms (SOPS)]. / Validez perdictiva de la escala de síntomas prodrómicos (SOPS).

INTRODUCTION: We conduct an exploratory factor analysis with the Scale of Prodromal Symptoms (SOPS) items, to determine its psychometric characteristics and construct validity, as well as we analyze criterion or predictive validity of its clinical subscales in the conversion of high mental risk subjects from prodrome to psychosis in a 1 year follow-up period. METHOD: The subjects were 30 patients referred for evaluation with the Structured Interview of Prodromal Syndromes (SIPS), which includes the SOPS, because of a suspected psychosis prodromal syndrome, a factor analysis with varimax rotation was carried out: Cronbach internal coherence indices were obtained, and predictive validity of the subscales comprising this instrument were analyzed using logistic regression. RESULTS: Three first-order factors were found, one of them was a homogeneous component made up of negative symptoms, consistent with previous studies, and higher scores were observed in negative, disorganized and general symptoms in males. Cronbach's alpha indices were 0.880, in the recruitment phase of risk patients, and 0.952 one year later. With an incidence rate of psychosis of 26.67 % in the sample studied, during the 1 year follow-up period, an excellent positive predictive value of the SOPS subscales was found, with negative symptoms having the best specificity (95.5 %) and sensitivity (100 %) indices. CONCLUSIONS: Diagnostic criteria based on the SIPS/ SOPS make it possible to identify persons at high risk of psychosis, and to make an accurate prediction of medium term psychotic episodes. It is a valid, economical and easy to use instrument in primary health care systems.

Detection of axillary metastases in breast cancer patients using ultrasound and colour Doppler combined with fine needle aspiration cytology.

The aims of this study were to evaluate the diagnostic value of ultrasonography and colour Doppler combined with fine needle aspiration (FNA) cytology for the detection of non-palpable axillary lymph node metastases in breast cancer patients. Forty patients with operable breast cancer (T1/T2), invasive carcinoma, not submitted to neo-adjuvant therapy, underwent axillary ultrasonography and colour Doppler preoperatively. FNA cytology was performed on axillary lymph nodes presenting ultrasonographic and/or Doppler suspicious features. A total of 542 lymph nodes were surgically removed from the 40 patients; 19 were metastatic lymph nodes. Ultrasound-guided FNA detected metastases in six out of 11 histologically node-positive patients. Sensitivity and specificity in this preliminary study was 55% and 100%, respectively. These are the preliminary results of a prospective study that has the purpose of reducing the sentinel node procedures in breast cancer patients with clinically negative axillae, but positive FNA cytology.

Correlatos neuropsicológicos y psicofisiológicos de los trastornos de la personalidad del DSM-IV: comparación entre sexos / Neuropsychological and psychophysiological correlates of DSM-IV personality disorders: Gender comparisons

Se trató de someter a prueba la posible existencia de características córtico-orbitales frontales y psicofisiológicas diferenciadas, en función del sexo, de pacientes con trastornos de la personalidad del DSM-IV, mediante pruebas neuropsicológicas que valoraron funciones ejecutivas frontales de vigilancia o atención sostenida, flexibilidad mental, y planificación y formación de conceptos (Stroop, CPT, WCST); y registros psicofisiológicos (tasa cardiaca y respuesta dermo-eléctrica) ante tareas de estrés experimental. Se evaluaron 138 sujetos (66 varones y 72 mujeres), de edades comprendidas entre 17 y 65 años, diagnosticados de algún trastorno de la personalidad DSM-IV. En conjunto, no se han encontrado diferencias significativas entre sexos en las funciones neuropsicológicas y respuestas psicofisiológicas, excepto en la respuesta dermo-eléctrica. Los resultados conceden, sin embargo, cierta validez de constructo exclusivamente al cluster B, fundamentalmente en base a las características psicofisiológicas observadas. (AU)

[Third ventricle meningioma in a child: case report]. / Meningioma do terceiro ventrículo na infância: relato de caso.

Meningiomas in childhood are rare, and those located in the third ventricle are even rarer, with only 16 cases reported. A five-year-old girl was seen at our hospital with headache and bilateral papilledema. CT scan showed a large third ventricular mass and associated hydrocephalus. Transcallosal interfornical approach was performed with total removal of the tumor, that was attached to the choroid plexus of the anterior third ventricle. Histologically the lesion proved to be a transitional meningioma. The recovery was uneventful, a permanent shunt was not necessary. The diagnosis of these tumors can be done using CT scan or MRI, that usually are sufficient for surgical planning. Angiography usually is not required, unless a vascular lesion is concerned, or embolization is necessary. The treatment of these tumors is surgical, aiming the total removal of the lesion, usually curative once it is acomplished. We report this case, and add a brief review of the literature on third ventricle meningiomas.