Influence of culture conditions on the technological properties of Carnobacterium maltaromaticum CNCM I-3298 starters.

AIM: The aim of this study is to investigate the effect of a broad spectrum of culture conditions on the acidification activity and viability of Carnobacterium maltaromaticum CNCM I-3298, the main technological properties that determine the shelf-life of biological time-temperature integrator (TTI) labels. METHODS AND RESULTS: Cells were cultivated at different temperatures (20-37°C) and pH (6-9·5) according to a modified central composite design and harvested at increasing times up to 10 h of stationary phase. Acidification activity and viability of freeze-thawed concentrates were assessed in medium mimicking the biological label. Acidification activity was influenced by all three culture conditions, but pH and harvest time were the most influential. Viability was not significantly affected by the tested range of culture conditions. CONCLUSIONS: Carnobacterium maltaromaticum CNCM I-3298 must be cultivated at 20°C, pH 6 and harvested at the beginning of stationary phase to exhibit fastest acidification activities. However, if slower acidification activities are pursued, the recommended culture conditions are 30°C, pH 9·5 and a harvest time between 4-6 h of stationary phase. SIGNIFICANCE AND IMPACT OF THE STUDY: Quantifying the impact of fermentation temperature, pH and harvest time has led to a predictive model for the production of biological TTI covering a broad range of shelf-lives.

Paciente con esplenomegalia nodular / Patient with nodular splenomegaly

No disponible

Dissociative flashbacks after right frontal injury in a vietnam veteran with combat-related posttraumatic stress disorder.

A Vietnam veteran with a combat-related posttraumatic stress disorder developed recurrent dissociative flashbacks (related to the atrocities of a specific war incident) several months after suffering a traumatic brain injury. CT disclosed a small lesion in the right dorsolateral prefrontal cortex. SPECT demonstrated more extensive functional changes in prefrontal and anterior paralimbic brain regions, mainly in the right hemisphere. This case further implicates the provocative effect of physical stimuli (brain damage) in reawakening old dormant memories and the preferential role of the right hemisphere for the storage of traumatic memories.

[Long course metastasis in renal adenocarcinoma. Adrenal gland involvement]. / Enfermedad mestastásica de larga evolución en el adenocarcinoma renal. Afectación suprarrenal.

OBJECTIVES: To report two cases of metachronic adrenal metastasis (one contralateral and the other bilateral) from renal cell carcinoma with long survival. METHODS: Two patients with clear cell renal carcinoma that developed metastasis to the adrenals are described. Each patient had undergone three operations for solitary metastasis during the 8-years follow-up. The indications for the surgical management of solitary metastasis, morbidity, prognosis and recent investigational treatment possibilities reported in the literature are analyzed. RESULTS: Resection of the renal cell carcinoma achieved a survival of more than 8 years with a good quality of life and no significant surgical complications. The outcome, however, is poor. CONCLUSIONS: Although there was no lymph node involvement and the tumor was localized to the renal parenchyma, one patient developed solitary lung metastasis and contralateral adrenal metastasis 4 and 8 years after the initial diagnosis, respectively. In the other case, contralateral adrenal metastasis appeared three years later. The possibility of long-term metastasis to the adrenal gland should be taken into account due to renal vein involvement. Preservation of the adrenal gland at the initial surgery (lower pole tumor) led to adrenal metastasis 8 years after the initial diagnosis. The prognosis is poor in both cases and the situation is discouraging for the urologist.

Diferencias entre carcinomas infrecuentes y adenocarcinomas habituales de la vesícula biliar / Differences between uncommon carcinomas and usual gallbladder adenocarcinomas

No disponible

[Painful erections related to sleeping]. / Erecciones dolorosas relacionadas con el sueño.

Case report of sleep-related painful erections in a 34 year-old male with grade C3 HIV infection. Due to severe impairment of the patient's general condition, no proper diagnostic studies were performed to gain deeper knowledge of the symptom's pathological etiology. Empirical therapy was started based on evidence from the literature consulted, and the results seen were optimal. This paper contributes a brief review of a condition infrequently seen by the vast majority of urologists.

[Disjunction patterns: the morphological and ultrastructural bases of bladder instability in the male]. / Patrones de disyunción: bases morfológicas y ultraestructurales de la inestabilidad vesical del varón.

OBJECTIVE: To apply the new protocols and recent contributions on detrusor ultrastructural morphology in order to standardize criteria and evaluate our findings relative to the ultrastructural morphology, the presence of a dysfunction pattern, changes in nerve supply and formation of a chained cellular syncytium in hyperactive detrusor bladder instability in the male. METHODS: We studied 480 ultrastructural preparations of detrusor muscle from 32 male patients with bladder outlet obstruction with and without urodynamically demonstrated bladder hyperactivity. Bladder biopsies were obtained from the anterior aspect of the bladder and prepared according to the standard procedures for ultrastructural study. Semiquantitative nerve supply ultrastructural patterns, syncytial composition, and complete and incomplete disjunction were analyzed. RESULTS: Lower urinary tract obstruction was demonstrated in all patients; 6 of these patients had involuntary phasic detrusor contractions during filling. No significant decrease in nerve supply was found in isolated obstruction or in bladder hyperactivity. No axonal degeneration was observed in any of the patients and the myelin sheath structure was normal. Nerve effector endings were also normal. Four patients with hyperactive detrusor showed complete and two incomplete disjunction pattern. Incomplete disjunction pattern was also demonstrated in two patients with isolated obstruction. CONCLUSIONS: The change in the properties of the detrusor muscle in the unstable bladder is due to a complete reduction in excitatory nerve relation to smooth muscle. Having established the concept of common final myogenic pathway that explains involuntary detrusor contraction, complete dysfunction ultrastructural patterns have been defined with univocal relation to hyperactive detrusor. These patterns indicate the existence of a syncytium of chained muscle cells with changes in the excitation threshold that are absent in the normal stable detrusor. Two ultrastructural components sustain this hypothesis: 1) the major loss observed in intermediate cellular unions that are thought to mediate in the mechanical coupling of cellular contraction and 2) the presence in all the microscopic fields of abutments in the narrow cellular unions like gap-junctions, which mediate the electrical coupling. In the present study we have found this pattern in 4 out of 6 patients with hyperactive detrusor, and congruent with other studies, the incomplete disjunction pattern could be the prelude of bladder hyperactivity.

[Valsalva minimal leak point pressure: a useful approximation to type III female urinary incontinence]. / Presión mínima de escape con Valsalva: una útil aproximación a la incontinencia urinaria femenina tipo III.

OBJECTIVE: It has been reported that anatomic female urinary incontinence with complex sphincteric malposition can coexist with intrinsic damage of the sphincter itself. In this study we analyzed the utility of measuring minimum abdominal pressure at standardized bladder capacities that causes urinary incontinence in order to quantify intrinsic sphincteric damage in female urinary incontinence. METHODS: The study comprised 50 women with urinary incontinence aged 36-78 years (mean 59.4), ICS standardized complete urodynamic study was performed. Minimum leak point pressure with Valsalva maneuver in decumbent and standing positions was determined during the filling phase of cystomanometry and it was defined as a measure of the abdominal pressure expressed as total baldder pressure without involuntary detrusor activity and exercised at standardized bladder capacities that originates objective urinary incontinence. Minimum leak point pressure for each bladder capacity was evaluated. Leak point pressures below 60 cm H2O indicate intrinsic sphincteric damage; pressures between 60 and 90 cm H2O indicate intrinsic damage and malposition or urethral hypermobility may coexist, and leak pressures over 90 cm H2O are related to complex sphincteric malposition. RESULTS: 5 women showed severe sphincteric deficiency (type III) and urinary incontinence was demonstrated with 50 ml bladder capacity and 30 cm H2O of abdominal pressure without detrusor activity. Thirty-five women (70%) had type II urinary incontinence. Of these, 10 (28.5%) showed intrinsic sphincteric damage in addition to malpositioning of the sphincteric complex at leak point pressures between 60 and 90 cm H2O. The rest of the women showed Blaivas' type 0 and I urinary incontinence. CONCLUSIONS: Valsalva minimum leak point pressure is a reproducible, reliable, useful and easily measured parameter in diagnosing female stress urinary incontinence. It allows approximation of the abdominal pressure to the level at which urinary leakage is produced during the filling phase of cystomanometry and gives us an idea of the extent of the intrinsic sphincteric damage, if any. Not only is sphincter damage demonstrated in type III urinary incontinence, but that it may also coexist to a varying degree with complex sphincteric malposition.

[Perforated jejunal tuberculosis in a patient with HIV-infection]. / Tuberculosis yeyunal perforada en paciente con infección por VIH.

Patients with AIDS are particularly susceptible to tuberculosis infection with a high incidence of extrapulmonary disease and surgical complications. Authors describe a 38-year-old male infected with the human immunodeficiency virus who presented intestinal perforation due to mycobacterium tuberculosis. A resection of jejunum was performed with primary anastomosis. The postoperative course was further compromised by hepatic failure and the patient died 16 days after the initial surgery.

Lesiones pulmonares en necropsias de consumidores de cocaina / Pulmonary injuries in necropsy of cocaine consumers

Esta investigación se propuso como objetivo general, establecer las lesiones pulmonares más comunes que se encuentran en las necropsias de occisos con antecedentes de adicción a la cocaina y bazuco. Fueron materiales básicos para la investigación los protocolos de las necropsias realizadas desde el primero de junio a 31 de diciembre de 1995 y las muestras patológicas de pulmón para establecer el tipo de lesión. Metodológicamente, se procedió de la siguiente forma: se seleccionaron 30 casos de 300 necropsias que cumplieran ciertas características tales como no poseer documento de identificación y quemadura de los pulpejos entre otras, donde se obtuvieron datos demográficos, manera de muerte y resultados de laboratorio previa su elaboración de instrumento. Los estudios de histopatología fueron realizados por patólogos del INME con tinciones de hematoxilina-eosina. Entre los resultados más sobresalientes podemos señalar que las lesiones más frecuentes encontradas fueron la ruptura alveolar con un 91.7 y la neumonitis intersticial un 90.2, así como hiperplasia alveolar, necrosis bronquial, metaplasma escamosa y trombosis arterial, los cuales se presentaron con menor frecuencia y no son descritos en la literatura internacional. Finalmente destacamos como conclusión que en nuestro medio los consumidores de bazuco presentan lesiones histopatológicas similares a las descritas en los consumidores de crack

[Mortality related to alcohol consumption in Spain: 1981-1990]. / Mortalidad relacionada con el consumo de alcohol en España: 1981-1990.

OBJECTIVE: The aim of this study was to assess the overall contribution of alcohol to Spanish mortality during 1981 to 1990, as well as the impact on the premature death. METHODS: To this purpose we have used the sources of data furnished by the 'Movimiento Natural de la Población' that provides data of causes of death. Figures of proportional mortality, adjusted mortality and years of potential life lost were calculated, as well as trend analysis. RESULTS: 6.3% (mean in the ten years period) of the mortality was due to alcohol. This mortality was higher among males than females. Adjusted mortality show a light increase during the period. The most important category referring to years of potential life lost was unintentional injuries. In this category, motor vehicle accidents were responsible for the majority of premature death. CONCLUSION: This study shows the importance of alcohol related mortality in our country and the large premature death.

Enfermedad Diarréica Aguda en niños procedentes del municipio de Sancti Spíritus

Se realizó un estudio caso-control desde enero de 1987a enero 1988 en 245 niños ingresados en el Hossspital Pediátrico Provincial, residentes en el municipio de Sancti Spíritus, de ellos 178 presentaban Enfermedad Diarréica Aguda (EDA) y 67 estaban ingresados por otra enfermedad. Se aplicó una encuesta a casos y controles y se estudió las caracteristicas del agua, ablactación, condiciones sanitarias de las viviendas y su influencia en la aparición de las EDA; fueron realizados análisis virológicos y parasitológicos detectándose que los agentes biológicos representados fundamentalmente por los parásitos y la ablactación incorrecta desempeñaron un papel importante.Fue significativamente más frecuente las EDA en niños que residian en viviendas con malas condiciones higiénicas e ingerian agua de pozo las que fueron catalogadas en un alto porcentaje como de mala calidad bacteriológica.(AU)

Enfermedad Diarréica Aguda en niños procedentes del municipio de Sancti Spíritus

Se realizó un estudio caso-control desde enero de 1987 a enero 1988 en 245 niños ingresados en el Hospital Pediátrico Provincial, residentes en el municipio de Sancti Spíritus, de ellos 178 presentaban Enfermedad Diarréica Aguda (EDA) y 67 estaban ingresados por otra enfermedad. Se aplicó una encuesta a casos y controles y se estudió las características del agua, ablactación, condiciones sanitarias de las viviendas y su influencia en la aparición de las EDA; fueron realizados análisis virológicos y parasitológicos detectándose que los agentes biológicos representados fundamentalmente por los parásitos y la ablactación incorrecta desempeñaron un papel importante.Fue significativamente más frecuente las EDA en niños que residian en viviendas con malas condiciones higiénicas e ingerian agua de pozo las que fueron catalogadas en un alto porcentaje como de mala calidad bacteriológica.(AU)