Multicentric Analysis of the Species Distribution and Antifungal Susceptibility of Clinical Isolates from Aspergillus Section Circumdati.

The clinical involvement and antifungal susceptibility of Aspergillus section Circumdati are poorly known. We analyzed 52 isolates, including 48 clinical isolates, belonging to 9 species inside the section Circumdati. The whole section exhibited, by the EUCAST reference method, a poor susceptibility to amphotericin B, but species/series-specific patterns were observed for azole drugs. This underlines the interest in getting an accurate identification inside the section Circumdati to guide the choice of antifungal treatment in clinical practice.

In Vitro Susceptibility of Fusarium to Isavuconazole.

To evaluate the in vitro susceptibility of Fusarium to isavuconazole, 75 clinical isolates were identified using matrix-assisted laser desorption ionization-time of flight mass spectrometry and then tested with a broth microdilution method (EUCAST) and the gradient concentration strip (GCS) technique. The activity of isavuconazole overall was shown to be limited, with an MIC50 of >16 µg/ml, without significant differences between the species complexes. The categorical agreement between GCS and EUCAST was 97.4% to 100%, making the GCS as a valuable alternative.

Estudio descriptivo del consumo de alcohol en los adolescentes de Gandía / Descriptive study of alcohol consumption in adolescents of Gandia

Introducción. La morbimortalidad en los países desarrollados se relaciona con hábitos adquiridos en la adolescencia. El alcohol es la droga más consumida por los adolescentes españoles, planteando su uso abusivo un problema preocupante para la salud pública. Objetivo. Valorar el patrón de consumo de bebidas alcohólicas de los jóvenes estudiantes de 4.o de ESO de la ciudad de Gandía y las características que definen a esta población y al entorno en el que se realiza. Metodología. Se trata de un estudio descriptivo transversal del consumo de alcohol en los adolescentes de entre 15 y 18 años de Gandía, que se lleva a cabo mediante una encuesta con diferentes cuestiones relacionadas con los hábitos de salud de las cuales 9 se refieren al consumo de alcohol. Resultados. De los 346 encuestados, el 98% son menores de edad. El 93,3% ha probado alguna vez una bebida alcohólica, haciendo botellón habitualmente el 48,5% y habiéndose emborrachado alguna vez el 45,5%, concentrándose el consumo en el fin de semana. Un 76,6% tuvo el primer contacto con el alcohol en el entorno familiar. Conclusión. El consumo de alcohol en el adolescente es muy elevado, es un consumo mayoritariamente de fin de semana con una alta prevalencia en las intoxicaciones etílicas, consumo que se realiza en espacios públicos y con los amigos (AU)

Introduction: The morbidity and mortality in developed countries is related to habits acquired in adolescence. Alcohol is the drug most consumed by Spanish adolescents, making its abuse a concern for public health. Objective: To evaluate the pattern of alcohol consumption of 4 th year secondary school pupils in the city of Gandia, the defining characteristics of this population and the environment in which this takes place. Methodology: This is a descriptive study of alcohol use in adolescents aged 15 to 18 years of Gandia, which was carried out through a survey of different issues related to health habits, nine of which relate to consumption alcohol. Results: Of the 346 adolescents surveyed, 98% were minors, 93.3% had tried an alcoholic drink. Just under half (48.5%) took part in street binge-drinking, and 45.5% had got drunk at least once. Consumption was mainly during the weekend. More than three-quarters (76.6%) had their first contact with alcohol in the family. Conclusion: Alcohol use among adolescents is high, with consumption is mostly at weekends and with a high prevalence of alcohol intoxication, drinking in public places, and with friends (AU)

[Descriptive study of alcohol consumption in adolescents of Gandia]. / Estudio descriptivo del consumo de alcohol en los adolescentes de Gandía.

INTRODUCTION: The morbidity and mortality in developed countries is related to habits acquired in adolescence. Alcohol is the drug most consumed by Spanish adolescents, making its abuse a concern for public health. OBJECTIVE: To evaluate the pattern of alcohol consumption of 4th year secondary school pupils in the city of Gandia, the defining characteristics of this population and the environment in which this takes place. METHODOLOGY: This is a descriptive study of alcohol use in adolescents aged 15 to 18 years of Gandia, which was carried out through a survey of different issues related to health habits, nine of which relate to consumption alcohol. RESULTS: Of the 346 adolescents surveyed, 98% were minors, 93.3% had tried an alcoholic drink. Just under half (48.5%) took part in street binge-drinking, and 45.5% had got drunk at least once. Consumption was mainly during the weekend. More than three-quarters (76.6%) had their first contact with alcohol in the family. CONCLUSION: Alcohol use among adolescents is high, with consumption is mostly at weekends and with a high prevalence of alcohol intoxication, drinking in public places, and with friends.

Malformación de Arnold-Chiari y siringomielia en atención primaria. A propósito de un caso / Arnold-Chiari malformation and syringomyelia in primary care. A case report

Dentro del equipo de atención primaria las enfermedades raras, por sus características epidemiológicas y en ocasiones por la inespecificidad de los síntomas, suponen una dificultad en la asistencia diaria. Presentamos un caso de malformación de Arnold-Chiari en un paciente varón joven con síntomas insidiosos iniciales (cervicalgia y cefaleas suboccipital) que consulta ante la aparición de nueva sintomatología (parestesias, debilidad muscular y dolor cervicobraquial y lumbar irradiado y cefaleas tras esfuerzos moderados) (AU)

Rare diseases, due to their epidemiological characteristics, and sometimes to the non-specific symptoms, are difficult to diagnose routinely at Primary Care Level. A case is presented of Arnold Chiari malformation in a young male patient with early insidious presentation (neck pain and sub-occipital headaches) consulting due to the emergence of new symptoms (paresthesias, muscular weakness, cervicobrachial and radiating lumbar pain, and headaches after mild exertion) (AU)

Hábitos de sueño de la población infantil del Grau de Gandía. Un estudio descriptivo / Sleep habits of the children in the Grau de Gandia. A descriptive study

El insomnio es es trastorno de sueño infantil más frecuente y puede aparecer en la edad lactante o en la etapa preescolar, siendo de utilidad para la detección precoz el uso de cuestionarios de sueño, como la versión española del Pediatric Sleep Questionnaire (PSQ). Nos planteamos conocer la prevalencia de los trastornos de sueño en una población de 3 a 6 años del Grau de Gandía, utilizando para ello la versión española del PSQ mediante una encuesta autocumplimentada por los padres de los alumnos de los diferentes colegios. Se ha realizado un estudio descriptivo de corte transversal, recogiéndose 144 encuestas válidas, realizándose la entrada de los datos en una base de datos EXCEL para su posterior descripción. Un 23,4% de los niños presentan insomnio en función de las respuestas dadas, siendo importante la presencia de otras parasomnias como somniloquias (70%), ronquidos (7.2%), bruxismo (22.3%), trastornos por movimientos rítmicos (7.1%) y un 4.1% de los niños presentan síntomas desatencionales independientemente de que se presente o no síntomas de hiperactividad, un 2.08% de las encuestas respondían a un TDHA combinado y un 6.25% sintomatología de hiperactividad-impulsividad. Nuestro estudio proporcióna datos similares a otros estudios poblacionales realizados en el medio escolar, tanto en este rango de edad como en superiores, respecto al insomnio, parasomnias, hábitos de sueño y los TDHA, siendo la etiología más frecuente la falta de educación del hábito de sueño, por lo que el papel de la enfermera es fundamental en la orientación y formación a los padres (AU)

Insomnia is the most common sleep disorder in chilhood and it may occur to unweaned babies or during the infant period. In order to be able to detect as early as possible this disease, it is useful to make sleep questionnaires, such as the Spanish Version of the Pediatric Sleep Questionnaire (PSQ). We considered to know the prevalence of sleep disorders in a population from 3 to 6 years old from the "Grau de Gandia", using de Spanish Version of PSQ by means of an autofilled survey answered by the parents of the students from the different schools. We performed a cross sectional study, collecting 144 valid surveys, performing data entry in a EXCEL database for further description. A 23.4% of the children have insomnia based on the responses and it is significant the presence of other parasomnias such as somniloquy (70%), snoring (7.2%), bruxism (22.3%), rhythmic movement disorders (7.1% ) and a 4.1% of the children have symptoms of attention deficit regardless of havingr or not symptoms of hyperactivity. A 2.08% of the survey responded to a combined ADHD and a 6.25% of the children had symptoms of hyperactivity-impulsivity. Our study provides similar data to other population studies carried out at schools at this age range and also in higher, with regard to insomnia, parasomnias, sleep habits and ADHD, being the lack of education of the habit of sleep the most common etiology, so the role of the nurse is fundamental in the orientation and training for parents (AU)

[Arnold-Chiari malformation and syringomyelia in primary care. A case report]. / Malformación de Arnold-Chiari y siringomielia en atención primaria. A propósito de un caso.

Rare diseases, due to their epidemiological characteristics, and sometimes to the non-specific symptoms, are difficult to diagnose routinely at Primary Care Level. A case is presented of Arnold Chiari malformation in a young male patient with early insidious presentation (neck pain and sub-occipital headaches) consulting due to the emergence of new symptoms (paresthesias, muscular weakness, cervicobrachial and radiating lumbar pain, and headaches after mild exertion).

Insuficiencia respiratoria global como primera manifestación de una neoplasia testicular. A propósito de un caso / Global respiratory failure as the presentation form of testicular neoplasia. A case report

Los tumores testiculares son las neoplasias más frecuentes en el grupo de edad entre 15 y 35 años, teniendo una alta tasa de curación, no obstante, siguen apareciendo debuts tardíos con manifestaciones metastásicas atípicas que pueden provocar un diagnóstico inicial erróneo. Presentamos el caso cínico de un paciente de 26 años con neoplasia testicular cuya primera sintomatología fue un cuadro de dificultad respiratoria, sensación distérmica y nerviosismo, cuyo estado de salud empeoró progresivamente siendo necesario su ingreso en la unidad de cuidados intensivos (AU)

Testicular tumors are the most common malignancies in the 15–35 years age group. They have a high recovery rate but late onsets may appear with atypical metastatic signs, which may lead to an erroneous initial diagnosis. We report a clinical case of a 26 years old patient with testicular neoplasm whose first symptoms were the presence of respiratory distress, feeling feverish and nervousness. His health condition progressively worsened and required admission to the intensive care unit (AU)

Incisivo central superior con dos conductos / Maxillary central incisor with two root canals

Para conseguir el éxito de la terapéutica endodoncia es imprescindible el conocimiento de la anatomía dental interna y externa así como las variaciones que se puedan presentar y su frecuencia aproximada. La anatomía del incisivo central superior es bien conocida y generalmente aparece con una raíz y un conducto. Presentamos un incisivo central con una raíz y dos conductos. El estudio detallado de la radiografía preoperatoria y radiografías desde distintas proyecciones en los casos que presentan dificultad son necesarias aún en dientes cuyo tratamiento endodóncico pueda parecer sencillo (AU)

The success of endodontic therapy requires a knowledge of the internal and external dental anatomy and its variations in presentation. The internal anatomy of the maxillary central incisor is well known and usually presents with one root and one root canal. This case report describes an endodontic treatment of a maxillary central incisor with one root and two root canals. The detailed study of preoperative radiographs and X-rays from different projections in cases that present difficulties are necessary even in teeth with endodontic treatmen may seem simple (AU)

Primer molar superior de seis conductos / No disponible

Presentamos un caso clínico de un molar superior de seis conductos. La morfología es atípica, caracterizada por tener dos conductos en la raíz mesiovestibular, dos en la distovestibular y dos en la palatina. Así mismo revisamos la literatura respecto a la morfología del primer molar superior (AU)

A case report is presented regarding a maxillary first molar with six canals. The morphology is atypical because it is characterized by having two root canals in the mesiobuccal root, two in the distobuccal root and two in the palatal root. A literature review pertaining to the morphology of maxillary first molars is discussed (AU)

Instrumentación rotatoria: una perspective endodóncica / Published for the Dental Professional Community by the Americal Association of Endodontists

No disponible

No disponible

Coriorretinopatía serosa central en la distrofia viteliforme foveomacular del adulto / Central serous corioretinopathy in adult onset foveomacular vitelliform dystrophy

Caso Clínico: Se presenta el caso clínico de un varón de 30 años con una distrofia foveomacular viteliforme del adulto bilateral simétrica, que de forma simultánea desarrolla una coriorretinopatía central serosa (CRCS) y en el que se aprecia la coexistencia de múltiples puntos blancos en la proximidad de las arcadas vasculares temporales. La angiografía fluoresceínica demuestra la alteración mixta de ambos tipos de fotorreceptores, así como la lesión aguda de la CRCS en el polo posterior OI. Discusión: La distrofia foveomacular del adulto es una alteración hereditaria del polo posterior que no suele evolucionar con complicaciones agudas. La aparición de una coriorretinopatía central no es habitual

Case report: The clinical case of a 30 year-old male patient with a bilateral and symmetric adult-onset foveomacular vitelliform dystrophy is presented. The simultaneous onset of a central serous chorioretinopathy (CSCR) with multiple white dots in the proximity of the temporal vascular arcades is documented. Fluorescein angiography showed a combined alteration of both types of photoreceptors, and the acute lesion of the CSCR at the posterior pole of the eye. Discussion: Adult-Onset Foveomacular Vitelliform Dystrophy is a hereditary condition which results in an alteration of the posterior pole of the eye, but is not usually associated with any acute complications. The onset of a CSCR, as seen in this case, is unusual 2008; 83: 505-508)

[Central serous corioretinopathy in adult onset foveomacular vitelliform dystrophy]. / Coriorretinopatía serosa central en la distrofia viteliforme foveomacular del adulto.

CASE REPORT: The clinical case of a 30 year-old male patient with a bilateral and symmetric adult-onset foveomacular vitelliform dystrophy is presented. The simultaneous onset of a central serous chorioretinopathy (CSCR) with multiple white dots in the proximity of the temporal vascular arcades is documented. Fluorescein angiography showed a combined alteration of both types of photoreceptors, and the acute lesion of the CSCR at the posterior pole of the eye. DISCUSSION: Adult-Onset Foveomacular Vitelliform Dystrophy is a hereditary condition which results in an alteration of the posterior pole of the eye, but is not usually associated with any acute complications. The onset of a CSCR, as seen in this case, is unusual 2008; 83: 505-508).

Identification of novel SLC3A1 gene mutations in Spanish cystinuria families and association with clinical phenotypes.

Cystinuria is an inherited metabolic disease characterized by an abnormal urinary excretion of cystine and dibasic amino acids, leading to kidney stone formation. Incidence of cystinuria in the Mediterranean Spanish population is one of the highest in the world. In view of the low prevalence of previously reported mutations in the SLC3A1 gene, analyses to identify novel variants were carried out on 20 cystinuria families. Additionally, we investigated the possible association between these molecular variants and clinical phenotypes. Genomic DNA from 48 cystinuria patients, 44 healthy relatives and 81 unrelated controls from the East Mediterranean coast of Spain was screened by conformation sensitive gel electrophoresis. Abnormal patterns were confirmed by nucleotide sequence determination and by further restriction fragment-length polymorphism. We only found 11 genetic variants within the SLC3A1 gene: five known polymorphisms (114C > A, 231T > A, 1136 + 3delT, 1332 + 7T > C and 1338G > A), four point mutations (M467T, R452W, I105R and Y461X), one single base pair deletion (1767delA) and one 2-bp insertion (1670insAT). Two of these genetic variants (I105R and 1670insAT) were described for the first time. All mutations but one were detected in families classified as Type I cystinuria due to the transmission pattern of the disease. Association analyses revealed that 231T > A (M467T), 1136 + 3delT and 1332 + 7T > C genetic variants were statistically related with urinary amino acid excretion in cystinuria patients. Although some molecular variants within the SLC3A1 gene were associated with clinical traits in cystinuria patients, the low detection rate of mutations in this gene strongly suggests that variation of the SLC3A1 is not the major genetic factor contributing to cystinuria in this Mediterranean population.

Renal transplantation in children with severe bladder dysfunction.

PURPOSE: Renal transplantation in children with bladder dysfunction carries a risk for the renal graft. We report our experience with transplantation in 15 patients 6 to 18 years old with severe abnormalities of the lower urinary tract. MATERIALS AND METHODS: A total of 18 renal transplants were performed in 15 children with bladder dysfunction secondary to myelomeningocele (3), occult spina bifida (1), malformation/agenesis of the sacrum (5), posterior urethral valves (4), female hypospadias (1) and bladder exstrophy (1) between 1979 and 2003. Urological surgery was performed before transplantation in 14 cases-7 bladder augmentations, 5 incontinent urinary conduits/reservoirs and 2 vesicostomies. Voiding was maintained by intermittent catheterization in 9 cases and incontinent ostomies in 6. Graft implantation was performed by extraperitoneal route with ureteral anastomosis to the native bladder in cases of bladder augmentation. Immunosuppression consisted of triple therapy with polyclonal/monoclonal antibodies. RESULTS: Urological complications consisted of urethral obstruction due to mucus hypersecretion (1), urinary fistula (1), ureterovesical obstruction (1), stone formation (3), urinary tract incrustation by Corynebacterium urealyticum (1) and pyelonephritis (2). Graft survival rates at 1 and 5 years were 77% and 62%, respectively, with a median of 79 months (95% CI 51 to 107). Three graft losses were related to urological disease. CONCLUSIONS: Renal transplantation in children with severe bladder dysfunction can achieve similar results to those obtained in the general population. Meticulous selection of patients and surgical reparative techniques ensuring voiding and adequate control of urinary infections are mandatory. Augmentation cystoplasty and intermittent catheterization are appropriate techniques currently used for achieving this outcome.

An ellipsoidal calculus based on propagation and fusion.

Presents an ellipsoidal calculus based solely on two basic operations: propagation and fusion. Propagation refers to the problem of obtaining an ellipsoid that must satisfy an affine relation with another ellipsoid, and fusion to that of computing the ellipsoid that tightly bounds the intersection of two given ellipsoids. These two operations supersede the Minkowski sum and difference, affine transformation and intersection tight bounding of ellipsoids on which other ellipsoidal calculi are based. Actually, a Minkowski operation can be seen as a fusion followed by a propagation and an affine transformation as a particular case of propagation. Moreover, the presented formulation is numerically stable in the sense that it is immune to degeneracies of the involved ellipsoids and/or affine relations. Examples arising when manipulating uncertain geometric information in the context of the spatial interpretation of line drawings are extensively used as a testbed for the presented calculus.

Environmental factors modulate the effect of the APOE genetic polymorphism on plasma lipid concentrations: ecogenetic studies in a Mediterranean Spanish population.

To investigate APOE gene--environment interaction effects on plasma lipid concentrations, we conducted a cross-sectional study in a Mediterranean Spanish population consisting of 396 men and 513 women aged 18 to 66 years. The frequency of the epsilon 4 variant was 0.071 (95% confidence interval 0.059, 0.082), confirming the lower frequency of this allele in Southern Europe. In general, the carriers of the epsilon 2 variant had lower concentrations (P <.05) of total and low-density lipoprotein cholesterol (LDL-C), carriers of the epsilon 3 variant had intermediate concentrations, and carriers of the epsilon 4 variant had higher concentrations (P <.05) in both sexes, even after multivariate adjustment for age, body mass index, alcohol consumption, tobacco smoking, physical activity, marital status, and education. However, when the homogeneity of allelic effects according to environmental factors was tested, significant interaction terms were found. In women, an important interaction between alcohol consumption and the APOE polymorphism in determining LDL-C concentrations was found (P <.003). LDL-C concentrations in female drinkers with the epsilon 2 variant were significantly lower (P <.014) than in nondrinkers with the epsilon 2 variant. Likewise, in female drinkers with the epsilon 4 variant, LDL-C concentrations were also significantly (P <.010) lower than in nondrinkers with the epsilon 4 variant. Moreover, in female drinkers, LDL-C concentrations did not differ between carriers of the epsilon 4 and the epsilon 3 variants, and in nondrinkers, LDL-C concentrations did not differ between carriers of the epsilon 2 and the epsilon 3 variants. We also found a statistically significant interaction effect (P <.001) between the APOE polymorphism and physical activity in determining high-density lipoprotein cholesterol concentrations in men. Our results indicate that environmental factors are important modulators of the effect of the APOE polymorphism on plasma lipid concentrations.