Feed pellets containing chitosan nanoparticles as plasmid DNA oral delivery system for fish: In vivo assessment in gilthead sea bream (Sparus aurata) juveniles.

The aim of this study was the assessment of preloaded feed pellets as a delivery system for plasmid DNA (pDNA), with the purpose of evaluating the potential administration of DNA vaccines orally in aquacultured fish. Pellets were made up by usual feed ingredients, which were mixed with chitosan nanoparticles entrapping a model plasmid (pCMVß) expressible in eukaryotic cells before being elaborated. The plasmid is characterized by the insertion of the reporter gene lacZ, encoding for the bacterial enzyme ß-galactosidase (ß-gal). The possible in vivo expression of the exogenous gene was measured in different fish tissues of gilthead sea bream (Sparus aurata) juveniles by two different procedures. On the one hand, the activity of the enzyme ß-gal was detected and quantified in muscle, liver and intestine; on the other, specific IgM against ß-gal antigen was titrated in blood samples. Intramuscular (i.m.) injection of equal amounts of plasmid was also carried out for the purpose of comparison with oral administration. The expression of the reporter gene was detected in fish tissues following both oral and i. m. administration of pDNA up to 60 days. However, organ distribution of the gene expression was more evident after oral (ß-gal activity measured in gut, liver and muscle) than after parenteral administration (restricted to adjacent muscle tissues). In agreement, specific IgM titration indicated that humoral immune response was more intense and sustained throughout the experimental period after oral than after i. m. delivery of equal amounts of pDNA. These results suggest that feed pellets containing chitosan nanoparticles might enable efficient oral delivery of pDNA, a fact that might imply valuable applications in terms of on-farm mass immunization purposes, especially with regard to DNA-based vaccines and small size fish, in which i. m. administration remains unfeasible.

Growth performance, body composition, and digestive functionality of Senegalese sole (Solea senegalensis Kaup, 1858) juveniles fed diets including microalgae freeze-dried biomass.

Senegalese sole is one of the most promising fish species cultivated in the Southern European countries. This study was aimed at assessing the effects of microalgae biomass added to diets for Senegalese sole juveniles on fish growing and condition status. Three isoproteic (52%) and isolipidic (10%) were formulated containing 15% Tisochrysis lutea (TISO), Nannochloropsis gaditana (NAN), or Scenedesmus almeriensis (SCE) biomass, respectively. An experimental microalgae-free diet (CT) and a commercial diet (COM) were used as controls. Fish were fed at 3% of their body weight for 85 days. Final body weight of fish fed microalgae-supplemented diets did not differ from group fed CT diet. Fish-fed CT, TISO, NAN, and SCE showed higher growth performance and nutrient utilization figures than specimen-fed COM diet. The highest carcass lipid content was found in COM group (141 g kg-1), and no differences were observed in body protein content. Ash was significantly higher in TISO, NAN, and SCE groups compared to fish-fed CT. Muscle EPA and DHA contents were not modified owing to the different dietary treatments. The n3/n6 and EPA/DHA ratios in muscle were similar in all the experimental groups. The quantification of digestive proteolytic activities did not differ among experimental groups, although differences in the protease pattern in digestive extracts by zymography were revealed in those fish fed on COM diet. Both α-amylase activity in the intestinal lumen and leucine aminopeptidase in the intestinal tissue were significantly lower in COM fish. Specimens fed on SCE diet showed a higher leucine aminopeptidase activity associated to the intestinal tissue compared to NAN-fed fish (0.40 and 0.25 U g tissue-1, respectively). The ultrastructural study revealed that the dietary inclusion of algal biomass, especially T. lutea and N. gaditana, had a positive impact on the absorptive capacity of the intestinal mucosa. The highest values for the parameters microvilli length and microvilli absorption surface were observed in fish fed on NAN diet (1.99 µm and 45.93 µm2, respectively). Even though further studies aimed at optimizing commercial formulas for Senegalese sole are required prior to any large-scale practical utilization, the results obtained clearly suggest the potential of microalgae as dietary ingredients for this fish species.

PCR cycles above routine numbers do not compromise high-throughput DNA barcoding results.

High-throughput DNA barcoding has become essential in ecology and evolution, but some technical questions still remain. Increasing the number of PCR cycles above the routine 20-30 cycles is a common practice when working with old-type specimens, which provide little amounts of DNA, or when facing annealing issues with the primers. However, increasing the number of cycles can raise the number of artificial mutations due to polymerase errors. In this work, we sequenced 20 COI libraries in the Illumina MiSeq platform. Libraries were prepared with 40, 45, 50, 55, and 60 PCR cycles from four individuals belonging to four species of four genera of cephalopods. We found no relationship between the number of PCR cycles and the number of mutations despite using a nonproofreading polymerase. Moreover, even when using a high number of PCR cycles, the resulting number of mutations was low enough not to be an issue in the context of high-throughput DNA barcoding (but may still remain an issue in DNA metabarcoding due to chimera formation). We conclude that the common practice of increasing the number of PCR cycles should not negatively impact the outcome of a high-throughput DNA barcoding study in terms of the occurrence of point mutations.

Incidence of allergic rhinitis in a cohort of young adults from 13-15 years old to 23-25 years old in Castellon (Spain)

BACKGROUND: The objective of this study was to estimate the incidence of Allergic Rhinitis (AR) in young adults and its risk or protective factors. METHODS: A population-based prospective cohort study was carried out in 2012. The cohort participated in the International Study of Asthma and Allergy in Childhood in Castellon in 1994 and 2002. A telephone survey was conducted using the same questionnaires. A new case of AR was defined as the participants free of the disease in 2002, who self-reported suffering from AR or taking medications for AR in the period 2002-2012. RESULTS: Of the 1805 schoolchildren in the cohort in 2002, 1435 young adults (23-25 years old) participated (follow-up 79.1%) in 2012; 743 were female and 692 male; their mean age was 24.9±0.6 years. Two hundred new cases of AR occurred in 1259 participants free of the disease with an incidence of 17.3 per 1000 person-years, and the incidence increased from 2002 (RR=1.42; 95% CI 1.15-1.75). The risk factors of AR adjusted by age and gender were sinusitis (RR=1.77; 95% CI 1.16-2.68), atopic dermatitis (RR=1.51; 95% CI 1.11-2.06) and constant exposure to truck traffic (RR=1.88; 95% CI 1.12-3.17). For male participants, the risk factors were asthma, sinusitis and atopic dermatitis, and for females bronchitis was a risk factor and presence of older siblings a protective factor. CONCLUSIONS: An increase in AR incidence was observed. Sinusitis, atopic dermatitis and constant exposure to truck traffic were the risk factors of the AR with some differences by gender

No disponible

Incidence of allergic rhinitis in a cohort of young adults from 13-15 years old to 23-25 years old in Castellon (Spain).

BACKGROUND: The objective of this study was to estimate the incidence of Allergic Rhinitis (AR) in young adults and its risk or protective factors. METHODS: A population-based prospective cohort study was carried out in 2012. The cohort participated in the International Study of Asthma and Allergy in Childhood in Castellon in 1994 and 2002. A telephone survey was conducted using the same questionnaires. A new case of AR was defined as the participants free of the disease in 2002, who self-reported suffering from AR or taking medications for AR in the period 2002-2012. RESULTS: Of the 1805 schoolchildren in the cohort in 2002, 1435 young adults (23-25 years old) participated (follow-up 79.1%) in 2012; 743 were female and 692 male; their mean age was 24.9±0.6 years. Two hundred new cases of AR occurred in 1259 participants free of the disease with an incidence of 17.3 per 1000 person-years, and the incidence increased from 2002 (RR=1.42; 95% CI 1.15-1.75). The risk factors of AR adjusted by age and gender were sinusitis (RR=1.77; 95% CI 1.16-2.68), atopic dermatitis (RR=1.51; 95% CI 1.11-2.06) and constant exposure to truck traffic (RR=1.88; 95% CI 1.12-3.17). For male participants, the risk factors were asthma, sinusitis and atopic dermatitis, and for females bronchitis was a risk factor and presence of older siblings a protective factor. CONCLUSIONS: An increase in AR incidence was observed. Sinusitis, atopic dermatitis and constant exposure to truck traffic were the risk factors of the AR with some differences by gender.

Not all are free-living: high-throughput DNA metabarcoding reveals a diverse community of protists parasitizing soil metazoa.

Protists, the most diverse eukaryotes, are largely considered to be free-living bacterivores, but vast numbers of taxa are known to parasitize plants or animals. High-throughput sequencing (HTS) approaches now commonly replace cultivation-based approaches in studying soil protists, but insights into common biases associated with this method are limited to aquatic taxa and samples. We created a mock community of common free-living soil protists (amoebae, flagellates, ciliates), extracted DNA and amplified it in the presence of metazoan DNA using 454 HTS. We aimed at evaluating whether HTS quantitatively reveals true relative abundances of soil protists and at investigating whether the expected protist community structure is altered by the co-amplification of metazoan-associated protist taxa. Indeed, HTS revealed fundamentally different protist communities from those expected. Ciliate sequences were highly over-represented, while those of most amoebae and flagellates were under-represented or totally absent. These results underpin the biases introduced by HTS that prevent reliable quantitative estimations of free-living protist communities. Furthermore, we detected a wide range of nonadded protist taxa probably introduced along with metazoan DNA, which altered the protist community structure. Among those, 20 taxa most closely resembled parasitic, often pathogenic taxa. Therewith, we provide the first HTS data in support of classical observational studies that showed that potential protist parasites are hosted by soil metazoa. Taken together, profound differences in amplification success between protist taxa and an inevitable co-extraction of protist taxa parasitizing soil metazoa obscure the true diversity of free-living soil protist communities.

Prevalencia de anticuerpos IgG al toxoide tetánico en trabajadores sanitarios / Prevalence of IgG antibodies to toxin tetanus in health workers

INTRODUCCIÓN: En el año 2009 el Ministerio de Sanidad y Consumo de España publica una nueva guía para la vacunación de la Difteria y Tétanos. Existen discrepancias con los tiempos de inoculación de las dosis de recuerdo con otros países y sociedades médicas. MATERIAL Y MÉTODOS: Estudio descriptivo. Las variables analizadas fueron: IgG-Toxoide Tetánico, tiempo última dosis de vacunación, dosis totales, edad, sexo, hospital, habito tabáquico e índice de masa corporal. Se construyó un modelo de Regresión Logística. Con el fin de determinar los puntos de corte más sensibles y específicos para las variables temporales (tiempo desde la última dosis y edad) se calcularon las curvas R.O.C RESULTADOS: Las variables, edad O,R= 17,56 (1,840 - 167,760), dosis de vacuna inoculadas al trabajador, O,R= 0,064 (0,006 - 0,908) y tiempo de la última dosis de vacunación, O,R= 1,03 (1,017 - 1,047), son las variables significativas en el análisis multivariante. Los puntos de cortes, para la edad son 54 años (Sensibilidad S= 0,72, Especificidad SP=0,77) y 15 años tras la última dosis años (S= 0,88, SP=0,86), por encima de este corte la probabilidad de no tener anticuerpos al Tétanos es alta. CONCLUSIONES: Ante un trabajador que refiere o documenta que hace más de 15 años de la ultima dosis deberíamos plantearnos la revacunación, si además este trabajador refiere no tener más de 5 dosis inoculadas y tiene más de 54 años la revacunación sería muy recomendable

INTRODUCTION: In 2009 the Ministry of Health of Spain published a new guide for the vaccination of diphtheria and tetanus. There are discrepancies with the time of inoculation of the booster with other countries and medical societies. The objective of this study was to estimate the health worker prevanlencia antibody negative to tetanus toxoid and see to it associated factors. MATERIAL AND METHODS: A descriptive study. The variables analyzed were: IgG - Tetanus Toxin, time last dose of vaccination, total dose, age, sex, hospital, smoking history and body mass index. Logistic regression model was constructed. In order to identify areas of more sensitive and specific cut for temporary variables (time since last dose and age) ROC curves were calculated. RESULTS: The variables, age O.R= 17,56 (1,840 - 167,760), inoculated vaccine doses to workers O.R= 0,064 (0,006 - 0,908) and the time of the last dose of vaccination O.R= 1,03 (1,017 - 1,047) are significant variables in the multivariate analysis. The cut-off points for age is 54 years (Sensitivity S= 0,72, Specificity SP=0,77) and 15 years after the last dose (S= 0,88, SP =0,86), above this cut the likelihood of having antibodies to tetanus is high. CONCLUSIONS: In a worker or documents referred to more than 15 years ago the last dose revaccination should ask, if this worker also reported not having more than 5 inoculated dose and has over 54 years would be highly recommended revaccination

Evaluación ecológica en el deterioro cognitivo leve y enfermedad de Alzheimer mediante el Rivermead Behavioural Memory Test / Ecological assessment of mild cognitive impairment and Alzheimer disease using the Rivermead Behavioural Memory Test

Objetivos: El Rivermead Behaviou al Memory Test (RBMT) es una batería ecológica breve que permite predecir el funcionamiento mnésico del sujeto en la vida diaria. Evaluamos mediante el RBMT el funcionamiento mnésico en la vida diaria, de pacientes con deterioro cognitivo leve (DCL), enfermedad de Alzheimer (EA) y sujetos sanos, así como las diferencias entre perfiles mnésicos de los sujetos DCL estables al año y los que progresarán a EA. Pacientes y métodos: Muestra de 91 sujetos con 60 o más años, 30 controles, 27 DCL y 34 pacientes con EA. Se evalúa a los sujetos mediante MMSE y RBMT. Resultados: Cuarenta hombres y 51 mujeres, con edad y escolaridad media de 74,29 ± 6,71 y 5,87 ± 2,93 años, respectivamente. En las puntuaciones totales, perfil y global del RBMT (p < 0,001) y del MMSE (p < 0,05), los sujetos control puntúan significativamente más alto que los DCL y estos que los EA. En todos los subtest, los controles (p < 0,001) y DCL (p < 0,05) se diferencian de la EA. Subtest prospectivos, retrospectivos y de orientación diferencian al grupo control del DCL (p < 0,05). Los sujetos DCL que progresan a EA puntúan más bajo en la exploración inicial en las puntuaciones totales del RBMT, MMSE y en el recuerdo del nombre, objeto personal, recuerdo inmediato de la historia, recuerdo diferido del recorrido y orientación (p < 0,05), reconocimiento de dibujos, recuerdo diferido de la historia y del mensaje (p < 0,01). Conclusiones: RBMT es una prueba ecológica de memoria episódica útil para diferenciar entre sí sujetos controles/DCL/EA, que además permite detectar a los pacientes con DCL que progresan a EA

Introduction: The Rivermead Behavioural Memory Test (RBMT) is a short, ecologically-valid memory test battery that can provide data about a subject's memory function in daily life. We used RBMT to examine daily memory function in patients with mild cognitive impairment (MCI), Alzheimer disease (AD), and in healthy controls. We also evaluated differences between the memory profiles of subjects whose MCI remained stable after 1 year and those with conversion to AD. Patients and methods: Sample of 91 subjects older than 60 years: 30 controls, 27 MCI subjects and 34 AD patients. Subjects were assessed using MMSE and RBMT. Results: The 40 men and 51 women in the sample had a mean age of 74.29 ± 6.71 and 5.87 ± 2.93 years of education. For the total profile and screening RBMT scores (P < .001) and total MMSE scores (P < .05), control subjects scored significantly higher than those with MCI, who in turn scored higher than AD patients. In all subtests, the control group (P < .001) and MCI group (P<.05) were distinguishable from the AD group. Prospective, retrospective, and orientation subtests found differences between the MCI and control groups (P < .05). MCI subjects who progressed to AD scored lower at baseline on the total RBMT and MMSE, and on name recall, belongings, story - immediate recall, route - delayed recall, orientation (P < .05), face recognition, story - delayed recall, and messages - delayed recall sections (P < .01). Conclusions: RBMT is an ecologically-valid episodic memory test that can be used to differentiate between controls, MCI subjects, and AD subjects. It can also be used to detect patients with MCI who will experience progression to AD

Ecological assessment of mild cognitive impairment and Alzheimer disease using the Rivermead Behavioural Memory Test.

INTRODUCTION: The Rivermead Behavioural Memory Test (RBMT) is a short, ecologically-valid memory test battery that can provide data about a subject's memory function in daily life. We used RBMT to examine daily memory function in patients with mild cognitive impairment (MCI), Alzheimer disease (AD), and in healthy controls. We also evaluated differences between the memory profiles of subjects whose MCI remained stable after 1 year and those with conversion to AD. PATIENTS AND METHODS: Sample of 91 subjects older than 60 years: 30 controls, 27 MCI subjects and 34 AD patients. Subjects were assessed using MMSE and RBMT. RESULTS: The 40 men and 51 women in the sample had a mean age of 74.29±6.71 and 5.87±2.93 years of education. For the total profile and screening RBMT scores (P<.001) and total MMSE scores (P<.05), control subjects scored significantly higher than those with MCI, who in turn scored higher than AD patients. In all subtests, the control group (P<.001) and MCI group (P<.05) were distinguishable from the AD group. Prospective, retrospective, and orientation subtests found differences between the MCI and control groups (P<.05). MCI subjects who progressed to AD scored lower at baseline on the total RBMT and MMSE, and on name recall, belongings, story-immediate recall, route-delayed recall, orientation (P<.05), face recognition, story-delayed recall, and messages-delayed recall sections (P<.01). CONCLUSIONS: RBMT is an ecologically-valid episodic memory test that can be used to differentiate between controls, MCI subjects, and AD subjects. It can also be used to detect patients with MCI who will experience progression to AD.

Hemorragia durante la cesárea: factores de riesgo / Blooder in caesarean section: risk factors

Objetivos Definir los factores que influyen en la producción de anemia poscesárea. Material y métodos Seiscientas veintiocho pacientes asistidas en el Servicio de Obstetricia del Hospital Universitario San Cecilio de Granada (España) sometidas a una cesárea durante 1 año, analizando las características sociodemográficas y los diferentes factores que pueden influir en la producción de anemia. Se calcula la incidencia de anemia y la necesidad de transfusión postintervención. Resultados El 80% de las pacientes tiene anemia poscesárea, y la pérdida es inferior a 2g/dl. La multiparidad, cesárea previa, edad gestacional menor a 30 semanas y cesárea urgente se asocia con mayores tasas de anemia, sin diferencias significativas en cuanto a antecedentes como preeclampsia previa o tipo de anestesia empleada. La técnica de Misgav-Ladach disminuye dicha pérdida. Conclusiones En nuestro estudio, la multiparidad y la cesárea de urgencia se asocian con mayores tasas de anemia (AU)

Objectives To identify the factors influencing blood loss after cesarean section. Material and methods A total of 628 patients who underwent a cesarean section during a 1-year period at the Obstetrics Service of the University Hospital of San Cecilio in Granada (Spain) were studied. The patients’ socio-demographic characteristics and the distinct factors that could be related to blood loss were analyzed. The incidence of anemia and the need for postsurgical transfusion were calculated. Results Postcesarean anemia was found in 80% of the patients, but with a loss below 2g/dl. The factors associated with a higher rate of blood loss were multiparity, previous cesarean section, gestational age <30 weeks and urgent cesarean section. No significant differences were found with regard to a history of preeclampsia or the type of anesthesia used. The Misgav-Ladach technique for cesarean section reduced blood loss. ConclusionsIn our study, multiparity and urgent cesarean section were associated with a higher rate of anemia( AU)

[Acute myocardial infarction in pregnancy of 39 week treated with fibrinolysis]. / Infarto agudo de miocardio en gestante a término de 39 semanas tratado con fibrinolisis.

We report a 39-year-old woman in her 39th week of pregnancy who presented acute myocardial infarction with clinical and electrocardiography criteria and was treated with systemic fibrinolysis. After this, she was transported to the hemodynamic service of a referral hospital where heart catheterization was done that confirmed the coronary lession. 24 hours after, she had a newborn without sequellae.

Infarto agudo de miocardio en gestante a término de 39 semanas tratado con fibrinolisis / Acute miocardial infarction in pregnancy of 39 week treated with fibrinolysis

Exponemos el caso de una paciente de 39 años de edad con gestación a término de 39 semanas que sufre un cuadro de infarto agudo de miocardio con criterios clínicos y electrocardiográficos y que fue tratada con fibrinolisis sistémica. Posteriormente fue trasladada al servicio de hemodinámica del Hospital de referencia donde se realizó cateterismo confirmando la lesión coronaria. A las 24 horas de éste episodio dio a luz un recién nacido a término sin complicaciones mediante parto vaginal

We report a 39 years old woman at ehr 39th week of pregancy who presented acute miocardial infarction with clinics and electrocardiography criteria and was trated with systemic fibrynolisis. After this was traslated to hemodynamic service of referency hospital were was done cateterism thas confirmed the coronary lession. 24 hours after she had an newborn without secuels

Estudio de las campañas de vacunación antigripal 2005 y 2006 a trabajadores del Area 2 de Madrid / No disponible

La vacunación antigripal es la medida más eficazpara prevenir la gripe. Dentro de los colectivos laborales en los que se recomienda su inoculación, seencuentran los trabajadores sanitarios.Objetivos:, Estudiar si existen diferencias significativas entre las Campañas del 2005-06 y 2006-07dirigidas a los trabajadores del área sanitaria 2 de laComunidad de Madrid.Metodología: Estudio descriptivo de ambas campañasen el área sanitaria 2 de la Comunidad de Madrid. Se realiza un análisis univariante y se construye un modelo de Regresión Logística cuya variable dependiente son las dos campañas. Comovariables independientes se incluyeron: edad, categoría, servicio, centro de trabajo, vacunación de la gripe en el año anterior, efectos secundarios en año el anterior, enfermedad crónica, medicación, fumador y procesos alérgicos.Resultado:. En la Campaña 2005 se vacunaron más en servicios centrales, hostelería y administración.Se declararon más efectos secundarios, se vacunaron más sanitarios y más trabajadores declararon tomar algún tipo de medicación. Sin embargo en la Campaña 2006 se vacunaron más en el H. U. Princesa, en la primera semana de campaña, en los servicios médicos y más trabajadores declararon tener algún tipo de enfermedad crónica.Conclusiones: Las coberturas vacunales han sidoiguales o inferiores a años anteriores en los distintoscentros excepto en el Hospital U. de la Princesadonde fue mayor

The vaccination against the influenza is the mosteffective way of preventing this illness. Workers inthe Sanitary sector are ones of the most recommendedto be vaccinated against the flu.Objectives: To study whether there are significantdifferences between the 2005-2006 and 2006-2007Campaigns addressed to the workers in the Sanitaryarea nº 2 in the Madrid Community.Methodology: Descriptive study of both campaignsin the Sanitary area nº 2 in the Madrid Community.A uni-variant analysis is carried out to builda Logistic Regression model in which the two campaignsare the dependant variables. The followingindependent variables were also included: age, professional category, service, working center, previousyear anti-flu vaccination, side effects in previousyear, chronic diseases, medication taken, smokinghabits and allergic processes.Results: In the 2005 campaign, vaccination wasmore intense in central services, catering and administration. There were more side effects, more sanitary workers were vaccinated and more workersdeclared to have taken any sort of medication. However,in the 2006 campaign there were more vaccinationsin the “H.U. la Princesa”, within the first weekof campaign, in the medical services, and more workersdeclared to suffer any type of chronic disease.Conclusions: The coverage of the vaccination hasbeen equal or lower than in previous years in all workingcenters, with the exception of the “H.U. la Princesa”,where the coverage was higher

International lung cancer trends by histologic type: male:female differences diminishing and adenocarcinoma rates rising.

Lung cancer rates have peaked among men in many areas of the world, but rates among women continue to rise. Most lung cancers are squamous cell carcinoma, small cell carcinoma, or adenocarcinoma; trends vary according to type. We compiled population-based morphology-specific incidence data from registries contributing to the International Agency for Research on Cancer (IARC) databases. Unspecified cancers and carcinomas were reallocated based on a registry, time period, sex and age group-specific basis. Where available, data from several registries within a country were pooled for analysis. Rates per 100,000 person-years for 1980-1982 to 1995-1997 were age-adjusted by the direct method using the world standard. Squamous cell carcinoma rates among males declined 30% or more in North America and some European countries while changing less dramatically in other areas; small cell carcinoma rates decreased less rapidly. Squamous and small cell carcinoma rates among females generally rose, with the increases especially pronounced in the Netherlands and Norway. In contrast, adenocarcinoma rates rose among males and females in virtually all areas, with the increases among males exceeding 50% in many areas of Europe; among females, rates also rose rapidly and more than doubled in Norway, Italy and France. Rates of all lung cancer types among women and adenocarcinoma among men continue to rise despite declining cigarette use in many Western countries and shifts to filtered/low-tar cigarettes. Renewed efforts toward cessation and prevention are mandatory to curb the prevalence of cigarette smoking and to reduce lung cancer rates eventually.

Síndrome de distrés respiratorio del adulto secundario a inhalación de cocaína / Adult respiratory distress syndrome secondary to cocaine inhalation

Presentamos un caso de síndrome de distrés respiratorio del adulto tras inhalación de cocaína de gran pureza. El paciente sufrió un rápido deterioro de su función respiratoria. Hubo de instaurarse ventilación mecánica durante 15 días. Se descartó la existencia de neumonía y de patología cardíaca que justificase el cuadro. Finalmente el enfermo mejoró y fue dado de alta sin secuelas (AU)

Time trends incidence of both major histologic types of esophageal carcinomas in selected countries, 1973-1995.

The purpose of our study was to examine the incidence patterns of 2 major histologic types of esophageal cancer, in selected countries world-wide and to identify components of birth cohort, period and age as determinants of observed time trends using regression modeling. The roles of temporal changes in specification of histology of tumors and of classification of cancers at the gastroesophageal junction as esophageal or gastric in origin were taken into consideration. In all, 56,426 esophageal cancer cases were included. The results indicate that the incidence rate of squamous cell carcinoma of the esophagus has been relatively stable in most of the countries analyzed, although increasing trends were observed in Denmark and the Netherlands (Eindhoven) among men and in Canada, Scotland and Switzerland among women. There was a significant increase in the incidence of esophageal adenocarcinomas in both sexes in the United States (among whites and blacks), Canada and South Australia and in 6 European countries (Scotland, Denmark, Iceland, Finland, Sweden and Norway). In France the increase was limited to men and in Switzerland the increase was observed only in women. Modeling was unable to distinguish which trends were the results of changes in risk between generations (as cohort effects), or changes in all age groups simultaneously (as a period effect).

Single origin of right and left pulmonary artery branches from ascending aorta with nonbranching main pulmonary artery: relevance to a new understanding of truncus arteriosus.

We report the third known case of origin of the right and left pulmonary artery branches from the ascending aorta via a short common pulmonary artery. A large unbranching main pulmonary artery opened through a patent ductus arteriosus into the descending thoracic aorta. Preductal coarctation of the aorta and multiple congenital anomalies were also present. This rare cardiovascular malformation facilitates a new anatomic and developmental understanding of truncus arteriosus.