Self-perception of dual career barriers and athletic identity in student-athletes with disabilities according to disability type and level of professionalization.

The objective of this study was to analyze the perceived barriers to dual career success and athletic identity of student-athletes according to disability type and level of professionalization. The final sample consisted of 203 student-athletes with disabilities from five European countries. The questionnaires used were ESTPORT, EBBS and AIMS. Depending on disability type, it was found that student-athletes with hearing and physical impairment showed the highest difficulty in reconciling sports and studies (p = 0.001); that student-athletes with a hearing impairment showed the highest score in the barrier 'the cost of education is high' (p = 0.023); that student-athletes with a physical impairment had the highest scores in the barrier 'Exercise tires me' (p = 0.013); that student-athletes with cerebral palsy showed the highest scores in the barrier 'I do not have enough university/educational institution support' (p = 0.014) and 'Exercise facilities do not have convenient timetables for me' (p = 0.001). Depending on sports professionalization level, semi-professional student-athletes showed the highest values in the barrier 'the university/educational institution is far from my training center' (p = 0.040); while professional student-athletes had the highest score in the barrier 'exercise takes too much time from family responsibilities' (p = 0.034). In most of the variables related to identity as athletes, professional student-athletes showed the highest values, followed by semi-professional athletes (p = 0.043- < 0.001). In conclusion, the self-perception of barriers is quite relevant, with differences arising from disability type and level of professionalization, whereas the identity as an athlete is only different according to the level of professionalization.

Edad relativa en baloncesto U12 español: Análisis de la última década / Relative Age Effect in U12 Spanish Basketball: The Past Decade Analysis

Los objetivos de este estudio fueron: (a) analizar el efecto de la edad relativa (RAE) en los jugadores que participaron en el Campeonato de España de Minibásquet durante la última década, y (b) determinar una posible relación entre RAE y la clasificación final de los equipos analizados. Los participantes analizados fueron todos los jugadores (n = 2268) de los 19 equipos participantes durante los años 2009-2018. Se dividió a los jugadores, según su fecha de nacimiento, en cuatro cuartiles y se agruparon a los 10 mejores equipos de la clasificación en tres categorías diferentes. Los resultados mostraron el RAE durante la última década (χ2 = 380.57, P = .000). Los tres mejores equipos incluyeron un mayor número de jugadores nacidos en la primera mitad del año (83.40%, χ2 = 183.15, P = .000). En conclusión, el rendimiento en baloncesto U12 podría verse afectado por el RAE. (AU)

The objectives of this study were: (a) to analyze the relative age effect (RAE) in the players participating in the Spanish Championship of Minibasket during the last decade, and (b) to determine a possible relationship between RAE and the final classification of the analyzed teams. All players (n = 2268) from the 19 participating teams during the years 2009-2018 were analyzed. We subdivided the players according to their date of birth into four quartiles and grouped the top 10 teams of the ranking into three different categories. The results showed RAE during the past decade (χ2 = 380.57, P = .000). In addition, the top three teams included a greater number of players born in the first half of the year (83.40%, χ2 = 183.15, P = .000). In conclusion, RAE could affect the U12-basketball performance. (AU)

Electroactive calcium-alginate/polycaprolactone/reduced graphene oxide nanohybrid hydrogels for skeletal muscle tissue engineering.

Graphene derivatives such as reduced graphene oxide (rGO) are used as components of novel biomaterials for their unique electrical properties. Electrical conductivity is a crucial factor for muscle cells, which are electrically active. This study reports the development of a new type of semi-interpenetrated polymer network based on two biodegradable FDA-approved biomaterials, sodium alginate (SA) and polycaprolactone (PCL), with Ca2+ ions as SA crosslinker. Several drawbacks such as the low cell adhesion of SA and weak structural stability can be improved with the incorporation of PCL. Furthermore, this study demonstrates how this semi-IPN can be engineered with rGO nanosheets (0.5% and 2% wt/wt rGO nanosheets) to produce electroactive nanohybrid composite biomaterials. The study focuses on the microstructure and the enhancement of physical and biological properties of these advanced materials, including water sorption, surface wettability, thermal behavior and thermal degradation, mechanical properties, electrical conductivity, cell adhesion and myogenic differentiation. The results suggest the formation of a complex nano-network with different interactions between the components: bonds between SA chains induced by Ca2+ ions (egg-box model), links between rGO nanosheets and SA chains as well as between rGO nanosheets themselves through Ca2+ ions, and strong hydrogen bonding between rGO nanosheets and SA chains. The incorporation of rGO significantly increases the electrical conductivity of the nanohybrid hydrogels, with values in the range of muscle tissue. In vitro cultures with C2C12 murine myoblasts revealed that the conductive nanohybrid hydrogels are not cytotoxic and can greatly enhance myoblast adhesion and myogenic differentiation. These results indicate that these novel electroactive nanohybrid hydrogels have great potential for biomedical applications related to the regeneration of electroactive tissues, particularly in skeletal muscle tissue engineering.

Spontaneous cerebrospinal fluid fistula in the clivus.

INTRODUCTION: Spontaneous cerebrospinal fluid (CSF) fistulas are infrequent and only 10 cases in the literature have been located in the clivus. We describe two new cases of CSF fistulas in this site and review the literature. CASE REPORT: The first patient was a 52-year-old woman referred to our centre for intermittent rhinorrhea that had been diagnosed after an episode of meningitis. The second case was a 69-year-old man who was visited for rhinorrhea of one-year duration; he also developed meningitis during the preoperative study. In both cases, the spontaneous CSF fistula was diagnosed by beta-2-transferrin testing, CT scan and MRI. We performed an endonasal endoscopic transsphenoidal approach and used free grafts and vascularized flaps to close the clival defect. Treatment was successful in both cases. DISCUSSION: The physiopathology of spontaneous CSF fistulas remains unknown. Possible explanations given to date in this location are pulsatility of the basilar artery, repeated Valsalva maneuvers and Marfan's disease, the two latter also related to CSF fistulas in other locations. Closure of a CSF leak towards the nasal cavity is mandatory due to potential complications. Our results support the endoscopic transsphenoidal approach using free grafts and/or pediculated flaps as a good alternative to open surgery.

Mortalidad infantil en un hospital de nivel terciario. Limitación de esfuerzo terapéutico, correspondencia clínico-patológica y precisión diagnóstica / Infant mortality in a third level paediatric hospital. therapeutic effort limitation, clinical-pathological agreement and diagnostic accuracy

Objetivo: Analizar la mortalidad en un hospital infantil de tercer nivel y alta complejidad. Material y métodos: Se revisaron los fallecidos en el Hospital Infantil La Paz durante los años 2007, 2008 y 2009. Se analizaron datos epidemiológicos, diagnósticos clínicos y de autopsia y su correspondencia, y si se llegaba a un diagnóstico etiológico definitivo. La limitación del esfuerzo terapéutico y la previsibilidad del fallecimiento también fueron recogidas. Las variables fueron prospectivamente definidas al inicio. Resultados: Se estudiaron 253 fallecimientos (6,08 por mil ingresos). El 43,4% eran menores de 1 mes y el 63,9% menores de un año. La patología neonatal y la hemato-oncológica fueron las causas más frecuentes. Fallecieron en las tres unidades de cuidado intensivo el 87%. Se practicó autopsia a 53% de los fallecidos y se detectó un 7,8% de nuevos hallazgos significativos, aunque solo en un caso podría el tratamiento haber modificado el pronóstico. Limitación de esfuerzo terapéutico y cuidado paliativo se instauró en el 41,9%. El fallecimiento era esperado al inicio del proceso en 83,9%, En 92% se consideró que existía un diagnóstico definitivo y en 86,4% un diagnóstico etiológico de los procesos que condujeron al fallecimiento. Conclusiones: El análisis de la mortalidad hospitalaria permite evaluar la calidad de la asistencia pediátrica y detectar resultados adversos. La autopsia continúa proporcionando información relevante. La limitación de esfuerzo terapéutico y cuidado paliativo es una medida cada vez más frecuente en la edad pediátrica. El número de niños que muere sin diagnóstico etiológico sigue siendo alto(AU)

Objective: To study infant and child mortality in a third level children's hospital treating highly complex patients. Patients and methods: All children dying in the period 2007- 2009 at La Paz Children's Hospital were evaluated. Epidemiological data, autopsy rate, clinical and autopsy diagnoses and their correspondence and the number of, patients with precise final diagnoses were analysed. Therapeutic effort limitation and palliative care were also evaluated as well as if the final result was expected according to the initial disease or clinical condition of the patients. All the variables were prospectively defined at the start of the study period. Results: A total of 253 cases (6.08‰ admissions) were analysed. The two leading causes of death were disorders related to prematurity and low birth weight, and haematology oncology malignant diseases. Most patients (87%) died in an intensive care unit (neonatal or paediatric). During the study period 134 autopsies (53%) were performed, and new clinically significant findings were observed in 12 of these (7.8%) but in only one case the treatment could have possibly modified the prognosis (class I discrepancy). Therapeutic effort limitation and palliative care were implemented in 41.9%. Death was initially expected in 83.9% of cases. An accurate final diagnosis was defined in 92%, and the aetiology of the disease was considered to be identified in 86.4% of all deaths. Conclusions: Hospital mortality analysis is useful to evaluate the quality of the paediatric care and to detect adverse results that could be corrected. Paediatric autopsy continues to provide clinically significant data for paediatricians and families. Therapeutic effort limitation and palliative care is increasingly applied in paediatric end of life care. The number of infants and children dying without a final aetiological diagnosis is still considerably high(AU)

[Infant mortality in a third level paediatric hospital. therapeutic effort limitation, clinical-pathological agreement and diagnostic accuracy]. / Mortalidad infantil en un hospital de nivel terciario. Limitación de esfuerzo terapéutico, correspondencia clínico-patológica y precisión diagnóstica.

OBJECTIVE: To study infant and child mortality in a third level children's hospital treating highly complex patients. PATIENTS AND METHODS: All children dying in the period 2007- 2009 at La Paz Children's Hospital were evaluated. Epidemiological data, autopsy rate, clinical and autopsy diagnoses and their correspondence and the number of, patients with precise final diagnoses were analysed. Therapeutic effort limitation and palliative care were also evaluated as well as if the final result was expected according to the initial disease or clinical condition of the patients. All the variables were prospectively defined at the start of the study period. RESULTS: A total of 253 cases (6.08‰ admissions) were analysed. The two leading causes of death were disorders related to prematurity and low birth weight, and haematology oncology malignant diseases. Most patients (87%) died in an intensive care unit (neonatal or paediatric). During the study period 134 autopsies (53%) were performed, and new clinically significant findings were observed in 12 of these (7.8%) but in only one case the treatment could have possibly modified the prognosis (class I discrepancy). Therapeutic effort limitation and palliative care were implemented in 41.9%. Death was initially expected in 83.9% of cases. An accurate final diagnosis was defined in 92%, and the aetiology of the disease was considered to be identified in 86.4% of all deaths. CONCLUSIONS: Hospital mortality analysis is useful to evaluate the quality of the paediatric care and to detect adverse results that could be corrected. Paediatric autopsy continues to provide clinically significant data for paediatricians and families. Therapeutic effort limitation and palliative care is increasingly applied in paediatric end of life care. The number of infants and children dying without a final aetiological diagnosis is still considerably high.

Corrección del pectus excavatum complicado con apoyo de circulación extracorpórea (CEC) / Correction of the complicated pectus excavatum with extracorporeal circulation (ecc) support

Introducción. La complicación más grave en la cirugía del pectusexcavatum es la posible perforación cardiaca. Tras la resolución de ésta ,es muy probable que la recidiva del excavatum sea más severa debido ala intensa fibrosis retroesternal que se genera, involucrando estructuras cardiacas y fijándolas al esternón. La reintervención requiere realizar modificaciones de las técnicas habituales y especial monitorización por el riesgo incrementado de lesión cardiaca y de los grandes vasos. Presentamos 2 pacientes con pectus excavatum severo e intento de corrección previo con perforación cardiaca .Casos clínicos. Caso 1. Varón de 16 años con índice de Haller 9,9,diagnosticado de S. de Ehlers-Dan los e intervenido en periodo neonatal de patología cardiaca, con intento de corrección previo con técnicade Ravitch, que recidivó, y perforación cardiaca durante el mismo. Caso 2. Mujer de 11 años, con antecedentes de hernia diafragmátic y perforación cardiaca al introducir la barra de Nuss a los 5 años devida, con índice de Haller 5,5.Ambos fueron intervenidos bajo CEC con colaboración del Servicio de Cirugía Cardiaca y tras esternotomía media se liberaron adherencias cardiacas. Tras ello se introdujo barra de Nuss y se procedió a (..) (AU)

Introduction. The most serious complication in surgery of the pectusexcavatum is the possible cardiac perforation. After its resolution, it is very likely that the relapse of the excavatum will be more severe dueto the intense retrosternal fibrosis generated, involving cardiac structures and fixing them to the sternum. Reintervention requires modifications of the usual techniques and special monitoring due to the increased risk of cardiac and large vessel lesions. We present the case of 2 patients with severe pectus excavatum with (..) (AU)

[Correction of the complicated pectus excavatum with extracorporeal circulation (ECC) support]. / Corrección del pectus excavatum complicado con apoyo de circulación extracorpórea (CEC).

INTRODUCTION: The most serious complication in surgery of the pectus excavatum is the possible cardiac perforation. After its resolution, it is very likely that the relapse of the excavatum will be more severe due to the intense retrosternal fibrosis generated, involving cardiac structures and fixing them to the sternum. Reintervention requires modifications of the usual techniques and special monitoring due to the increased risk of cardiac and large vessel lesions. We present the case of 2 patients with severe pectus excavatum with a previous attempt for correction with cardiac perforation. CLINICAL CASES: Case 1. A 16 year old male with Haller index 9.9, diagnosed of Ehlers-Danlos syndrome and operated on in neonatal period of cardiac disease, with previous attempt for correction using the Ravitch technique that relapsed and cardiac perforation during it. Case 2. An 11 year old girl, with background of diaphragmatic hernia and cardiac perforation on introducing the Nuss bar at 5 years of age, with Haller index 5.5. Both were operated on under ECC with the collaboration of the Cardiac Surgery Service and cardiac adherences were released after median sternotomy. After it, the Nuss bar was introduced and then sternal closure was performed with reinforced steel wires with titanium plates in the anterior and posterior part. DISCUSSION: The backgrounds of the cardiac approach complicate the intervention for the correction of the pectus excavatum, with a high risk of cardiac trauma. Counting on the support of the cardiac surgery and the ECC, we achieve an adequate control and prediction of the complications

Cirugía de arco aortica en neonatos y lactantes con perfusión cerebral selectiva: resultados a corto y medio plazo (AU) / Aortic arch surgery with selective cerebral perfusion in neonates and infants. Short and middle term results

Introducción: La cirugía de arco aórtico en neonatos y lactantes históricamente se realizaba con circulación extracorpórea, hipotermia profunda y parada circulatoria total, que como complicación pueden causar daño cerebral. Las técnicas de perfusión cerebral selectiva (PSC) permiten reducir o eliminar la parada, protegiendo al cerebro que recibe en todo momento sangre oxigenada. Presentamos nuestra experiencia con estas operaciones. Métodos: Estudio retrospectivo de 40 pacientes con reconstrucción quirúrgica de la arco aórtico desde 2002 hasta 2009, empleando técnicas de PSC. Análisis de distintas variables con especial interés en la cirugía realizada y en los resultados a corto-medio plazo. Estudio estadístico con SPSS versión 15.0. Resultados: Edad: 1,3 ± 2,4 meses; peso 3,4 ± 1,7 kg; 55% varones. Cardiopatía asociada en un 90%. Morfología del arco aórtico: hipoplásico 62%; interrumpido 30%; recoartación postquirúrgica en 2 niños. El 82% necesitaron prostaglandinas intravenosas. La anastomosis aórtica fue terminolateral (avance aórtico) en el 77,5%, termino terminal en el 17,5% y aortoplastia con parche en el 5%. La PSC duró 36 ± 11 minutos a 23º C rectales, canulando el tronco braquiocefálico en el 47%, reduciendo los flujos a 30-40 ml/kg/min. La monitorización cerebral se hizo con presión radial derecha y saturación cerebral (INVOS). La mortalidad hospitalaria fue del 10% y la tardía del 2,7%. Durante la estancia hospitalaria concurrieron: lesión del recurrente 38%, reintervención por recoartación precoz 5%, e infarto cerebral 2,8%. El seguimiento medio es de 26 ± 21 meses. En la evolución posterior se recortaron 3 pacientes (8%) precisando 2 de ellos angioplastia percutánea. Conclusiones: La PSC en la reconstrucción del arco aórtico permite al cirujano gran precisión, minimizando el riesgo de injuria cerebral. La mortalidad hospitalaria es aceptable y en cuanto a la morbilidad destaca la lesión del nervio recurrente asociado a la movilización aórtica y a la resección ductal. La evolución posterior es buen estando el 92% de los pacientes libres de recoartación (AU)

Background: Infantil and neonatal aortic arch surgery historically has been performed with deep hypothermia and cirucularoty arrest (DHCA). Neurodevelopment impairment could be a side effect of DHCA. Antegrade cerebral perfusion (ACP) techniques let us reduce or even not use DHCA, so protecting the brain form hypoxic ischemic injury. We revise our experience with these operations. Methods: Retrospective study of 40 patients with aortic arch surgery from 2002 until 2009, using ACP. We analyze operative techniques, surgical results, morbid-morbidity and follow-up. Statistical study with SPSS 15.0. Results: Age: 1,3 ± 2,4 months; weigh: 3,4 ± 1,7 kg; 55% males. Cardipathy associated in 90%. The aortic arch was hypoplastic in 62&, interrupted in 30%, and was restenosed post surgery in 2 patients. Intravenous prostaglandins were used in 82%. Aortic arch anastomosis was termino-lateral in 77,5%, termino-terminal in 17,5% and patch aortoplaty in 5%. ACP duration was 36 ± 11 minutes, 23ºC rectal, with in nominate artery cannulation in 47%, and flow reduced to 30-40 ml/kg/min. Brain monitorization used right radial artery pressure and cerebral saturation (INVOS). Hospital mortality was 10%. Hospital morbidity: Vocal cord paralysis in 38%, recoarctation with reoperation in 5%, and brain stroke in 2,8%. Mean follow-up was 26 ± 21 months, with 2,7% mortality, and 3 patients with recoarctation (8%, percutaneous angioplasty performed in 2 children). Conclusion: Aortic arch surgery with ACP minimize neurologic injury. Hospital mortality is acceptable, but vocal cord paralysis is still an important problem, probably caused during aortic dissection. After hospital stay the evolution is good with 92% patients free of recoarctation (AU)

Tratamientos actuales aplicables a la transposición de las grandes arterias / Current treatment of complete transposition of the great arteries

Las distintas variantes de trasposición completa de grandes arterias (GA) constituyen el 8% del total de cardiopatías congénitas. Además, la TGA es la primera causa de cianosis neonatal de origen cardíaco. Por su frecuencia y homogeneidad, la corrección anatómica de la TGA simples es el principal marcador de calidad de un programa de cirugía cardíaca neonatal. Se incide en aspectos fisiopatológicos, diagnóstico y de manejo pre y postoperatorio y se revisan históricamente las diferentes técnicas quirúrgicas que se han empleado para reparar las TGA simples y complejas, hasta la corrección anatómica (operación de Jatene). Se analiza la mejora en la mortalidad hospitalaria y tardía hasta llegar a la excelencia situación actual, que ha variado el ominosos pronóstico de esta cardiopatía, abandonada a su evolución natural. En cualquier caso, los pacientes portadores de una TGA reparada, aún asintomáticos y sin tratamiento farmacológico, necesitarán revisiones cardiológicos de por vida (AU)

Different forms of transposition of the great arteries are a common form (8%) of congenital heart disease, being the primary cause of neonatal cardiac cyanosis. The anatomic correction of simple TGA is the main quality marker of any programme of neonatal cardiac surgery. We review pathophysiology, the improvent of pre and postoperative care, diagnostic criteria and the different surgical techniques, till the anatomic correction (arterial switch operation). Actually, hospital and late results are excellent, but even asympthomatics patients with a corrected TGA need cardiology follow-up for ever (AU)

[Strategy for high cavoatrial tumor thrombus in children with nephroblastoma]. / Tratamiento del nefroblastoma con trombosis tumoral cavoatrial en niños.

INTRODUCTION: Wilms tumor surgery with intracaval-atrial extension is a challenge. Modern imaging techniques, precise preoperative thrombus location, and multidisciplinary surgical approach is mandatory. We aim to evaluate the outcome of our patients. PATIENTS AND METHODS: Between 1992 and 2005, 52 patients with nephroblastomas underwent surgery in our institution. Nine of them had renal-caval (RC) or cavo-atrial(CA) thrombus extension. Four patients presenting short RC intravascular extension were excluded. RESULTS: All cases were treated with pre-postoperative chemotherapy SIOP protocols. The level of the extension was retrohepatic in 2 cases, atrial in 3 patients and it even reached the ventricle in 2 of them. A multidisciplinary team was necessary to plan surgery and in all patients thrombus and tumor could be removed under cardiopulmonary by-pass in 3 cases (CPBP). One pulmonary tamponade due to thrombus migration (CAV) occurred and was solved by CPBP. Three cases were stage III, one stage IV and 1 stage II. Conclusions. Tumor size can be significantly reduced by preoperative chemotherapy. In case of CA extension, CPBP and right liver displacement to gain access to retro-hepatic cava are mandatory in order to reduce surgical complications.

Tratamiento del nefroblastoma con trombosis tumoral cavoatrial en niños / Strategy for high cavoatrial tumor thrombus in children with nephroblastoma

Introducción. El tratamiento quirúrgico del tumor de Wilms con extensión cavo-atrial es aún un reto para el cirujano. Es fundamental el empleo de las técnicas de imagen actuales, la localización preoperatoria exacta del trombo y un equipo quirúrgico multidisciplinar. El objetivo de nuestra revisión es evaluar el resultado en estos pacientes. Pacientes y métodos. Entre 1992 y 2005 se intervinieron en nuestro servicio 52 pacientes con nefroblastomas. Nueve de ellos tenían extensión tumoral cavo-renal o cavo-atrial. Excluimos en nuestro estudio a 4 pacientes con extensión extravascular mínima a vena renal. Resultados. Todos fueron tratados con quimioterapia pre y postoperatoria según el protocolo de la SIOP. La extensión intravascular afectaba vena cava en 2 casos, aurícula en 3 pacientes e incluso llegaba a ventrículo en 2 de ellos. En la planificación quirúrgica intervino un equipo multidisciplinar y se consiguió la extirpación del tumor y el trombo en todos, mediante circulación extracorpórea en 3 de ellos. En un paciente se produjo una embolia pulmonar por migración del trombo, que se resolvió mediante circulación extracorpórea. Tres casos fueron estadio III, 1 estadio IV y 1 estadio II. Conclusión. El tamaño tumoral puede reducirse significativamente mediante quimioterapia preoperatoria. En caso de extensión cavoatrial, la circulación extracorpórea y el desplazamiento del lóbulo hepático derecho que permita acceder a la cava retro-hepática, son necesarios para reducir las complicaciones quirúrgicas (AU)

Introduction. Wilms tumour surgery with intracavalatrial extension is a challenge. Modern imaging techniques, precise preoperative thrombus location, and multidisciplinary surgical approach is mandatory. We aim to evaluate the outcome of our patients. Patients and methods. Between 1992 and 2005, 52 patients with nephroblastomas underwent surgery in our institution. Nine of them hadrenal-caval (RC) or cavoatrial (CA) thrombus extension. Four patients presenting short RC intravascular extension were excluded. Results. All cases were treated with pre-postoperative chemotherapy SIOP protocols. The level of the extension was retrohepatic in 2 cases, atrial in 3 patients and it even reached the ventricle in 2of them. A multidisciplinary team was necessary to plan surgery and in all patients thrombus and tumour could be removed under cardiopulmonary by-pass in 3 cases (CPBP). One pulmonary tamponed due to thrombus migration (CAV) occurred and was solved by CPBP. Three cases were stage III, one stage IV and 1 stage II. Conclusions. Tumor size can be significantly reduced by preoperative chemotherapy. In case of CA extension, CPBP and right liver displacement to gain access to retro-hepatic cava are mandatory in order to reduce surgical complications (AU)

First Report of Lasiodiplodia theobromae Associated with Decline of Grapevine Rootstock Mother Plants in Spain.

A field of Richter 110 rootstock mother plants in Valencia Province (eastern Spain) was surveyed during November 2006 to study the mycoflora of declining plants. Two canes with stunted leaves were collected from a plant with a reduced number of shoots. No cankers or vascular lesions were observed in the collected canes. Six wood chips (1 to 2 mm thick) were taken from one basal fragment (3 to 4 cm long) of each cane, surface sterilized in 70% ethanol for 1 min, and plated on malt extract agar supplemented with 0.5 g L-1 of streptomycin sulfate. Petri dishes were incubated for 7 days at 25°C. A fungus was consistently isolated from all samples that showed the following characteristics: colonies grown on potato dextrose agar (PDA) at 25°C developed a white, aerial mycelium that turned gray after 4 to 6 days and produced pycnidia after 1 month on sterile grapevine slivers of twigs placed on the PDA surface; conidia from culture were ellipsoidal, thick walled, initially hyaline, nonseptate, and measuring 20 to 25 (22.5) × 12 to 14 (13) µm; aged conidia were brown, 1-septate with longitudinal striations in the wall; and pseudoparaphyses variable in form and length were interspersed within the fertile tissue. The fungus was identified as Lasiodiplodia theobromae (Pat.) Griffon & Maubl. from the above characteristics (2). Identity was confirmed by analysis of the nucleotide sequences of the internal transcribed spacer (ITS) region from the rRNA repeat and part of the translation elongation factor 1-alpha (EF1-α) and the ß-tubulin (B-tub) genes, as done elsewhere (1,3). BLAST searches at GenBank showed a high identity with reference sequences (ITS: 100%, EF1-α: 97%; B-tub: 99%). Representative sequences of the studied DNA regions were deposited at GenBank (Accession Nos.: ITS: EU254718; EF1-α: EU254719; and B-tub: EU254720). A pathogenicity test was conducted on 1-year-old grapevine plants cv. Macabeo grafted onto Richter 110 rootstocks maintained in a greenhouse. A superficial wound was made on the bark of 10 plants with a sterilized scalpel, ≈10 cm above the graft union. A mycelial plug obtained from the margin of an actively growing fungal colony (isolate JL664) was placed in the wound and the wound was wrapped with Parafilm. Ten additional control plants were inoculated with sterile PDA plugs. All control plants grew normally, and the inoculation wound healed 3 months after inoculation. Plants inoculated with L. theobromae showed no foliar symptoms in the same period, but developed cankers variable in size surrounding the inoculation sites. Vascular necroses measuring 8.4 ± 1.5 cm (mean ± standard error) developed in the inoculated plants that were significantly longer than the controls (0.3 ± 0.2 cm). The pathogen was reisolated from all inoculated plants and no fungus was reisolated from the controls. These results confirmed the pathogenicity of L. theobromae to grapevine and points to a possible involvement of L. theobromae in the aetiology of grapevine decline as previously reported (3,4). To our knowledge, this is the first report of L. theobromae isolated from grapevine in Spain. References: (1) J. Luque et al. Mycologia 97:1111, 2005. (2) E. Punithalingam. No. 519 in: Descriptions of Pathogenic Fungi and Bacteria. CMI, Kew, Surrey, UK, 1976. (3) J. R. Úrbez-Torres et al. Plant Dis. 90:1490, 2006. (4) J. M. van Niekerk et al. Phytopathol. Mediterr. 45(suppl.):S43, 2006.

Acrylic scaffolds with interconnected spherical pores and controlled hydrophilicity for tissue engineering.

Polymer scaffolds are obtained in which the geometric characteristics (pore size, connectivity, porosity) and the physico-chemical properties of the resulting material can be controlled in an independent way. The interconnected porous structure was obtained using a template of sintered PMMA microspheres of controlled size. Copolymerization of hydrophobic ethyl acrylate and hydrophilic hydroxyethyl methacrylate comonomers took place in the free space of the template, different comonomer ratio gave rise to different hydrophilicity degrees of the material keeping the same pore architecture. The morphology of the resulting scaffolds was investigated by scanning electron microscopy (SEM), the porosity of the material calculated, and the mechanical properties compared with those of the bulk (non porous) material of the same composition.

Sinus venosus syndrome: atrial septal defect or anomalous venous connection? A multiplane transoesophageal approach.

OBJECTIVE: To discuss the anatomical features of sinus venosus atrial defect on the basis of a comprehensive transoesophageal echocardiography (TOE) examination and its relation to surgical data. METHODS: 24 patients (13 men, 11 women, mean (SD) age 37 (17) years, range 17-73 years) with a posterior interatrial communication closely related to the entrance of the superior (SVC) or inferior vena cava (IVC) who underwent TOE before surgical repair. Records of these patients were retrospectively reviewed and compared with surgical assessments. RESULTS: In 13 patients, TOE showed a deficiency in the extraseptal wall that normally separates the left atrium and right upper pulmonary vein from the SVC and right atrium. This deficiency unroofed the right upper pulmonary vein, compelling it to drain into the SVC, which overrode the intact atrial septum. In three patients, TOE examination showed a defect in the wall of the IVC, which continued directly into the posterior border of the left atrium. Thus, the intact muscular border of the atrial septum was overridden by the mouth of the IVC, which presented a biatrial connection. In the remaining eight patients, the defect was located in the muscular posterior border of the fossa ovalis. A residuum of atrial septum was visualised in the superior margin of the defect. Neither caval vein overriding nor anomalous pulmonary vein drainage was present. CONCLUSIONS: Sinus venosus syndrome should be regarded as an anomalous venous connection with an interatrial communication outside the confines of the atrial septum, in the unfolding wall that normally separates the left atrium from either caval vein. It results in overriding of the caval veins across the intact atrial septum and partial pulmonary vein anomalous drainage. It should be differentiated from posterior atrial septal defect without overriding or anomalous venous connections.

Pseudo-Clase III. Valoración diagnóstica de una maloclusión atípica (Parte I) / Pseudo-Class III. Diagnostic evaluation of atypical maloclusion (Part I)

La pseudo-Clase III constituye una variante maloclusiva que ha despertado reducido interés entre los ortodoncistas, lo que ha motivado un limitado número de publicaciones sobre ella, así como un reducido volumen de material clínico que pudiera ayudar a caracterizarla de forma precisa. Para algunos autores no merece la consideración de una entidad nosológica per se y es contemplada como una situación maloclusiva circunstancial motivada por un contacto prematuro en el sector incisivo secundario a una malposición de los dientes del sector anterior. Sin embargo, es sabido que toda situación de mordida cruzada anterior que conlleve una protrusión forzada de la mandíbula comporta la posibilidad de inducir un crecimiento anómalo de las bases óseas. Cuando el patrón esquelético inicial del paciente es de Clase I y la posición mandibular forzada se perpetúa en el tiempo a lo largo del período de crecimiento puede producirse una discrepancia máxilomandibular verdadera con un patrón de Clase III. De otro lado, dado el escaso nivel de documentación clínica existente en la literatura a propósito de esta peculiar forma de maloclusión, estudios recientes han intentado dilucidar si existen o no rasgos característicos de la pseudo-Clase III que permitan identificarla desde el punto de vista diagnóstico. Esta circunstancia, unida a su indudable potencial patógeno y, en consecuencia, a la necesidad de ser abordada y tratada en fases tempranas, motiva el presente artículo en un intento de aportar cierto nivel de información que resulte clarificadora o, al menos, de apoyo en la valoración diagnóstica (AU)

[Papillary muscle rupture during subaortic membrane balloon dilatation]. / Rotura de músculo papilar durante la dilatación con balón de una membrana subaórtica.

A 37 year-old female patient underwent catheter-balloon dilation for discrete subaortic stenosis. During the procedure severe mitral regurgitation was produced requiring emergency surgery. Transesophageal and intraoperative findings were posteriormedial papillary muscle rupture. Retrospective viewing of the cineangiogram during balloon inflation revealed distal balloon indentation, corresponding to the injured papillary muscle. This severe complication of the left ventricular outflow tract angioplasty should be avoided by careful positioning of the guidewire and balloon before inflation.

Multiple recurrence of a "sporadic" (non-familial) cardiac myxoma.

This report describes a myxoma with three recurrences, two of them synchronous neoplasms in both atrial chambers, without evidence of familial history or features of the "myxoma complex" (lentiginosis, other non-cardiac myxomas and endocrine overactivity). The patient underwent complete resection of the myxoma with their surrounding tissue 3 times between 1983 and 1992. At the time of writing no other myxoma has been diagnosed in this patient.

Situs inversus and myocardial revascularization. Case report.

This report describes an internal mammary artery by-pass grafting to the anterior descending coronary artery in a man with an unstable postinfarction angor pectoris and a "situs inversus totalis" condition. The association of "situs inversus totalis" and atherosclerotic coronary artery disease has the same incidence as in normal people. To the authors' knowledge, this is the second case in medical literature of coronary artery by-pass surgery with internal mammary artery graft in a patient with "situs inversus totalis".

Giant left atrial myxoma: case report.

This report describes the case of a 40 year old woman with a giant left atrial myxoma. Only a thin path of 9 mm diameter allowed blood flow through the left atrial chamber to the left ventricle. Despite this obstruction, the patient developed only minimal symptoms. Echocardiography, especially transoesophageal mode is the diagnostic procedure of choice to detect these tumours. The giant mass was successfully removed and the patient is doing well two years after surgery.