Anatomical and biomechanical factors of osteoporotic vertebral fracture and the occurrence of cascade fractures. / Factores anatómicos y biomecánicos de la fractura vertebral osteoporótica y la aparición de las fracturas en cascada.

Osteoporosis weakens the structural strength of bone to such an extent that normal daily activity may exceed the capacity of the vertebra to bear this load. Vertebral fracture and deformity is a hallmark of osteoporosis. The detriment of trabecular bone properties alone cannot explain the occurrence of osteoporotic vertebral fracture. The ability of the spine to bear and resist loads depends on the structural capacity of the vertebrae, but also on loading conditions arising from activities of daily living or low-energy trauma. This review describes the mechanical properties of the vertebral bone, the structural load-bearing capacity of the various elements forming the spine, the neuromuscular control of the trunk, as well as the biomechanics of the loads to which the spine is subjected in relation to the presence of osteoporosis and the risk of vertebral fracture. A better understanding of biomechanical factors may help to explain both the high incidence of osteoporotic vertebral fractures and their mechanism of production. Consideration of these issues may be important in the development of prevention and management strategies.

Clinical and Sociodemographic Features of Alopecia Areata in Five Colombian Cities: An Analysis of the RENAAC Registry.

BACKGROUND: Alopecia areata (AA) is an autoimmune disease characterized by non-scaring hair loss and preservation of hair follicles. The information available on disease course, and clinical features of AA is scarce worldwide, and almost nonexistent in Colombia. OBJECTIVE: To determine the clinical and sociodemographic characteristics of patients diagnosed with AA who presented to a dermatology consultation in five Colombian cities. MATERIAL AND METHODS: This was a retrospective and multicenter study on data from an ongoing National Registry of Alopecia Areata in Colombia (RENAAC) collected in Bogota, Cali, Cartagena, Barranquilla, and Medellin, Colombia from March 2022 through April 2023. Data was recorded in a standardized form by trained physicians. The variables were expressed as measures of central tendency and dispersion, and absolute and relative frequencies. RESULTS: A total of 562 patients were included, 59.4% of whom were women, aged between 15 and 49 years (63.9%) with a mean disease course of 1.7 years. The most common finding was multiple plaque (53.2%), the predominant AA subtype was patchy (71.4%), and 29.5% of the patients had a past dermatological history, 18.3% had a past endocrinological history, and 8.9% had a past psychiatric history. The treatments most widely used were steroid injections (76.4%), 5% topical minoxidil (46.4%), followed by high-potency corticosteroids (42.5%). STUDY LIMITATIONS AND CONCLUSIONS: AA was slightly predominant in women. As seen in other populations, this disease had an earlier onset in men vs women. Presentation in pediatric age was uncommon. The previous history of other dermatological diseases was checked in almost one third of the patients. Analysis of the co-presentation of AA with other autoimmune diseases is biased due to excluding patients with systemic erythematous lupus from the study.

Muscle of dark and normal beef differs metabolically.

Reduction in muscle glycogen triggered by adverse antemortem handling events alters postmortem energy metabolism and results in a high ultimate pH and dark, firm and dry beef, often referred to as 'dark-cutting'. However, the relationship between atypical dark (AT) beef, postmortem energy metabolism and underlying tissue characteristics remains somewhat unclear. Cattle harvested in the US and Canada representing normal (pH < 5.6), AT dark (pH 5.6-5.8) and dark cutting (DC; pH > 5.8) beef were analyzed for tissue characteristics related to energy metabolism. Results show AT dark beef is more oxidative but similar to normal beef in glycolytic potential and nucleotide abundance. Mitochondria DNA content (P < 0.05, Canada; P < 0.005, US) and oxidative enzymes for DC and AT dark beef were greater (P < 0.01; Canada and US) compared to normal beef. Myoglobin tracked (P < 0.01) with color classification. These findings show both DC and AT beef are inherently more oxidative and raise the possibility that more oxidative muscle may be more prone to develop dark beef.

[Prognostic power of soluble urokinase plasminogen activator receptor (suPAR) for short-term mortality in patients seen in Emergency Departments due to infections]. / Poder pronóstico de mortalidad a corto plazo del receptor soluble activador del plasminógeno tipo uroquinasa (suPAR) en los pacientes atendidos en urgencias por infección.

OBJECTIVE: To analyse and compare 30-day mortality prognostic power of several biomarkers (C-reactive protein, procalcitonin, lactate and suPAR) in patients seen in emergency departments (ED) due to infections. Secondly, if these could improve the accuracy of systemic inflammatory response syndrome (SIRS) and quick Sepsis-related Organ Failure Assessment (qSOFA). METHODS: A prospective, observational and analytical study was carried out on patients who were treated in an ED of one of the eight participating hospitals. An assessment was made of 32 independent variables that could influence mortality at 30 days. They covered epidemiological, comorbidity, functional, clinical and analytical factors. RESULTS: The study included 347 consecutive patients, 54 (15.6%) of whom died within 30 days of visiting the ED. SUPAR has got the best biomarker area under the curve (AUC)-ROC to predict mortality at 30 days of 0.836 (95% CI: 0.765-0.907; P <.001) with a cut-off > 10 ng/mL who had a sensitivity of 70% and a specificity of 86%. The score qSOFA ≥ 2 had AUC-ROC of 0.707 (95% CI: 0.621-0.793; P < .001) with sensitivity of 53% and a specificity of 89%. The mixed model (suPAR > 10 ng/mL plus qSOFA ≥ 2) has improved the AUC-ROC to 0.853 [95% CI: 0.790-0.916; P < .001] with the best prognostic performance: sensitivity of 39% and a specificity of 97% with a negative predictive value of 90%. CONCLUSIONS: suPAR showed better performance for 30-day mortality prognostic power from several biomarkers in the patients seen in ED due to infections. Score qSOFA has better performance that SRIS and the mixed model (qSOFA ≥ 2 plus suPAR > 10 ng/mL) increased the ability of qSOFA.

Differences in native and introduced chalcid parasitoid communities recruited by the invasive chestnut pest Dryocosmus kuriphilus in two Iberian territories.

Dryocosmus kuriphilus (Hymenoptera: Cynipidae) is a global invasive gall wasp and a pest of chestnuts (Castanea spp.). A study of the Chalcidoidea parasitoid community of D. kuriphilus was undertaken over two years, from March 2017 to March 2019, at 15 sites in south and northwest Spain (Málaga and Galicia regions). More than 18,000 galls were collected, and 1153 parasitoids belonging to 22 species of seven chalcidoid families, plus two individuals of an inquiline Cynipidae, Synergus facialis, emerged. Richness was higher in the Málaga region, with 20 species, while 17 parasitoids and one inquiline were identified in Galicia. The parasitism rate of native chalcid parasitoid species in both regions was low. Eupelmus urozonus and Mesopolobus lichtensteini were the most abundant native species. Mesopolobus tibialis was a dominant species in south Spain, while Ormyrus pomaceus was a dominant species in northwest Spain. Our results revealed the existence of a sub-community of univoltine, probably host specialized, parasitoids in south Spain, which overwinter in galls, exhibiting a similar life cycle to Torymus sinensis. These species were Torymus notatus, Aulogymnus bicolor, Aulogymnus obscuripes and Aulogymnus balani. Data on the recovery of T. sinensis after release in the south Spain region show it to be well established, but its numbers are still low in northwest Spain.

Resting state functional magnetic resonance imaging in attention deficit hyperactivity disorder. / Resonancia magnética funcional de reposo en el trastorno por déficit de atención e hiperactividad.

OBJECTIVE: To explore whether children and adolescents with attention deficit/hyperactivity disorder (ADHD) have altered the functional connectivity between the executive control network and the default mode network. METHODS: Exploratory study of a diagnostic test, prospective, case and control design. A total of 56 participants were recruited consecutively (29 inattentive or combined ADHD subtype and 27 controls) between 7 and 16 years old, male, right dominance. DSM-5 was applied as reference test and a battery of neuropsychological tests to confirm the diagnosis and assess comorbidities. Resting state functional magnetic resonance imaging was performed as an index test. The application and evaluation of the tests was blind. The brain regions were chosen a priori and the region of interest technique was used. The functional connectivity of the anterior cingulate cortex (ACC) was evaluated with: the precuneus (P), the posterior cingulate cortex (PCC) and the dorsomedial prefrontal cortex (DMPC). RESULTS: The functional connectivity in each of the associations evaluated in the patients with ADHD compared with the controls were: P_D=0.41 vs 0.44; CCP_D=0.43 vs 0.53; CPDM_D=0.75 vs. 0.79; P_I=0.40 vs 0.41; CCP_I=0.48 vs 0.53; CPDM_I=0.76 vs. 0.72). D: right side I: left side. Value of p> 0.05. CONCLUSION: Cerebral functional connectivity at rest is lower in ADHD patients when compared with healthy controls, however, the difference was not statistically significant.

Effects of immunocastration and a ß-adrenergic agonist on retail cuts of feedlot finished Nellore cattle.

Immunocastration (ImC) has been proposed as an animal welfare-friendly alternative to reduce sexual and aggressive behavior and to increase carcass fat deposition with positive effects on meat quality. The ß-adrenergic agonists (ß-AA) are known as repartitioning agents that acts increasing lean tissue deposition. The combined use of these technologies can positively affect meat quality and increase retail cuts yield. Thus, this research was conducted to evaluate the combined effects of ImC and ß-AA (zilpaterol hydrochloride (ZH) and ractopamine hydrochloride (RH)) on retail cuts, bones, and fat trim of feedlot finished Bos indicus (Nellore) cattle. No interaction was observed between sexual condition and diet for any trait. The ImC decreased cold carcass, hindquarter (HQ), forequarter (FQ) and combined brisket, short ribs and flank (BSF) weights. The ImC also showed smaller weights of retail cuts and bones on the HQ and on the FQ than non-castrated (NoC). Fat trim weights did not differ from ImC and NoC. The most of subprimal cuts were heavier in NoC than in ImC. Feeding ß-AA did not affect cold carcass weight; however, animals fed ZH had higher weights of HQ and retail cuts in HQ when compared with RH and control (CO) group, with no differences between RH and CO for both traits. The weights of FQ, BSF, retail cuts in FQ, as well as bones and fat trimmings were not affected by ß-AA. In summary, ImC decreases carcass and retail cut weights, whereas ZH supplementation leads to an improvement in carcass lean tissue and retail cuts.

Effects of immunocastration and ß-adrenergic agonists on the performance and carcass traits of feedlot finished Nellore cattle.

ß-Adrenergic agonists (ß-AA) are non-hormonal growth promoters which promote muscle hypertrophy in supplemented animals. The effects of two ß-AA in combination with the immunocastration technique on the performance and carcass traits were evaluated using 96 feedlot Nellore males in a randomized complete block design with two sex conditions (immunocastrated (IC) v. non-castrated (NC)) and three treatments: CON (no ß-agonists added), RH (300 mg of ractopamine hydrochloride/day, for 33 days) or ZH (80 mg of zilpaterol·hydrochloride animal/day for 30 days, removed 3 days for required withdrawal period). The trial was carried for 100 days where in the first 70 days animals did not receive ß-AA (phase 1) and during the last 30 days they were treated with ß-AA (phase 2). The performance and ultrasound measurements of longissimus muscle area (LMA), backfat thickness (BFT) and rump fat thickness (RFT) were evaluated in both phases. No sex condition v. treatment interactions were observed for any trait. The NC animals had higher average daily gain (ADG) and final BW than the IC animals, but they did not differ in dry matter intake (DMI) and feed efficiency (gain to feed). The NC animals showed greater LMA (P=0.0001) and hot carcass weight (P=0.0006), and smaller BFT (P=0.0007), RFT (P=0.0039) and percentage of kidney, pelvic and heart fat (P<0.0001) when compared with IC animals. The animals fed ZH showed greater ADG (P=0.0002), G : F (P<0.0001) and dressing per cent (P=0.0136) than those fed RH and CON diets. No differences in BW and DMI were observed. A interaction between treatment and time on feed was observed for LMA and BFT, in which the animals fed ZH diet showed greater LMA (P<0.01) and lower BFT (P<0.01) at 100 days than the animals fed RH and CON diets, whereas RH and CON diets did not differ. Immunocastration decreases muscle development and increases carcass finishing. In contrast, ß-AA increases muscle and decreases fat deposition. The ZH has a higher action on the muscle metabolism than animals fed RH diet. However, RH diet achieves a better balance because it has an intermediary performance between non-supplemented and ZH animals and does not decrease the carcass fat.

Evolución de la demanda ambulatoria del sector público de la ciudad de Corrientes en el período 1991-2013 / Evolution of public sector demand ambulatory City Corrientes in the period 1991-2013

La estrategia de atención primaria de la salud (APS) promueve fuertemente el rol del primer nivel de atención (PNA) como puerta de entrada al sistema; siendo su utilización un indicador de importancia que tiene dentro del sistema. A fin de evaluar la tendencia y distribución de demanda ambulatoria del subsector público en la ciudad de Corrientes (CCtes.), se analizaron las consultas externas del período 1991-2013 según los Anuarios de Estadísticas de la Provincia. Se utilizaron datos censales y proyecciones de población. Se evaluó la tendencia de utilización mediante el número de consultas en ambos niveles y tasas poblacionales. En el período la población de la CCtes. creció un 81,20 %; en tanto, el incremento de las consultas fue del 51,66 %: un 99,27 % las hospitalarias y 21,55 % las del PNA. En el primer trienio del período las consultas fueron superiores en el PNA. Luego la relación se invirtió y sólo volvió a superar el PNA al hospital en dos oportunidades: en el año 1998 y el período 2004-2007. Finalmente, se observa una recuperación en los últimos cuatro años observados. Las tasas provinciales pasaron de 3,5 a 5,0 consultas/habitantes/año; en tanto en la CCtes. pasó de 5,0 a 5,2 consultas/habitantes/año. Se concluye que en la CCtes., según las tasas, la utilización no ha variado y que el PNA no ha ocupado un lugar de relevancia en la atención ambulatoria

The strategy of primary health care strongly promotes the rol of the first level of attention (FLA) as an entrance door to the system. In order to evaluate the ambulatory demand's tendencies and distribution of the public subsector in the city of Corrientes (CCtes), were analyzed the external consultations from the 1991-2013 period, according to the Anuary of Statistics of the Province. Were used the population's census data and projections. It was evaluated the use's tendency by the consulting number in both levels and population rate. In this period the population of Corrientes grew 81,20%, while the consultation increased a 51,66%: 99,27% in hospitals and 21,55% in FLA. Then the proportion reverts and only surpassed the FLA at hospitals in two periods: in 1998, and between 2004 and 2007. Finally, it was observed a recovery in the last four years considered. The province's rates went from 3,5 to 5,0 consultants/habitants/year, while in CCtes went from 5,0 to 5,2. In concludes that in CCtes, according to rates, the use haven't changed and FLA wasn't relevant in the ambulatory attention

La satisfacción de la atención. Una forma de integrar la comunidad a los servicios de salud / The satisfaction of attention. A way to integrate the community into health services

La integración entre servicios de salud del primer nivel de atención (PNA) y la comunidad es una de las características de la calidad de la atención; y para que ella se concrete es menester que exista satisfacción de la atención por parte de los usuarios. El solo hecho de indagar sobre la misma promueve la inclusión activa de los sujetos al sistema, condición necesaria para el desarrollo de Atención Primaria de la Salud como estrategia. El objetivo del trabajo, aquí reportado, fue explorar la satisfacción de usuarios del PNA de Salas de Atención Primaria de la Salud de la Ciudad de Corrientes (SAPS). Mediante una encuesta estructurada, se entrevistaron a usuarios de dichos servicios indagando sobre: razones de concurrencia a la SAPS y servicios requeridos, opinión sobre la atención recibida de los profesionales y administrativos, y opinión respecto al espacio físico y horarios de atención. El estudio abarcó al 10% de las SAPS, con una muestra de 105 usuarios. Como resultados, se pudo observar satisfacción con la atención recibida de los profesionales y administrativos, aunque con variaciones entre las SAPS. Es destacable el hecho que el 35% de los encuestados no pertenecían al área de referencia de las SAPS; sin embargo, adujeron su desplazamiento por la buena atención de los servicios. Respecto al espacio físico y horarios de atención, un 72% de los encuestados manifestó estar conforme. Un reclamo mayoritario fue que se aumentara la cantidad de profesionales. Las conclusiones de este trabajo fueron: 1) los encuestados están satisfechos con los servicios recibidos y en confianza con el personal (dos condiciones necesarias para el acercamiento de la comunidad a los servicios); 2) existen condiciones funcionales que facilitan la integración entre comunidad y servicios de salud; 3) se observa la necesidad de capacitar al personal en atención al usuario

The integration between first level of attention of health care service (FLA) and the community is one of the characteristics of the attention's quality, and in order for it to happen, the users of the service must be satisfied with it. Just inquiry about this promotes the active inclusion of the subjects to the system, necessary condition for the FLA development as a strategy. The objective of this work was explore the FLA user's satisfaction from the Rooms of Primary Health Care (RPHC) in the city of Corrientes (CCtes).The users were asked through a structured survey about: reasons of consultation to the RPHC and required services, opinion about the attention received from professionals and administrative personnel, opinion about the physical space and opening hours. The study included 10% of the RPHC, with a sample of 105 users. As a result, it was observed satisfaction with the attention received from professionals and administrative personnel, although with some variations between RPHC. It is remarkable the fact that 35% of the surveys didn't belong to the area of reference of the respective RPC, awarding this behavior to the nice attention perceived in those services. In reference to the physical space and opening hours, about 72% manifest agreement. A pronounced complain was the increase of professionals available. The conclusions of this work were: 1) the consulted were satisfied with the received services and with the relationship with the personnel (tow necessary conditions for the approach of the community to the services); 2) there are functional conditions that facilitates the integration between community and health care services; 3) it's observed the necessity to capacitate the personnel in customer care.Key words: satisfaction of attention, quality of attention, integration

The mobility gap between older men and women: the embodiment of gender.

OBJECTIVES: To present the study design and baseline results of the longitudinal International Mobility in Aging Study (IMIAS) on gender differences in physical performance and mobility disability prevalence in five diverse societies. METHODS: Data are from surveys on random samples of people aged 65-74 years at Canadian (Kingston, Ontario; Saint-Hyacinthe, Quebec), Mediterranean (Tirana, Albania) and Latin American sites (Natal, Brazil; Manizales, Colombia) (N=1995). Mobility disability was defined as reporting difficulty in walking 400m or climbing stairs. Activities of daily living (ADL) disability was based on any self-reported difficulty in five mobility-related ADLs. The short physical performance battery (SPPB) was used to assess physical performance. Poisson regression models were fitted to estimate prevalence ratios. RESULTS: Age-adjusted prevalence of low SPPB, mobility disability and ADL disability were higher in women than in men in all sites except for Kingston. After adjustment for education and income, gender differences in SPPB and ADL disability attenuated or disappeared in Saint-Hyacinthe and Manizales but remained large in Tirana and Natal and mobility disability remained more frequent in women than in men at all sites except Kingston. After further adjustment by chronic conditions and depressive symptoms, gender differences in mobility remained large at all sites except Kingston but only in Tirana did women have significantly poorer physical performance than men. DISCUSSION: Results provide evidence for gender as a risk factor to explain poorer physical function in women and suggest that moving toward gender equality could attenuate the gender gap in physical function in old age.

Multimodal approach to assess tumour vasculature and potential treatment effect with DCE-US and DCE-MRI quantification in CWR22 prostate tumour xenografts.

The aim of this study was to compare intratumoural heterogeneity and longitudinal changes assessed by dynamic contrast-enhanced ultrasound (DCE-US) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in prostate tumour xenografts. In vivo DCE-US and DCE-MRI were obtained 24 h pre- (day 0) and post- (day 2) radiation treatment with a single dose of 7.5 Gy. Characterization of the tumour vasculature was determined by Brix pharmacokinetic analysis of the time-intensity curves. Histogram analysis of voxels showed significant changes (p < 0.001) from day 0 to day 2 in both modalities for kep , the exchange rate constant from the extracellular extravascular space to the plasma, and kel , the elimination rate constant of the contrast. In addition, kep and kel values from DCE-US were significantly higher than those derived from DCE-MRI at day 0 (p < 0.0001) for both groups. At day 2, kel followed the same tendency for both groups, whereas kep showed this tendency only for the treated group in intermediate-enhancement regions. Regarding kep median values, longitudinal changes were not found for any modality. However, at day 2, kep linked to DCE-US was correlated to MVD in high-enhancement areas for the treated group (p = 0.05). In contrast, correlation to necrosis was detected for the control group in intermediate-enhancement areas (p < 0.1). Intratumoural heterogeneity and longitudinal changes in tumour vasculature were assessed for both modalities. Microvascular parameters derived from DCE-US seem to provide reliable biomarkers during radiotherapy as validated by histology. Furthermore, DCE-US could be a stand-alone or a complementary technique.

Stellar physics. Observing the onset of outflow collimation in a massive protostar.

The current paradigm of star formation through accretion disks, and magnetohydrodynamically driven gas ejections, predicts the development of collimated outflows, rather than expansion without any preferential direction. We present radio continuum observations of the massive protostar W75N(B)-VLA 2, showing that it is a thermal, collimated ionized wind and that it has evolved in 18 years from a compact source into an elongated one. This is consistent with the evolution of the associated expanding water-vapor maser shell, which changed from a nearly circular morphology, tracing an almost isotropic outflow, to an elliptical one outlining collimated motions. We model this behavior in terms of an episodic, short-lived, originally isotropic ionized wind whose morphology evolves as it moves within a toroidal density stratification.

Hospital and ambulatory management, and compliance to treatment in HIV infection: regional health insurance agency analysis.

OBJECTIVE: We had for objective to study HIV management (hospital, ambulatory, and mixed) and assess compliance with health insurance database. METHOD: We conducted a retrospective study using the French Social Security (CPAM) database. The inclusion criteria were: age>18years of age, at least 2 prescriptions of antiretroviral therapy. RESULTS: Five hundred and seventy-five patients were included: extra-hospital (12), hospital (162), mixed (401). The prescriptions were exclusively hospital issued for 76.2% of the patients. Among the mixed group patients, 91% of treatments were delivered at least once in the community, and 45.6% of biological tests were performed in private laboratories at least once. The sex ratio (2.1 vs. 1.3), the number of patients having switched antiretroviral therapy (36.7% vs. 27.8%), and the frequency of biological tests (3.1 vs. 2.6) were significantly higher in the mixed group compared to the hospital group. The mean compliance was 90% in the hospital group and 91.8% in the mixed group. The compliance was<80% for 104 patients (21.8%). Patients with≥80% compliance were older (46.1years of age vs. 42.7years of age), with more frequent biological tests (3 per year vs. 2.5 per year), and more frequent switches in treatment (35.4% vs. 26.0%). CONCLUSION: Prescriptions of ARV were almost exclusively hospital issued. Their dispensation and biological tests were split between hospital and extra-hospital settings. Most patients demonstrated an optimal compliance. The CPAM database allows describing HIV management and assessing compliance.

Informe alta enfermería: historia clínica integral / No disponible

Mediante la elaboración de nuestro trabajo pretendemos unificar criterios de actuación, fomentar el desarrollo de nuestra profesión mediante la práctica de la enfermería basada en la evidencia, garantizando la comunicación entre profesionales de enfermería de diferentes niveles de salud, mejorando la calidad de los cuidados proporcionados, promoviendo el trabajo en equipo, siempre en beneficio del paciente (AU)

With our paper we aim to unify action criteria, promote the development of our job by means of nursing practice based on evidence, guarantying the communication among nurse professionals of different health roles, improving the quality of cares delivered, promoting teamwork, always for the patients interest (AU)

Esporotricosis en niños. Estudio de 133casos en el Instituto Dermatológicode Jalisco “Dr. José Barba Rubio” / Sporotrichosis in childhood. A study of 133 cases in the Instituto Dermatológico of Jalisco “Dr. Barba Rubio”

Introducción: La esporotricosis es una micosis causada por Sporothrix schenckii. En las formas cutáneas, es común la inoculación traumática. EnMéxico, el estado de Jalisco es el área con mayor endemia y representa la micosis subcutánea más frecuente.Objetivo: El propósito de este estudio es describir la frecuencia y características clínicas de la esporotricosis en niños, en el Instituto Dermatológico deJalisco “Dr. José Barba Rubio” en los años de 1983 a noviembre del 2006.Material y métodos: Se trata de un estudio clínico retrospectivo, observacional y transversal donde se incluyen pacientes menores de 15 años deedad, con diagnóstico de esporotricosis y confirmado con cultivo positivo a Sporothrix schenckii. Las variables estudiadas fueron edad, sexo, topografía,forma clínica y lugar de procedencia.Resultados: En 23,11 años encontramos 133 casos de esporotricosis en niños, con una frecuencia de 5,7 infantes con esporotricosis por año. Laforma clínica linfangítica se observó en 72 casos (54,1%), la topografía más afectada fueron las extremidades superiores con 57 casos (42,8%). Elgrupo etario más representativo fue el de 13 a 15 años con 43 pacientes (32,4%) y el municipio de Guadalajara fue el más representativo.Concluimos que la esporotricosis en niños menores de 15 años, en nuestro Instituto es la micosis subcutánea más frecuente y representa la casuísticamás grande en México en este grupo de edad (AU)

Introduction: Sporotrichosis is a fungal infection caused by Sporothrix schenckii. In cutaneous sporotrichosis traumatic inoculation is common. Jaliscois the state in Mexico with a highest endemic and this is the most frequent subcutaneous mycosis in the Instituto Dermatológico de Jalisco “Dr. JoséBarba Rubio”. The purpose of this study is to describe the frequency and clinical characteristics of sporotrichosis in childhood at the Institute from1983 to the year 2006.Material and methods: This is a retrospective, observational and transversal clinical study. We included patients under 15 years of age with diagnosisof sporotrichosis confirmed by a positive culture of Sporothrix schenckii.We registered age, sex, topography, clinical form and residency.Results: In the period of 23.11 years we found 133 cases of sporotrichosis in children (5.7 children with sporotrichosis per year). Lymphangitic formwas observed in 72 cases (54.1%), the most affected localization was upper extremities with 57 cases (42.8%). The most frequent age group wasfrom 13 to 15 years of age with 43 patients (32.4%).Conclusions: Sporotrichosis in children under 15 years of age in our Institute of dermatology is the most frequent subcutaneous mycosis and representthe largest report of pediatric cases in Mexico (AU)

Treatment of carotid cavernous fistulas using covered stents: midterm results in seven patients.

BACKGROUND AND PURPOSE: Carotid cavernous fistulas (CCF) can be effectively treated by using different therapeutic alternatives such as detachable balloons and detachable coils, alone or in combination with N-butyl-2-cyanoacrylate (n-BCA) or Onyx. Stents have also been used in an attempt to improve preservation of the parent artery while still occluding the fistula. We present our experience using balloon-expandable covered stents to treat CCF, focusing on arterial wall reconstruction. To our knowledge, this is the first series with midterm follow-up between 3 months and 3.5 years. MATERIALS AND METHODS: From the 46 CCF treated at our institution between November 1998 and September 2006, a total of 7 posttraumatic direct CCF were treated using polytetrafluoroethylene (PTFE)-covered stents between April 2003 and September 2006. Five were treated with covered stents alone. One patient with transection of the internal carotid artery (ICA) first underwent bare stent placement to provide support for the covered stent. One patient had to be treated with coils and n-BCA. RESULTS: Control angiograms obtained in the 7 patients demonstrated occlusion of the fistula and preservation of the ICA in all cases. There was no mortality and no immediate postprocedural morbidity. There was 1 case of morbidity identified at 1-month follow-up with asymptomatic occlusion of the ICA; the other 6 patients had angiographic follow-up between 3 and 42 months (mean, 18.4 months), with persistent occlusion of the fistulas, patent stent grafts, and no significant intimal hyperplasia. CONCLUSIONS: PTFE-covered stents are evolving as a promising intracranial therapeutic alternative to treat CCF and preserve the parent artery by reconstructing the arterial wall. They should be considered in patients in whom fistulas cannot be successfully occluded with detachable balloons or detachable coils. More investigation is required to further develop their specifications and indications.

Utility of point-of-care haemoglobin measurement in the HemoCue-B haemoglobin for the initial diagnosis of anaemia.

Measurement of haemoglobin (Hb) concentration provides a reliable indication of the presence and severity of anaemia. However, other laboratory parameters are usually requested as well, leading to an increase in socio-sanitary costs. Accordingly, this study was undertaken to ascertain the reliability of point-of-care Hb determination with the portable photometer HemoCue-B haemoglobin (HBH) and to evaluate its utility for the initial diagnosis of anaemia. Hb was measured (x3) in 20 venous blood samples diluted with saline (v/v; 1 : 0, 2 : 1, 1 : 1, 2 : 1 and 3 : 1) to obtain a wide range of Hb and in venous and capillary blood samples from 247 primary health care patients. All HBH results were compared with those yielded by the reference cell counter Pentra 120 Retic (ABX). In diluted samples, Hb values obtained with either method were not significantly different (ABX-HBH, -0.01 +/- 0.32 g/dl; 95% CI, -0.04 to 0.028 g/dl) and showed an excellent Pearson's coefficient of correlation (r = 0.992; P < 0.01). HBH provides accurate values if at least 4 mul of blood is loaded into the cuvette. There were no significant differences between Hb measured in venous (v) and capillary (c) blood samples in primary care patients. Eighteen anaemic patients were detected by ABX measurements (7.3%; 15 female/3 male), 18 by HBHv (specificity, 100%; sensitivity, 100%) and 25 by HBHc (eight false positives; one false negative; specificity, 94.4%; sensitivity, 96.5%). Compared with ABX, HBH provides accurate and precise measurements for a wide range of Hb and its use in primary health care seems to be a good method for the initial diagnosis of anaemia.