Pattern formation of spherical particles in an oscillating flow.

We study the self-organization of spherical particles in an oscillating flow through experiments inside an oscillating box. The interactions between the particles and the time-averaged (steady streaming) flow lead to the formation of either one-particle-thick chains or multiple-particle-wide bands, depending on the oscillatory conditions. Both the chains and the bands are oriented perpendicular to the direction of oscillation with a regular spacing between them. For all our experiments, this spacing is only a function of the relative particle-fluid excursion length normalized by the particle diameter, A_{r}/D, implying that it is an intrinsic quantity that is established only by the hydrodynamics. In contrast, the width of the bands depends on both A_{r}/D and the confinement, characterized by the particle coverage fraction ϕ. Using the relation for the chain spacing, we accurately predict the transition from one-particle-thick chains to wider bands as a function of ϕ and A_{r}/D. Our experimental results are complemented with numerical simulations in which the flow around the particles is fully resolved. These simulations show that the regular chain spacing arises from the balance between long-range attractive and short-range repulsive hydrodynamic interactions, caused by the vortices in the steady streaming flow. We further show that these vortices induce an additional attractive interaction at very short range when A_{r}/D≳0.7, which stabilizes the multiple-particle-wide bands. Finally, we give a comprehensive overview of the parameter space where we illustrate the different regions using our experimental data.

Técnicas de radiología intervencionista para el manejo del sangrado uterino anormal (SUA) / Interventional radiology techniques for the management of abnormal uterine bleeding (AUB)

El sangrado uterino anormal (SUA) es una de las patologías ginecológicas más comunes en mujeres en edad reproductiva. El sistema de clasificación de la Federación Internacional de Ginecología y Obstetricia (PALM-COEIN) armoniza las definiciones de los síntomas de hemorragia normal y anormal y clasifica las posibles causas subyacentes en causas estructurales y no estructurales. El objetivo de este manuscrito es revisar el diagnóstico radiológico de cada una de las causas estructurales de sangrado uterino anormal, examinar las indicaciones de las técnicas de radiología vascular intervencionista en el manejo del SUA y conocer el procedimiento de embolización de arterias uterinas, así como sus posibles complicaciones y contraindicaciones.(AU)

Abnormal uterine bleeding is one of the most common gynaecological pathologies in women of reproductive age. The classification system of the International Federation of Gynaecology and Obstetrics (PALM-COEIN) harmonizes the definitions of normal and abnormal bleeding symptoms and classifies possible underlying causes as structural and non-structural. The aim of this manuscript is to review the radiological diagnosis of each of the structural causes of abnormal uterine bleeding, to examine the indications for interventional vascular radiology techniques in the treatment of abnormal uterine bleeding, and to learn about the uterine artery embolization procedure, as well as its possible complications and contraindications.(AU)

Wavelength selection of vortex ripples in an oscillating cylinder: The effect of curvature and background rotation.

We present results of laboratory experiments on the formation, evolution, and wavelength selection of vortex ripples. These ripples formed on a sediment bed at the bottom of a water-filled oscillating cylindrical tank mounted on top of a rotating table. The table is made to oscillate sinusoidally in time, while a constant background rotation was added for some experiments. The changes in bed thickness are measured using a light attenuation technique. It was found that the wavelength normalized with the excursion length depends on both a Reynolds number and the Strouhal number. This differs from straight or annular geometries where the wavelength is proportional to the excursion length. The flow in an oscillating cylinder has the peculiarity that it develops a secondary flow in the radial direction that depends on the excursion length. The effect of this secondary circulation is evident in the radial transport for small values of the Strouhal number or in the orientation of the ripples for strong enough background rotation. Additionally, ripples in an oscillating cylinder present a rich dynamic behavior where the number of ripples can oscillate even with constant forcing parameters.

Correction: Temporal Patterns of Influenza A and B in Tropical and Temperate Countries: What Are the Lessons for Influenza Vaccination?

[This corrects the article DOI: 10.1371/journal.pone.0152310.].

The syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis mimicking an acute stroke.

BACKGROUND AND PURPOSE: The syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL) can present as sudden onset of focal neurological deficits which are clinically and radiologically indistinguishable from an ischaemic stroke. Its diagnosis requires a lumbar puncture (LP), which contraindicates intravenous thrombolytic therapy (IV-tPA). METHODS: All patients referred to our stroke centre as a stroke code resulting in a final diagnosis of HaNDL syndrome from June 2005 to June 2015 were retrospectively analysed. RESULTS: Nine cases were identified: seven women and two men (mean age 27.6 years, range 15-51). Clinical onset consisted of isolated aphasia (two) and aphasia with right hemiparesis/hemiparaesthesia (seven). All patients had headache in the acute setting, lasting 2-12 h. Cranial computed tomography (CT) and CT angiography (CTA) were normal in all patients. Perfusion CT was performed in seven patients, showing left hemispheric focal hypoperfusion in five cases; the remaining two were normal. Five patients were initially diagnosed as stroke and treated uneventfully with IV-tPA. Cranial magnetic resonance imaging within 48 h was normal in all cases. LP performed in all patients showed pleocytosis (range 17-351 cells/mm(3) ), high protein levels (range 0.4-1.6 g/l) and normal glucose levels. All cases recovered within 12 h and suffered a second episode within 72 h. Patients were asymptomatic between episodes and after remission. CONCLUSIONS: The decision to thrombolyse or perform an LP in HaNDL patients mimicking a stroke is difficult in the acute setting. Perfusion CT can provide misleading results and CTA may be useful in ruling out occlusion of a cerebral vessel.

[Decompressive craniectomy in malignant middle cerebral artery infarction. Experience after the implementation of a response protocol]. / Craniectomía descompresiva en el infarto maligno de la arteria cerebral media. Experiencia tras la implantación de un protocolo de actuación.

INTRODUCTION: Descompressive craniectomy (DC) for treatment of malignant infarction of the middle cerebral artery (MIMCA) reduces mortality and increases the probability of favourable outcome. AIM: To present the experience in daily practice after implantation of a clinical protocol of DC. PATIENTS AND METHODS: Prospective register of patients with MIMCA treated with DC. Age, stroke severity -National Institute of Health Stroke Scale (NIHSS) score-, basal characteristics, delay until DC, mortality, modified Rankin Scale (mRS) score at three and twelve months and questionnaire of satisfaction are recorded. RESULTS: From February 2008 to December 2010, 15 patients were treated. Mean age: 60 years (range: 35-69); basal NIHSS, median (p25/p75): 17 (15.5/21), NIHSS before craniectomy: 20 (18/23.5). DC was performed within 48 hours in 8 patients (53.3%). 5 subjects (33.3%) died during in-hospital stay. Mortality was 25% among those treated within 48 hours and 42.9% among those treated later and 37.5% among patients <= 60 years vs 28.6% in older patients. All survivors scored <= 4 in the mRS at three months and expressed satisfaction with surgery despite sequelae. Rate of favourable outcome (mRS <= 3) was higher among patients under 60 (63%) and among those treated before 48 h (50%). CONCLUSION: DC is safe in clinical practice and reduces mortality after MIMCA, especially if it is performed within 48 hours from stroke onset. Benefit appears to be greater in younger patients, but older people may benefit also. The decision to perform DC should be made on an individual basis.

Off-label intravenous thrombolysis in acute stroke.

BACKGROUND AND PURPOSE: Therapy for stroke with intravenous tissue plasminogen activator (IV-tPA) is hampered by tight licensing restrictions; some of them have been discussed in recent literature. We assessed the safety and effectiveness of off-label IV-tPA in the clinical settings. METHODS: Retrospective analysis of all the patients treated with IV-tPA at our Stroke Unit. Patients were divided into two groups by licence criteria [on-label group (OnLG), off-label group (OffLG)]. Primary outcome measures were symptomatic intracranial haemorrhages (sICH), major systemic haemorrhages, modified Rankin scale (mRS) and mortality rate at 3months. RESULTS: Five hundred and five patients were registered, 269 (53.2%) were assigned to OnLG and 236 (46.9%) to OffLG. Inclusion criteria for the OffLG were aged >80 years (129 patients), time from onset of symptoms to treatment over 3h (111), prior oral anticoagulant treatment with International Normalised Ratio≤1.7 (41), combination of previous stroke and diabetes mellitus (14), surgery or severe trauma within 3months of stroke (13), National Institutes of Health Stroke Scale score over 25 (11), intracranial tumours (5), systemic diseases with risk of bleeding (7) and seizure at the onset of stroke (2). No significant differences were identified between both groups regarding the proportion of sICH (OnLG 2.2% vs. OffLG 1.6%, P=0.78) or the 3-month mortality rate (11.1% vs. 19%: odds ratio (OR), 1.49; 95% CI, 0.86-2.55; P=0.14). Multivariate analysis showed no significant differences in functional independence at 3months between both groups (mRS <3 64.3% vs. 50.4%: OR mRS >2 1.7; 95% CI, 0.96-2.5; P=0.07). CONCLUSION: Intravenous thrombolysis may be safe and efficacious beyond its current label restrictions.

Scaling and asymmetry in an electromagnetically forced dipolar flow structure.

A dipolar flow structure is experimentally studied in a layer of salt solution driven by time-independent electromagnetic forcing. In particular, the response of the flow to the forcing is quantified by measuring the Reynolds number Re as a function of the Chandrasekhar number Ch (the ratio of Lorentz forces to viscous forces) and δ (the ratio of vertical to horizontal length scales of the flow domain). In agreement with theoretical predictions, two scaling regimes are found: Re~Ch/π(2) (viscous regime) and Re~Ch(1/2)δ(-1) (advective regime). The transition between the two regimes at Ch(1/2)δ~π(2) is reflected in the flow geometry in the form of an asymmetry of the dipolar flow structure.

Estudio de los bordes de resección en la cirugía conservadora del cáncer de mama. Experiencia en el Hospital de Barbastro / No disponible

Introducción: El objetivo de este estudio es determinar laamplitud del margen obtenido y la tasa de recidiva local en loscarcinomas de mama operados en el hospital de Barbastrocon cirugía conservadora entre 1989 y 2003.Material y métodos: Se han incluido 141 casos, 119 invasoresy 22 intraductales. El margen se ha definido como positivocuando se hallaba afectado por células tumorales, cercanosi era ≤ 1 mm y libre si era > 1 mm. Se evaluó preferentementemediante estudio macroscópico intraoperatorio.Resultados: La media de la edad fue de 57,36 ± 12,32años, del tamaño tumoral 14,7 ± 0,83 mm y del seguimiento86,05 ± 32,62 meses. El margen resultó positivo en 13 casos,6 reintervenidos. Los 7 restantes afectaban a la cara anteriory/o posterior y no se reintervinieron. Treinta y un casostuvieron margen cercano. Han presentado recidiva local ipsilateral3 carcinomas infiltrantes.Conclusiones: El 73% de los casos tienen bordes libres.Nuestra tasa de recidiva local, tras una media de seguimientode 86 meses, es baja (2%). La afectación de las caras anteriory posterior no ha ocasionado recidiva y creemos que deberíanvalorarse de forma diferente al resto de los márgenes(AU)

Objective: The aim of this study was to analyze the tumormargindistance and the local recurrences of breast cancer casestreated at the Hospital of Barbastro with breast-conservingtherapy between 1989 and 2003.Patients and method: 141 cases are included, 119 invasiveand 22 intraductal carcinomas. Margin was defined aspositive when tumor cells where in contact with india ink,close if ≤ 1 mm and free if > 1 mm. A macroscopic intraoperativeassessment of margin was carried out mainly.Results: The mean age was 57,36 ± 12,32, the mean tumorsize 14,7 ± 0,83 mm and the mean follow-up 86,05 ±32,62 months. The final margin was positive in 13 cases witha need for reintervention in 6 of them. The remaining 7, affectinganterior and/or posterior surfaces, were not operated.The distance was ≤ 1 mm in 31 cases. Local recurrences havebeen found in 3 invasive ipsilateral carcinomas.Conclusion: A free margin was found in 73% of cases. Localrecurrence rate is low (2%) after a median follow-up of 86months. Involvement of anterior and posterior surfaces hasnot been cause of recurrences. Thus it seems they should beassessed in different way to the others(AU)

Soil transmitted nematodes in children in Buea Health District of Cameroon.

OBJECTIVE: To investigate the prevalence, intensity of infection and control of soil-transmitted nematodes in primary school pupils of urban, suburban and rural localities. SETTING: Buea Health District. DESIGN: A cross section experimental study. SUBJECTS: Three hundred and forty primary school children. INTERVENTION: Mebendazole treatment complemented with health education. RESULTS: The overall prevalence rate of soil-transmitted nematodes in the Buea Health District was 59.1%. The infection rate was significantly different in the urban, suburban and rural localities of the health district (P<0.01), with the rural area having the highest rate of infection. Ascaris lumbricoides was the most predominant parasite. The intensity of infection with the various helminth species was not significantly different between children of urban, suburban and rural localities. Mebendazole treatment significantly reduced the intensities of infection with Ascaris and Trichuris (P<0.05). The treatment, however, was ineffective against hookworm infection. Re-infection rate with Ascaris and Trichuris was slower in children who additionally received health education than in those who received only anthelminthic treatment. CONCLUSION: Ascaris lumbricoides, Trichuris trichiura and hookworms are the predominant nematodes reported in children of urban, suburban and rural localities in the health district. Health education is advocated as a complement to chemotherapy in the control of soil-transmitted nematodes.

[Evaluation of conventional hepatic scintigraphy as a diagnostic method]. / Evaluación de la centellografía hepática convencional como método de diagnóstico.

The usefulness of liver scintiscann and its correlation with final diagnosis was evaluated in a retrospective study of 195 patients with suspected hepatic disease. It was found that the overall sensitivity and specificity were 83% and 61%, respectively. These data are in accordance with other previously described. The highest diagnostic accuracy was found in diffuse and focal hepatocellular disease. Multifocal disease group showed the highest false negative interpretations. The role of the factors affecting our results is discussed.

Evaluacion de la centellografia hepatica convencional como metodo de diagnostico. / Evaluation of conventional hepatic scintigraphy as a diagnostic method

En un estudio retrospectivo de 195 pacientes en los que se sospechaba hepatopatia se evaluo la utilidad de la centellografia hepatica en cuanto a su correlacion con el diagnostico de certeza obtenido por otros metodos. Se observo que la sensibilidad y especificidad globales, 83% y 61% respectivamente estan dentro de las cifras ya comunicadas en otras series. En cuanto a la utilidad en las diferentes hepatopatias se observo una muy buena correlacion en la enfermedad difusa y le enfermedad unifocal en tanto que la enfermedad multifocal presento el mayor numero de falsos negativos.Se comentan los factores que pudieron influir en estos resultados

Evaluacion de la centellografia hepatica convencional como metodo de diagnostico. / Evaluation of conventional hepatic scintigraphy as a diagnostic method

En un estudio retrospectivo de 195 pacientes en los que se sospechaba hepatopatia se evaluo la utilidad de la centellografia hepatica en cuanto a su correlacion con el diagnostico de certeza obtenido por otros metodos. Se observo que la sensibilidad y especificidad globales, 83% y 61% respectivamente estan dentro de las cifras ya comunicadas en otras series. En cuanto a la utilidad en las diferentes hepatopatias se observo una muy buena correlacion en la enfermedad difusa y le enfermedad unifocal en tanto que la enfermedad multifocal presento el mayor numero de falsos negativos.Se comentan los factores que pudieron influir en estos resultados

Evaluación de la centellografía hepática convencional como método de diagnóstico. / [Evaluation of conventional hepatic scintigraphy as a diagnostic method]

The usefulness of liver scintiscann and its correlation with final diagnosis was evaluated in a retrospective study of 195 patients with suspected hepatic disease. It was found that the overall sensitivity and specificity were 83

and 61

, respectively. These data are in accordance with other previously described. The highest diagnostic accuracy was found in diffuse and focal hepatocellular disease. Multifocal disease group showed the highest false negative interpretations. The role of the factors affecting our results is discussed.

Surgical correction of cervical incompetence.

Results obtained with a modified surgical cerclage technique in 80 patients suffering from isthmic cervical incompetence are analyzed. The operation was performed once in 58 patients and twice in 22, giving a total of 102 pregnancies treated. The technique is described in detail, emphasizing its advantages. In 73 pregnancies (71.5%) the outcome was satisfactory (the newborn babies survived) despite the fact that in 66 instances (65%) cervical modifications were present at the time of the operation.

Chemical inducers of ovulation: comparative results.

Chemical inducers of ovulation are frequently used to reestablish a normal hypothalamic-ovarian function in the sterile woman. At present, several types are available and it is useful to evaluate comparatively their efficacy. In this paper we present our results in 396 cases treated with some of these drugs. Clomiphene citrate was administered to 307 patient. Ovulation was obtained in 85.99% and pregnancy in 35.50%. There were 16 abortions (14.68%) among the 109 pregnancies obtained. Cisclomiphene was used in 11 cases. The ovulation rate was 81.81%, with 54.5% of pregnancies. Thirty-eight patients were treated with Cyclophenil. Ovulation was obtained in 71.05% of the cases and pregnancy in 23.68%. In forty cases Tamoxifen was administered: the ovulation rate was 95% and the pregnancy rate was 35%, but the abortion rate was 35%. Tolerance was good with all medications. They had similar adverse side effects (mild and rare). None produced overstimulation. With Cyclophenil and specially with Tamoxifen the cycles were longer. The incidence of abortion in the 131 pregnancies obtained was 14.68% with Clomiphene; none with Cisclomiphene; 11.11% with Cyclophenil, and 35.10% with Tamoxifen. We conclude that Clomiphene is the drug which gives the best results at present.

[Gastric emptying in patients with chronic gastritis. Its relation to serum gastric levels]. / Evacuación gástrica en pacientes con gastritis crónica. Su relación con los niveles de gastrina sérica.

Forty eight patients were evaluated to ascertain a correlation (if any) between gastric acid secretion, fasting and post prandial serum gastrin levels, gastric biopsy (antrum and fundus) and gastric emptying time after a standard test meal. The following conclusions were obtained: a) 57.8% of patients with atrophic gastritis and achlorhydria had evaluated serum gastrin levels; b) most patients with high gastrin levels had normal antrum on biopsy or showed only minimal inflamatory changes, while those with normal gastrin levels disclosed more pronounced histological changes; c) patients with achlorhydria had slower gastric emptying rates, and this was more evident among those with higher gastrin levels (though differences were not statistically significant). Further studies are required for a better understanding of the relationship between gastric emptying rate and gastrin levels in patients with chronic gastritis.

Evacuación gástrica en pacientes con gastritis crónica. Su relación con los niveles de gastrina sérica / [Gastric emptying in patients with chronic gastritis. Its relation to serum gastric levels]

Forty eight patients were evaluated to ascertain a correlation (if any) between gastric acid secretion, fasting and post prandial serum gastrin levels, gastric biopsy (antrum and fundus) and gastric emptying time after a standard test meal. The following conclusions were obtained: a) 57.8

of patients with atrophic gastritis and achlorhydria had evaluated serum gastrin levels; b) most patients with high gastrin levels had normal antrum on biopsy or showed only minimal inflamatory changes, while those with normal gastrin levels disclosed more pronounced histological changes; c) patients with achlorhydria had slower gastric emptying rates, and this was more evident among those with higher gastrin levels (though differences were not statistically significant). Further studies are required for a better understanding of the relationship between gastric emptying rate and gastrin levels in patients with chronic gastritis.