Bilateral extensor digitorum brevis manus. / Extensor digitorum brevis manus bilateral.

INTRODUCTION: The extensor digitorum brevis manus (EDBM) is an accessory muscle of the dorsum of the hand that may appear as a painful mass. It is treated surgically, usually by excision of the muscle. CASE REPORT: 14-year-old male with bilateral painful masses on the dorsal aspect of his hands. Ultrasound confirmed the diagnosis of EDBM. Due to the associated symptoms, decision was made to conduct surgical treatment with resection of both muscle masses. DISCUSSION: EDBM is an infrequent cause of wrist pain, especially in children and adolescents. Surgical treatment has proven to have a significant impact on the improvement of the symptoms suffered by these patients.

INTRODUCCION: El extensor digitorum brevis manus (EDBM) es un músculo accesorio del dorso de la mano que puede presentarse como una masa dolorosa. Su tratamiento es quirúrgico, generalmente consiste en la extirpación del mismo. CASO CLINICO: Varón de 14 años que presenta tumoraciones dolorosas bilaterales en la cara dorsal de las manos. La ecografía confirma el diagnóstico de EDBM. Debido a la sintomatología asociada, se decide tratamiento quirúrgico, con resección de ambas masas musculares. COMENTARIOS: El EDBM constituye una causa poco frecuente de dolor a nivel de la muñeca, especialmente en población infanto-juvenil. El tratamiento quirúrgico ha demostrado un impacto significativo en la mejoría de la sintomatología que presentan estos pacientes.

Extensor digitorum brevis manus bilateral / Bilateral extensor digitorum brevis manus

Introducción: El extensor digitorum brevis manus (EDBM) es unmúsculo accesorio del dorso de la mano que puede presentarse comouna masa dolorosa. Su tratamiento es quirúrgico, generalmente consisteen la extirpación del mismo. Caso clínico: Varón de 14 años que presenta tumoraciones dolorosas bilaterales en la cara dorsal de las manos. La ecografía confirma eldiagnóstico de EDBM. Debido a la sintomatología asociada, se decidetratamiento quirúrgico, con resección de ambas masas musculares. Comentarios: El EDBM constituye una causa poco frecuente dedolor a nivel de la muñeca, especialmente en población infanto-juvenil.El tratamiento quirúrgico ha demostrado un impacto significativo en lamejoría de la sintomatología que presentan estos pacientes.(AU)

Introduction: The extensor digitorum brevis manus (EDBM) isan accessory muscle of the dorsum of the hand that may appear as apainful mass. It is treated surgically, usually by excision of the muscle. Clinical case: 14-year-old male with bilateral painful masses onthe dorsal aspect of his hands. Ultrasound confirmed the diagnosis ofEDBM. Due to the associated symptoms, decision was made to conductsurgical treatment with resection of both muscle masses. Discussion: EDBM is an infrequent cause of wrist pain, especiallyin children and adolescents. Surgical treatment has proven to have asignificant impact on the improvement of the symptoms suffered bythese patients.(AU)

Rapamicina oral: una alternativa en niños con anomalías vasculares complicadas / Oral rapamycin: an alternative in children with complicated vascular abnormalities

Objetivos: El uso del inhibidor mTOR sirolimus ha supuesto unavance en el tratamiento de pacientes con anomalías vasculares complicadas. El objetivo de este estudio es presentar nuestra serie de pacientespediátricos con anomalías vasculares tratados con sirolimus oral y haceruna revisión de la literatura al respecto. Material y métodos: Se realizó un análisis retrospectivo de lospacientes con anomalías vasculares complicadas tratados con sirolimusoral en nuestro centro desde el año 2016. La dosis inicial utilizada fuede 0,8 mg/m2 cada 12 horas y el rango terapéutico de 5-15 ng/ml. Todos los pacientes recibieron profilaxis con trimetoprim-sulfametoxazol. Resultados: Se incluyeron seis niños, tres varones y tres mujeres, con una edad media al inicio del tratamiento de 9,5 años. Trespresentaban una malformación linfática en cabeza y cuello, dos unamalformación venosa en miembro inferior y la última una malformación combinada linfática-venosa a nivel toracoabdominal. Todos habíanrecibido múltiples tratamientos previos sin mejoría. Tras el inicio desirolimus, cinco pacientes mejoraron clínicamente (tiempo medio 3,6meses) y cuatro radiológicamente (tiempo medio 6,6 meses). Se registraron efectos adversos leves y transitorios en tres casos. Actualmente,cinco pacientes continúan con el tratamiento. Conclusiones: El sirolimus oral es un tratamiento eficaz y seguroen pacientes con anomalías vasculares complicadas. Nuestros resultadosapoyan su uso en malformaciones linfáticas y venosas en las que hanfracasado otros tratamientos, presentando buenas respuestas sintomáticasy, en menor medida, radiológicas.(AU)

Objective: Sirolimus mTOR inhibitor represents a major advancein the treatment of patients with complicated vascular abnormalities.The objective of this study was to present our series of pediatric patientswith vascular abnormalities treated with oral sirolimus, and to conducta review of the relevant literature. Materials and methods: A retrospective analysis of patients withcomplicated vascular abnormalities treated with oral sirolimus in ourhealthcare facility from 2016 was carried out. Initial dosage was 0.8 mg/m 2 every 12 hours, and therapeutic range was 5-15 ng/ml. All patientsreceived trimethoprim-sulfamethoxazole prophylaxis. Results: 6 children –3 boys and 3 girls– with a mean age of 9.5years at treatment initiation were included. 3 of them had head and necklymphatic malformation, 2 had lower limb venous malformation, and 1had combined lymphatic-venous malformation at the thoracoabdominal level. They all had received multiple previous treatments withoutimprovement. Following sirolimus initiation, 5 patients had clinicalimprovement (mean time: 3.6 months) and 4 had radiological improvement (mean time: 6.6 months). Mild and transitory adverse effects werenoted in the 3 cases. Today, 5 patients remain under treatment. Conclusions: Oral sirolimus is an effective and safe treatment inpatients with complicated vascular abnormalities. Our results supportsirolimus use in lymphatic and venous malformations in which previoustreatments have failed, with a good symptomatic and, to a lesser extent,radiological response.(AU)

Anti-oxidant and anti-inflammatory effect of polar extracts obtained from waste product of wine making.

A lot of diseases are characterized by an increased inflammatory response with an exacerbated production of free radicals. The anti-inflammatory effect of different compounds with antioxidant capacity, as polyphenols present in grape is well known. Therefore, the objective is to evaluate the anti-oxidant and anti-inflammatory activity of waste product of wine production.Six different non-toxic-marc-polar extracts from Malbec and Syrah grape varieties were obtained, their total phenol and flavonoid content were evaluated, and their antioxidant and anti-inflammatory activity were determined.High content of total phenols and flavonoids were found mainly in extracts obtained from Syrah (80.51 ± 16.63 g equivalent to gallic acid/100 g and 25.47 ± 3.33 g equivalent to quercetin/100 g). In addition, they had a high antioxidant effect (above 88.5% of ABTS inhibition by Syrah extracts). Finally, all extracts decreased the nitric oxide (NO) production, but this was more accented when extract from Syrah obtained by infusion was used, which decreased NO levels to baseline (4.46 µM).Taking together, our results show the potential pharmaceutical use of waste product of wine making to prevent or to treat diseases which inflammatory response is exacerbated.

Oral rapamycin: an alternative in children with complicated vascular abnormalities. / Rapamicina oral: una alternativa en niños con anomalías vasculares complicadas.

OBJECTIVE: Sirolimus mTOR inhibitor represents a major advance in the treatment of patients with complicated vascular abnormalities. The objective of this study was to present our series of pediatric patients with vascular abnormalities treated with oral sirolimus, and to conduct a review of the relevant literature. MATERIAL AND METHODS: A retrospective analysis of patients with complicated vascular abnormalities treated with oral sirolimus in our healthcare facility from 2016 was carried out. Initial dosage was 0.8 mg/m2 every 12 hours, and therapeutic range was 5-15 ng/ml. All patients received trimethoprim-sulfamethoxazole prophylaxis. RESULTS: 6 children -3 boys and 3 girls- with a mean age of 9.5 years at treatment initiation were included. 3 of them had head and neck lymphatic malformation, 2 had lower limb venous malformation, and 1 had combined lymphatic-venous malformation at the thoracoabdominal level. They all had received multiple previous treatments without improvement. Following sirolimus initiation, 5 patients had clinical improvement (mean time: 3.6 months) and 4 had radiological improvement (mean time: 6.6 months). Mild and transitory adverse effects were noted in the 3 cases. Today, 5 patients remain under treatment. CONCLUSIONS: Oral sirolimus is an effective and safe treatment in patients with complicated vascular abnormalities. Our results support sirolimus use in lymphatic and venous malformations in which previous treatments have failed, with a good symptomatic and, to a lesser extent, radiological response.

OBJETIVOS: El uso del inhibidor mTOR sirolimus ha supuesto un avance en el tratamiento de pacientes con anomalías vasculares complicadas. El objetivo de este estudio es presentar nuestra serie de pacientes pediátricos con anomalías vasculares tratados con sirolimus oral y hacer una revisión de la literatura al respecto. MATERIAL Y METODOS: Se realizó un análisis retrospectivo de los pacientes con anomalías vasculares complicadas tratados con sirolimus oral en nuestro centro desde el año 2016. La dosis inicial utilizada fue de 0,8 mg/m2 cada 12 horas y el rango terapéutico de 5-15 ng/ml. Todos los pacientes recibieron profilaxis con trimetoprim-sulfametoxazol. RESULTADOS: Se incluyeron seis niños, tres varones y tres mujeres, con una edad media al inicio del tratamiento de 9,5 años. Tres presentaban una malformación linfática en cabeza y cuello, dos una malformación venosa en miembro inferior y la última una malformación combinada linfática-venosa a nivel toracoabdominal. Todos habían recibido múltiples tratamientos previos sin mejoría. Tras el inicio de sirolimus, cinco pacientes mejoraron clínicamente (tiempo medio 3,6 meses) y cuatro radiológicamente (tiempo medio 6,6 meses). Se registraron efectos adversos leves y transitorios en tres casos. Actualmente, cinco pacientes continúan con el tratamiento. CONCLUSIONES: El sirolimus oral es un tratamiento eficaz y seguro en pacientes con anomalías vasculares complicadas. Nuestros resultados apoyan su uso en malformaciones linfáticas y venosas en las que han fracasado otros tratamientos, presentando buenas respuestas sintomáticas y, en menor medida, radiológicas.

Diet-Induced Pulmonary Inflammation and Incipient Fibrosis in Mice: a Possible Role of Neutrophilic Inflammation.

Chicken fat and fructose are added into food-processing to reduce costs and enhance acceptability; however, these additives turn food into unhealthy and hypercaloric meals. Herein we have hypothesized that chronic feeding with chicken fat and fructose, together or by separate, can cause pulmonary redox and inflammatory changes. These changes are particularly related to neutrophils and myeloperoxidase, with consequent changes in the organ histophysiology. To test this hypothesis, we fed mice for 16 weeks with either control food (low-fat diet, LFD) or control food supplemented with 22% chicken fat and with or without 10% fructose in the drinking water. At the end of the feeding regimen, we measured redox and inflammatory changes in the lung with particular emphasis on neutrophil accumulation/activation and molecular-histological markers of fibrosis. Our results suggest that a diet supplemented with chicken fat and fructose causes additive effects on pulmonary oxidative stress, inflammation, and a pro-fibrotic status. Neutrophilic inflammation may play a critical role in pulmonary pathology associated with metabolic syndrome.

[Surgical management of non-tuberculous mycobacterial lymphadenitis in a third level center]. / Manejo quirúrgico de la linfadenitis por micobacterias no tuberculosas en un centro de tercer nivel.

AIM OF STUDY: To describe our experience in the management of non-tuberculosis mycobacterial lymphadenitits (NTML). METHODS: Retrospective analysis of patients who underwent surgery for NTML in our centre during the period between 2010-2017. Demographic data, diagnostic tests, treatment and follow up information were recovered from medical records. RESULTS: 65 patients (26 male/39 female) with a mean age of 31 months (range 7 months-12 years) were intervened during the period of study. As diagnostic tests, chest X-ray was performed in 92.3% of patients with normal result in all cases, Mantoux test was positive in 20.3%, inconclusive in 12.5% and negative in 67.1%. Preoperative fine needle aspiration was positive for NTML (granulomatous necrotizing lymphadenitis) in 93.7% whereas culture for mycobacteria was only positive in 23.4% of cases, being Mycobacterium lentiflavum the most frequent agent found. Mean preoperative waiting time was 2.5 months with 7.7% of fistulization previous to surgery. Mean hospital stay was 1,1 days and there were no intraoperative complications. Mean follow up time was 5.5 months (range 1-24 months) during which 19 cases of temporal facial paralysis were noted, among which only 2 persisted after one year. CONCLUSIONS: NTML is a disease with a growing incidence in our country. It is important to make an early diagnosis and surgical treatment in order to avoid complications, as surgery has demonstrated to be safe and effective, with a low rate of complications. We believe the actual protocols should be revised/checked due to low effectiveness of diagnostic tests.

OBJETIVOS: Describir nuestra experiencia en el manejo de la linfadenitis por micobacterias no tuberculosas (LMNT). MATERIAL Y METODOS: Análisis retrospectivo de 65 pacientes (26 varones/ 39 mujeres) intervenidos en nuestro centro de LMNT durante los años 2010-2017. Se analizaron datos demográficos, pruebas complementarias realizadas y datos de seguimiento. RESULTADOS: La edad media fue de 31 meses (rango 7 meses-12 años). Para el diagnóstico la radiografía de tórax se realizó al 92,3% de pacientes, siendo en todos normal. El Mantoux fue positivo en 20,3%, dudoso en 12,5% y negativo en 67,1%. La PAAF preoperatoria fue diagnóstica (linfadenitis granulomatosa necrotizante) en 93,7% mientras que el cultivo para micobacterias fue positivo solo en 23,4%, siendo el Mycobacterium lentiflavum el patógeno más frecuentemente encontrado. El tiempo de espera preoperatorio fue de 2,5 meses con un porcentaje de fistulización previo a la cirugía de 7,7%. La estancia hospitalaria media fue 1,1 días y no hubo complicaciones perioperatorias. El tiempo medio de seguimiento fue 5,5 meses (rango 1-24 meses) observándose 19 casos de parálisis facial temporal, de los cuales 2 persistieron al cabo de 1 año. CONCLUSIONES: La LMNT es una enfermedad cada vez más frecuente en nuestro medio. Es importante realizar un diagnóstico y tratamiento precoz, puesto que el tratamiento quirúrgico ha demostrado ser seguro y eficaz asociando baja tasa de complicaciones. Creemos que los protocolos actuales se deben revisar, debido a la escasa rentabilidad de algunas pruebas complementarias.

The nitrone spin trap 5,5-dimethyl-1-pyrroline N-oxide dampens lipopolysaccharide-induced transcriptomic changes in macrophages.

OBJECTIVE: M1-like inflammatory phenotype of macrophages plays a critical role in tissue damage in chronic inflammatory diseases. Previously, we found that the nitrone spin trap 5,5-dimethyl-1-pyrroline N-oxide (DMPO) dampens lipopolysaccharide (LPS)-triggered inflammatory priming of RAW 264.7 cells. Herein, we tested whether DMPO by itself can induce changes in macrophage transcriptome, and that these effects may prevent LPS-induced activation of macrophages. MATERIALS AND METHODS: To test our hypothesis, we performed a transcriptomic and bioinformatics analysis in RAW 264.7 cells incubated with or without LPS, in the presence or in the absence of DMPO. RESULTS: Functional data analysis showed 79 differentially expressed genes (DEGs) when comparing DMPO vs Control. We used DAVID databases for identifying enriched gene ontology terms and Ingenuity Pathway Analysis for functional analysis. Our data showed that DMPO vs Control comparison of DEGs is related to downregulation immune-system processes among others. Functional analysis indicated that interferon-response factor 7 and toll-like receptor were related (predicted inhibitions) to the observed transcriptomic effects of DMPO. Functional data analyses of the DMPO + LPS vs LPS DEGs were consistent with DMPO-dampening LPS-induced inflammatory transcriptomic profile in RAW 264.7. These changes were confirmed using Nanostring technology. CONCLUSIONS: Taking together our data, surprisingly, indicate that DMPO by itself affects gene expression related to regulation of immune system and that DMPO dampens LPS-triggered MyD88- and TRIF-dependent signaling pathways. Our research provides critical data for further studies on the possible use of DMPO as a structural platform for the design of novel mechanism-based anti-inflammatory drugs.

[Surgery in times of crisis: conservative treatment of pectus carinatum by static corset]. / Cirugía en tiempos de crisis: tratamiento conservador del pectus carinatum mediante corsé estático.

INTRODUCTION: Dynamic compression system is the elective treatment for chondrogladiolar pectus carinatum. Nevertheless, its high cost poses a problem for its prescription in places where it is not subsidized. This article analyzes the experience of the Paediatric Plastic Surgery Service at a third grade hospital in the treatment of this deformity with a static compression system. MATERIALS AND METHODS: The study presents a descriptive, retrospective analysis of 30 patients with pectus carinatum treated with a static compression system. Furthermore, we describe the protocol of treatment used at our unit, and we analyse the satisfaction with bracing therapy, and its relation to therapeutic compliance. RESULTS: The study includes 28 boys and 2 girls. 93% of the patients presented a chondrogladiolar pectus carinatum. At the moment of finishing the study, 11 patients have completed the treatment, 14 still bracing, and 5 were lost in the follow-up. Satisfaction questionnaires were answered by 19 patients. CONCLUSION: Bracing therapy with static compression system is the treatment of choice for chondrogladiolar pectus carinatum in our unit, because of its effectiveness and lower price. Quality of life questionnaires show better marks in patients that are in the second phase of treatment.

INTRODUCCION: El corsé de compresión dinámica constituye el tratamiento de elección de las formas condrogladiolares de pectus carinatum. Sin embargo, su elevado coste supone un problema para su prescripción en las comunidades en las que no se encuentra subvencionado. El presente trabajo analiza la experiencia de la Unidad de Cirugía Plástica Infantil de un hospital terciario en el manejo de esta patología mediante tratamiento ortopédico con corsé de compresión estática. MATERIAL Y METODOS: Se realiza un estudio descriptivo, de carácter retrospectivo, de 30 pacientes afectos de pectus carinatum tratados mediante ortesis estática. Además, se expone el protocolo de actuación de la unidad, y se analiza la satisfacción de los pacientes con el tratamiento, y su relación con la adherencia terapéutica. RESULTADOS: La muestra incluye 28 varones y 2 mujeres. El 93% de los pacientes presentaban una malformación de tipo condrogladiolar. En el momento de finalización del estudio, 11 pacientes habían completado la terapia, 14 continuaban en tratamiento, y 5 fueron pérdidas en el seguimiento. Las encuestas de satisfacción pudieron ser realizadas a 19 pacientes. CONCLUSION: La terapia con corsé de compresión estática resulta eficaz, con un coste asociado más bajo al de la terapia dinámica, convirtiéndose en el tratamiento de referencia de nuestra unidad. Los cuestionarios de calidad de vida empleados muestran mejores puntuaciones en pacientes en fase de mantenimiento, respecto a pacientes en fase de corrección.

Choline induces opposite changes in pyramidal neuron excitability and synaptic transmission through a nicotinic receptor-independent process in hippocampal slices.

Choline is present at cholinergic synapses as a product of acetylcholine degradation. In addition, it is considered a selective agonist for α5 and α7 nicotinic acetylcholine receptors (nAChRs). In this study, we determined how choline affects action potentials and excitatory synaptic transmission using extracellular and intracellular recording techniques in CA1 area of hippocampal slices obtained from both mice and rats. Choline caused a reversible depression of evoked field excitatory postsynaptic potentials (fEPSPs) in a concentration-dependent manner that was not affected by α7 nAChR antagonists. Moreover, this choline-induced effect was not mimicked by either selective agonists or allosteric modulators of α7 nAChRs. Additionally, this choline-mediated effect was not prevented by either selective antagonists of GABA receptors or hemicholinium, a choline uptake inhibitor. The paired pulse facilitation paradigm, which detects whether a substance affects presynaptic release of glutamate, was not modified by choline. On the other hand, choline induced a robust increase of population spike evoked by orthodromic stimulation but did not modify that evoked by antidromic stimulation. We also found that choline impaired recurrent inhibition recorded in the pyramidal cell layer through a mechanism independent of α7 nAChR activation. These choline-mediated effects on fEPSP and population spike observed in rat slices were completely reproduced in slices obtained from α7 nAChR knockout mice, which reinforces our conclusion that choline modulates synaptic transmission and neuronal excitability by a mechanism independent of nicotinic receptor activation.

Presence of pharmaceutically active compounds in Doñana Park (Spain) main watersheds.

Among the emerging environmental contaminants, pharmaceutically active compounds have become a growing public concern because of their potential to cause undesirable ecological and human health effects. Doñana Park (South of Spain) includes a mosaic of unique ecosystems known around the world which is particularly affected by the quality of the incoming flowing water. This study reports the presence of a number of priority pharmaceuticals in wastewater and surface water samples from Doñana watersheds. In general, ibuprofen, naproxen, salicylic acid, propranolol, caffeine and gemfibrozil were the compounds most frequently found in all locations, in the range of ng/L to microg/L. Carbamazepine, with high potential risk to the environment, was also detected, although only in a few water samples. The main results are: (i) pharmaceuticals, as water pollutants, are continually discharged into Doñana water bodies and, owing to their biological activity, could lead to adverse effects in this outstanding aquatic ecosystem; (ii) wastewater treatments implemented in the area are insufficient to remove pharmaceuticals; and (iii) therefore, there is a requirement for better wastewater treatments in this natural area to reduce or avoid the presence of organic pollutants in general and pharmaceutical active compounds in particular. To the best of our knowledge, these data constitute the first measurements of pharmaceutical compounds in water not only from the protected area of Doñana Park but also from other Natural or National Parks in the world.

Incidencia y características epidemiológicas del crecimiento intrauterino restringido en el Hospital Universitario Reina Sofía / Incidence and epidemiologic characteristics of intrauterine growth restriction (IUGR) in Hospital Universitario Reina Sofía

Objetivo Determinar la incidencia y describir las características epidemiológicas del crecimiento intrauterino restringido (CIR) en el Hospital Universitario Reina Sofía de Córdoba en el 2007.Material y métodos Estudio descriptivo transversal en el que se revisaron las historias clínicas de los fetos con CIR entre el 1 de enero del 2007 y el 31 de diciembre del 2007.ResultadosLa incidencia de CIR en el Hospital Universitario Reina Sofía en el 2007 fue de 411 casos (9,94%). De éstos, 43 casos (10,47%) fueron pretérmino. La media del pH de la arteria umbilical al nacimiento de los fetos con menos de 34 semanas fue más baja que la media del pH de los fetos de mayor edad gestacional (p=0,065). El porcentaje de cesáreas en los fetos con CIR fue del 24%, frente a un 19,7% en los fetos con crecimiento normal (p=0,030). Las principales causas de CIR encontradas fueron edad materna >35 o <20 años (29,68%), tabaquismo (17,78%), causas vasculares (10,46%) y embarazo múltiple (4,37%). En el 29,93% de los fetos con CIR no se encontró ninguna causa. La tasa de mortalidad perinatal para los fetos con CIR (17,03/1.000) fue significativamente más alta (p<0,001) que en los fetos sin esta patología (3,22/1.000). Conclusiones El CIR es una patología cuya etiología es multifactorial y no del todo conocida, que afectó al 9,94% de las pacientes embarazadas del Hospital Universitario Reina Sofía en el 2007. La mayoría de los casos fueron fetos con más de 37 semanas de gestación y fue posible encontrar una causa subyacente en el 70% de los casos estudiados. El porcentaje de cesáreas fue significativamente mayor en los fetos con CIR; la mortalidad perinatal encontrada en estos fetos fue 5,3 veces mayor a la mortalidad perinatal de aquellos fetos con crecimiento normal. La sensibilidad de nuestras consultas hospitalarias para el diagnóstico de CIR fue del 78,72% (AU)

Objectives To determine the incidence and describe the epidemiologic characteristics of intrauterine growth restriction (IUGR) in 2007 in the Reina Sofia University Hospital in Cordoba. Material and methods We performed a descriptive, cross-sectional study in which the charts of IUGR fetuses born between January 1st and December 31st, 2007 were reviewed. ResultsT he incidence of IUGR during 2007 in the Reina Sofia University Hospital in Cordoba was 411 cases (9.94%), of which 43 cases (10.47%) were preterm fetuses. The mean pH in IUGR newborns with a gestational age of less than 34 weeks was lower than that in newborns with higher gestational age (p=0.065). A total of 24% of IUGR fetuses had a cesarean delivery compared with 19.7% of cesareans in newborns with normal weight (p=0.030). The principal causes of IUGR were maternal age >35 or <20 years old (29.68%), smoking (17.78%), vascular causes (10.46%) and multiple pregnancies (4.37%). In 29.93% of IUGR fetuses no cause was found. The perinatal mortality rate was significantly higher (p<0.001) in IUGR fetuses (17.03×1000) than in the group with normal weight (3.22×1000).Conclusions IUGR is an abnormality of unknown etiology that affects 9.94% of pregnancies in the Reina Sofia University Hospital. In most IUGR fetuses, gestational age is more than 37 weeks and in approximately 70% of these fetuses an underlying cause can be found. Cesarean sections were significantly more frequent in IUGR fetuses than in those with normal weight. Similarly, perinatal mortality was 5.3 times higher in this group than in the normal group. In our hospital the sensitivity rate for the detection of this entity is 78.72% (AU)

Aged wild-type and APP, PS1, and APP + PS1 mice present similar deficits in associative learning and synaptic plasticity independent of amyloid load.

Wild-type and single-transgenic (APP, PS1) and double-transgenic (APP+PS1) mice were studied at three different (3-, 12-, and 18-month-old) age periods. Transgenic mice had reflex eyelid responses like those of controls, but only 3-month-old mice were able to fully acquire conditioned eyeblinks, using a trace paradigm, whilst 12-month-old wild-type and transgenic mice presented intermediate values, and 18-month-old wild-type and transgenic mice were unable to acquire this type of associative learning. 18-month-old wild-type and transgenic mice presented a normal synaptic activation of CA1 pyramidal cells by the stimulation of Schaffer collaterals, but they did not show any activity-dependent potentiation of the CA3-CA1 synapse across conditioning sessions, as was shown by 3-month-old wild-type mice. Moreover, 18-month-old wild-type and transgenic mice presented a noticeable deficit in long-term potentiation evoked in vivo at the hippocampal CA3-CA1 synapse. The 18-month-old wild-type and transgenic mice also presented a significant deficit in prepulse inhibition as compared with 3-month-old controls. Except for results collected by prepulse inhibition, the above-mentioned deficits were not related with the presence of amyloid beta deposits. Thus, learning and memory deficits observed in aged wild-type and transgenic mice are not directly related to the genetic manipulations or to the presence of amyloid plaques.

[Minor cutaneous ambulatory surgery and cryotherapy. Comparative study between a dermatologist and family physicians]. / Cirugía menor ambulatoria dermatológica y crioterapia. Estudio comparativo entre un dermatólogo y médicos de familia.

INTRODUCTION: Lack of diagnostic skill in cutaneous surgery may lead to erroneous and potentially detrimental therapies. This study compares the diagnosis and treatment in cutaneous surgery, including cryotherapy, between a dermatologist and family physicians. METHODS: It is an observational, prospective study on a random sample of patients that consulted the dermatologist for candidate lesions. Each lesion was independently evaluated by a dermatologist and a family physician, both of whom assigned the clinical diagnosis and therapeutic advice. Concordance for diagnosis, recommended treatment and indication for cryotherapy was calculated by Cohen's kappa coefficient. RESULTS: Six hundred forty-six lesions were evaluated. Global kappa indexes were 0.69 (95 % CI, 0.65-0.73) for diagnostic concordance, 0.62 (95 % CI, 0.56-0.67) for recommended treatment and 0.73 (95 % CI, 0.67-0.78) for indication of cryotherapy. Diagnostic concordance was significantly better for melanocytic nevus, achrocordon and for lesions with multiple and monomorphous presentation, and worse for isolated pigmented lesions. For recommended treatment concordance was better for multiple and monomorphous lesions and worse for skin cancer and seborrheic keratosis. For indication of cryotherapy concordance was worse for skin cancer, melanocytic nevus, acrochordon and seborrheic keratosis. Family physicians made an erroneous indication for cryotherapy in 5.88 % of cases, including 3 non melanoma skin cancers. CONCLUSIONS: Concordance between dermatologists and family physicians for minor cutaneous surgery is generally good. Family physicians should be more careful in evaluating solitary pigmented lesions and patients at risk for skin cancer.

Cirugía menor ambulatoria dermatológica y crioterapia. Estudio comparativo entre un dermatólogo y médicos de familia / Minor cutaneous ambulatory surgery and cryotherapy. Comparative study between a dermatologist and family physicians

Introducción. En cirugía dermatológica, una menor habilidad diagnóstica podría conducir a tratamientos erróneos y potencialmente perjudiciales. En este trabajo se compara el diagnóstico y la decisión terapéutica en cirugía dermatológica, incluyendo la crioterapia, entre un dermatólogo y médicos de familia. Métodos. Estudio prospectivo observacional, sobre una muestra no seleccionada de pacientes que consultan al dermatólogo por lesiones candidatas. Cada lesión fue evaluada independientemente por un dermatólogo y un médico de familia, consignando ambos el diagnóstico clínico y el consejo terapéutico. Se calculó la concordancia para el diagnóstico, tratamiento recomendado e indicación de crioterapia mediante el estadístico kappa de Cohen. Resultados. Se evaluaron 646 lesiones. Los índices kappa globales fueron 0,69 (intervalo de confianza [IC] del 95 %, 0,65-0,73) en concordancia diagnóstica, 0,62 (IC del 95 %, 0,56-0,67) en tratamiento recomendado y 0,73 (IC del 95 %, 0,67-0,78) en indicación de crioterapia. La concordancia diagnóstica resultó significativamente mejor en nevus melanocítico, acrocordón y en lesiones con presentación múltiple y monomorfa, y peor en lesiones pigmentadas aisladas. En tratamiento recomendado fue mejor para lesiones múltiples y monomorfas, y peor en cáncer de piel y queratosis seborreica. En indicación de crioterapia fue peor en cáncer de piel, nevus melanocítico, acrocordón y queratosis seborreica. Los médicos de familia indicaron crioterapia incorrectamente en el 5,88 % de casos, incluyendo tres cánceres de piel no melanoma. Conclusiones. La concordancia entre dermatólogos y médicos de familia en cirugía menor dermatológica es en general buena. Los médicos de familia deberían ser cautos en lesiones pigmentadas solitarias y pacientes de riesgo para cáncer de piel

Introduction. Lack of diagnostic skill in cutaneous surgery may lead to erroneous and potentially detrimental therapies. This study compares the diagnosis and treatment in cutaneous surgery, including cryotherapy, between a dermatologist and family physicians. Methods. It is an observational, prospective study on a random sample of patients that consulted the dermatologist for candidate lesions. Each lesion was independently evaluated by a dermatologist and a family physician, both of whom assigned the clinical diagnosis and therapeutic advice. Concordance for diagnosis, recommended treatment and indication for cryotherapy was calculated by Cohen's kappa coefficient. Results. Six hundred forty-six lesions were evaluated. Global kappa indexes were 0.69 (95 % CI, 0.65-0.73) for diagnostic concordance, 0.62 (95 % CI, 0.56-0.67) for recommended treatment and 0.73 (95 % CI, 0.67-0.78) for indication of cryotherapy. Diagnostic concordance was significantly better for melanocytic nevus, achrocordon and for lesions with multiple and monomorphous presentation, and worse for isolated pigmented lesions. For recommended treatment concordance was better for multiple and monomorphous lesions and worse for skin cancer and seborrheic keratosis. For indication of cryotherapy concordance was worse for skin cancer, melanocytic nevus, acrochordon and seborrheic keratosis. Family physicians made an erroneous indication for cryotherapy in 5.88 % of cases, including 3 non melanoma skin cancers. Conclusions. Concordance between dermatologists and family physicians for minor cutaneous surgery is generally good. Family physicians should be more careful in evaluating solitary pigmented lesions and patients at risk for skin cancer