Mortality in emphysematous pyelonephritis: Can we reduce it further by using a protocol-based treatment? The results of a prospective study.

INTRODUCTION: Even though the mortality rate in emphysematous pyelonephritis (EPN) is brought down presently to 13%-25%, there is still scope for improvement. The hurdle lies in identifying those patients at risk of mortality earlier in the disease process and providing intensive management to them. In this study, we created risk groups by combining both clinical and radiological presentations and applied a protocol-based treatment to evaluate its role in reducing mortality. METHODS: We formulated a treatment protocol based on the available literature. The first step was to recruit all patients diagnosed with EPN into the treatment protocol as soon as possible without any delay. The second step was to stratify the patients into risk groups based on our clinicoradiological risk group classification. The third step was to apply the treatment protocol according to the risk group they belonged to. RESULTS: We treated 24 patients with EPN in the past 4 years. According to the radiological classification - four patients had Type 1 disease, five patients had Type 2A disease, six patients had Type 2B disease, four patients had Type 3A disease, two patients had Type 3B disease, two patients had Type 4A disease, and one patient had 4B disease. Following risk stratification, we have categorized seven patients into category 1, eight patients into category 2, and nine patients into category 3. All except one patient survived following the treatment protocol followed by us. CONCLUSIONS: Early risk stratification, intensive management, and prompt treatment according to a protocol can reduce mortality even further in patients with EPN.

Slow magnetic relaxations in manganese(III) tetra(meta-fluorophenyl)porphyrin-tetracyanoethenide. Comparison with the relative single chain magnet ortho compound.

Mn(III) tetra(meta-fluorophenyl)porphyrin-tetracyanoethenide coordination polymer (abbreviated meta-F) was synthesized and crystallographically and magnetically characterized. The compound crystallizes in the space group C2/c with four equivalent molecules in the unit cell arranged along two symmetry related nonparallel linear chain directions. Magnetic properties were studied by SQUID dc magnetization and ac susceptibility techniques and high field-high frequency electron spin resonance (HF-ESR). Glassy transition to a ferromagnetic-like state is observed at 10 K accompanied by slow magnetic relaxations. The glassiness is interpreted as due to 3D domain wall pinning. In a bias dc magnetic field the width of the relaxation time distribution decreases and the relaxations become similar to the relaxations of the single chain magnet Mn(III) tetra(ortho-fluorophenyl)porphyrin-tetracyanoethenide (abbreviated ortho-F), for which comparative HF-ESR studies were also conducted in this work. Magnetic properties of these two compounds are compared, and the nature of magnetic relaxations in meta-F is discussed.

[Pigeon breeder's lung]. / Pulmón del cuidador de palomas.

Bird fancier's or breeder's lung is an unusual hypersensitivity pneumonitis found in pediatric patients, due to avian antigen inhalation. A case of pigeon breeder's lung in a 12 years old child is presented. Clinical symptoms were dry cough for 15 days, dyspnea and weight loss. Physical examination of the patient showed cyanosis, chest tightness, tachypnea, inspiratory crackles and oxygen saturation of 91% in room air. Laboratory data revealed hypergammaglobulinemia and elevated LDH. Pulmonary function testing showed a mixed ventilatory pattern and a decreased carbon monoxide diffusion (DLCO) capacity. Radiological findings were compatible with hypersensitivity pneumonitis, and pigeon IgG antibodies (ELISA) and skin tests with pigeon serum were positive. The child improved with corticoid therapy and antigen avoidance.

Pulmón del cuidador de palomas / Pigeon breeder's lung

El pulmón del cuidador de palomas es una neumonitis por hipersensibilidad poco frecuente en pediatría, que se desarrolla por inhalación de proteínas derivadas de las palomas. Presentamos un caso de pulmón de cuidador de palomas en un niño de 12 años. Refería tos seca de 15 días de evolución, disnea y pérdida de peso. A la exploración física, destacaba cianosis, tiraje intercostal y supraclavicular, taquipnea, subcrepitantes a la auscultación respiratoria y saturación de oxígeno del 91% a FiO2 ambiente. En la analítica de sangre destacaba hipergammaglobulinemia y aumento de lactato deshidrogenasa. Las pruebas funcionales respiratorias mostraron un patrón mixto con disminución de la difusión de monóxido de carbono (DLCO). Los hallazgos radiológicos fueron compatibles con el diagnóstico de neumonitis por hipersensibilidad y los anticuerpos de inmunoglobulina G a palomas (método ELISA) y los tests cutáneos con suero de paloma fueron positivos. El niño presentó una buena respuesta al tratamiento corticoideo y a la evitación del antígeno (AU)

Bird fancier’s or breeder’s lung is an unusual hypersensitivity pneumonitis found in pediatric patients, due to avian antigen inhalation. A case of pigeon breeder’s lung in a 12 years old child is presented. Clinical symptoms were dry cough for 15 days, dyspnea and weight loss. Physical examination of the patient showed cyanosis, chest tightness, tachypnea, inspiratory crackles and oxygen saturation of 91% in room air. Laboratory data revealed hypergammaglobulinemia and elevated LDH. Pulmonary function testing showed a mixed ventilatory pattern and a decreased carbon monoxide diffusion (DLCO) capacity. Radiological findings were compatible with hypersensitivity pneumonitis, and pigeon IgG antibodies (ELISA) and skin tests with pigeon serum were positive. The child improved with corticoid therapy and antigen avoidance (AU)

Extended triple-bridged Ni(II)- and Co(II)-hydroxamate trinuclear complexes: synthesis, crystal structures, and magnetic properties.

Crystal structures of new trinuclear complexes [Ni 3(mu-OAc F) 4(mu-AA) 2(tmen) 2], [Ni 3(mu-OAc F) 4(mu-BA) 2(tmen) 2], and [Co 3(mu-OAc F) 4(mu-BA) 2(tmen) 2] have been determined (OAc F = CF 3COO (-), AA = acetohydroxamate anion, BA = benzohydroxamate anion, tmen = N, N, N', N'-tetramethylethylenediamine). In each structure, the metal ions have distorted octahedral coordination and are triply bridged by one hydroxamate and two trifluoroacetate bridges. Magnetic properties of these compounds and of relative [Co 3(mu-OAc F) 4(mu-AA) 2(tmen) 2] were studied by susceptibility and magnetization measurements. It was shown that for nickel trimers the intramolecular magnetic coupling is weak ferromagnetic in the case of the complex with the AA group, and there is nearly no coupling in the case with BA group. Rather large zero field splitting was obtained for the distorted octahedral environments of the terminal nickel ions. The cobalt trimers were additionally studied by magnetic circular dichroism (MCD) measurements. The exchange interaction of the cobalt complexes is antiferromagnetic.

Probing the quantum critical behavior of CeCoIn5 via Hall effect measurements.

We present highly sensitive Hall effect measurements of the heavy fermion compound CeCoIn5 down to temperatures of 55 mK. A pronounced dip in the differential Hall coefficient | partial differential rho(xy)/ partial differential H| at low temperature and above the upper critical field of superconductivity, H(c2), is attributed to critical spin fluctuations associated with the departure from Landau Fermi liquid behavior. This identification is strongly supported by a systematic suppression of this feature at elevated pressures. The resulting crossover line in the field-temperature phase diagram favors a field induced quantum critical point at mu(0)H(qc) approximately 4.1 T below H(c2)(T=0) suggesting related, yet separate, critical fields.

First-order transition in the spin dynamics of geometrically frustrated Yb2Ti2O7.

Using neutron diffraction, 170Yb Mössbauer and muon spin relaxation spectroscopies, we have examined the pyrochlore Yb2Ti2O7, where the Yb3+S' = 1/2 ground state has planar anisotropy. Below approximately 0.24 K, the temperature of the known specific-heat lambda transition, there is no long range magnetic order. We show that the transition corresponds to a first-order change in the fluctuation rate of the Yb3+ spins. Above the transition temperature, the rate, in the GHz range, follows a thermal excitation law, whereas below, the rate, in the MHz range, is temperature independent, indicative of a quantum fluctuation regime.

Estudio de la estabilidad del alcohol etílico en muestras forenses de sangre / Stability study of ethyl alcohol in stored forensic blood

En las pruebas periciales puede surgir la necesidad de repetir un análisis de alcoholemia transcurrido un cierto periodo de tiempo, por ello se decidió la realización de este estudio con la finalidad de conocer la variación de la tasa de alcoholemia a lo largo de tiempo. Para su realización se seleccionaron 145 muestras de sangre procedentes de autopsias de cádaveres y se distribuyeron en tres grupos en función del periodo de almacenamiento transcurrido entre el primero y el segundo análisis de alcoholemia (2 años ñ 1 mes, 1 año ñ 1 mes y menos de 48 horas). Durante éstos periodos de tiempo las muestras fueron almacenadas a 4°C.La técnica empleada para la realización del análisis fue la cromatografla de gases con detector de ionización de llama acoplada con analizador de espacio en cabeza. Los análisis se realizaron de acuerdo con el protocolo normalizado de trabajo del Centro y con las garantías de calidad que en él se reflejan. Para determinar si los cambios producidos en las alcoholemias fueron o no significativos se aplicó el test de Wilcoxon. En el grupo en el que el periodo de almacenamiento de las muestras entre análisis fue de 2 años ñ 1 mes las diferencias obtenidas fueron estadísticamente significativas con un 99 por ciento de nivel de confianza. Los otros dos grupos de muestras de sangre en los que los intervalos de tiempo transcurridos entre los dos análisis de alcoholemia fueron de 1 año ñ 1 mes y de menos de 48 horas, respectivamente no mostraron cambios estadísticamente significativos en los resultados obtenidos con un 99 por ciento de nivel de confianza (AU)

[Epidemiological study of Steinert's congenital myotonic dystrophy: dysmorphological characteristics]. / Estudio epidemiológico de la distrofia miotónica congénita de Steinert: características dismorfológicas.

OBJECTIVE: Steinert's congenital myotonic dystrophy (CMD) is a systemic disease with autosomal mother-to-child transmission and characterized by generalized hypotonia, areflexia, facial diplegia, respiratory and alimentary diseases, arthrogryposis, polyhydramnios, etc. We present the study of the clinical and epidemiological characteristics of Steinert's CMD in our population, with special attention to its dysmorphological features. PATIENTS AND METHODS: In this study we present the analysis of 12 cases of Steinert's CMD identified among 26,956 infants with congenital defects registered by the Spanish Collaborative Study of Congenital Malformations (ECEMC) between April 1976 and March 1998. RESULTS: The minimum estimation of the prevalence in our population is 0.08 per 10,000 live births. We have epidemiologically observed in newborns with Steinert's CMD the presence of a statistically significant difference in the following variables: lower gestational age and birth weight, more polyhydramnios, more feet presentations and Cesarean sections, and a higher frequency of similar congenital defects in first degree relatives. The congenital defects most frequently associated to our population of CMD are located in the extremities, the head and face. CONCLUSIONS: It is important to recognize the congenital defects associated with neuromuscular disorders in the neonatal period, and particularly, the wide spectrum of Steinert's CMD that results in a fetal hypokinesia deformation sequence.

Determination of endosulfan and its metabolites in human urine using gas chromatography-tandem mass spectrometry.

A method was developed for determining the occupational exposure to endosulfan and its main metabolites (endosulfanether, -lactone and -sulfate) in human urine using dieldrin as an internal standard. Solid phase extraction (SPE) and gas chromatography-tandem mass spectrometry (GC-MS-MS) have been used due to their high sensitivity and selectivity in avoiding most matrix interferences. The recovery efficiencies of the tested compounds yielded more than 89.2% at the fortification level of 10 ng ml(-1) in urine and their relative standard deviations were between 9.1 and 12.8%. The detection limit of each compound ranged between 6 and 18 pg ml(-1). Urine samples from nine pest control operators were analysed and total endosulfan concentrations between 94 and 2038 pg ml(-1) were found.

Gas chromatographic data for 187 nitrogen- or phosphorus-containing drugs and metabolites of toxicological interest analysed on methyl silicone capillary columns.

Retention data, retention indices and retention times relative to diazepam, associated with 187 nitrogen- or phosphorus-containing drugs and metabolites likely to be found in toxicological analysis, are presented. The work was carried out with cross-linked methyl silicone, siloxane-deactivated fused-silica capillary columns in different gas chromatographs equipped with nitrogen-phosphorus flame ionization detectors and a gas chromatograph-mass spectrometer. Results show the high reproducibility offered by the capillary system, which permits the reduction of identification problems and analysis time.