Paciente joven con nódulos pulmonares / Young patient with pulmonary nodules

Describimos el caso de una paciente de 33 años que ingresó por dolor centrotorácico de características pleuríticas, tos, disnea y síndrome constitucional. En la radiografía de tórax se observaron infiltrados pulmonares nodulares bilaterales. Tras la realización de una biopsia pulmonar se llegó al diagnóstico de micosis pulmonar causada por Cryptococcus neoformans.La criptococosis pulmonar es una entidad poco habitual, que puede afectar tanto a individuos inmunodeprimidos como a inmunocompetentes, aunque con menor frecuencia en estos últimos.Este caso demuestra la importancia de considerar causas in-fecciosas en el diagnóstico diferencial de nódulos pulmonares. Destacamos a su vez lo poco habitual de la infección por Cryp-tococcus en pacientes inmunocompetentes

The case of a 33 year-old patient is described; she was admitted to hospital due to pleuritic chest pain, cough, dyspnoea and constitutional syndrome. Infiltrated bilateral lung nodules were observed in the chest x-ray. After performing a lung biopsy, the diagnosis was lung micosis due to Cryptococcus neoformans. Lung cryptococcus is an uncommon entity that can affect both immunodeficient and immunocompetent individuals, although less frequent in these latter. This case demonstrates the importance of considering infec-tious causes in the differential diagnosis of pulmonary nodules. At the same time, it must be noted that infections due to cryptococcus is in immunocompetent patients are rare

Long constructs in the thoracic and lumbar spine with a minimally invasive technique.

BACKGROUND: Literature about long implants used together with a minimally invasive spine surgery (MISS) technique is scarce. Our objective is to contribute our surgical experience in this field and to specifically focus on several technical details. PATIENTS AND METHODS: A digitally-dissected canal along the paravertebral muscles was created linking the stab wounds on each side in relation with the pedicles to be cannulated. Screws were inserted following the percutaneous technique. Long rods were modelled, threaded through the extender sleeves along the paravertebral canal and pushed into the screw heads with the reduction forceps. When fusion was needed, the facet complex was decorticated with a drill. To insert a cross-link, a canal between the 2 rods was digitally created and the spinous process was drilled. RESULTS: 8 patients underwent surgery (age range: 25-77 years). Indications were postosteomyelitis kyphosis in 3 patients, bone tumor in 3, and spine fracture in 2. No blood transfusions were necessary during or after surgery. A cross-link was inserted in 2 patients. Posterolateral bone fusion was attempted in 4, but radiologically identifiable in none. In one patient a cantilever manoeuvre was done to correct kyphosis. Mean duration of surgery was 4 h. There were no clinical complications related to the operation or the hardware (mean follow-up of 7.14 months, range: 1-15 months). CONCLUSION: The application of MISS techniques can be broadened to long spinal constructs to assess fractures, tumors or deformity, especially in elderly or debilitated patients. Nevertheless, posterolateral fusion is still a challenge through these limited exposures.

Development of a bioremediation process by biostimulation of native microbial consortium through the heap leaching technique.

Heap leaching is an effective and widely used method of recovering metals from low-grade ores. However, the heap leaching technique has not yet been used in other biotechnological processes such as bioremediation. This work describes biostimulation of the native microbial consortium as a novel application of the heap leaching technique to bioremediate mining soils contaminated with hydrocarbons. Microorganisms present in the polluted soil were isolated in a liquid mineral solution using diesel fuel as the sole energy and carbon source. Biodegradation activity was evaluated and two genera, Flavobacterium and Aspergillus, were identified as the primary microorganisms that degraded hydrocarbons in the polluted soil. In order to simulate the heap leaching process on a laboratory scale, using both columns and piles, the contaminated soil was mixed with different sand concentrations and was agglomerated before it was used. Three flow rates, of the mineral solution, were evaluated. Of the rates tested, biodegradation was most efficient at a flow rate of 200 ml h(-1). The heap leaching technique demonstrated good efficiency in the column and pile, with a 2% soil-sand mixture lowering the TPH concentration from 61,000 to 1800 mg kg(-1) (98.5%) in 15 d.

Peritoneal carcinomatosis by pineoblastoma secondary to ventriculoperitoneal shunt

Los tumores primitivos neuroectodermicos normalmenteproducen metástasis en el eje craneoespinal.Las metástasis estracraneales por estos tumoresson infrecuentes y son debidas a diseminación a travésdel líquido cefalorraquídeo. Hasta la fecha, hansido descritos en la literatura 62 casos que nos informansobre carcinomatosis peritoneal secundariaa diseminación a través de un shunt ventriculoperitoneal,cuatro de los cuales se han debido a pineoblastomas.Presentamos el caso de un pineoblastomaque evoluciona de esta forma tan poco frecuentey como responde a quimioterapia con platinos y taxanos.Después haremos un repaso de la literaturadescrita hasta el momento actual sobre esta patología

The primitive neuroectodermal tumors (PNETs) produce metastases in the basicranial axis. Extracranialmetastases are infrequent and occur by disseminationthrough the cerebrospinal fluid (CSP). Sixtytwo cases of peritoneal carcinomatosis have beenreported to date as due to a ventriculo-peritonealshunt (VPS), four of them by pineoblastoma. Wepresent the case of a pineoblastoma showing thisextremely rare evolution and its response to platinumcompounds and taxanes. We reviewed the literature which relates to this neoplasm and its treatment (AU)

Levodopa withdrawal after bilateral subthalamic nucleus stimulation in advanced Parkinson disease.

CONTEXT: Subthalamic nucleus (STN) stimulation may be effective in ameliorating parkinsonian symptoms even to the extent to permit levodopa withdrawal. OBJECTIVES: To analyze the efficacy of STN stimulation in patients with Parkinson disease (PD) and to determine if levodopa may be withdrawn after surgery. DESIGN: Before-after trial. SETTING: Referral center, hospitalized care. PATIENTS: Fifteen patients with advanced PD. INTERVENTIONS: Microelectrode-guided bilateral STN high-frequency stimulation. OUTCOME MEASURES: Before surgery patients were evaluated in off-medication and on-medication conditions. Dopaminergic drug dosages were reduced after surgery, aiming for complete withdrawal. Six months after surgery, patients were reeavaluated in off- and on-medication conditions, with the stimulation turned on and off. RESULTS: Total Unified Parkinson's Disease Rating Scale (UPDRS) motor score in the off-medication condition improved by 65.9%; and axial symptoms, bradykinesia, rigidity, and tremor improved by 65.8%, 60.4%, 66.1%, and 81.1%, respectively. UPDRS part II scores were reduced by 71.8% and Schwab and England scores improved by 45.3%. Levodopa was withdrawn in 8 patients and the overall levodopa dose was reduced 80.4%. "Off" time was reduced 89.7% and the severity of dyskinesias decreased 80.6% after surgery. All results reached significance (P<.001). Stimulation of the STN achieved antiparkinsonian effect similar to that of treatment with levodopa. No life-threatening adverse effects occurred. CONCLUSIONS: Bilateral STN stimulation safely improves all parkinsonian symptoms, decreases or eliminates the need for levodopa, and ameliorates motor fluctuations and dyskinesias. Complete withdrawal of levodopa is feasible with this technique and the overall motor effect of STN stimulation is quantitatively comparable to that obtained with levodopa.

Curvatura cervical: estudio cefalométrico en posición de reposo clínico postural / Cervical curvature: a cephalometric analysis in a position of clinical rest

Background: Alterations in the head position and in cervical curvature are associated with mandibular dysfunction, an increased vertical occlusal dimension, upper airways obstruction and bad postural behaviors at work among other conditions. Aim: To perform a cephalometric analysis in young adults. Subjects and methods: Lateral cervical X-ray examinations were performed in 46 university students (26 female) aged 19 years old as a mean. Cephalometric landmarks and planes reported by Sollow & Tallgren, determined by investigators, were used for radiographic analysis. Results: The combined error of the method did not exceed 0.9­ for any studied variable. Mean craniocervical angulations were 102­ for OPT-SNL, 109­ for CVT-SNL, 94.8­ for craneum-C2 and 105 for SN-vertical. There were significant sex differences in craniocervical angulations and these were abnormal in two thirds of subjects studies. The Forward Head Position is characterized by a cervical compensation with head inclination. This abnormal postural position showed a dolichofacial growth and an alteration of hyoid angle. Conclusions: The craniocervical position appeared to be related to a vertical craniofacial growth pattern

[Spanish, Italian, and Portuguese immigration: Chile 1860-1930]. / La inmigracion espanola, italiana y portugesa: Chile 1860-1930.

"The paper refers to the amount and some characteristics of the Spanish, Italian and Portuguese immigration to Chile during the period 1860-1930. It is compared with [movements to] Argentina, Brazil, Cuba and Uruguay.... Different information sources are used and in spite of data weakness, the low preference for Chile of the European migratory flows is ratified as compared with those to Argentina.... It is pointed out that the migratory flows to Latin America, in particular to Chile, are associated, on the one hand, with the favourable... European [immigration] policy in this country and on the other hand with the huge European emigration overseas during that period." (SUMMARY IN ENG)

Comportamiento de cultivos mixtos bacterianos que utilizan metanol para biosíntesis de proteinas / Growth behavior of mixed bacterial cultures on methanol

Utilizando metanol como única fuente de carbono y energía, se aislaron diez cultivos mixtos, constituidos al menos por dos tipos de bacterias, morfológicamente diferentes. Las bacterias son Gram negativas y tienen como forma predominante la bacilar. Difieren en la apariencia de sus colonias, principalmente en el tamaño y grado de viscosidad. La colonias en medio sintético son apigmenteadas y cuando desarrollan en medios complejos son de color amarillo cremoso. Las bacterias que integran los cultivos mixtos no desarrollaron por separado en medio mineral, pero sí en un medio complejo, lo cual indica que se trata de metilótrofos facultativo. Dos de los cultivos (CM-3 y CM-15) fueron seleccionados para llevar a efecto estudios de producción de biomasa en fermentadores. Un tercer cultivo (CM-3A) que fue aislado a partir del CM-3 en cultivo continuo, fue tambiém seleccinado para el mismo propósito. En un sistema intermitente se establecieron las condiciones óptimas para el crecimiento (temperatura 37-C, concentración de metanol de 1.5% (v/v) y pH de 6.9 a 7.0). Los valores de las velocidades específicas de crecimiento fueron de 0.46 h-1 a 0.50 h-1 con tiempos de generación entr 1.50 h y 1.38 h. En cultivo continuo, los cultivos mixtos presentaron oscilaciones amplias sin haverse logrado estabilizar a ninguna de las velocidades de dilución ensayadas. Debido a estas oscilaciones se incluyeron valores promedio de concentración celular y de productividad. En general fueron poco susceptibles a la contaminación. Los cultivos CM-15 y CM-3 sintetizaron una substancia mucoide cuya concentración fue dependiente de las condiciones de operación. La velocidad específica de crecimiento máxima, determinada en sistema continuo, fue menor que la determinada en sistema intermitentee

Análisis de variables socioeconómicas para la estimación de los beneficios del proyecto colector cloacal Palmira-San Martín

Describe la situación socio-económica en el área de influencia del proyecto colector cloacal Palmira-San Martín. Contiene las bases metodológicas del estudio, una breve descripción del proyecto y de su área de influencia y por último los resultados de las estimaciones de las variables socio-económicas

Análisis de variables socioeconómicas para la estimación de los beneficios del proyecto colector cloacal Palmira-San Martín

Describe la situación socio-económica en el área de influencia del proyecto colector cloacal Palmira-San Martín. Contiene las bases metodológicas del estudio, una breve descripción del proyecto y de su área de influencia y por último los resultados de las estimaciones de las variables socio-económicas