High-velocity hot CO emission close to Sgr A*: Herschel/HIFI☠, ☠☠submillimeter spectral survey toward Sgr A.

The properties of molecular gas, the fuel that forms stars, inside the cavity of the circumnuclear disk (CND) are not well constrained. We present results of a velocity-resolved submillimeter scan (~480 to 1250 GHz) and [C ii] 158 µm line observations carried out with Herschel/HIFI toward Sgr A*; these results are complemented by a ~2'×2' 12CO (J=3-2) map taken with the IRAM 30 m telescope at ~7″ resolution. We report the presence of high positive-velocity emission (up to about +300 km s-1) detected in the wings of 12CO J=5-4 to 10-9 lines. This wing component is also seen in H2O (11,0-10,1), a tracer of hot molecular gas; in [C ii]158 µm, an unambiguous tracer of UV radiation; but not in [C i] 492, 806 GHz. This first measurement of the high-velocity 12CO rotational ladder toward Sgr A* adds more evidence that hot molecular gas exists inside the cavity of the CND, relatively close to the supermassive black hole (< 1 pc). Observed by ALMA, this velocity range appears as a collection of 12CO (J=3-2) cloudlets lying in a very harsh environment that is pervaded by intense UV radiation fields, shocks, and affected by strong gravitational shears. We constrain the physical conditions of the high positive-velocity CO gas component by comparing with non-LTE excitation and radiative transfer models. We infer T k≃400 K to 2000 K for n H≃(0.2-1.0)·105 cm-3. These results point toward the important role of stellar UV radiation, but we show that radiative heating alone cannot explain the excitation of this ~10-60 M ⊙ component of hot molecular gas inside the central cavity. Instead, strongly irradiated shocks are promising candidates.

Effects of yohimbine and drug cues on impulsivity and attention in cocaine-dependent men and women and sex-matched controls.

BACKGROUND: Deficits in executive function have been associated with risk for relapse. Data from previous studies suggest that relapse may be triggered by stress and drug-paired cues and that there are significant sex differences in the magnitude of these responses. The aim of this study was to examine the impact of the pharmacological stressor and alpha-2 adrenergic receptor antagonist yohimbine and cocaine cues on executive function in cocaine-dependent men and women. METHODS: In a double-blind placebo controlled cross-over study, cocaine-dependent men (n=12), cocaine-dependent women (n=27), control men (n=31) and control women (n=25) received either yohimbine or placebo prior to two cocaine cue exposure sessions. Participants performed the Connors' Continuous Performance Test II prior to medication/placebo administration and immediately after each cue exposure session RESULTS: Healthy controls had a significant increase in commission errors under the yohimbine condition [RR (95% CI)=1.1 (1.0-1.3), χ(2)1=2.0, p=0.050]. Cocaine-dependent individuals exhibited a significant decrease in omission errors under the yohimbine condition [RR (95% CI)=0.6 (0.4-0.8), χ(2)1=8.6, p=0.003]. Cocaine-dependent women had more omission errors as compared to cocaine-dependent men regardless of treatment [RR (95% CI)=7.2 (3.6-14.7), χ(2)1=30.1, p<0.001]. Cocaine-dependent women exhibited a slower hit reaction time as compared to cocaine-dependent men [Female 354 ± 13 vs. Male 415 ± 14; t89=2.6, p=0.012]. CONCLUSIONS: These data add to a growing literature demonstrating significant sex differences in behaviors associated with relapse in cocaine-dependent individuals.

Análisis comprensivo de los traumatismos torácios penetrantes atendidos en Hospital Padre Hurtado de Santiago / Penetrating chest trauma

Objectives: Penetrating chest trauma (PCT) is a life threatening condition that challenges emergency surgeons daily. The aim of this study is to make an epidemiological characterization of these patients, and secondarily analyze their treatment and outcome. Methods: A retrospective analysis of a series of consecutive patients experiencing PCT who presented at our hospital, was performed from 1st May 2009 to 30th April 2013. Results: Of 274 consecutive patients who presented to the emergency department (ED) with PCT, 257 (94 percent) were male and 17 (6 percent) were female. The median age was 26 (range 15-66) years. Stab wounds (SW) accounted for 185 (68 percent) of the injuries, and 80 (29 percent) suffered from gunshot wounds (GSW). As first treatment, chest tube drainage was performed in 229 (84 percent) patients, emergent thoracotomy in 21 (8 percent) and observation, in 13 (5 percent). 26 (9 percent) patients died: 21 (81 percent) from GSW and 4 (15 percent) with SW P<0.0001; 20 (77 percent) had heart or thoracic great vessels involvement. Thoracic complications occurred in 30 (12 percent) patients. There was no mortality associated with thoracic complications. The median hospital stay was 4 days. Conclusions: PCT is frequent in our hospital compared with historical series. The majority of the patients who died had cardiac or thoracic great vessels involvement due to GSW. Therefore, healthcare improvements are needed to reduce mortality in this group of patients.

Objetivos: Los traumatismos torácicos penetrantes (TTP) son graves y desafían diariamente a los cirujanos de urgencia. El objetivo de este estudio es realizar una caracterización epidemiológica de los pacientes con TTP, y como objetivo secundario analizar el tratamiento efectuado y su evolución. Métodos: Se realizó un estudio retrospectivo de los pacientes atendidos en el Hospital Padre Hurtado de Santiago que presentaron un TTP desde el 1 de mayo de 2009 hasta el 30 de abril de 2013. Resultados: 274 pacientes que se consultaron al servicio de urgencia con un TTP, 257 (94 por ciento) eran hombres y 17 (6 por ciento) eran mujeres. La mediana de edad fue 26 (15-66) años. Lesiones por arma blanca 185 (68 por ciento), y 80 (29 por ciento) fueron por arma de fuego. Como primer tratamiento la pleurostomía fue realizada en 229 (84 por ciento) pacientes. La toracotomía de emergencia fue realizada en 21 (8 por ciento) pacientes. No se realizó tratamiento y solo observación en 13 (5 por ciento) de los casos. 26 (9 por ciento) de los pacientes murieron, 21 (81 por ciento) fueron consecuencia de lesiones por arma de fuego y 4 (15 por ciento) por arma blanca P<0,0001, 20 (77 por ciento) tenían lesiones cardíacas o de grandes vasos torácicos. 30 (12 por ciento) pacientes presentaron complicaciones torácicas. No hubo mortalidad asociada a complicaciones torácicas. La mediana de días de hospitalización fue 4. Conclusiones: El TTP es frecuente en nuestro hospital comparado con series históricas. La mayoría de los pacientes fallecidos presentaban TTP por arma de fuego con lesiones cardíacas o de grandes vasos torácicos. Se precisan mejoras asistenciales en este grupo para disminuir su mortalidad.

Resección traqueal y anastomosis primaria en traumatismo traqueo esofágico por arma de fuego / Tracheal resection and primary anastomosis in tracheoesophagueal gunshot trauma

Introduction: even though tracheoesophagueal lesions due to cervicothoracic gunshot wound are infrecuent, they should always be considered in a lesion of this kind, based on the proximity of the structures in this area, as well as the rapid compromise and deterioration that can develop these patients if the air way or vascular structures are damaged. Clinical case: we present a patient with a tracheoesophageal gunshot trauma and the surgical repair.

Introducción: las lesiones traqueo esofágicas secundarias a heridas de bala en cuello, a pesar de ser infrecuentes, siempre deben descartarse frente a un mecanismo de este tipo, no sólo por la proximidad de las estructuras sino también por el importante compromiso y rápido deterioro que pudieran presentar estos pacientes si la vía aérea o estructuras vasculares se vieran comprometidas. Caso clínico: se presenta en este trabajo un paciente con lesión traqueo esofágica secundaria a herida de bala, además de la técnica de reparación utilizada.

Dermatitis atópica / Atopic dermatitis

La dermatitis atópica (DA) es una dermatosis pruriginosa crónica caracterizada por múltiples exacerbaciones y remisiones que se manifiestan de distintas formas según la edad del paciente. La DA es una de las patologías dermatológicas más comunes en los niños, con una prevalencia que varía entre el 5 y 20 por ciento en la primera década de la vida. En los pacientes con DA hay una tendencia a desarrollar otras condiciones alérgicas como eczema, asma y rinitis alérgica, lo que se denomina diátesis atópica, sin embargo, el fundamento fisiopatológico de esta asociación aún no ha sido aclarado y/o incluso es controversial. La DA es el resultado de interacciones genéticas, metabólicas, infecciosas, inmunes, neuroendocrinas y ambientales, por este motivo el manejo es complejo, multifactorial y las estrategias son hacia los distintos focos patológicos de cada caso en particular.

The atopic dermatitis (AD) is a chronic pruritic dermatitis, typified by multiple flare ups and remissions, which can vary according to the patients age. The AD is one of the most common childhood pathologies affecting between 5 to 20 per cent of the children before they reach the age of 10. Patients suffering from AD are prone to developing other allergic reactions such us eczema, asthma and allergic rhinitis. This condition is known as atopic diathesis; however, the physio-pathological basis of this association has not yet been clarified and is rather controversial.AD is the end result of a number of genetic, metabolic, infectious, immune, endocrine and environmental interactions, which makes it hard to treat because of the various aspects involved and the management strategies needed to deal with each particular case.

Aplicaciones de cirugía robot asistida en otorrinolaringología / Use of robot-assisted surgery in otorhinolaryngology

La introducción en el arsenal quirúrgico de los sistemas endoscópicos mínimamente invasivos robot-asistidos ha permitido un gran avance al permitir que cirugías complejas puedan llevarse a cabo en forma laparoscópica o toracoscópica. Las ventajas que éstos proporcionan son principalmente una visión estereoscópica y una versatilidad y precisión del movimiento comparable y en algunos casos superiores a las de un procedimiento abierto. Aunque tienen limitaciones cuando se utilizan en campos quirúrgicos reducidos, como en el caso de la cirugía de cabeza y cuello, esos beneficios por sobre métodos endoscópicos convencionales han permitido su uso en cirugía endoscópica de cuello y cirugía transoral robot-asistida. Hasta el momento se ha reportado su uso para procedimientos tan complejos como disección cervical, laringectomía supraglótica y cirugía de base de lengua. Estos reportes sientan las bases para el desarrollo de la cirugía robot-asistida en otorrinolaringología, la que podría evolucionar aún más cuando el instrumental robótico sea diseñado específicamente para este campo.

The introduction of minimally invasive robot-assisted endoscopic procedures has led to great advances in general surgery, allowing the performance of complex procedures by laparoscopy or thoracoscopy The main advantages of these systems are stereoscopic vision and motion precision and versatility comparable, and sometimes even superior, to open procedures. Although there are limitations when acting on confined spaces, as is the case in head and neck surgery, the advantages over conventional endoscopy have permitted the expansion of robot-assisted surgery to our field. To date, there have been reports of procedures as complex as selective neck dissection, supraglottic laryngectomy and base of tongue surgery. These reports are the first steps of the development of robot-assisted surgery on ENT and head and neck surgery, a field that will evolve tremendously when the robotic instrumentation is designed specifically for it.

A theoretical and experimental study of the fluxional behaviour of molybdenum dihydrobis- and hydrotris-pyrazolylborates.

The fluxional barrier of (dicarbonyl)[dihydrobis(3,5-dimethylpyrazol-1-yl)borato][eta-(1,2,3)-2-methylpropen-1-yl]-molybdenum (1) has been measured and a complete assignment of its (1)H, (13)C and (15)N NMR signals has been carried out. Theoretical calculations at the B3LYP/LANL2DZ level including GIAO absolute shieldings (sigma) have allowed to analyze the molecular contributions to the barrier as well as to assign some signals involved in the fluxional process.

Molecular recognition: improved binding of biotin derivatives with synthetic receptors.

NMR titrations and Monte Carlo conformational searches have been used to study the molecular recognition features of five urea derivatives with two synthetic hosts. We have improved the binding constant (Kb) values for all the studied guests and measured the largest binding constant of a complex involving a biotin derivative (biotin methyl ester) bound to a synthetic host by means of several interaction points and not only through the urea moiety.

A 1H, 13C and 15N NMR study in solution and in the solid state of six N-substituted pyrazoles and indazoles.

Three N-substituted pyrazoles and three N-substituted indazoles [1-(4-nitrophenyl)-3,5-dimethylpyrazole (1), 1-(2,4-dinitrophenyl)-3,5-dimethylpyrazole (2), 1-tosyl-pyrazole (3), 1-p-chlorobenzoylindazole (4), 1-tosylinda-zole (5) and 2-(2-hydroxy-2-phenylethyl)-indazole (6)] have been studied by NMR spectroscopy in solution (1H, 13C, 15N) and in the solid state (13C, 15N). The chemical shifts have been compared with GIAO/DFT calculated absolute shieldings. Some discrepancies have been analyzed.

Host-guest chemistry of tolbutamide.

The molecular recognition features of tolbutamide with four synthetic hosts have been studied by means of NMR titrations, NOESY experiments and Monte Carlo (MC) conformational search. The interaction strength and the most probable structure reveal new insights on the recognition phenomena of this urea derivative in comparison with close related compounds.

Towards the design of host-guest complexes: biotin and urea derivatives versus artificial receptors.

Molecular mechanics calculations (Macromodel v.5.0 and v.8.1) have been used in order to correlate the minimized energies of the complexes with the binding constant Kb values measured on two hosts and five urea derivatives including methyl biotin. Kb values obtained by means of NMR titrations, in the right concentration range between 20 and 80% of saturation, correlate well with the energies provided by the molecular modeling study of the complexes.

[Ring chromosome 20, hypersensitivity to valproate and hyperammonemic encephalopathy]. / Cromosoma 20 en anillo, hipersensibilidad al valproato y encefalopatía hiperamoniémica.

INTRODUCTION: Ring chromosome 20 syndrome (C20A) is characterised by mental retardation, behavioural disorders, dysmorphias and refractory epilepsy with polymorphic seizures. It should therefore be treated with broad-spectrum antiepileptic drugs (AEDs), such as valproate (VPA) and topiramate (TPM). The relatively frequent hypersensitivity reactions to aromatic AEDs, not to VPA, the hyperammonemic encephalopathy (HAE) caused by the combination of VPA and TPM and the chromosome disorder described, affecting the same patient, do not appear in the literature we reviewed. CASE REPORT: A patient aged 5 years who, at the age of 11 months, was seen to have psychomotor retardation, microcephaly, plagiocephaly, facial dysmorphia and hypotonia. At 26 months, the patient presented seizures with fever, sucking, perioral cyanosis, clonisms in the upper extremities and hypotonia. Karyotype: C20A, with no mosaicism. Treatment was started with VPA up to 600 mg/day, and moderate eosinophilia appeared from 450 mg/day onwards. At the age of 4 years, the patient suffered partial complex seizures, which stopped with the addition of TPM. At the same age there was also anorexia, loss of weight, adynamia, hypotonia, drowsiness, confusion, increased eosinophilia (20.3%) and IgE and a rash caused by the VPA. The clinical features yielded on adding dexchlorpheniramine. Nine months later, apathy, adynamia, eosinophilia and hyperammonemia reappeared; we therefore reduced and later stopped administration of VPA, although TPM was maintained. CONCLUSIONS: No relation between hypersensitivity to VPA, HAE and C20A has been described. The VPA TPM combination was effective, but in the end we had to stop administering VPA because of hypersensitivity and the side effects (HAE) of the combination.

Micosis fungoide granulomatosa unilesional / Unilesional granulomatous mycosis fungoides

La presencia de granulomas en el estudio histológico define una rara variante de micosis fungoide: la micosis fungoide granulomatosa. Presentamos el caso de una mujer de 68 años con una placa eritematoedematosa de 5 5 cm en región mandibular, estable durante 12 años y biopsiada con resultados similares en varias ocasiones. (AU)

On the duration of spatial fluency measures.

Various measures of spatial fluency have been developed and have been shown to be sensitive to right frontal lobe dysfunction. Patients with diffuse cerebral injuries (traumatic brain injury) also show impaired performance. Administration times for these tests range from three to five minutes. It is well known that longer tests provide more reliable data. In the present study, the base rates of unique designs and perseverative errors on the Five-Point Test were examined minute-by-minute for ten minutes, in a sample of healthy young adults (n=80). Contrasts between each minute showed significant decreases in number of unique designs to the ninth minute (significant at p<.001). Contrasts between each minute revealed significant increases (significant at p<.00l) in percentage of perseverative errors to the eighth minute. Data demonstrating the progressive decrease of unique designs and progressive increase of perseverative errors as a function of time have important implications for clinical practice. Optimal administration time is considered in the context of clinicians' objectives.

Stability of postconcussion symptomatology differs between high and low responders and by gender but not by mild head injury status.

A large sample of undergraduates (N = 2,326) were screened for general health. The screen discretely included items assessing postconcussion symptomatology and neurologic history. A subsample of experiment-blind participants whose self-reported postconcussion symptom levels were >0.5 SD below the screening sample mean (low symptomatic; n = 45) or >0.5 SD above the screening sample mean (high symptomatic; n = 53) were re-evaluated for postconcussion symptomatology 3 to 90 days later. The sample included 50 participants who reported history of mild head injury (MHI) and 48 controls. MHI was defined as loss of consciousness of < or =20 minutes within the past 10 years, but no more recent than 3 months. Persons with history of >1 head injury or with other neurologic history were not included in the study. The stability of postconcussion symptoms differed by high symptomatic versus low symptomatic presentation (high symptomatic presentation was more variable) and by gender (females were more variable), but not by actual history of MHI. Sex differences in self-reported postconcussion symptomatology are consistent with gender-related differences in reporting of other physical and psychological symptoms. In addition to demonstrating differences in the stability of self-reported postconcussion symptomatology, the current study provides normative test-retest data for the Postconcussion Symptom Checklist for extreme responders by gender and MHI status.

[Cytological screening of uterine cervical cancer by samples in liquid medium (CytoRich). Preliminary study of a series of 111 292 patients]. / Dépistage cytologique du cancer du col utérin par prélèvements en milieu liquide (CytoRich). Etude préliminaire d'une série de 111 292 patientes.

We report on the preliminary results of a series of 111,292 patients who benefited from a liquid medium sample (CytoRich) for cervical cancer screening. The number of dubious or limited smears was reduced by 0.03% and 0.53% respectively. The junction zone was better explored, and metaplastic changes were observed in 35.71% of the cases. This method improved the identification of low-grade lesions by +56% (2751/111,292; 2.47%) and of high-grade lesions by +75% (860/111,292; 0.77%), with a reduction in the number of ASCUS/AGUS by -44% (2065/111,292; 1.85%). This preliminary study confirms the results already published. The results demonstrating cytohistological correlation should prove to be a decisive factor, enabling the testing of the sensitivity and specificity of this technique. It will then be possible to envisage a future 'new paradigm' for screening cervical cancer as the result of a liquid medium sample, computer-assisted screening and HPV viral identification by Hybrid capture II.

Fine tuning the graphesthesia assessment: one stroke versus two.

The Finger-Tip Number-Writing test (Reitan, 1967; Reitan & Wolfson, 1993) is a standardized neuropsychological procedure for the evaluation of tactile perception. Test standardization has neglected to consider the variability associated with the way in which the numerals are traced. We present findings that suggest that the sensitivity of the test can be increased by tracing all numerals with one stroke.

Conocimientos y actitudes sobre el SIDA en el ámbito educacional medio y superior iquiqueño / Knowledge and attitude about AIDS in mid and high educational environment in Iquique

Entre los meses de septiembre y noviembre de 1989 realizamos 1897 encuestas voluntarias sobre el SIDA a alumnos de enseñanza media y universitaria de las carrera no relacionadas con estudios biológicos de la Universidad Arturo Prat. Por medio de esta encuesta se obtuvieron informaciones relacionadas con el nivel de conocimientos generales, medios de transmisión, prevención y actitudes que los estudiantes manejaban con respecto al SIDA. Comprobamos que el nivel de conocimientos sobre SIDA es bueno y alcanza un porcentaje igual a 80,82% de conocimiento aceptable, hubo un 17,54% de mal manejo o bien desconocen eltema. El rol de los profesores es informar, prevenir y educar desde una pespectiva moral, ética, social, psicológica y biológica

Coprophilous fungi of the horse.

A total of 1267 microfungi, including 35 Myxomycetes, were recorded from the fecal samples of the 60 horses; of these 395 were found on 20 saddle-horse feces, 363 on 20 race-horses and 509 on 20 working horses. Eighty two species representing 53 genera were recorded; of these 7 were Zygomycetes, 18 Ascomycetes, 1 Basidiomycetes and 25 Fungi Imperfecti: 2 Myxomycetes. Common coprophilous fungi are in decreasing order Pilobolus kleinii, Saccobolus depauperatus, Mucor hiemalis, Lasiobolus ciliatus, Podospora curvula, Petriella guttulata, M. circinelloides, Coprinus radiatus, Dictyostelium mucoroides, Sordaria fimicola, C. miser, C. stercorariusm, Acremonium sp., Coprotus granuliformis, Graphium putredinis, Iodophanus carneus, Chaetomium murorum, Podospora communis, P. inaequalis, P. setosa, Saccobolus versicolor and Cladosporium cucumerinum. Species of Myrothecium verrucaria, Actinomucor elegans, Kernia nitida, Spiculostilbella dendritica and Mucor parvispora were found exclusively in working-horses feces. Badhamia sp., Anixiopsis stercoraria, Echinobotryum state of D. stemonitis, Geotrichum candidum and Oidiodendron sp. were found only in saddle-horses feces. Chlamidomyces palmarum, Philocopra sp. were found exclusively in race-horses feces. Notes on infrequent or interesting fungi include Thamnostylum piriforme, Phialocephala dimorphospora, Rhopalomyces elegans and Spiculostilbella dendritica.