Clasificación, diagnóstico y tratamiento de los trastornos miccionales en la infancia / Classification, diagnosis and treatment of urinary disorders in childhood

La disfunción vesical o disfunción del tracto urinario inferior(DTUI), traducción literal del inglés de Lower urinary Tract Disfunction (LUTD) puede ser causa del 40% de las consultas en pediatría. Estos trastornos suponen una alteración en cualquiera de las fases del ciclo miccional y pueden responder a causas neurológicas, anatómicas o funcionales. Es muy importante realizar una adecuada historia clínica que nos permita conocer al paciente de manera global de manera que podamos lograr un correcto diagnóstico de la causa de la disfunción y así poder realizar un tratamiento dirigido. La evaluación de la mayoría de los niños con disfunción vesical puede limitarse a una anamnesis exhaustiva, un examen físico y pruebas no invasivas, como un análisis de orina y un urocultivo. En niños seleccionados, una evaluación más extensa incluye estudios de imagen urológicos, mediciones del flujo urinario y determinación del residuo postmiccional. En cuanto a las herramientas terapéuticas, partiremos de pautas higiénico-dietéticas básicas y de aplicación global a las que podremos asociar terapia conductual, farmacológica, fisioterápica o quirúrgica, siempre de manera individualizada.(AU)

Vesical disfunction or Lower urinary Tract Dysfunction (LUTD), can be the cause of 40% of pediatric consultations. Dysfunctions of the lower urinary tract involve an alteration in any of the phases of the voiding cycle and may respond to neurological, anatomical or functional causes. It is very important to take an adequate clinical history that allows us to know the patient globally so that we can achieve a correct diagnosis of the cause of the lower urinary tract dysfunction and thus be able to carry out targeted treatments. The evaluation for most children with bladder dysfunction can be limited to a thorough history, physical examination, and noninvasive testing, such as a urinalysis and urine culture. In selected children, more extensive evaluation includes urologic imaging studies, measurements of urinary flow, and post-void residual determination. As for therapeutic tools, we will start from basic hygienic-dietary guidelines of global application to which we can associate behavioral, pharmacological, physiotherapy or surgical therapy, always in an individualized manner.(AU)

Carotid glomus in childhood: presentation of a clinical case. / Glomus carotídeo en la infancia. Presentación de un caso clínico.

INTRODUCTION: Carotid glomus is an exceptional extra-adrenal paraganglioma in childhood originating at the carotid body. Only 3% of paragangliomas occur in the head and the neck. Familial forms, associated with Succinate Dehydrogenase (SDH) gene mutations, account for 10% of cases, the proportion being higher in childhood. They are benign in 95% of patients, but they can extend to both carotids. Treatment is surgical with or without previous embolization. Metastasis is rare and associated with malignant cases, which are limited. CLINICAL CASE: 8-year-old patient with a cervical mass originating 4 months ago and normal serum levels. Regarding family history, she had an aunt who underwent cervical surgery. Ultrasound examination demonstrated a greatly vascularized hypoechoic mass most likely related to carotid glomus. Full surgical resection without embolization was decided upon, which proved uneventful. The genetic study was positive for SDH gene mutation. CONCLUSION: Carotid glomus in childhood should be considered as a differential diagnosis in cervical masses. Surgical treatment without previous embolization represents a safe therapeutic option in selected cases.

INTRODUCCION: El glomus carotídeo es un paraganglioma extraadrenal, excepcional en la infancia, cuyo origen es el cuerpo carotídeo. Solo el 3% de los paragangliomas se presentan en cabeza y cuello. Existe un 10% de formas familiares asociadas a mutaciones en el gen de la succinato deshidrogenasa (SDH), porcentaje que es mayor en la infancia. Son tumores benignos en un 95% de los pacientes, pero pueden afectar por extensión a ambas carótidas. Su tratamiento es quirúrgico con o sin embolización previa. Las metástasis son raras y están asociadas a los escasos casos de malignidad. CASO CLINICO: Paciente de 8 años de edad con masa cervical de 4 meses de evolución, serologías normales. Como antecedente destaca una tía sometida a cirugía cervical. Ecográficamente se objetiva masa hipoecoica muy vascularizada en probable relación con glomus carotídeo. Se decide resección quirúrgica sin embolización que resulta completa y sin incidencias. Estudio genético positivo para la mutación en el gen de la SDH. CONCLUSION: El glomus carotídeo en la infancia ha de ser tenido en cuenta como diagnóstico diferencial en masas cervicales. El tratamiento quirúrgico sin embolización previa es una opción terapéutica segura en casos seleccionados.

Glomus carotídeo en la infancia. Presentación de un caso clínico / Carotid glomus in childhood: presentation of a clinical case

Introducción: El glomus carotídeo es un paraganglioma extraadre-nal, excepcional en la infancia, cuyo origen es el cuerpo carotídeo. Soloel 3% de los paragangliomas se presentan en cabeza y cuello. Existeun 10% de formas familiares asociadas a mutaciones en el gen de lasuccinato deshidrogenasa (SDH), porcentaje que es mayor en la infancia.Son tumores benignos en un 95% de los pacientes, pero pueden afectarpor extensión a ambas carótidas. Su tratamiento es quirúrgico con o sinembolización previa. Las metástasis son raras y están asociadas a losescasos casos de malignidad. Caso clínico: Paciente de 8 años de edad con masa cervical de 4meses de evolución, serologías normales. Como antecedente destacauna tía sometida a cirugía cervical. Ecográficamente se objetiva masahipoecoica muy vascularizada en probable relación con glomus ca-rotídeo. Se decide resección quirúrgica sin embolización que resultacompleta y sin incidencias. Estudio genético positivo para la mutaciónen el gen de la SDH. Conclusión: El glomus carotídeo en la infancia ha de ser tenido encuenta como diagnóstico diferencial en masas cervicales. El tratamientoquirúrgico sin embolización previa es una opción terapéutica segura encasos seleccionados.(AU)

Introduction: Carotid glomus is an exceptional extra-adrenal para-ganglioma in childhood originating at the carotid body. Only 3% ofparagangliomas occur in the head and the neck. Familial forms, associ-ated with Succinate Dehydrogenase (SDH) gene mutations, account for10% of cases, the proportion being higher in childhood. They are benignin 95% of patients, but they can extend to both carotids. Treatment issurgical with or without previous embolization. Metastasis is rare andassociated with malignant cases, which are limited. Clinical case. 8-year-old patient with a cervical mass originating4 months ago and normal serum levels. Regarding family history, shehad an aunt who underwent cervical surgery. Ultrasound examinationdemonstrated a greatly vascularized hypoechoic mass most likely relatedto carotid glomus. Full surgical resection without embolization wasdecided upon, which proved uneventful. The genetic study was positivefor SDH gene mutation.Conclusion: Carotid glomus in childhood should be considered as adifferential diagnosis in cervical masses. Surgical treatment without pre-vious embolization represents a safe therapeutic option in selected cases.(AU)

[Multilayer repair of palatal fistula with an interpositional collagen matrix]. / Reparación multicapa de la fístula palatina con interposición de matriz de colágeno.

OBJECTIVE: Palatal fistula after the repair of cleft palate appears in 7.7-35% of patients. We present two cases of palatal fistula, detailing a multi-layer repair with an interpositional collagen graft. MATERIAL AND METHODS: Patient 1: girl with a cleft palate operated using a Furlow technique. A reintervention was performed due to a Pittsburgh type III fistula. Patient 2: male with cleft palate operated using a Furlow technique. A reintervention was performed due to a type V fistula. RESULTS: We used a multilayer repair with a local rotational flap and the interposition of a collagen matrix between the nasal and oral layers. The suture was reinforced with a fibrin hemostatic adhesive. No recurrence of the fistula after 2 years. CONCLUSIONS: The three-layer closure is simple, safe, effective and avoids refistulizations. Interpositional grafts of a resorbable collagen membrane provide a "scaffold" for tissue growth, revascularization and epithelialization of the mucosa.

OBJETIVO: La fístula palatina tras la reparación del paladar fisurado aparece en un 7,7-35% de pacientes. Presentamos dos casos de fístula palatina, detallando la técnica de reparación multicapa con injerto interposicional de colágeno. MATERIAL Y METODOS: Paciente 1: niña con fisura de paladar blando, operada mediante técnica de Furlow. Se programa reintervención por fístula secundaria tipo III de Pittsburgh. Paciente 2: varón con fisura de paladar blando, operado mediante técnica de Furlow. Se programa reintervención por fístula secundaria tipo V. RESULTADOS: Reparación multicapa mediante flap rotacional y matriz de colágeno entre las capas nasal y oral. Refuerzo con adhesivo hemostático de fibrina. Ausencia de recidiva tras 2 años de seguimiento. CONCLUSIONES: El cierre en tres capas es sencillo y efectivo a la hora de evitar refistulizaciones. Los injertos interposicionales de membrana reabsorbible de colágeno proporcionan un "andamio" para el crecimiento de los tejidos, revascularización y epitelialización de la mucosa.

Risk of bursitis and other injuries and dysfunctions of the shoulder following vaccinations.

While vaccination injection site adverse reactions are usually mild and transient in nature, several cases of bursitis and other shoulder injuries have been reported in the medical literature. However, these lesions are not included in vaccine label inserts. To identify the characteristics of post-vaccination shoulder injuries and those of patients and involved vaccines, as well as their potential causes, a systematic review of the cases of vaccination-related bursitis and other shoulder injuries reported in the literature and notified to the Spanish Pharmacovigilance System database (FEDRA) have been conducted. We found 45 cases of bursitis and other shoulder injuries that appeared following the vaccine intramuscular injection given into the deltoid muscle (37 from the systematic review of the literature, and 8 from the scrutiny in the Spanish Pharmacovigilance System database, FEDRA). All the patients were adult, 71.1% females, with a mean and median age of 53.6years (range: 22-89). The most frequently involved vaccines were influenza and pneumococcal vaccines, respectively; followed by diphtheria-tetanus-pertussis, diphtheria-tetanus toxoid, human papillomavirus, and hepatitis A vaccines. The most frequent shoulder lesion was bursitis. Most of patients required medical care due to severe local pain and arm mobility restriction. In a majority of cases, symptoms started 48h post vaccination. Subdeltoid or subacromial bursitis and other shoulder lesions may be more common than suspected. Such lesions predominantly affect women. The cause may be related to antigens or adjuvants contained in the vaccines that would trigger an immune or inflammatory response. However, they are more likely to be the consequence of a poor injection technique (site, angle, needle size, and failure to take into account patient's characteristics, i. e., sex, body weight, and physical constitution). Therefore, vaccination-related shoulder injuries would be amenable to prevention.

[Laparoscopic assisted percutaneous treatment of inguinal hernia in infants]. / Tratamiento percutáneo asistido por laparoscopia de la hernia inguinal infantil.

INTRODUCTION: Thanks to the generalization of minimally invasive surgery in pediatric patients some classic techniques are being replaced. Inguinal hernia repair may be an example. MATERIAL AND METHODS: We present the technique and our first results in 10 patients treated by percutaneous laparoscopic assisted herniotomy. For this purpose we used an umbilical port, for a 5 mm camera and an optional 2 mm grasper. By laparoscopic guidance we make two inguinal punctures with a 20G needle that introduces a non absorbable suture that crosses the whole inguinal defect and allows it closure by extracorporeal knot tying. RESULTS: The ages ranged between 1 month and 8 years with a median age of 10 months. 50% of the patients were boys. 50% of the patients had previous diagnosis of inguinal bilateral hernia. 30% of patients presented a postoperatory diagnosis different from the previous one. The average time of intervention was 32 minutes in bilateral hernias, and 19 in the unilateral ones. Follow-up time was 6 months without complications. The aesthetic result was ideal. CONCLUSION: Percutaneous laparoscopic assisted herniotomy is an effective, simple and feasible option for inguinal hernia in chidren without a high rate of complications.

Tratamiento percutáneo asistido por laparoscopia de la hernia inguinal infantil / Laparoscopic assisted percutaneous treatment of inguinal hernia in infants

Introducción. Gracias a la generalización de la cirugía mínimamente invasiva en pacientes pediátricos se están sustituyendo algunas técnicas clásicas, como el tratamiento de la hernia inguinal, por nuevos abordajes asistidos por laparoscopia. Material y métodos. Presentamos nuestra técnica y nuestros primeros resultados de 10 pacientes tratados mediante herniotomía inguinal percutánea asistida por laparoscopia. Para ello utilizamos un puerto umbilical, por el que introducimos una óptica de 5 mm y una pinza opcional de 2 mm. Mediante dos punciones a nivel inguinal con una aguja de epidural de 20 G se introduce un hilo de sutura de 3/0 irreabsorbible que recorre todo el trayecto del orifico y permite que, al traccionar de este es de la piel, se cierre el orifico inguinal, quedando el nudo de sutura bajo una incisión subcutánea de 2 mm. Resultados. Las edades de los pacientes varían entre 1 mes y 8 años con una mediana de 10 meses. El 50% de los pacientes fueron niños. El 50% de los pacientes tenían diagnóstico previo de hernia inguinalbilateral y el resto, unilateral, 3 de los 10 pacientes presentaron un diagnóstico postoperatorio distinto al previo. El tiempo de intervención medio fue de 32 minutos en hernias bilaterales, mayor en varones, y 19 (..) (AU)

Introduction. Thanks to the generalization of minimally invasivesurgery in pediatric patients some classic techniques are being replaced. Inguinal hernia repair may be an example. Material and methods. We present the technique and our first results in 10 patients treated by percutaneous laparoscopic assisted herniotomy. For this purpose we used an umbilical port, for a 5 mm camera and an optional2 mm grasper. By laparoscopic guidance we make two inguinal punctures with a 20G needle that introduces a non absorbable suture that crosses the whole inguinal defect and allows it closure by extracorporeal knot tying. Results. The ages ranged between 1 month and 8 years with a median age of 10 months. 50% of the patients were boys. 50% of the patients had previous diagnosis of inguinal bilateral hernia. 30% of patients presented a postoperatory diagnosis different from the previous one. The average time of intervention was 32 minutes in bilateral hernias, and 19 in the unilateral ones. Follow-up time was 6 months without complications. The aesthetic result was ideal. Conclusion. Percutaneous laparoscopic assisted herniotomy isan effective, simple and feasible option for inguinal hernia in chidren without a high rate of complications (..) (AU)

Nefroureterectomía laparoscópica en el tumor de Wilms / Laparoscopic nephroureterectomy in wilms tumor

Introducción. La cirugía mínimamente invasiva (CMI) en el tratamiento de tumores malignos en la infancia comienza a tener un importante papel con resultados similares a la cirugía abierta en casos seleccionados. Presentamos nuestros dos primeros casos de tumor de Wilms tratados por laparoscopia. Material y métodos. Caso 1: niña de tres años de edad que acude or hematuria macroscópica. En el diagnóstico por imagen se identifi ca masa de 8 cm en riñón izquierdo en probable relación con tumor de Wilms. Tras 4 semanas de quimioterapia se realiza nefroureterectomía laparoscópica. El resultado anatomopatológico es tumor de Wilms estadio I de alto riesgo anaplásico. Se completa el tratamiento quimioterápico7 meses más. Caso 2: paciente de 5 años, diagnosticada de tumoración renal derecha de 6,5 cm en una ecografía realizada por abdominalgia en probable relación con tumor de Wilms. Después de 4semanas de quimioterapia se realiza nefroureterectomía laparoscópica. El resultado anatomopatológico es tumor de Wilms estadio II de alto riesgo (blastematoso). Se completa el tratamiento con quimioterapia ostoperatoria. Resultados. Después de 1 año de seguimiento ambas pacientes se encuentran libres de enfermedad. Conclusión. La CMI en casos seleccionados de tumor de Wilms cumple con éxito los objetivos del tratamiento quirúrgico (AU)

Introduction. Minimally invasive surgery (CMI) for the treatment of malignant tumors in children begins to have a role for selected cases and reaches similar results than open surgery. We show our first two cases of Wilms tumor treated by laparoscopy describing patients and technique. Material and methods. Three-year-old girl with macroscopic hematuriais diagnosed of 8 cm mass in the left kidney suggesting Wilms tumor. After 4 weeks of chemotherapy she went under laparoscopic nephroureterectomy. The histological result was Wilms tumor. Chemotherapy was completed seven more months. Five-year-old patient with abdominal pain is diagnosed of renal right mass suggesting Wilms tumor. After 4 weeks of chemotherapy the laparoscopic nephroureterectomy was performed. The histological result was Wilms tumor. Treatment was completes with postoperatory chemotherapy .Results. After 1 year follow-up both patients have clinical and radiological absence of disease. Conclusion. The CMI in selected cases of Wilms tumor fulfi llssuccessfully the aims of the surgical treatment (AU)

[Laparoscopic nephroureterectomy in Wilms tumor]. / Nefroureterectomía laparoscópica en el tumor de Wilms.

INTRODUCTION: Minimally invasive surgery (CMI) for the treatment of malignant tumors in children begins to have a role for selected cases and reaches similar results than open surgery. We show our first two cases of Wilms tumor treated by laparoscopy describing patients and technique. MATERIAL AND METHODS: Three-year-old girl with macroscopic hematuria is diagnosed of 8 cm mass in the left kidney suggesting Wilms tumor. After 4 weeks of chemotherapy she went under laparoscopic nephroureterectomy. The histological result was Wilms tumor. Chemotherapy was completed seven more months. Five-year-old patient with abdominal pain is diagnosed of renal right mass suggesting Wilms tumor. After 4 weeks of chemotherapy the laparoscopic nephroureterectomy was performed. The histological result was Wilms tumor. Treatment was completes with postoperatory chemotherapy. RESULTS: After 1 year follow-up both patients have clinical and radiological absence of disease. CONCLUSION: The CMI in selected cases of Wilms tumor fulfills successfully the aims of the surgical treatment.

[Role of alpha antagonists in uncoordinated micturition syndrome in childhood]. / Papel de los alfa-antagonistas en el síndrome de micción no coordinada en la infancia.

INTRODUCTION: Dysfunctional voiding syndrome in children is characterized by a pattern of dysfunctional bladder emptying due to an active contraction of the external sphincter during micturition. Diagnosis is based on electromyographic and flowmetry results. The treatment is focused on relaxing the external sphincter during micturition where biofeedback is the treatment of choice. By the moment there are still centres without this possibility, alpha blockers are an alternative. OBJECTIVE: To determine the efficacy of alpha blockers as an alternative to biofeedback as a therapeutic possibility. MATERIAL AND METHODS: We included a total of 17 children with dysfunctional voiding syndrome and carried out a retrospective study. We registered age, symptoms at diagnosis, presence of associated urologic problems, flowmetry results pre and post-treatment, type of treatment used and its effectiveness comparing patients treated with alpha blockers and those who are starting to deal with biofeedback. RESULTS: There were 12 girls and 5 boys. The mean age at diagnosis was 4.9 years old, 88% of these children related enuresis, diurnal urinary incontinence and urgency, 57% of them had also urinary infections, 63% constipation, 36% had psychosocial problems. Ten patients were treated with alpha-antagonists: 6 with Tamsulosin and 4 with Doxazosin. They followed this treatment an average of 5.8 months, range between 2 and 12 months. Five patients were treated with biofeedback. All cases had an abnormal pelvic electromyography. Patients treated with alpha-blockers achieved a 70% of electromyographic improvement with a 70% of recurrence. In children treated with biofeedback we got improvement in 80% with no recurrence. After alpha blocker therapy, maximum flow rates and average flow values were better but not statistically significant, this difference was significant with biofeedback. A patient treated with Tamsulosin left treatment due to hypotension, 2 patients left Doxazosin because of dizziness. CONCLUSIONS: Alpha-blockers are effective in the treatment of dysfunctional voiding syndrome with a high percentage of recurrence. They can be an alternative to biofeedback but this one is the effective and definitive treatment.

Deleterious versus neuroprotective effect of metabolic inhibition after traumatic spinal cord injury.

STUDY DESIGN: This work is an experimental and prospective study in adult, female, Long-Evans rats. OBJECTIVES: The aim of this study was to probe the effect of metabolic inhibition after an acute traumatic spinal cord injury (TSCI) using a standardized contusion model (NYU impactor) to know whether the metabolic inhibition is a 'secondary mechanism of injury' or a mechanism of protection. SETTING: All experimental procedures were carried out in the Mexico City. METHODS: Animals were divided into five groups: one sham and four with TSCI, including no treatment, rotenone (inhibitor of mitochondrial complex I), sodium azide (inhibitor of mitochondrial complex IV) and pyrophosphate of thiamine or non-degradable cocarboxylase as a metabolic reactivator. RESULTS: After TSCI, the metabolic inhibition with sodium azide treatment diminished the lipid peroxidation process (malondialdehyde levels by spectrophotometric procedures) and the damage to the spinal cord tissue (morphometric analysis), and increased the activity of creatine kinase and lactate dehydrogenase enzymes (P<0.05) (measured by spectrophotometric procedures 24 h after TSCI as well as after the functional recovery of the hind limb (evaluated weekly for 2 months by the BBB (Basso, Beattie and Bresnahan) scale)) when compared with the TSCI group without treatment. CONCLUSION: The results show that the partial and transitory inhibition of the aerobic metabolism after an acute TSCI could be a self-protection mechanism instead of being a 'secondary mechanism of injury'.

The LMS method and weight and height centiles in Jujuy (Argentina) children.

Human growth and its resulting patterns display a great inter- and intra-population heterogeneity that reflects the quality of life, health and nutritional condition of populations. The aim of this work was to expand the knowledge about the growth of Jujenean children by statistical procedures that graphically express the relation of anthropometric variables to age and allow their comparison with specific references. Anthropometric data came from 9092 children (0-5 years) from various localities of Jujuy province (northwest Argentina) located at 1200 m above sea level (ma.s.l.). The centiles of weight for age (W/A) and height for age (H/A) were obtained by the LMS method using maximum penalized likelihood. A statistical and graphic comparison was made with the corresponding Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) centile references. In general, estimated centiles were lower than those in both references. Discrepancies for H/A in comparison with the CDC reference ranged between 1.09+/-0.59% and 1.66+/-0.34%, and for W/A between 1.82+/-1.56% and 3.36+/-1.4%. In comparison with the WHO reference, discrepancies ranged from 1.38+/-0.65% to 1.87+/-0.41% for H/A, and from 1.12+/-1.28% to 2.74+/-1.49% for W/A. Centile discrepancies were attributed to the characteristics of early childhood feeding and the interaction of a set of biological and mesological factors that the Jujenean population is exposed to. Growth and nutritional conditions of this population should be evaluated with the WHO reference, for it reflects the recent growth pattern of biologically and culturally healthy children raised in favourable conditions, a pattern that also reflects that of Jujenean children.

[Geographic variability in prescribing antibiotics in the pediatric population of Castille and León during 2001-2005]. / Variabilidad geográfica de la prescripción de antibióticos en la población pediátrica de Castilla y León durante los años 2001 a 2005.

The aim of this study was to determine if there were differences in the antibiotic consumption among the pediatric population of the eleven Primary Health Care centers in the Community of Castilla Leon during the years 2001-2005 and to analyze the possible causes. Data of non-hospital antibiotic consumption in the pediatric population provided the amount of antibiotics billed in the Health Service of the area of Castilla and Leon (central region of Spain). The data was analyzed according to the Anatomic Therapeutic Chemical Classification System (ATC) and expressed as defined daily doses per 1000 inhabitants per day (DID). There were statistically significant differences in the use of antibiotics, varying 8.3 DID between the area with the highest rate (24.86 DID in Leon) and the area with the lowest rate (16.56 DID in Soria). The temporal fluctuations were great and varied especially in Segovia. The pattern of prescribing also varied. The use of penicillin in combination with beta-lacatamase inhibitors varied by a factor of almost three times between Burgos and Segovia. Segovia showed the best management in antibiotic prescriptions with data showing low consumption based on prescribing recommendations. Data from Soria showed low consumption but patterns of misuse in regard to protocols and prescribing. There was wide quantitative and qualitative variability of antibiotic use among the primary health care centers in the region of Castilla and Leon. More detailed studies by age groups, welfare pressure and indication are needed to better understand the determinants of antibiotic use in children.

Tratamiento fisioterápico de las alteraciones posturales y reflejos orales en la parálisis cerebral infantil, y otras alteraciones neurológicas. Ayudas técnicas para la alimentación / Physiotherapy treatment of the postural changes and oral reflexes in the children cerebral palsy and other neurological changes. Aids to feeding

En este trabajo se pretende describir las alteraciones posturales más frecuentes en la parálisis cerebral infantil (PCI), traumatismo craneoencefálico (TCE), y en la hemiplejia; y analizar cómo influyen éstas en las alteraciones orofaciales, presentes en la mayoría de estos pacientes. Se presenta una valoración de fisioterapia analítica de la disfunción orofacial, y se muestra un posible tratamiento de fisioterapia, adaptable a las diferentes alteraciones presentes en estos pacientes (AU)

Microdistributions of prospective BNCT-compound CuTCPH in tissue sections with a heavy ion microbeam.

Microdistributions of the prospective BNCT-compound CuTCPH, a carborane-containing tetraphenylporphyrin with one Cu atom in its molecular structure, have been obtained in tissue sections of different organs of tumor-bearing and normal Syrian hamsters injected with the boron compound by employing a heavy ion microbeam. High resolution X-ray spectroscopy following micro-PIXE (Particle Induced X-ray Emission with micrometer-sized beams) with a focused (16)O ion beam was used. Focusing was performed with a heavy-ion scanning high-precision magnetic quadrupole triplet microprobe. Squamous Cell Carcinomas were induced on the right Cheek Pouch of Syrian Hamsters (HCP), sampled, cryo-sectioned and freeze-dried. Two-dimensional maps of elemental concentration were obtained by scanning the beam over the samples. Very non-uniform Cu concentrations were found in all sections.

Parasitic mycelial forms of coccidioides species in Mexican patients.

Of 26 cases of coccidioidomycosis reported here, 15 showed hyphae, atypical parasitic structures of Coccidioides spp. in fresh cytologic and/or histologic specimen preparations. The finding of this morphology could have implications which should be considered, especially when the disease affects areas of nonendemicity.

Cambios histopatológicos en arterias humanas sometidas a procesos de isquemia fría y criopreservación / Histopathological changes in human arteries following cold ischemia and cryo preservation processes

Introducción. La creciente demanda de injertos vasculares ha provocado una búsqueda continua del método `ideal' para minimizar los daños vasculares durante el proceso de conservación. Objetivo. Estudiar la repercusión sobre la histología arterial del proceso de preservación del tejido en sus distintas fases. Pacientes y métodos. Hemos analizado 86 segmentos arteriales (ilíaca y femoral superficial) procedentes de 50 donantes. De cada segmento se obtuvieron tres muestras en distintas fases del proceso, y se establecieron otros tantos grupos de estudio: arterias frescas; postisquemia fría y poscriopreservación. El tiempo máximo de isquemia fria fue de 20 horas y las muestras se mantuvieron en solución antibiótica a 4 °C. La criopreservación se realizó en una solución con dimetil sufóxido (DMSO) con descenso térmico programado de 1 ºC / min con almacenamiento en fase gas (-150 °C a -190 °C). Se valoraron parámetros como la preservación del endotelio, la intensidad de cambios degenerativos (degeneración mixoide, apoptosis) en la pared arterial y la presencia de fracturas, comparando los resultados entre los distintos grupos. Se estudiaron igualmente las causas que llevaron al fracaso de algunos injertos. Resultados. El 81,4 por ciento de las arterias criopreservadas mostró una pérdida prácticamente total del endotelio (3,5 por ciento en los otros dos grupos) y más del 50 por ciento, importantes cambios degenerativos en su pared frente al 3,5 y 8,1 por ciento de los grupos 1 y 2. Conclusiones. El proceso de criopreservación provoca una importante pérdida endotelial y cambios degenerativos en la pared arterial. El tiempo de isquemia fría que se empleó en nuestro estudio no tiene repercusión en la estructura arterial (AU)