[Frequency of spinopelvic alterations in postoperative total hip arthroplasty patients and their association with functional outcomes]. / Frecuencia de alteraciones espinopélvicas en pacientes postoperados de artroplastía total de cadera y su asociación con resultados funcionales.

INTRODUCTION: the analysis of spinopelvic imbalance in patients undergoing total hip arthroplasty has gained significance in recent years, being recognized as a risk factor for instability. Few reports exist regarding the prevalence of spinopelvic alterations in Latin American literature. The aim of this study is to determine the frequency of spinopelvic imbalance in our patients and to associate them with functional outcomes. MATERIAL AND METHODS: 29 patients who underwent total hip arthroplasty using a lateral approach (32 arthroplasties) were included. All patients completed clinical outcome questionnaires preoperatively. Twelve months after surgery, they underwent anteroposterior pelvic and lateral pelvic X-rays, both standing and sitting, and clinical outcome questionnaires were completed. The radiographic parameters examined were: pelvic incidence, lumbar lordosis, sacral slope, anterior pelvic plane and pelvic femoral angle. Functional outcome was assessed with the Harris Hip Score and WOMAC scales. Patients were classified according to their spinopelvic alteration and statistical analysis was performed to identify significant differences between the groups and the correlation with functional outcomes. RESULTS: there was a high frequency of spinopelvic balance alterations (46.8%); 6.2% (n = 2/32) presented isolated spinal stiffness (group 1B), 37.5% (n = 12/29) spinal deformity without spinal stiffness (group 2A) and 3.1% (n = 1/29) spinal deformity associated with stiffness (group 2B). We found no improvement in HHS and WOMAC scores in the groups with spinal stiffness (1B and 2B) (p = 0.98 y 0.15). There is association between spinal stiffness (SS < 10°) and poor functional outcomes (p = 0.02). CONCLUSIONS: the frequency of spinopelvic balance alterations was high. While there was no observed rise in prosthetic dislocations, the existence of spinal stiffness, defined by a SS of less than 10°, was associated to poor outcomes on functional scales.

INTRODUCCIÓN: el análisis de las alteraciones del balance espinopélvico en pacientes sometidos a artroplastía total de cadera ha adquirido importancia en años recientes, siendo reconocido como un factor de riesgo para inestabilidad. Existen pocos reportes de la prevalencia de alteraciones espinopélvicas en literatura latinoamericana. El objetivo de esta investigación es determinar la frecuencia de alteraciones del balance espinopélvico en nuestros pacientes y su asociación con los resultados funcionales. MATERIAL Y MÉTODOS: se incluyeron 29 pacientes intervenidos de artroplastía total de cadera mediante abordaje lateral (32 artroplastías). Todos los pacientes completaron escalas funcionales preoperatoriamente. A los 12 meses de la intervención, se valoró el balance espinopélvico mediante radiografías anteroposterior de pelvis y laterales de pelvis tanto de pie como en sedestación y completaron escalas funcionales. Los parámetros radiográficos valorados fueron: incidencia pélvica, lordosis lumbar, inclinación del sacro (sacral slope), plano pélvico anterior y ángulo pélvico femoral. El estado funcional se valoró con las escalas Harris Hip Score (HHS) y WOMAC. Se clasificó a los pacientes de acuerdo a su alteración espinopélvica y se realizó análisis estadístico para identificar diferencias significativas entre los grupos y la asociación con resultados funcionales. RESULTADOS: encontramos una elevada frecuencia de alteraciones del balance espinopélvico (46.8%); 6.3% (n = 2/32) presentaron rigidez espinal aislada (grupo 1B), 37.5% (n = 12/29) deformidad espinal sin rigidez espinal (grupo 2A) y 3.1% (n = 1/29) deformidad espinal asociada a rigidez (grupo 2B). En los grupos con rigidez espinal (1B y 2B) no hubo mejoría significativa en HHS y WOMAC (p = 0.98 y 0.15). Encontramos asociación entre la presencia de rigidez espinal (SS < 10°) y resultados funcionales subóptimos con valor de p = 0.02. CONCLUSIONES: la frecuencia de alteraciones en el balance espinopélvico fue elevada. A pesar de no verse reflejado en un aumento en la incidencia de luxaciones protésicas, la presencia de rigidez espinal caracterizada por un SS menor a 10° se asoció con resultados subóptimos en las escalas funcionales.

Síndrome de tolosa hunt: presentación de caso clínico / Tolosa Hunt syndrome: case report

El síndrome de Tolosa-Hunt es una entidad poco frecuente cuya etiopatogenia y mecanismos fi- siopatológicos son controversiales, se caracteri- za por cefalea asociada a parálisis de uno o más nervios craneales, diplopía, estrabismo y ptosis palpebral, ocasionados por el compromiso del seno cavernoso o la fisura orbitaria superior. Su diagnóstico es un reto y se aborda dentro de los diagnósticos diferenciales de las oftalmoplejías dolorosas. Con el objetivo de describir y actua- lizar el conocimiento sobre esta enfermedad se presenta el caso de una paciente de 14 años que acudió a consulta por cefalea intensa, dolor ocu- lar y afección de nervios craneales. Los hallazgos clínicos y la resonancia magnética confirmaron el diagnóstico del síndrome de Tolosa Hunt...(AU)

Utilidad del tromboelastograma en pediatría: correlación con pruebas habituales de la coagulación / Usefulness of the thromboelastogram in children: correlation with habitual coagulation tests

INTRODUCCIÓN: Los exámenes habituales de coagulación evalúan distintos elementos de la hemostasia en forma par cial, y no traducen las interacciones celulares, lo que es especialmente sensible en pacientes críticos. Las técnicas viscoelásticas, como el tromboelastograma (TEG) muestran el proceso de coagulación completo, y están siendo evaluadas como exámenes de la coagulación global. OBJETIVO: determinar la correlación de los exámenes habituales de coagulación con los valores del TEG, en niños atendidos en una unidad de cuidados intensivos (UCI). PACIENTES Y MÉTODO: Se revisaron 238 TEG de pacientes <18 años, con evidencia de alteración de coagulación clínica y/o de laboratorio, hospitalizados en UCI. Se correlacionaron los valores de los parámetros del TEG con cada uno de los valores de los exámenes habituales de coagulación. Los exámenes se obtuvieron según protocolo, utilizando una muestra de sangre de 4,5 ml para TEG con equipo TEG® 5000 Thrombelastograph Hemostasis Sys tem, mediante un transductor electromagnético que permite la medición de la resistencia durante la formación y lisis del coágulo. El recuento de plaquetas se obtuvo utilizando método automatizado o microscopía con contraste de fase; el fibrinógeno, tiempo de protrombina y de tromboplastina parcial activada por métodos nefelométricos. RESULTADOS: 201 TEGs correspondientes a 59 pacientes. Se evidenció una correlación moderada a baja en todos los parámetros medidos. No se encontró co rrelación entre porcentaje de lisis del coágulo, ni firmeza del coágulo. CONCLUSIONES: Existe una baja correlación entre la información entregada por TEG y los exámenes de coagulación habituales, esto sugiere que el TEG aporta información diferente acerca del estado de coagulación de los pacientes críticos evaluados.

INTRODUCTION: Usual coagulation tests partially evaluate different elements of hemostasis, and do not translate cell interactions, which is an especially sensitive issue in critically ill patients. Viscoelastic measurement techniques, such as thromboelastogram (TEG) show the complete coagulation pro cess and are being evaluated as global coagulation tests. OBJECTIVE: To determine the correlation of the usual coagulation tests with the TEG values, in children treated in an intensive care unit (ICU). PATIENTS AND METHOD: We reviewed 238 TEGs of patients under 18 years of age, with evidence of clinical and/or laboratory coagulation alterations, who were hospitalized in the ICU. The TEG para meter values were correlated with each of the usual coagulation test values. The tests were obtained according to the protocol, using a 4.5 ml blood sample for TEG with TEG® 5000 Thrombelastograph Hemostasis System, through an electromagnetic transducer that allows the measurement of resis tance during the clot formation and lysis. Platelet count was obtained using an automated method or phase-contrast microscopy, and fibrinogen levels, prothrombin time, and partial thromboplastin time activated by nephelometric methods. RESULTS: 201 TEGs corresponding to 59 patients were re viewed. A moderate to low correlation was observed in all the measured parameters. No correlation was found between the percentages of clot lysis or clot firmness. CONCLUSIONS: There is a low corre lation between the information provided by TEG and the usual coagulation tests. This suggests that the TEG provides different information about the coagulation status of the evaluated critical patients.

Usefulness of the thromboelastogram in children: correlation with habitual coagulation tests. / Utilidad del tromboelastograma en pediatría: Correlación con pruebas habituales de la coagulación.

INTRODUCTION: Usual coagulation tests partially evaluate different elements of hemostasis, and do not translate cell interactions, which is an especially sensitive issue in critically ill patients. Viscoelastic measurement techniques, such as thromboelastogram (TEG) show the complete coagulation pro cess and are being evaluated as global coagulation tests. OBJECTIVE: To determine the correlation of the usual coagulation tests with the TEG values, in children treated in an intensive care unit (ICU). PATIENTS AND METHOD: We reviewed 238 TEGs of patients under 18 years of age, with evidence of clinical and/or laboratory coagulation alterations, who were hospitalized in the ICU. The TEG para meter values were correlated with each of the usual coagulation test values. The tests were obtained according to the protocol, using a 4.5 ml blood sample for TEG with TEG® 5000 Thrombelastograph Hemostasis System, through an electromagnetic transducer that allows the measurement of resis tance during the clot formation and lysis. Platelet count was obtained using an automated method or phase-contrast microscopy, and fibrinogen levels, prothrombin time, and partial thromboplastin time activated by nephelometric methods. RESULTS: 201 TEGs corresponding to 59 patients were re viewed. A moderate to low correlation was observed in all the measured parameters. No correlation was found between the percentages of clot lysis or clot firmness. CONCLUSIONS: There is a low corre lation between the information provided by TEG and the usual coagulation tests. This suggests that the TEG provides different information about the coagulation status of the evaluated critical patients.

[Sickle cell disease: A diagnosis to keep in mind]. / Enfermedad de células falciformes: Un diagnóstico para tener presente.

Sickle cell disease (SCD) is an autosomal recessive genetic disorder. It is the most frequent structural hemoglobinopathy worldwide, and it is produced by an alteration in the globin chain genes. In Chile, there is no data on the prevalence of SCD since it is considered a very rare condition. The incidence of this disease has been increasing due to migration of people from areas with greater presence of SCD. It is important to know and consider this diagnosis in a selected group of patients with anemia, in order to prevent and treat the different complications of this disease. This article reviews the most recent information that shows new concepts in the knowledge of the physiopathology, and especially publications of guidelines and consensus in relation to the diagnosis and management of this con dition.

Enfermedad de células falciformes: un diagnóstico para tener presente / Sickle cell disease: a diagnosis to keep in mind

La enfermedad de células falciformes (ECF) es un trastorno genético autosómico recesivo. Es la hemoglobinopatía estructural más frecuente en todo el mundo y se produce por alteración en los genes de la cadena de globina. En Chile, no hay datos sobre la prevalencia de la ECF ya que es considerada una condición muy rara. La incidencia de esta enfermedad ha venido aumentando debido a la migra ción de personas de áreas con mayor prevalencia de ECF. Por esta razón resulta importante conocer y considerar este diagnóstico en un grupo seleccionado de pacientes con anemia, para prevenir y tratar las diferentes complicaciones de la enfermedad. En este artículo se revisan los nuevos aportes en el conocimiento de la fisiopatología, con especial énfasis en aquellas publicaciones de consenso y guías relacionadas al diagnóstico y manejo de esta entidad.

Sickle cell disease (SCD) is an autosomal recessive genetic disorder. It is the most frequent structural hemoglobinopathy worldwide, and it is produced by an alteration in the globin chain genes. In Chile, there is no data on the prevalence of SCD since it is considered a very rare condition. The incidence of this disease has been increasing due to migration of people from areas with greater presence of SCD. It is important to know and consider this diagnosis in a selected group of patients with anemia, in order to prevent and treat the different complications of this disease. This article reviews the most recent information that shows new concepts in the knowledge of the physiopathology, and especially publications of guidelines and consensus in relation to the diagnosis and management of this con dition.

Estudio longitudinal del estado nutricional y de la condición física de estudiantes de enseñanza media de un liceo municipal de Talca, Chile / Longitudinal study of the nutritional status and physical condition of high school students of a municipal high school of Talca, Chile

El objetivo de esta investigación es analizar las variables de estado nutricional y condición física de estudiantes de dos niveles de enseñanza media (primero y cuarto) durante los años 2016, 2017 y 2018, para saber cómo ingresan y cómo egresan del establecimiento. Se evaluaron parámetros de peso, talla y perímetro de cintura para el estado nutricional, mientras que para la condición física se contemplaron pruebas físicas de salto horizontal y flexo-extensión de codos. Las variables peso y salto horizontal sufrieron cambios. La primera tuvo un aumento constante durante los años de estudio en Primer Año Medio (p<0,068), lo cual conllevó a un aumento del IMC (p<0,054) mientras el salto horizontal tuvo una disminución significativa en Cuarto Año Medio (p<0,004). Con esto se determina que los parámetros de estado nutricional y condición física de los estudiantes evaluados sufren efectos negativos durante los años de investigación.

The objective of this research is to analyze the variables or nutritional status and physical condition of students from two high school grades (first and fourth year) during the years 2016, 2017 and 2018, to know their measurements upon entering and when leaving the establishment. For this, parameters of weight, height and waist circumference were evaluated in terms of nutritional status, while for physical condition; physical tests such as horizontal jump and elbow flexionextension were contemplated. The variables of weight and horizontal jumps underwent changes. The first had a constant increase during the years of study in first year (p<0,068), which led to an increase in BMI (p<0,054) while the horizontal jump had a significant decrease in fourth year (p<0,004). This determines that the parameters of nutritional status and physical condition of the students evaluated suffered negative effects during this research.

Circulating CD4+CD28null and extra-thymic CD4+CD8+ double positive T cells are independently associated with disease damage in systemic lupus erythematosus patients.

OBJECTIVE: To determine whether circulating CD4+CD28null and extra-thymic CD4+CD8+ double positive (DP) T cells are independently associated with damage accrual in systemic lupus erythematosus (SLE) patients. METHODS: This cross-sectional study was conducted between September 2013 and April 2014 in consecutive SLE patients from our Rheumatology Department. CD4+CD28null and CD4+CD8+ DP T-cell frequencies were analyzed by flow-cytometry. The association of damage (SLICC/ACR Damage Index, SDI) and CD4+CD28null and CD4+CD8+ DP T cells was examined by univariable and multivariable Poisson regression models, adjusting for possible confounders. All analyses were performed using SPSS 21.0. RESULTS: Patients' (n = 133) mean (SD) age at diagnosis was 35.5 (16.8) years, 124 (93.2%) were female; all were mestizo (mixed Caucasian and Amerindian ancestry). Disease duration was 7.4 (6.8) years. The SLE Disease Activity Index was 5.5 (4.2), and the SDI 0.9 (1.2). The percentages of CD4+CD28null and CD4+CD8+ DP T cells were 17.1 (14.4) and 0.4 (1.4), respectively. The percentage of CD4+CD28null and CD4+CD8+ DP T cells were positively associated with a higher SDI in both univariable (rate ratio (RR) 1.02, 95% confidence interval (CI): 1.01-1.03 and 1.17, 95% CI: 1.07-1.27, respectively; p < 0.001 for both) and multivariable analyses RR 1.02, 95% CI: 1.01-1.03, p = 0.001 for CD4+CD28null T cells and 1.28, 95% CI: 1.13-1.44, p < 0.001 for CD4+CD8+ DP T cells). Only the renal domain remained associated with CD4+CD28null in multivariable analyses (RR 1.023 (1.002-1.045); p = 0.034). CONCLUSIONS: In SLE patients, CD4+CD28null and CD4+CD8+ DP T cells are independently associated with disease damage. Longitudinal studies are warranted to determine the predictive value of these associations.

Coagulación en daño hepático crónico / Coagulation in chronic liver disease

Cirrhotic patients frequently exhibit abnormal coagulation tests such as prothrombin time (PT) and activated partial thromboplastin time (APTT) due to impairment in hepatic synthesis of coagulation factors. Due to these abnormalities and also to the numerous bleeding episodes that characterize advanced or decompensated liver cirrhosis, these patients were traditionally considered as “anticoagulated”. More recently, this paradigm has been challenged due to the increased occurrence of thrombotic complications among this population. This can only be understood when analyzed under the prism of the cellular theory of coagulation, which describes the complex interactions between endothelial, platelets and inflammatory cells that determine the status of coagulation, anticoagulation and fibrinolysis. The liver participates actively in this process contributing to the maintenance of a dynamic equilibrium in healthy patients. During liver failure there is evidence of impairment of synthesis of factors involved in the coagulation process, but also in anticoagulation and fibrinolysis. However, stable cirrhotic patients tend to maintain a delicate dynamic equilibrium. This equilibrium can be altered in acute decompensations leading to hemorrhagic or thrombotic complications.

Los pacientes con cirrosis presentan disminución en la producción de factores de coagulación de síntesis hepática, esto determina alteración del tiempo de protrombina (TP) y tiempo de tromboplastina parcial activada (TTPa). Esta característica, junto con los episodios de sangrado, que se presentan frecuentemente en pacientes descompensados y en etapa avanzada de la enfermedad, significó que por muchos años se considerara a los pacientes con daño hepático crónico como “anticoagulados”. En los últimos años este paradigma ha sido desafiado por estudios que muestran una mayor frecuencia de trombosis en esta población. Este fenómeno se comprende mejor con la teoría celular de la coagulación que integra a la ecuación las membranas celulares, especialmente de endotelio, plaquetas y células inflamatorias, y que permite visualizar las complejas interacciones entre factores coagulantes, anticoagulantes y fibrinolisis. El hígado participa en forma activa en este proceso que determina un amplio equilibrio dinámico en individuos sanos. El daño hepático claramente altera la coagulación, sin embargo, la evidencia actual demuestra que en la mayoría de los pacientes se produce un delicado rebalance hemostático, que determina una coagulación efectiva. Si este frágil equilibrio se altera, se produce un desbalance que puede generar un estado hemorrágico o trombótico.

[Subcutaneous catheter used for administration of low-molecular-weight-heparin in pediatrics]. / Catéter subcutáneo para la administración de heparina de bajo peso molecular en pediatría.

INTRODUCTION: Subcutaneous catheter is a device easy to assemble, which was created for the administration of insulin in diabetic patients, especially in children, aiming to reduce the number of punctures, pain and anxiety of patients and their parents. OBJECTIVE: To describe the experience using the catheter for subcutaneous administration of low molecular weight heparin (LMWH) in hospitalized pediatric patients. PATIENTS AND METHOD: A prospective descriptive study in 28 patients who used 87 subcutaneous catheters for the administration of LMWH in the Pediatric Service of the Universidad Catolica de Chile between July, 2010 and November, 2011. RESULTS: Complications associated with the catheter had an incidence of 33 % in total catheters evaluated; the most frequent complication was the presence of hematoma at the site of insertion (26%). These complications occurred more frequently in male (38% versus 31% in females) and younger patients (9 months versus 12 months), who received dalteparin (54% versus 30% of other types of heparin) administered every 24 hours (41% versus 30%, administered every 12 hours), and when the catheter was located on both thighs (36 % versus 32% in both arms); however, these differences were not statistically confirmed. CONCLUSION: The subcutaneous catheter is a good technique to be considered for LMWH in children as it presents minor complications for drug administration.

Catéter subcutáneo para la administración de heparina de bajo peso molecular en pediatría / Subcutaneous catheter used for administration of low-molecular-weight-heparin in pediatrics

Introduction: Subcutaneous catheter is a device easy to assemble, which was created for the administration of insulin in diabetic patients, especially in children, aiming to reduce the number of punctures, pain and anxiety of patients and their parents. Objective: To describe the experience using the catheter for subcutaneous administration of low molecular weight heparin (LMWH) in hospitalized pediatric patients. Patients and Method: A prospective descriptive study in 28 patients who used 87 subcutaneous catheters for the administration of LMWH in the Pediatric Service of the Universidad Catolica de Chile between July, 2010 and November, 2011. Results: Complications associated with the catheter had an incidence of 33 percentin total catheters evaluated; the most frequent complication was the presence of hematoma at the site of insertion (26 percent). These complications occurred more frequently in male (38 percent versus 31 percent in females) and younger patients (9 months versus 12 months), who received dalteparin (54 percent versus 30 percent of other types of heparin) administered every 24 hours (41percent versus 30 percent, administered every 12 hours), and when the catheter was located on both thighs (36 percent versus 32 percent in both arms); however, these differences were not statistically confirmed. Conclusion: The subcutaneous catheter is a good technique to be considered for LMWH in children as it presents minor complications for drug administration.

Introducción: El catéter subcutáneo es un dispositivo de fácil instalación, el cual fue ideado para la administración de insulinas en pacientes diabéticos, especialmente en pediatría, con el fin de disminuir el número de punciones, el dolor y la ansiedad de los pacientes y sus padres. Objetivo: Describir la experiencia del uso del catéter subcutáneo para la administración de heparina de bajo peso molecular (HBPM) en pacientes pediátricos hospitalizados. Pacientes y Método: Estudio descriptivo prospectivo en 28 pacientes que utilizaron 87 catéteres subcutáneos instalados para la administración de HBPM, en el Servicio de Pediatría de la Pontificia Universidad Católica de Chile en el período comprendido entre los meses de julio de 2010 y noviembre de 2011. Resultados: Las complicaciones asociadas al catéter presentaron una incidencia de 33 por ciento en el total de catéteres evaluados, siendo la más frecuente la presencia de hematoma en el sitio de inserción (26 por ciento). Estas complicaciones se presentaron con mayor frecuencia en pacientes de sexo masculino (38 por ciento versus 31 por ciento en sexo femenino) de menor edad (9 meses versus 12 meses), con indicación de dalteparina (54 por ciento versus 30 por ciento con otros tipos de heparina) administrada cada 24 h (41 por ciento versus 30 por ciento cuando fue administrada cada 12 h), y cuando el catéter estuvo ubicado en ambos muslos (36 por ciento versus 32 por ciento en ambos brazos); sin embargo, estas diferencias no fueron confirmadas estadísticamente. Conclusión: El catéter subcutáneo es una buena técnica a considerar para la administración de HBPM en la edad pediátrica, ya que permite la administración del medicamento con complicaciones leves asociadas a su uso.

Photoconductive logic gate based on platinum decorated carbon nanotubes.

Electrical and nonlinear optical experiments were performed on multiwall carbon nanotubes (CNTs) prepared by a chemical vapor deposition method. We report that the incorporation of platinum particles on the CNTs surface originates an enhancement in the photoconductive properties with noticeable capabilities to modulate optical and electrical signals. The photoconductive logic gate function OR was experimentally demonstrated using a simple photoconductive platform based on our samples. A two-photon absorption effect was identified as the main mechanism of third-order optical nonlinearity under a nonresonant nanosecond excitation. Multiphotonic interactions were described in order to explain the observed behavior.

Management of children with inherited mild bleeding disorders undergoing adenotonsillar procedures.

OBJECTIVE: To evaluate the incidence of perioperative bleeding among children with mild bleeding disorders who underwent adenotonsillar surgery in our hospital and were treated with our perioperative bleeding prophylaxis protocol. METHODS: Retrospective chart review was aimed at determining the perioperative bleeding rate in children with mild bleeding disorders subjected to our prophylactic protocol while undergoing adenotonsillar procedures. Low von Willebrand factor (LVWF), unspecific platelet function disorders (UPFD) and mild factor VII deficiency were considered as mild bleeding disorders. The protocol utilizes intravenous desmopressin, tranexamic acid, NSAID avoidance, and overnight observation. RESULTS: Between 2004 and 2009, 44 children with mild bleeding disorders underwent adenotonsillar procedures in our hospital and were treated with the protocol. One patient (LVWF+UPFD) developed perioperative bleeding (2.3%). CONCLUSIONS: It is possible to obtain low rates of perioperative bleeding in children with mild bleeding disorders undergoing adenotonsillar procedures, provided there is a well-timed diagnosis and an adequate prophylaxis protocol. We believe that further efforts must be directed at preoperative diagnosis of mild bleeding disorders to ensure safer surgeries.

Production of poly-ß-hydroxybutyrate (PHB) by Methylobacterium organophilum isolated from a methanotrophic consortium in a two-phase partition bioreactor.

The biodegradation of methane, a greenhouse gas, and the accumulation of poly-ß-hydroxybutyrate (PHB) were studied using a methanotrophic consortium and an isolated strain thereof. The specific rates for methane consumption were 100 and [Formula: see text] for the isolate and the consortium, respectively. Also the effect of including 10% (vv(-1)) of silicone oil in a two-phase partitioning bioreactor (TPPB) was assayed for the elimination of 1% methane in air stream. TPPB allowed a 33-45% increase of methane elimination under growing conditions. Nitrogen limitation was assayed in bioreactors to promote PHB production. Under this condition, the specific methane degradation rate remained unchanged for the consortium and decreased to [Formula: see text] for the isolated strain. The accumulated PHB in the reactor was 34% and 38% (ww(-1)) for the consortium and the isolate, respectively. The highest productivity was obtained in the TPPB and was 1.61 mg(PHB)g(x)(-1) h(-1). The CZ-2 isolate was identified as Methylobacterium organophilum, this is the first study that reports this species as being able to grow on methane and accumulate up to 57% (ww(-1)) of PHB under nitrogen limitation in microcosm experiments.

Pileflebitis asociada a apendicitis aguda en una niña de 11 años / Pylephlebitis associated to acute appendicitis: report of an eleven years old patient

We report a 11 years old female who presented fever and pain in the lower abdomen. An abdominal CAT sean showed the presence of an acute appendicitis and a mesenteric vein thrombosis. The patient was operated laparoscopically and received antimicrobials and anticoagulants, with a good evolution. It is important an early suspicion and aecurate treatment for this complication.

Se presenta el caso clínico de una paciente de 11 años de edad, que cursa un cuadro febril asociado a dolor abdominal hipogástrico. Se realizan estudios de laboratorio e imágenes y se diagnostica una apendicitis aguda asociada a una trombosis de la vena mesentérica superior. Se efectúa apendicectomía laparoscópica y se administra tratamiento antibiótico y anticoagulante, tras lo cual la paciente evoluciona en buenas condiciones. Es importante una sospecha precoz y un tratamiento adecuado para tratar esta complicación.

Utilização do ultrassom modo-B no estudo do sistema reprodutivo de fêmeas suínas / Use of the mode-B ultrasound on the evaluation of the sows reproductive system

A introdução da ultrassonografia em tempo real na suinocultura tem ocasionado um forte impacto no desenvolvimento da técnica de avaliação do desempenho reprodutivo de fêmeas suínas. Com o uso dessa tecnologia, é possível diagnosticar gestação precocemente, além de determinar a viabilidade embrionária e fetal; estabelecer melhores programas de inseminação artificial para cada granja; diminuir o tempo de introdução de fêmeas de reposição sem prejudicar seu desempenho reprodutivo; determinar patologias do trato urogenital, como a presença de cistos ovarianos ou mesmo infecções urinárias, o que implica um melhor aproveitamento não somente dos animais, como também dos funcionários e equipamentos.(AU)

The introduction of real time ultrasound on swine industry has had a strong impact in the development of the reproductive performance evaluation of swine herds. With this technology, it is possible to diagnose gestation precociously, to determine the embryonic and fetal viability, to establish better programs of artificial insemination for each farm; to decrease the time of replacement females without impairing the reproductive performance and to diagnose pathologies of the urogenital tract, like ovarian cysts or urinary infections. Therefore, the mode-B ultrasound represents an excellent tool to improve the reproductive parameters of the farm.(AU)

Utilização do ultrassom modo-B no estudo do sistema reprodutivo de fêmeas suínas / Use of the mode-B ultrasound on the evaluation of the sows reproductive system

A introdução da ultrassonografia em tempo real na suinocultura tem ocasionado um forte impacto no desenvolvimento da técnica de avaliação do desempenho reprodutivo de fêmeas suínas. Com o uso dessa tecnologia, é possível diagnosticar gestação precocemente, além de determinar a viabilidade embrionária e fetal; estabelecer melhores programas de inseminação artificial para cada granja; diminuir o tempo de introdução de fêmeas de reposição sem prejudicar seu desempenho reprodutivo; determinar patologias do trato urogenital, como a presença de cistos ovarianos ou mesmo infecções urinárias, o que implica um melhor aproveitamento não somente dos animais, como também dos funcionários e equipamentos.

The introduction of real time ultrasound on swine industry has had a strong impact in the development of the reproductive performance evaluation of swine herds. With this technology, it is possible to diagnose gestation precociously, to determine the embryonic and fetal viability, to establish better programs of artificial insemination for each farm; to decrease the time of replacement females without impairing the reproductive performance and to diagnose pathologies of the urogenital tract, like ovarian cysts or urinary infections. Therefore, the mode-B ultrasound represents an excellent tool to improve the reproductive parameters of the farm.

Immunosuppression with generic tacrolimus and mycophenolate mofetil in renal transplant recipients: preliminary report in Chile.

The association of tacrolimus (TAC) and mycophenolate mofetil (MMF) in renal transplant patients has diminished the incidence of acute rejection. We evaluated the use of generic TAC and MMF as primary immunosuppression in 6 living related (LR) and 11 cadaveric (C) donor renal transplant recipients (9 men, 8 women) of mean age 37 +/- 12 years (range, 17-56 years) between May 2006 and June 2007. From day 0 all patients received TAC, MMF, and prednisone without antibody induction. They were followed for the development of acute rejection, graft loss, side effects, and mortality. Mean follow-up was 7.6 months (range, 2-15 months). No biopsy-proven acute rejection episodes, graft loss, or recipient deaths were observed. Creatinine levels at the end of the study were 1.90 +/- 1.0 mg/dL (range, 0.62-4.25 mg/dL for C recipients and 1.19 +/- 0.15 mg/dL (range, 0.91-1.35 mg/dL) for LR recipients. Mean systolic and diastolic blood pressures were 130/73 mm Hg with 12 patients (70.5%) on antihypertensive therapy with calcium antagonists and beta-blockers. Mean (range) of total cholesterol, triglycerides, and glucose were 172 (110-244) mg/dL, 139 (69-277) mg/dL, and 89 (63-129) mg/dL, respectively. MMF was suspended in 1 patient due to diarrhea and 1 other because of leukopenia. We observed that generic TAC and MMF yielded effective and safe immunosuppression in terms of mortality, biopsy-proven acute rejection, and graft loss with a low incidence of adverse effects during the study period.

Tratamiento de anemia aplásica severa adquirida en pacientes pediátricos con inmunosupresión y trasplante alogénico de precursores hematopoiéticos / Treatment of acquired severe aplastic anemia in pediatric patients with immunosupression and allogeneic stem cell hematopoyetic transplant

Background: Severe acquired aplastic anemia (SAA) is an uncommon disease of childhood. Patients with SAA receive supportive care with transfusions and timely treatment of opportunistic infections, along with specific therapies, which may be allogenic stem cell transplantation (SCT) from a matched sibling or immunosupressive therapy (IT). Aim: To report the experience in the management of SAA. Patients and methods: Twenty five children with acquired SAA were treated from July 1992 to September 2005. Patients with full matched sibling donors received allogenic SCT after conditioning with a cyclophosphamide containing regimen. The other patients received immune suppression with cyclosporine plus methylprednisolone (n= 18) plus ATG (n=17). All received supportive care until recovery of hematopoietic function. Those who had severe opportunistic infections at diagnosis or did not respond to two cycles of ATG were evaluated for unrelated donor SCT. Results: Seven patients received sibling donor SCT and 18 IT, which was repeated in six. Three patients received mismatched related (1) or unrelated (2) SCT. Nineteen patients survived with a median follow up time of 4 years, 14 with full hematologic recovery. Six patients died: four due to infections after IT or SCT, one due to intracranial hemorrhage and one with secondary myelodysplasia 12 years after IT. Conclusions: Most children with SAA can be treated successfully with sibling donor SCT or IT. Patients without a histocompatible sibling who fail to respond to IS have a worse prognosis.

[Hematopoietic stem cell transplantation for patients with Wiskott-Aldrich syndrome]. / Trasplante alogénico de precursores hematopoyéticos en pacientes con síndrome de Wiskott-Aldrich.

BACKGROUND: Wiskott-Aldrich syndrome (WAS) is an X linked congenital disease that presents as eczema, thrombocytopenia and immune deficiency. The only curative procedure for this illness is hematopoietic stem cell transplant (HSCT), preferably from a healthy HLA identical sibling donor. Cord blood is becoming an excellent alternative as stem cell source from unrelated donors. AIM: To report our experience with HSCT in children with WAS. PATIENTS AND METHODS: Six boys with WAS diagnosed at 1 to 6 months of age were transplanted at our institution. All of them developed eczema and thrombocytopenia. Two had episodes of severe bleeding and three had repetitive infections (two with recurrent pulmonary infections and one a recurrent otitis). Three patients had a positive family history. Two received HSCT from sibling donors and four from unrelated cord blood donors at 7 months to 4 years of age. RESULTS: AH 6 patients had full hematopoietic engraftment after transplantation. Three had mild chronic graft-versus- host disease which responded to immune suppressive therapy. One patient died of cytomegalovirus related pneumonia 111 days after grafting. The other 5 patients are alive and healthy 11 to 104 months after transplantation. CONCLUSIONS: HSCT is an effective treatment for patients with WAS. The procedure should be done as soon as diagnosis is confirmed and before life threatening infections occur.