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OBJECTIVE: The objective of the study is to identify the risk factors associated with mortality at six weeks, especially by analyzing the role of antivirals and munomodulators. DESIGN: Prospective descriptive multicenter cohort study. SETTING: 26 Intensive care units (ICU) from Andalusian region in Spain. PATIENTS OR PARTICIPANTS: Consecutive critically ill patients with confirmed SARS-CoV-2 infection were included from March 8 to May 30. INTERVENTIONS: None. VARIABLES: Variables analyzed were demographic, severity scores and clinical condition. Support therapy, drug and mortality were analyzed. An univariate followed by multivariate Cox regression with propensity score analysis was applied. RESULTS: 495 patients were enrolled, but 73 of them were excluded for incomplete data. Thus, 422 patients were included in the final analysis. Median age was 63 years and 305 (72.3%) were men. ICU mortality: 144/422 34%; 14 days mortality: 81/422 (19.2%); 28 days mortality: 121/422 (28.7%); 6-week mortality 152/422 36.5%. By multivariable Cox proportional analysis, factors independently associated with 42-day mortality were age, APACHE II score, SOFA score at ICU admission >6, Lactate dehydrogenase at ICU admission >470U/L, Use of vasopressors, extrarenal depuration, %lymphocytes 72h post-ICU admission <6.5%, and thrombocytopenia whereas the use of lopinavir/ritonavir was a protective factor. CONCLUSION: Age, APACHE II, SOFA>value of 6 points, along with vasopressor requirements or renal replacement therapy have been identified as predictor factors of mortality at six weeks. Administration of corticosteroids showed no benefits in mortality, as did treatment with tocilizumab. Lopinavir/ritonavir administration is identified as a protective factor.

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OBJECTIVE: The objective of the study is to identify the risk factors associated with mortality at six weeks, especially by analyzing the role of antivirals and munomodulators. DESIGN: Prospective descriptive multicenter cohort study. SETTING: 26 Intensive care units (ICU) from Andalusian region in Spain. PATIENTS OR PARTICIPANTS: Consecutive critically ill patients with confirmed SARS-CoV-2 infection were included from March 8 to May 30. INTERVENTIONS: None. VARIABLES: Variables analyzed were demographic, severity scores and clinical condition. Support therapy, drug and mortality were analyzed. An univariate followed by multivariate Cox regression with propensity score analysis was applied. RESULTS: 495 patients were enrolled, but 73 of them were excluded for incomplete data. Thus, 422 patients were included in the final analysis. Median age was 63 years and 305 (72.3%) were men. ICU mortality: 144/422 34%; 14 days mortality: 81/422 (19.2%); 28 days mortality: 121/422 (28.7%); 6-week mortality 152/422 36.5%. By multivariable Cox proportional analysis, factors independently associated with 42-day mortality were age, APACHE II score, SOFA score at ICU admission >6, Lactate dehydrogenase at ICU admission >470U/L, Use of vasopressors, extrarenal depuration, %lymphocytes 72h post-ICU admission <6.5%, and thrombocytopenia whereas the use of lopinavir/ritonavir was a protective factor. CONCLUSION: Age, APACHE II, SOFA>value of 6 points, along with vasopressor requirements or renal replacement therapy have been identified as predictor factors of mortality at six weeks. Administration of corticosteroids showed no benefits in mortality, as did treatment with tocilizumab. Lopinavir/ritonavir administration is identified as a protective factor.

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BACKGROUND: CO2 resurfacing and CO2 microfractionated laser systems are reliable tools to improve different facial pathologic skin conditions but are associated with a high rate of complications specially in Fitzpatrick III, IV, and V skin phototypes, predominant in the Latin population, which has pushed many surgeons to change technologies and abandon its use. OBJECTIVE: To compare patient results with the CO2 resurfacing laser and microfractionated CO2 laser resurfacing in all skin types and show similar results to those obtained worldwide in patients with phototypes III, IV, and V. METHODS: Standardized review of medical records from a database of private practice patients treated since January 1998 to July 2012 with SlimE30 MiXto SX(®) CO2 laser. Evaluation of outcomes, complications, and satisfaction of three different modalities of treatment (CO2 ablative laser, CO2 microfractionated and a combination of both) was made. RESULTS: A total of 665 treated patients were included. Ablative CO2 was applied to 80.3 %, CO2 microfractionated to 15.1 %, and mixed treatment to 4.5 % of cases. Globally, hyperpigmentation rates were 30.4 % in the CO2 resurfacing group, 16.3 % when a combination of modalities was applied and 11 % in microfractionated CO2 cases. A steady increase of these rates is shown as the phototype becomes higher. Satisfaction rates were high for all groups: 86.7 % in the mixed group, 82.2 % in the microfractionated CO2, and 79.6 % in the CO2 ablative. CONCLUSIONS: Good results and an acceptable rate of complications in latin skins are obtainable after treating patients with CO2 ablative and microfractionated CO2 systems alone or in combination. Staged treatments and adequate post-procedure care reduce these complications.

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En el año 2008 fueron publicadas las recomendaciones para eltratamiento hacia el objetivo en artritis reumatoidea (treat to target:T2T). Originalmente diseñadas como recomendaciones para guiar areumatólogos en el tratamiento de la AR, en el año 2011 se publicóla primera versión para pacientes de estas recomendaciones eninglés.Objetivo: validar la versión para pacientes de las recomendacionesT2T para su uso en Argentina a través de la adaptación transculturalde la versión original.Método: Se realizó un proceso de adaptación transcultural a partirde la versión original. De este proceso de traducción y retraduccióny del análisis por parte de un comité de expertos, se obtuvo unaversión prefinal.Esta versión fue sometida a una prueba de campo mediante unaentrevista a pacientes alfabetos consecutivos con diagnósticode AR en diferentes centros de Buenos Aires, Ciudad de BuenosAires y Santa Fe. En esta entrevista se evaluó validez de forma,equivalencia conceptual, interpretabilidad y aceptabilidad. Elresultado obtenido de estas entrevistas fue discutido con el comitédesignado de investigadores para desarrollar una versión final dela pieza validada.Durante la entrevista se permitió leer la versión en español prefinaly se invitó a calificar de 0 a 10 cada oración de acuerdo al gradode comprensión del texto. A su vez se exploró el grado de acuerdoy de adaptabilidad a su problema de salud y se reemplazaron laspalabras que ofrecieron mayores dificultades...

In 2008 recommendations for the treatment towards the targetin rheumatoid arthritis (treat to target: T2T) were published.Originally designed as recommendations to guide rheumatologistsin the treatment of RA, in 2011 the first patient version of theserecommendations was published in English.Objective: To validate the Spanish version of the patient version ofthe T2T recommendations through cross-cultural adaptation of theoriginal version.Method: A cross-cultural adaptation process was made from theoriginal version. In this process of translation and back translationand analysis by a committee of experts, a prefinal version wasobtained.This version was subjected to a field test by interviewing alphabetsconsecutive patients diagnosed with RA at different centers inBuenos Aires, CABA and Santa Fe. Construct validity, cross-culturaladaptability, interpretation and acceptability were evaluated andlater discussed with the committee to get the final version.After reading patients had to point each sentence from 0 to 10according to the degree of understanding of the text. The degreeof agreement and adaptability to their health problem was exploredand words that offered greater difficulties were replaced...

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The recovery of proteins from effluents of beamhouse operations in a hair-pulping process of hides is proposed. Precipitation with sulphuric acid at the isoelectric pH was chosen for protein recovery. The precipitates were characterized in order to study their potential uses. Apart from the protein nitrogen, the precipitate also contained a considerable content of fats resulting from the co-precipitation of natural fat of the hide in the wastewaters. The precipitation of the protein fraction resulted in a reduction of 80-85% of COD, whereas the protein content decreased 68-78%. This diminution of the contamination load led to a notable reduction of the tax on wastewater. The content of protein material in the precipitate varied from 15 to 44%. As expected, the protein in the precipitate did not result from the collagen decomposition of the hide but from soluble proteins such as albumin and globulin and remains of keratin. The precipitates obtained met the maximum limits of heavy metals according to legislation on organic fertilizers. The potential uses of the protein fraction recovered from tannery wastewaters are currently being investigated.

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Objetivo: Conocer la epidemiología de los traumatismos craneales (TC) leves en un servicio de urgencias pediátricas mediante un estudio basado en la recogida de datos y su análisis estadístico, ya que su prevención mejorará con el mejor conocimiento de la epidemiología. Material y métodos: Serie de casos. Se elaboró una ficha de recogida de datos. Se efectuó estadística descriptiva. Resultados: La población del estudio estuvo compuesta por 153 pacientes (95 niños y 58 niñas), 94,1 % caucásicos. La madre trabajaba fuera de casa en el 68,6% de los casos. Las condiciones sociales eran desfavorables en un 6,5%. La mayor frecuencia de hermanos fue dos. La franja horaria más frecuente en que se produjeron los TC fue de 11 a 13 horas (24,9%). El lugar más frecuente fue el patio del colegio (19,6%). Del total de TC, un 35,3% se produjo en el domicilio y un 64,7% fuera de éste. En el 26,1% de los casos la lesión fue frontal, y recibieron tratamiento médico y/o cirugía menor el 52,9%. Conclusiones: Los TC leves atendidos son más frecuentes en niños menores de 5 años, varones (62,1%), precedidos de otro accidente en un 32,7% de los casos, y más de uno en el 19,7%. Ocurren con mayor frecuencia fuera del domicilio, siendo los lugares más frecuentes el patio del colegio y los parques. La región frontal fue la más afectada. La atención se realizó en menos de 2 horas en el 68% de los casos. No existieron criterios para efectuar neuroimagen

Objective. To determine the epidemiology of mild head injury by means of a study carried out among children treated in hospital emergency services. Material and methods. We evaluated 153 cases of pediatric head injury diagnosed in our institution. The data were analyzed using descriptive statistics. Results. The series consisted of 95 boys and 58 girls (94.1 % were white). In 68.6% of cases, the mother worked outside the home. The socioeconomic conditions were poor in 6.5%. The most prevalent number of siblings per family was two. Injuries were more frequent between 11:00 and 13:00 hours (24.9%). A large majority of the injuries were produced outside the home (64.7%), with 19.6% occurring at the school playground, while 35.3% occurred at home. Frontal region injury accounted for 26.1% of the cases and 52.9% were treated by medical procedures and/or minor surgery. Conclusions. Mild head injuries were most prevalent among children under 5 years of age and occurred more frequently in boys (62.1 %) than in girls; 32.7% of the children had had a previous head injury, while 19.7% had had more than one. The accidents occurred more frequently outdoors, mainly at the school playground and parks. The frontal region was that most often involved. The children received medical attention within 2 hours in 68% of cases. Neuroimaging was not necessary in our series

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OBJECTIVE: To evaluate components of clinical semiology in the differential diagnosis of communication disorders (TC) and their possible biological markers. We consider two groups, according to the communication disorders themselves and their effects on social interaction. In the first case both aspects are affected in parallel and in the second it is predominantly social interaction which is affected. DEVELOPMENT: In the first groups we studied dyslalias, dyrhrythmias, acquired aphasias, TC relation to epilepsy, types of seizures and EEG discharges. The dysphasia of development and epilepsy may be associated by chance, as a result of the same cause or the epilepsy be responsible for the TC, either because of seizures or continuously (acquired epileptic aphasia, SLK). Based on personal data and the literature we studied the semiology, possible biological markers and differential diagnosis. We consider disorders of neurone migration and metabolic alterations of initial neuropsychological semiology and cerebellar anomalies involved in cognitive functions. In the second group we assessed autism, generalized disorders of development and particular syndromes with semantic pragmatic TC. CONCLUSIONS: The development of language cannot be separated from other aspects of neurological maturation. One cannot affirm that there is a direct relationship between epilepsy and TC, although this does occur in some cases. We accept the hypothesis that SLK, POCSL and atypical EPB are clinical forms of the same syndrome of epilepsy. Recognition of the cognitive affective cerebellar syndrome by its involvement in social executive function, language and personality characterizes certain conditions (Williams, Asperger, fragile X, autism). A progressive rational battery of complementary studies on clinical data is essential to determine biological markers in syndromes which still lack them.

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Objetivo. Valorar elementos semiológicos clínicos en el diagnóstico diferencial de trastornos de la comunicación (TC) y sus eventuales marcadores biológicos. Consideramos dos grupos, según la propia afectación de la comunicación y de la interacción social. En el primero, se afectan paralelamente ambos aspectos; en el segundo, se afecta predominantemente la interacción social. Desarrollo. En el primer grupo, estudiamos dislalias, disritmias, afasias adquiridas, relación TC y epilepsia, tipos de crisis y descargas EEG; la disfasia del desarrollo y la epilepsia pueden asociarse fortuitamente, ser consecuencia de una misma causa o la epilepsia responsable del TC, bien de forma crítica, bien constante (afasia-epiléptica adquirida, SLK).Sobre datos de literatura y personales sobre SLK, estudiamos su semiología, marcadores biológicos posibles y diagnóstico diferencial. Consideramos trastornos de migración neuronal y alteraciones metabólicas de semiología inicial neuropsicológica y anomalías cerebelosas implicadas en funciones cognitivas. En el segundo grupo, valoramos el autismo, trastornos generalizados del desarrollo y síndromes peculiares con TC semanticopragmático. Conclusiones. El desarrollo del lenguaje no puede aislarse de otros aspectos de la maduración neurológica. No se puede afirmar relación directa entre epilepsia y TC, aunque hay casos en los que sí existe. Aceptamos la hipótesis de que SLK, POCSL y EPB atípica son formas clínicas de un mismo síndrome epiléptico. Reconocer el síndrome cerebeloso cognitivoafectivo por sus implicaciones en la función ejecutiva social, lenguaje y personalidad, caracteriza determinados procesos (Williams, Asperger, X-frágil, autismo). Una batería racional progresiva de estudios complementarios, sobre prerrequisitos clínicos, es básica para hallar marcadores biológicos en síndromes hoy en día, `huérfanos' de los mismos (AU)

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OBJECTIVE: At the present time the study of epileptogenesis is becoming increasingly interested in the function of ionic channels in which localization of new gene sites and mutations have been aetiopathogenically related to certain syndromes involving epilepsy. The pathology of these channels known as channelopathies is responsible for a certain number of conditions affecting the central nervous and neuromuscular systems. Its clinical expression is often paroxystic. The mutations cause inactivation of the channel, which depending on the degree, conditions the phenotype of the process. DEVELOPMENT: We studied the main epileptic channelopathies related to idiopathic epilepsy syndromes. To date it has been possible to codify four genes responsible for: benign familial neonatal convulsions, generalized epilepsy with febrile convulsions plus and frontal lobe nocturnal dominant autosomal epilepsy, together with other syndromes in which potentially related mutations have arisen. CONCLUSIONS: Ionic channels, both voltage and receptor dependent, are involved in the genesis of idiopathic epilepsy syndromes. Their importance is due to the contribution made to understanding epileptogenesis and the application of this in the investigation of drugs which act by modifying the initial cause of the seizure. Today it may be said that the idiopathic epilepsies, or at least some of them, make up a family of channelopathies.

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Objetivo. Actualmente, el estudio de la epileptogénesis muestra un interés creciente en la función que desempeñan los canales iónicos en los que la localización de nuevos situs génicos y mutaciones se han relacionado etiopatogénicamente con determinados síndromes epilépticos. La patología de estos canales, conocida como canalopatías, es responsable de cierto número de procesos que afectan al sistema nervioso central y neuromuscular, y es su expresión clínica con frecuencia paroxística. Las mutaciones provocan una inactivación del canal, que según su grado condiciona el fenotipo del proceso. Desarrollo. Se estudian las principales canalopatías epilépticas relacionadas con síndromes epilépticos idiopáticos, en los que hasta ahora se han codificado cuatro genes responsables de: las convulsiones neonatales familiares benignas, la epilepsia generalizada con convulsiones febriles plus y la epilepsia autosómica dominante nocturna del lóbulo frontal, junto a otros síndromes en los que se han sugerido mutaciones potencialmente relacionadas. Conclusiones. Los canales iónicos, tanto voltaje como receptordependientes, están implicados en la génesis de síndromes epilépticos idiopáticos, y su importancia viene dada por su aporte al conocimiento de la epileptogénesis y su aplicación a la investigación de fármacos que actúen modificando la causa inicial de las crisis. Hoy en día se puede afirmar que las epilepsias idiopáticas, al menos una parte de las mismas, configuran una familia de canalopatías (AU)

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We report the isolation and characterization of a mutant strain of the mold Aspergillus nidulans showing an altered response to environmental pH, including a reduction in its pH range for growth and the production of a melanin-like pigment at alkaline pH. We also show that the mutant strain is not detergent-sensitive and that its acid sensitivity is osmotically remediable with 0.5 M NaCl or 1.0 M sorbitol. Furthermore, the mutant phenotype is temperature-remediable with respect to pigmentation, extent of conidiation and growth diameter, with the restoration of a wild-type phenotype to the mutant strain being observed at 28 degrees C. On the other hand, the severity of the mutant phenotype is increased at 40 degrees C. Genetic analysis shows that this pH- and temperature-sensitive mutation, named phsA1, is located on the right arm of linkage group I of A. nidulans, between pabaA and yA, and that mutation phsA1 is recessive.

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Se revisaron las historias clínicas de 12 pacientes, quienes padecían Anemia Drepanocítica y eran controlados en el Hospital "San Juan de Dios", Caracas, desde 1983 hasta 1989, a fin de investigar el tipo de complicación (es) ortopédica (s) que presentaban, se reviso el manejo médico-quirúrgico de cada paciente. En los pacientes con Anemia Drepanocítica las complicaciones más frecuentes encontradas fueron infecciosas (Artritis séptica y osteomelitis), siendo el Estafilococo Aureus el germen más frecuente y el manejo fue médico quirúrgico, otras complicaciones ortopédicas fueron las contracturas en flexión de caderas y rodillas, el acuñamiento vertebral y la necrosis avascular de cabeza de fémur. Los resultados de este trabajo, permiten sugerir que se realice un mejor seguimiento a los pacientes con Anemia Drepanocítica a fin de detectar complicaciones ortopédicas las cuales tienen un buen pronóstico con un manejo médico-quirúrgico

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