The diagnostic accuracy of truncal ataxia and HINTS as cardinal signs for acute vestibular syndrome

Copyright: © 2016 Carmona, Martínez, Zalazar, Moro, Batuecas-Caletrio, Luis and Gordon. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.The head impulse, nystagmus type, test of skew (HINTS) protocol set a new paradigm to differentiate peripheral vestibular disease from stroke in patients with acute vestibular syndrome (AVS). The relationship between degree of truncal ataxia and stroke has not been systematically studied in patients with AVS. We studied a group of 114 patients who were admitted to a General Hospital due to AVS, 72 of them with vestibular neuritis (based on positive head impulse, abnormal caloric tests, and negative MRI) and the rest with stroke: 32 in the posterior inferior cerebellar artery (PICA) territory (positive HINTS findings, positive MRI) and 10 in the anterior inferior cerebellar artery (AICA) territory (variable findings and grade 3 ataxia, positive MRI). Truncal ataxia was measured by independent observers as grade 1, mild to moderate imbalance with walking independently; grade 2, severe imbalance with standing, but cannot walk without support; and grade 3, falling at upright posture. When we applied the HINTS protocol to our sample, we obtained 100% sensitivity and 94.4% specificity, similar to previously published findings. Only those patients with stroke presented with grade 3 ataxia. Of those with grade 2 ataxia (n = 38), 11 had cerebellar stroke and 28 had vestibular neuritis, not related to the patient's age. Grade 2-3 ataxia was 92.9% sensitive and 61.1% specific to detect AICA/PICA stroke in patients with AVS, with 100% sensitivity to detect AICA stroke. In turn, two signs (nystagmus of central origin and grade 2-3 Ataxia) had 100% sensitivity and 61.1% specificity. Ataxia is less sensitive than HINTS but much easier to evaluate.info:eu-repo/semantics/publishedVersio

Widening the gene pool of sexual tetraploid bahiagrass: Generation and reproductive characterization of a sexual synthetic tetraploid population

The improvement of bahiagrass, Paspalum notatum Flüggé, has been inhibited by reduced levels of genetic diversity in sexual tetraploid germplasm. A few experimental sexual tetraploid genotypes (ESTGs) have been generated by chromosome doubling, but these plants typically exhibit low vigor. The objectives of this work were to generate and characterize the ploidy level, mode of reproduction, and fertility of a novel 308 individual sexual synthetic tetraploid population (SSTP) developed by intercrossing 29 sexual F1 hybrids originated by hybridizing several naturally occurring apomictic tetraploids from diverse origin with a few ESTGs. Ploidy levels were determined using flow cytometry, and reproductive modes were evaluated by a molecular assay with apospory-linked markers and embryo sac observations. The tetraploid level and the sexual mode of reproduction remained stable after two cycles of recombination during the generation of the SSTP. Fertility was evaluated based on seed set under self- and open pollination during 3 yr. The SSTP exhibited in average 30.2 and 15.2% seed set under open and self-pollina-tion, respectively, showing a predominantly cross-pollination behavior with variable levels of self-fertility. There were no differences in terms of fertility between the SSTP and the ESTG. The novel tetraploid population behaves as sexual and cross-pollinated, and it is expected to allow a more efficient genetic improvement under the proposed breeding approaches.Fil: Zilli, Alex Leonel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Acuña, Carlos Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Schulz, R. R.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Brugnoli, Elsa Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Guidalevich, Veronica. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Quarin, Camilo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Martínez, Eric Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; Argentin

Informes clínicos breves

Trabeculectomía y endotelio. Autor: Dr. Juan Carlos Vega Higuera. Residente de Oftalmología.Tutores: Dr. Gabriel Ortiz, Instructor Asociado, Unidad de Oftalmología, Departamento de Cirugía, yJorge Barrero, Profesor de Oftalmología, U.N. Eficacia de heparina intravenosa vs. heparina subcutánea en la prevención de la formación de trombo ventricular izquierdo que sigue a un infarto agudo del miocardio de pared anterior. Autores: Drs. Benedicto Velasco, Carlos Sánchez y Antonio Oviedo Leonel. Tutor: Dr. Ariel Pérez Monroy, Instructor Asociado, Unidad de Medicina Interna Integral, Departamento de Medicina Interna. Facultad de Medicina, U.N. Comorbilidad psiquiátrica en los pacientes de la Unidad de Diálisis del Hospital San Juan de Dios de Santafé de Bogotá. Autor: Dra. Ana Isabel Gómez Martínez, Residente III, Departamento de Psiquiatría. Tutor: Dra. Elena Martín Cardinal, Profesora Asistente, Departamento de Psiquiatría. Facultad de Medicina, U.N. Meningiomas intracraneanos. Hospital San Juan de Dios, 1990-1994. Autor: Dr. Carlos Alberto Mora Ojeda. Residente de la Unidad de Neurocirugía. Tutor: Dr. Víctor Hugo Bastos, Instructor Asociado, Unidad de Neurocirugía, Departamento de Cirugía, Facultad de Medicina, U.N. Utilidad de la gamagrafía ósea y la biopsia sinovial en el diagnóstico precoz de la artritis reumatoidea. Autor: Dr. Abel R. González S., Residente JI, Unidad de Reumatología, Departamento de Medicina Interna. Facultad de Medicina, U.N. Tutor: Dr. Mario Peña Cortés, Profesor Titular, Unidad de Reumatología, Departamento de Medicina Interna. Facultad de Medicina, U.N

Combined fit to the spectrum and composition data measured by the Pierre Auger Observatory including magnetic horizon effects

The measurements by the Pierre Auger Observatory of the energy spectrum and mass composition of cosmic rays can be interpreted assuming the presence of two extragalactic source populations, one dominating the flux at energies above a few EeV and the other below. To fit the data ignoring magnetic field effects, the high-energy population needs to accelerate a mixture of nuclei with very hard spectra, at odds with the approximate E$^{-2}$ shape expected from diffusive shock acceleration. The presence of turbulent extragalactic magnetic fields in the region between the closest sources and the Earth can significantly modify the observed CR spectrum with respect to that emitted by the sources, reducing the flux of low-rigidity particles that reach the Earth. We here take into account this magnetic horizon effect in the combined fit of the spectrum and shower depth distributions, exploring the possibility that a spectrum for the high-energy population sources with a shape closer to E$^{-2}$ be able to explain the observations

Studies of the mass composition of cosmic rays and proton-proton interaction cross-sections at ultra-high energies with the Pierre Auger Observatory

In this work, we present an estimate of the cosmic-ray mass composition from the distributions of the depth of the shower maximum (Xmax) measured by the fluorescence detector of the Pierre Auger Observatory. We discuss the sensitivity of the mass composition measurements to the uncertainties in the properties of the hadronic interactions, particularly in the predictions of the particle interaction cross-sections. For this purpose, we adjust the fractions of cosmic-ray mass groups to fit the data with Xmax distributions from air shower simulations. We modify the proton-proton cross-sections at ultra-high energies, and the corresponding air shower simulations with rescaled nucleus-air cross-sections are obtained via Glauber theory. We compare the energy-dependent composition of ultra-high-energy cosmic rays obtained for the different extrapolations of the proton-proton cross-sections from low-energy accelerator data

Study of downward Terrestrial Gamma-ray Flashes with the surface detector of the Pierre Auger Observatory

The surface detector (SD) of the Pierre Auger Observatory, consisting of 1660 water-Cherenkov detectors (WCDs), covers 3000 km2 in the Argentinian pampa. Thanks to the high efficiency of WCDs in detecting gamma rays, it represents a unique instrument for studying downward Terrestrial Gamma-ray Flashes (TGFs) over a large area. Peculiar events, likely related to downward TGFs, were detected at the Auger Observatory. Their experimental signature and time evolution are very different from those of a shower produced by an ultrahigh-energy cosmic ray. They happen in coincidence with low thunderclouds and lightning, and their large deposited energy at the ground is compatible with that of a standard downward TGF with the source a few kilometers above the ground. A new trigger algorithm to increase the TGF-like event statistics was installed in the whole array. The study of the performance of the new trigger system during the lightning season is ongoing and will provide a handle to develop improved algorithms to implement in the Auger upgraded electronic boards. The available data sample, even if small, can give important clues about the TGF production models, in particular, the shape of WCD signals. Moreover, the SD allows us to observe more than one point in the TGF beam, providing information on the emission angle