The utility of superficial abdominal reflex in the initial diagnosis of scoliosis: a retrospective review of clinical characteristics of scoliosis with syringomyelia

<p>Abstract</p> <p>Background</p> <p>With increasing use of magnetic resonance imaging (MRI), underlying syringomyelia is increasingly found in patients with presumed idiopathic scoliosis. To determine the indications for MRI in the differential diagnosis of scoliosis, several clinical characteristics of syringomyelia have been reported. Neurological signs, particularly abnormal superficial abdominal reflex (SAR), are important in establishing the initial diagnosis of scoliosis. However, the prevalence of abnormal SAR in patients with scoliosis and the sensitivity of this sign in predicting syringomyelia are not well known. We aimed to determine the diagnostic utility of SAR and other characteristics of syringomyelia in patients with scoliosis.</p> <p>Methods</p> <p>We reviewed the medical records of 93 patients with scoliosis, 90 of whom underwent corrective surgery. All patients underwent MRI to determine the presence of syringomyelia. Mean age at surgery was 12.5 years. Abnormal SAR was defined as unilateral or bilateral absence or hyporeflexia of SAR. We calculated indices of diagnostic utility of abnormal SAR for non-idiopathic scoliosis and for syringomyelia. Abnormal SAR, left thoracic curve pattern, gender, and curve flexibility were compared between scoliosis with syringomyelia and idiopathic scoliosis. Logistic regression analysis was performed with the existence of syringomyelia as the dependent variable and curve flexibility as the independent variable.</p> <p>Results</p> <p>Abnormal SAR was observed in 20 patients (prevalence 22%). All 6 patients with myopathic scoliosis displayed bilateral absence of SAR. The sensitivity of abnormal SAR for non-idiopathic scoliosis was 38%, with 96% specificity, 90% PPV (positive predictive value), and 60% NPV (negative predictive value). Syringomyelia was identified in 9 of the 93 patients (9.7%); 8 of these had abnormal SAR. The sensitivity of abnormal SAR for syringomyelia in presumed idiopathic scoliosis was 89%, with 95% specificity, 80% PPV, and 98% NPV. Gender, abnormal neurological findings, and curve flexibility differed significantly between patients with syringomyelia and those with idiopathic scoliosis (P < 0.05). In the logistic regression model, the area under the receiver operating characteristic (ROC) curve was 0.79 and the cut-off value of curve flexibility for syringomyelia was 50% (P = 0.08).</p> <p>Conclusion</p> <p>Abnormal SAR was a useful indicator not only for syringomyelia, but also for myogenic scoliosis.</p

Gene Disruption of Plasmodium falciparum p52 Results in Attenuation of Malaria Liver Stage Development in Cultured Primary Human Hepatocytes

Difficulties with inducing sterile and long lasting protective immunity against malaria with subunit vaccines has renewed interest in vaccinations with attenuated Plasmodium parasites. Immunizations with sporozoites that are attenuated by radiation (RAS) can induce strong protective immunity both in humans and rodent models of malaria. Recently, in rodent parasites it has been shown that through the deletion of a single gene, sporozoites can also become attenuated in liver stage development and, importantly, immunization with these sporozoites results in immune responses identical to RAS. The promise of vaccination using these genetically attenuated sporozoites (GAS) depends on translating the results in rodent malaria models to human malaria. In this study, we perform the first essential step in this transition by disrupting, p52, in P. falciparum an ortholog of the rodent parasite gene, p36p, which we had previously shown can confer long lasting protective immunity in mice. These P. falciparum P52 deficient sporozoites demonstrate gliding motility, cell traversal and an invasion rate into primary human hepatocytes in vitro that is comparable to wild type sporozoites. However, inside the host hepatocyte development is arrested very soon after invasion. This study reveals, for the first time, that disrupting the equivalent gene in both P. falciparum and rodent malaria Plasmodium species generates parasites that become similarly arrested during liver stage development and these results pave the way for further development of GAS for human use

Cancer Biomarker Discovery: The Entropic Hallmark

Background: It is a commonly accepted belief that cancer cells modify their transcriptional state during the progression of the disease. We propose that the progression of cancer cells towards malignant phenotypes can be efficiently tracked using high-throughput technologies that follow the gradual changes observed in the gene expression profiles by employing Shannon's mathematical theory of communication. Methods based on Information Theory can then quantify the divergence of cancer cells' transcriptional profiles from those of normally appearing cells of the originating tissues. The relevance of the proposed methods can be evaluated using microarray datasets available in the public domain but the method is in principle applicable to other high-throughput methods. Methodology/Principal Findings: Using melanoma and prostate cancer datasets we illustrate how it is possible to employ Shannon Entropy and the Jensen-Shannon divergence to trace the transcriptional changes progression of the disease. We establish how the variations of these two measures correlate with established biomarkers of cancer progression. The Information Theory measures allow us to identify novel biomarkers for both progressive and relatively more sudden transcriptional changes leading to malignant phenotypes. At the same time, the methodology was able to validate a large number of genes and processes that seem to be implicated in the progression of melanoma and prostate cancer. Conclusions/Significance: We thus present a quantitative guiding rule, a new unifying hallmark of cancer: the cancer cell's transcriptome changes lead to measurable observed transitions of Normalized Shannon Entropy values (as measured by high-throughput technologies). At the same time, tumor cells increment their divergence from the normal tissue profile increasing their disorder via creation of states that we might not directly measure. This unifying hallmark allows, via the the Jensen-Shannon divergence, to identify the arrow of time of the processes from the gene expression profiles, and helps to map the phenotypical and molecular hallmarks of specific cancer subtypes. The deep mathematical basis of the approach allows us to suggest that this principle is, hopefully, of general applicability for other diseases

Imaginarios que tienen los adolescentes de Jamundí sobre relaciones de pareja en la vida adulta [recurso electrónico

La presente investigación trata de los imaginarios que tienen los adolescentes de Jamundí sobre las relaciones de pareja en la vida adulta; es el resultado de ocho (8) meses de revisión bibliográfica sobre el concepto de imaginario social para ser usado en la comprensión del adolescente actual en el que los estudios sobre sexualidad y adolescencia buscan comprender las causas de los comportamientos en los adolescentes. Es en este sentido que el concepto imaginario y el concepto adolescencia albergan un potencial llamativo para la investigación en humanidades con miras al enriquecimiento al momento de crear procesos de intervención. Temas como la adolescencia y las relaciones de pareja son continua y ampliamente estudiados

Identification of Most Aggressive Carcinoma Among Patients Diagnosed With Prostate Cancer Using Mathematical Modeling of Prostate-Specific Antigen Increases

International audienceBACKGROUND: Tools for differentiating aggressive and indolent prostate carcinoma (PCa) are needed. Mathematical modeling is a promising approach for longitudinal analysis of tumor marker kinetics. PATIENTS AND METHODS: The prostate-specific antigen (PSA) increases from patients with PCa and those with benign prostatic hyperplasia (BPH) were retrospectively analyzed using a mathematical model. Using the NONMEM program, individual PSA kinetics were fit to the following equation: [d(PSA)/dt = (PROD.K x exp [RHO1 x t]) x (1 - BPH) + PROD.NK x exp (RHO2 x t) - KELIM x (PSA)], where RHO1 is the PSA production increase rate by PCa cells (PROD.K), RHO2 is the PSA production increase rate by non-PCa cells (PROD.NK), and KELIM is the PSA elimination rate. The comparative value of the modeled kinetic parameters, estimated for each patient, for predicting the D'Amico score and relapse-free survival (RFS) were tested using logistic regression analysis and multivariate survival tests. RESULTS: The PSA kinetics from 62 patients with BPH and 149 patients with PCa before radical prostatectomy were successfully modeled. We identified statistically significant relationships between the PSA growth rate related to cancer cells (RHO1) and the probability of D'Amico high-risk group (less than the median RHO1 vs. at the median or greater: odds ratio, 2.15; 95% confidence interval [CI], 1.00-4.77; P = .05). RHO1 was also a significant prognostic factor for RFS on univariate analysis and against other reported prognostic factors using multivariate Cox tests. Three independent prognostic factors of RFS were found: RHO1 (hazard ratio [HR], 2.71; 95% CI, 1.25-5.84; P = .01), Gleason score (HR, 8.54; 95% CI, 4.19-17.40; P \textless .01), and positive surgical margins (HR, 2.04; 95% CI, 1.05-3.97; P = .03). CONCLUSION: Using a few PSA time points analyzed with a mathematical model (easily manageable in routine practice), it could be possible to determine before surgery whether a patient has presented with aggressive PC

Oxigenación por membrana extracorpórea en COVID-19:Una revisión narrativa

10 páginasEl sindrome de dificultad respiratoria aguda es unacomplicación potencialmente mortal que se caracterizapor insuficiencia respiratoria de inicio agudo. porel momento, no existe un manejo especifico paraCOVID-19, el tratamiento es suficiente de apoyoy sintomatico; además de las medidas de protecciónpara prevenir la transmisión. El uso de la tecnica deoxigenación por membrana extracorpórea está siendoampliamente estudiada en pacientes con síndrome deDificultad respiratoria aguda secundaria a COVID-19que ha fallado a la terapia convencional. El propositode esta revisión es presentar la información actualsobre el síndrome respiratorio agudo secundario alnuevo coronavirus, el uso de soporte de oxigenacionpor membrana extracorpórea y cómo puede seruna herramienta valiosa para los pacientes en estacondición

El juego ancalini: Una estrategia pedag?gico-did?ctica, para disminuir la agresividad f?sica, entre estudiantes que inician la educaci?n b?sica secundaria

109 p. Recurso Electr?nicoEl juego Ancalini es una estrategia pedag?gico-did?ctica, dise?ada para disminuir la agresividad f?sica, entre estudiantes que inician la educaci?n b?sica secundaria; es un proyecto de investigaci?n, que permite la interacci?n conjunta y participativa entre educandos dentro de los escenarios escolares, fortaleciendo las relaciones interpersonales por medio del disfrute que el juego proporciona desde la ?ptica de la reflexi?n hacia un actuar ?tico, generando cambios de conductas negativas en los estudiantes; de igual manera el juego se presenta como herramienta novedosa que ayuda a mejorar los procesos de calidad de la educaci?n, ya que motiva al ni?o a explorar sus pre- saberes, abandonar sus miedos y mejorar sus procesos de aprendizaje; de esta manera se genera una cultura de empat?a propositiva hacia las tem?ticas educativas y a la vez fomenta una sana convivencia, estas afirmaciones se podr?n evidenciar en el desarrollo de este estudio confirmando que el juego fortalece las habilidades cognitivas, emocionales y contribuye a la formaci?n integral del ni?o; sin embargo, debe ser orientado desde una ?ptica pedagog?a para evitar caer en activismo. La metodolog?a utilizada es de car?cter explicativo y su dise?o cualitativo, llevado a cabo desde el m?todo etnogr?fico.The game Ancalini is a pedagogical, didactic strategy designed to reduce physical aggression among students entering secondary basic education. It is an affiliated research projectof the Universidad of the Tolima in the distance mode, which seeks to alleviate aggressive behavior through joint and participatory interaction, allowing a communicative and dialogic enjoyment from the game parameters and intellectual interpretation of the child, established from the point of reflection to act ethically, self-generating positions in students. Likewise, the game is presented as a teaching and educational tool that helps improve the quality processes of education, since it motivates the child to explore their pre-knowledge, leave their fears, to improve their learning processes. Thus, a culture of proactive empathy is generated toward the educational topic and also it encourages a healthy coexistence. These claims can be further evidenced in the development of this study and confirm that the game strengthens the cognitive and emotional skills and contributes to the integral development of the child, but must be directed from an optical pedagogy to avoid falling into activism. The methodology used is explanatory. Its qualitative, quantitative design is typical of an action research ? participatory through the ethnographic method. KEY WORDS: Strategy, game, pedagogic, didactic, Dialogic, consciousness-raising