Detection of a multi-shell planetary nebula around the hot subdwarf O-type star 2MASS J19310888+4324577

(Abridged) The origin of hot subdwarf O-type stars (sdOs) remains unclear since their discovery in 1947. Among others, a post-Asymptotic Giant Branch (post-AGB) origin is possible for a fraction of sdOs. We are involved in a comprehensive ongoing study to search for and to analyze planetary nebulae (PNe) around sdOs with the aim of establishing the fraction and properties of sdOs with a post-AGB origin. We use deep Halpha and [OIII] images of sdOs to detect nebular emission and intermediate resolution, long-slit optical spectroscopy of the detected nebulae and their sdO central stars. These data are complemented with other observations for further analysis of the detected nebulae. We report the detection of an extremely faint, complex PN around 2MASS J19310888+4324577 (2M1931+4324), a star classified as sdO in a binary system. The PN shows a bipolar and an elliptical shell, whose major axes are oriented perpendicular to each other, and high-excitation structures outside the two shells. WISE archive images show faint, extended emission at 12 and 22 microns in the inner nebular regions. The internal nebular kinematics is consistent with a bipolar and a cylindrical/ellipsoidal shell, in both cases with the main axis mainly perpendicular to the line of sight. The nebular spectrum only exhibits Halpha, Hbeta and [OIII]4959,5007 emission lines, but suggests a very low-excitation ([OIII]/Hbeta = 1.5), in strong contrast with the absence of low-excitation emission lines. The spectrum of 2M1931+4324 presents narrow, ionized helium absorptions that confirm the previous sdO classification and suggest an effective temperature >= 60000 K. The binary nature of 2M1931+4324, its association with a complex PN, and several properties of the system provide strong support for the idea that binary central stars are a crucial ingredient in the formation of complex PNe.Comment: 8 pages, 7 figures, accepted in Astronomy and Astrophysic

European guidelines from the EHTG and ESCP for Lynch syndrome: an updated third edition of the Mallorca guidelines based on gene and gender

Background: Lynch syndrome is the most common genetic predisposition for hereditary cancer but remains underdiagnosed. Large prospective observational studies have recently increased understanding of the effectiveness of colonoscopic surveillance and the heterogeneity of cancer risk between genotypes. The need for gene- and gender-specific guidelines has been acknowledged. Methods: The European Hereditary Tumour Group (EHTG) and European Society of Coloproctology (ESCP) developed a multidiscipli nary working group consisting of surgeons, clinical and molecular geneticists, pathologists, epidemiologists, gastroenterologists, and patient representation to conduct a graded evidence review. The previous Mallorca guideline format was used to revise the clinical guidance. Consensus for the guidance statements was acquired by three Delphi voting rounds. Results: Recommendations for clinical and molecular identification of Lynch syndrome, surgical and endoscopic management of Lynch syndrome-associated colorectal cancer, and preventive measures for cancer were produced. The emphasis was on surgical and gastroenterological aspects of the cancer spectrum. Manchester consensus guidelines for gynaecological management were en dorsed. Executive and layperson summaries were provided. Conclusion: The recommendations from the EHTG and ESCP for identification of patients with Lynch syndrome, colorectal surveil lance, surgical management of colorectal cancer, lifestyle and chemoprevention in Lynch syndrome that reached a consensus (at least 80 per cent) are presented

Computer-aided diagnosis of multiple sclerosis using a support vector machine and optical coherence tomography features

The purpose of this paper is to evaluate the feasibility of diagnosing multiple sclerosis (MS) using optical coherence tomography (OCT) data and a support vector machine (SVM) as an automatic classifier. Forty-eight MS patients without symptoms of optic neuritis and forty-eight healthy control subjects were selected. Swept-source optical coherence tomography (SS-OCT) was performed using a DRI (deep-range imaging) Triton OCT device (Topcon Corp., Tokyo, Japan). Mean values (right and left eye) for macular thickness (retinal and choroidal layers) and peripapillary area (retinal nerve fibre layer, retinal, ganglion cell layer—GCL, and choroidal layers) were compared between both groups. Based on the analysis of the area under the receiver operator characteristic curve (AUC), the 3 variables with the greatest discriminant capacity were selected to form the feature vector. A SVM was used as an automatic classifier, obtaining the confusion matrix using leave-one-out cross-validation. Classification performance was assessed with Matthew’s correlation coefficient (MCC) and the AUCCLASSIFIER. The most discriminant variables were found to be the total GCL++ thickness (between inner limiting membrane to inner nuclear layer boundaries), evaluated in the peripapillary area and macular retina thickness in the nasal quadrant of the outer and inner rings. Using the SVM classifier, we obtained the following values: MCC = 0.81, sensitivity = 0.89, specificity = 0.92, accuracy = 0.91, and AUCCLASSIFIER = 0.97. Our findings suggest that it is possible to classify control subjects and MS patients without previous optic neuritis by applying machine-learning techniques to study the structural neurodegeneration in the retina

Detailed studies of IPHAS sources -- III. The highly extinguished bipolar planetary nebula IPHASX J191104.8++060845

We present the first detailed study of the bipolar planetary nebula (PN) IPHASX J191104.8$+$060845 (PN G040.6$-$01.5) discovered as part of the Isaac Newton Telescope Photometric H$\alpha$ Survey of the Northern Galactic plane (IPHAS). We present Nordic Optical Telescope (NOT) narrow-band images to unveil its true morphology. This PN consists of a main cavity with two newly uncovered extended low-surface brightness lobes located towards the NW and SE directions. Using near-IR WISE images we unveiled the presence of a barrel like structure, which surrounds the main cavity, which would explain the dark lane towards the equatorial regions. We also use Gran Telescopio de Canarias (GTC) spectra to study the physical properties of this PN. We emphasise the potential of old PNe detected in IPHAS to study the final stages of the evolution of the circumstellar medium around solar-like stars.Comment: 9 pages, 8 Figures, 3 Tables; Accepted to MNRA

Diagnostic ability of multifocal electroretinogram in early multiple sclerosis using a new signal analysis method

Purpose To determine if a novel analysis method will increase the diagnostic value of the multifocal electroretinogram (mfERG) in diagnosing early-stage multiple sclerosis (MS). Methods We studied the mfERG signals of OD (Oculus Dexter) eyes of fifteen patients diagnosed with early-stage MS (in all cases < 12 months) and without a history of optic neuritis (ON) (F: M = 11:4), and those of six controls (F:M = 3:3). We obtained values of amplitude and latency of N1 and P1 waves, and a method to assess normalized root-mean-square error (FNRMSE) between model signals and mfERG recordings was used. Responses of each eye were analysed at a global level, and by rings, quadrants and hemispheres. AUC (area under the ROC curve) is used as discriminant factor. Results The standard method of analysis obtains further discrimination between controls and MS in ring R3 (AUC = 0.82), analysing N1 waves amplitudes. In all of the retina analysis regions, FNRMSE value shows a greater discriminating power than the standard method. The highest AUC value (AUC = 0.91) was in the superior temporal quadrant. Conclusion By analysing mfERG recordings and contrasting them with those of healthy controls it is possible to detect early-stage MS in patients without a previous history of ON

Lateral pterygoid muscle dystonia. A new technique for treatment with botulinum toxin guided by electromyography and arthroscopy

Lateral pterygoid muscle dystonia is characterized by mandibular displacement towards the opposite side of the affected muscle. It may be associated with functional disorders affecting speech, swallowing, chewing and facial symmetry. Injection with botulinum toxin is recognized as the most effective treatment. Locating the lower head of the lateral pterygoid muscle for the injection is not difficult using electromyographic guidance; however, location of the upper head is more complicated, even with electromyography. We report a case of lateral pterygoid muscle dystonia in which precise injection of the upper head was achieved with the aid of arthroscopy

Results of salt intake restriction monitored with the new sodium control biosensor

Adherence to a low sodium (Na) diet is crucial in patients under hemodialysis, as it improves cardiovascular outcomes and reduces thirst and interdialytic weight gain. Recommended salt intake is lower than 5 g/day. The new 6008 CareSystem monitors incorporate a Na module that offers the advantage of estimating patients' salt intake. The objective of this study was to evaluate the effect of dietary Na restriction for 1 week, monitored with the Na biosensor.A prospective study was conducted in 48 patients who maintained their usual dialysis parameters and were dialyzed with a 6008 CareSystem monitor with activation of the Na module. Total Na balance, pre/postdialysis weight, serum Na (sNa), changes in pre- to post-dialysis sNa (ΔsNa), diffusive balance, and systolic and diastolic blood pressure were compared twice, once after 1 week of patients' usual Na diet and again after another week with more restricted Na intake.Restricted Na intake increased the percentage of patients on a low-sodium diet (<85 Na mmol/day) from 8% to 44%. Average daily Na intake decreased from 149 ± 54 to 95 ± 49 mmol and interdialytic weight gain was reduced by 460 ± 484 g per session. More restricted Na intake also decreased pre-dialysis sNa and increased both intradialytic diffusive balance and ΔsNa. In hypertensive patients, reducing daily sodium by more than 3 g Na/day lowered their systolic blood pressure.The new Na module allowed objective monitoring of Na intake, which in turn could permit more precise personalized dietary recommendations in patients under hemodialysis.S. Karger AG, Basel

Frecuencia de genes que codifican factores de virulencia en Staphylococcus aureus aislados de niños que concurrieron al Hospital General Pediátrico Niños de Acosta Ñú, durante el año 2010

Staphylococcus aureus es un microorganismo con habilidad de infectar diferentes tejidos celulares, por portar genes que le confieren resistencia a antibióticos, factores de virulencia y su plasticidad genética, que podrían contribuir a una progresión rápida y complicada de la enfermedad. El Paraguay no cuenta con datos epidemiológicos que indiquen los factores de virulencia que presentan las cepas de S. aureus, por lo que el objetivo del trabajo fue determinar un perfil de virulencia detectando los genes codificantes de: hemolisinas α y β, enterotoxinas A, B, C, D, H y toxinas exfoliativas A y B. Este estudio observacional descriptivo de corte transverso, con muestreo no probabilístico de casos consecutivos, incluyó 50 aislados de S. aureus obtenidos a partir de muestras clínicas de secreciones de piel, partes blandas o líquidos corporales de pacientes menores de 17 años que concurrieron al Hospital General Pediátrico Niños de Acosta Ñú durante el año 2.010. Las reacciones de PCR incluyeron la detección de los genes: sea+seb+sec+ADNr16S, hlA+hlB, eta+etb, sed y seh. El 82% de los aislados provenía de niños que presentaron cuadros clínicos compatibles con infecciones de piel y partes blandas y el 18% de cuadros clínicos graves como sepsis, osteomielitis y neumonías. Los aislados contaban con datos de portación de Leucocidina de Panton-Valentine, el cual fue el factor de virulencia más frecuentemente detectado (58%), seguido de las hemolisinas alfa (16%) y beta (8%). Las enterotoxinas y las toxinas exfoliativas fueron menos frecuentes (0-2%), y no se detectaron genes codificantes de las enterotoxinas C y D

Alternativas terapéuticas a la situación de «escalada simétrica» en terapia de familia.

Se realiza en este trabajo una revisión de los aspectos terapéuticos de la situación de Escalada simétrica en Terapia Familia