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Introducción: Un istmocele es una una disrupción del miometrio que genera una cavidad a nivel de la histerorrafia, como consecuencia de una alteración de la cicatrización del lecho de una cesárea anterior. Además de diferentes complicaciones obstétricas y de la fertilidad, existe la posibilidad de que se produzca retención de restos ovulares y placentarios en el mismo. Se presenta el caso de un istmocele sin antecedente de cesárea previa, con restos ovulares y placentarios y un nódulo del lecho placentario en su interior.

Molds are responsible for postharvest spoilage of citrus fruits. The objective of this study was to evaluate the effect of temperature on growth rate and the time to visible growth of Aspergillus nigerstrains isolated from citrus fruits. The growth of these strains was studied on agar lime medium (AL) at different temperatures, and growth rate was estimated using the Baranyi and Roberts model (Int. J. Food Microbiol.23:277–294, 1994). The Rosso et al. cardinal model with inflexion (L. Rosso, J. R. Lobry, S. Bajard, and J. P. Flandrois, J. Theor. Biol.162:447–463, 1993) was used as a secondary model to describe the effect of temperature on growth rate and the lag phase. We hypothesized that the same model could be used to calculate the time for the mycelium to become visible (tv) by substituting the lag phase (1/λ and 1/λopt) with the time to visible colony (1/tv-optand 1/tv), respectively, in the Rosso et al. model. High variability was observed at suboptimal conditions. Extremes of temperature of growth for A. nigerseem to have a normal variability. For the growth rate and time tv,the model was satisfactorily compared with results of previous studies. An external validation was performed in lime fruits; the bias and accuracy factors were 1.3 and 1.5, respectively, for growth rate and 0.24 and 3.72, respectively, for the appearance time. The discrepancy may be due to the influence of external factors. A. nigergrows significantly more slowly on lime fruit than in culture medium, probably because the nutrients are more easily available in medium than in fruits, where the peel consistency may be a physical barrier. These findings will help researchers understand the postharvest behavior of mold on lime fruits, host-pathogen interactions, and environmental conditions infecting fruit and also help them develop guidelines for future work in the field of predictive mycology to improve models for control of postharvest fungi.

Enmarcado en el Proyecto PaSQ, el Hospital Universitario Marqués de Valdecilla implementa una estrategia multimodal de mejora de la higiene de manos (HM) para fomentar su cumplimiento de forma mantenida en el tiempo y mejorar la seguridad de los pacientes.

El enfrentamiento y el manejo de las fracturas de platillos tibiales de alta energía representan un desafío para todo cirujano. El compromiso de partes blandas y la conminución articular secundaria a la energía involucrada determinan una mayor tasa de complicaciones y morbilidad.

Describir la utilidad de la determinación de la concentración plasmática de cistatinaC en el diagnóstico precoz de la lesión renal aguda en el shock séptico.

Inflammatory myxohyaline tumor of the distal extremities is an extremely rare low-grade sarcoma with a tendency to produce local recurrence after surgical excision, but with a low metastatic potential. We present the case of a 49-year-old woman with a slow-growing asymptomatic tumor on the right pretibial region that was initially considered to be a lipoma. Histopathology revealed the presence of a polymorphic inflammatory infiltrate within a myxoid and hyaline matrix. Interspersed between the inflammatory cells were 3 different populations of neoplastic cells: atypical spindle-shaped cells; bizarre epithelioid cells, some of which were multinucleated and resembled the virocytes or Reed-Sternberg cells; and cells with abundant, vacuolated cytoplasm, similar to lipoblasts. These clinical-pathologic findings led to a diagnosis of inflammatory myxohyaline tumor of the distal extremities. Although the tumor was excised with wide surgical margins, local recurrence developed after 3 months and was treated with re-excision and radiotherapy.

This work assesses the extent of patulin contamination in Penicillium expansum-infected apples stored at room temperature for short periods of time and its relationship with apple variety (Golden or Fuji), degree of ripeness and size of lesions. Inoculated apples were incubated at 20°C. Patulin was determined in both sound and decayed tissue from cylindrical samples taken around the lesions and cut into 0.5-cm thick sections. Higher accumulation of patulin occurred in Golden apples, with less ripened apples showing higher concentrations. Total accumulated patulin was similar or higher in 4-cm compared to 2-cm lesioned apples, although a decrease in patulin concentration was observed in older lesion sections. Patulin accumulation occurred over a short period of time at room temperature, thus the stand-by period before processing should be minimised. Of total patulin, 2-6% migrated to the surrounding sound tissue, thus trimming tissue around the rotten part may be a good preventive practice for apple derivative production.

A study was undertaken to evaluate the impact of the application of several fungicide treatments used in Spanish vines on Aspergillus carbonarius growth and ochratoxin A production. Three trials were designed in order: (1) to screen 26 fungicides at the doses recommended by manufacturers on grape-like synthetic medium at 20 and 30°C; (2) to find out the minimum inhibitory concentration of each fungicide for A. carbonarius growth on synthetic medium; and (3) to investigate the effect of several fungicides on A. carbonarius-inoculated grapes. In synthetic medium nine fungicides significantly reduced A. carbonarius growth rate. Meanwhile, 13 fungicides completely inhibited its growth. In general, growth was faster at 30°C than at 20°C, contrary to ochratoxin A production. Fungicides that stopped fungal growth also inhibited ochratoxin A production, but not all the fungicides that reduced growth reduced the ochratoxin A synthesis. In general, fungicides that contained copper or strobilurins reduced both growth and ochratoxin A production, contrary to sulphur fungicides. At the optimum temperature for A. carbonarius growth of 30°C, higher amounts of fungicide were needed to prevent fungal growth than at 20°C. Among the fungicides that inhibited A. carbonarius growth on synthetic medium at the initial doses, cyprodinil seemed to be the active ingredient more effective at stopping fungal growth when testing reduced doses. The fungicide effect on grapes was similar to that on synthetic medium. Both infection and ochratoxin A production were reduced when using cyprodinil (37.5%) plus fludioxonil (25%) and azoxystrobin (25%). Penconazole (10%) also showed a clear reduction in ochratoxin A production at both temperatures, although infection was only reduced at 20°C. Ochratoxin A reduction was strain and temperature-dependent. In general, fenhexamid (50%), mancozeb (80%) and copper hydroxide (80%) plus copper (50%) enhanced infection and ochratoxin A production.

Ochratoxin A (OTA) is a secondary metabolite produced by several species of Aspergillusand Penicillium; among them Aspergillus ochraceusand Penicillium verrucosumare two ochratoxigenic species capable of growing in different climates and thus contamination of food crops with OTA can occur worldwide. OTA can be found in a wide range of foods such as cereals, coffee, cocoa, spices, beer, wine, dried vine fruit, grapes and meat products. OTA is toxic to animals, it presents neurotoxic, immunotoxic and nephrotoxic effects. It has been implicated in a human kidney disorder known as Balkan Endemic Nephropathy. This review focuses on the ecophysiology of ochratoxin-producing Aspergillus ochraceusand Penicillium verrucosum, the effect of environmental factors on their germination, mycelial growth, and OTA production. Knowledge of environmental conditions required for sucessive stages of fungal development represent the first step towards preventing mycotoxin formation. Predictive models for different stages of fungal development are presented, which allow prediction of the time before spoilage as a function of the abiotic factors. Finally, the implications of these studies in management of barley, coffee and grapes are described. This can help to identify the critical control points in their production, storage and distribution processes.

Extrusion cooking is one of the fastest growing food-processing operations in recent years due to several advantages over traditional methods. Apart from its main goal of improving the quality of intermediate and final processed products, it may incidentally also improve safety because of the potential to reduce mycotoxin levels in cereals. This review is focused on extrusion cooking and aims to give a general overview of its impact in reducing mycotoxin levels in cereals. Extrusion cooking generally decreases the mycotoxins levels at rates depending on different factors such as the type of extruder, the type of screw, the die configuration, the initial mycotoxin concentration, the barrel temperature, the screw speed, the moisture content of the raw material and the use of additives. Reductions of 100, 95 and 83% for fumonisins, aflatoxins and zearalenone, respectively, have been reported during extrusion cooking of cereals, while lower reductions were observed for deoxynivalenol, ochratoxin A and moniliformin, where maximum reductions did not exceed 55, 40 and 30%, respectively.

Aspergillus ochraceusas a fungal contaminant and ochratoxin A (OTA) producer plays an important role in coffee quality. Temperature and water activity (aw) significantly influence mycelial growth and OTA production by isolates of A. ochraceuson green coffee beans. Maximum mycelial growth was found at 30°C and 0.95 to 0.99 aw. A marked decrease in growth rate was observed when temperature and awwere reduced. At 0.80 aw, mycelial growth occurred only at 30 and 20°C for one isolate. Maximum OTA production was found at 20°C and 0.99 aw. At 10°C, OTA was not produced, regardless of aw. Similarly, no OTA was detected at 0.80 aw. OTA production ranged from the limit of detection (40 ng g−1of green coffee) to 17,000 ng g−1of green coffee. Significant intraspecific differences in mycelial growth and OTA production were found. Primary data for lag phases prior to mycelial growth under the influence of temperature and awwere modelled by multiple linear regression, and the response surface plots were obtained.

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A sponge cake analog was used to study the influence of pH, water activity (aw), and carbon dioxide (CO2) levels on the growth of seven fungal species commonly causing bakery product spoilage (Eurotium amstelodami, Eurotium herbariorum, Eurotium repens, Eurotium rubrum, Aspergillus niger, Aspergillus flavus, and Penicillium corylophilum). A full factorial design was used. Water activity, CO2, and their interaction were the main factors significantly affecting fungal growth. Water activity at levels of 0.80 to 0.90 had a significant influence on fungal growth and determined the concentration of CO2needed to prevent cake analog spoilage. At an awlevel of 0.85, lag phases increased twofold when the level of CO2in the headspace increased from 0 to 70%. In general, no fungal growth was observed for up to 28 days of incubation at 25°C when samples were packaged with 100% CO2, regardless of the awlevel. Partial least squares projection to latent structures regression was used to build a polynomial model to predict sponge cake shelf life on the basis of the lag phases of all seven species tested. The model developed explained quite well (R2= 79%) the growth of almost all species, which responded similarly to changes in tested factors. The results of this study emphasize the importance of combining several hurdles, such as modified atmosphere packaging, aw, and pH, that have synergistic or additive effects on the inhibition of mold growth.

Fusarium verticillioides and F proliferatum isolates were inoculated in mixed cultures with Aspergillus parasiticus on irradiated maize grain at two different inoculum concentrations (2 × 10⁵ and 2 × 10² conidia g^-1 dry maize). The treatments were 0.93-0.98 water activity (a_w) and 15 and 25 °C for 28 days. A complex relationship was found between a_w, temperature, inoculum concentration and the interactions which took place between fumonisin and aflatoxin producers. In general, A parasiticus reduced F verticillioides and F proliferatum populations (by 6-36%) but did not affect fumonisin B₁ production by these species. In contrast, while the Fusarium species were not able to decrease A parasiticus populations, they significantly reduced aflatoxin B₁ accumulation (by 30-93%).
© 2001 Society of Chemical Industry

The impact on fungal growth and mycotoxin formation of interactions between fumonisin-producing isolates of Fusarium moniliforme and F proliferatum and a zearalenone (ZEA)- and deoxynivalenol (DON)-producing isolate of F graminearum inoculated together on irradiated maize at 15 and 25 °C and at 0.98, 0.95 and 0.93 a_w was studied. The presence of F graminearum decreased the fungal populations (CFU g^-1 grain) of F moniliforme and F proliferatum under almost all conditions tested. In the presence of F moniliforme, CFUs of F graminearum increased significantly at 25 °C, especially at 0.93 and 0.95 a_w, while the presence of F proliferatum caused them to increase at 15 °C. The presence of F graminearum always inhibited FB₁ production, except at 25 °C and 0.98 a_w where it increased. However, the observed differences were not statistically significant. There was no effect of fungal interaction on ZEA production by F graminearum; however, when paired with F moniliforme and F proliferatum, DON production by F graminearum was significantly stimulated, especially at 0.98 a_w.
© 2000 Society of Chemical Industry

The day-to-day reproducibility of planned radiotherapy treatment is an important precondition for achieving good clinical results and reducing toxic effects. This reproducibility is difficult to achieve in the irradiation of head and neck malignancies because of the mobility of this anatomical area. This paper presents a dosimetric study and analysis of the utility of a facial mask immobilization system prepared from an orthopedic glass-fiber bandage. The dosimetric study conducted on a lucite phantom shows that the interposition of one, two, or three layers of the bandage reduces the deep absorbed dose by about 1% at 0.5 cm2, while increasing the absorbed surface dose by 12% (for a field of 15 × 15 cm2and one layer of bandage) to 46% (for a field of 5 × 5 cm and three layers of bandage). The dosimetric study conducted on a Rando Anderson®manikin shows an average increase in the skin dose of about 8% and a maximum increase of about 20%. The good dosimetric results and the practicality of this system of immobilization have persuaded us to propose it as an alternative to the systems currently on the market, which, although rather more sophisticated, are also more expensive.