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100 mcg intrathecal morphine (ITM) for hip arthroplasty provides adequate functional recovery and reduces associated complications but is not exempt from opioid-related adverse effects. We evaluate efficacy of a reduced dose of ITM (80 mcg) in terms of anesthetic quality, postoperative analgesia, complication rates and early recovery. Case control study. Patients under hip arthroplasty were treated on a specific protocol, using neuraxial anesthesia with hyperbaric bupivacaine 10.5-13.5 mg plus 80 mcg ITM controls with 100 mcg ITM. Demographic variables, intra and perioperative course were extracted from medical records. Pain severity and morphine associated complications were blindly assessed at regular intervals postoperatively. p < 0.01 were considered significant. 82 patients were analyzed. Mean age was 64.21 years, 62.20% women and 70.73% ASA-2. Main endoprosthesis indication was arthrosis (58.53%). No statistically significant differences in demographic and operative data were found between groups, including surgical time, ambulation time, length of stay, and patient satisfaction for pain management. Mean VAS for pain during first 24 hours was 0.24 for the low ITM group and 0.22 for control. Rescue intravenous morphine was the same between groups. Compared to 80 mcg ITM, 100 mcg showed trends for higher complication rates for respiratory depression (OR 2.58, CI 95% 0.45-14.54, p = 0.28), nausea without vomiting (OR 1.82, CI 95% 0.82-4.01, p = 0.13), urinary retention (OR 2.02, CI95% 0.88-4.61, p = 0.09) and significantly higher rates of pruritus (OR 3.55, CI 95% 1.61-7.82, p < 0.01). 80 mcg ITM during spinal anesthesia for hip arthroplasty provided comparable postoperative analgesia and lower incidence of opioid-related adverse effects.

La deformación permanente es una de las fallas más frecuentes producidas en el pavimento asfaltico, principalmente en los carriles de tráfico pesado y de baja velocidad. La predicción de este tipo de defecto se dificulta por la alta complejidad del asfalto, debido a que es un material termoplástico que presenta un comportamiento viscoelástico lineal a baja cargas y viscoelástico no lineal a altas cargas. Su comportamiento también va variando por el envejecimiento oxidativo, producido por los efectos ambientales durante toda su vida útil, lo que hace más complicada su predicción. Los ensayos empleados para su análisis son altamente costosos y en muchas ocasiones necesitan un gran número de pruebas destructivas de laboratorio, los cuales a veces no logran reproducir las mismas condiciones ambientales y de soporte de las vías. En este trabajo se propone emplear el método de indentación esférica, para asfaltos envejecidos por el ensayo de agitación mecánica a altas revoluciones; estos son ensayos económicos que emplean equipos de fácil accesibilidad para cualquier laboratorio de pavimentos, como lo es el penetrómetro manual (previamente establecido para los cálculos de indentación esférica) y un agitador mecánico convencional de doble hélice (empleado en el proceso de envejecimiento oxidativo). Este método se utilizó en un asfalto convencional AC 60-70, envejecido en tiempos de 30 min, 1 hora, 1.5 horas, 2 horas, 2.5 horas y 3 horas, con el fin de determinar la variación de sus propiedades a medida que se incrementa el efecto del envejecimiento., Permanent deformation is one of the most frequent failures produced in the asphalt pavement, mainly in heavy and low-speed traffic lanes. Predicting this type of defect is made difficult by the high complexity of asphalt, since it is a thermoplastic material that exhibits linear viscoelastic behavior at low loads and nonlinear viscoelastic behavior at high loads. Its behavior also varies due to oxidative aging, produced by environmental effects throughout its useful life, which makes its prediction more complicated. The tests used for its analysis are highly expensive and often require a large number of destructive laboratory tests, which sometimes fail to reproduce the same environmental and support conditions of the tracks. In this work, it is proposed to use the spherical indentation method, for asphalts aged by the mechanical agitation test at high revolutions, which are economic tests that use easily accessible equipment for any pavement laboratory, such as the manual penetrometer (previously established for spherical indentation calculations) and a conventional double helix mechanical stirrer (used in the oxidative aging process). This method was used in a conventional asphalt AC 60-70, aged in times of 30 min, 1 hour, 1.5 hours, 2 hours, 2.5 hours and 3 hours, in order to determine the variation of its properties as it increases. the effect of aging.

El estudio tuvo como objetivo describir radiológicamente la osteología del mono tití de Goeldi (Callimico goeldii). Se emplearon cinco individuos en estado de cautiverio, en aparente buen estado de salud, del Parque Zoológico Huachipa (Lima, Perú). Se les realizó un examen clínico previo para constatar el buen estado de salud. Los animales fueron anestesiados y posicionados en decúbito dorsal y lateral para la evaluación radiológica. Asimismo, se obtuvo vistas del esqueleto apendicular y se hizo un registro de distintos valores de exposición para determinar los valores óptimos de estos. Los resultados mostraron que los valores de exposición óptimos para obtener imágenes radiográficas en esta especie para cabeza y tórax-abdomen fueron en posición dorso ventral y lateral 50Kv, 20 mA, 0.03s y para las extremidades en vista medio lateral de 50 kV, 20 mA, 0.02 s. Se evidenció que la tibia y el peroné se encuentran fusionados en su tercio inferior y poseen una curvatura hacia distal, ancho máximo de la pelvis es a nivel de las eminencias iliopúbicas, y las proporciones de las cuatro extremidades de esta especie son menores a las proporciones de otros primates neotropicales. Del presente estudio se puede concluir que existen diferencias morfológicas a nivel de la pelvis y las extremidades posteriores con relación a otras especies de primates, posiblemente debidas al patrón de locomoción por saltos verticales en Callimico goeldii., The objective of the study was to radiologically describe the osteology of the Goeldi’s marmoset (Callimico goeldii). Five individuals reared in captivity, in apparently good health, of the Huachipa Zoological Park (Lima, Peru) were used. They underwent a previous clinical examination to verify the good state of health. The animals were anesthetized and positioned in dorsal and lateral decubitus for radiological evaluation. Likewise, views of the appendicular skeleton were obtained and a record of different exposure values was made to determine their optimum values. The results showed that the optimal exposure values to obtain radiographic images in this species for head and thorax-abdomen were dorso-ventral and lateral views of 50Kv, 20 mA, 0.03 s and for the extremities mediallateral view of 50 kV, 20 mA, 0.02 s. It was evidenced that the tibia and the fibula are fused in their lower third and have a distal curvature, the pelvis has its maximum width at the level of the iliopubic eminences, and the proportions of the four limbs of this species are less than proportions of other Neotropical primates. From the present study it can be concluded that there are morphological differences at the level of the pelvis and hind limbs in relation to other primate species, possibly due to the locomotion pattern by vertical jumps in this species.

ECORECARGA es un modelo de negocio que se basa en la comercialización de estaciones de recarga de productos de aseo para ropa y cuidado personal, que busca promover la conciencia ambiental y la cultura de la reutilización de envases plásticos con el fin de reducir el impacto ambiental inherente a su consumo. El modelo de negocio está estructurado sobre una estrategia de crecimiento basada en el desarrollo de capacidades logísticas que permitan atender el demandante mercado del menudeo a través del canal tienda-a-tienda, persiguiendo un mercado potencial de cerca de 73.000 tiendas y establecimientos de menudeo dentro de las tres principales ciudades de Colombia.

Despite the growing amount of data, much information is needed on patients' mental capacity to consent to psychiatric treatment for acute mental disorders. The present study was undertaken to compare differences in capacity to consent to psychiatric treatment in patients treated voluntarily and involuntarily and to investigate the role of psychiatric symptoms, competency, and cognitive functioning in determining voluntariness of hospital admission. Involuntary patients were interviewed with the MacArthur Competence Assessment Tool for Treatment (MacCAT-T), the 24-item Brief Psychiatric Rating Scale (BPRS), the Mini Mental State Examination (MMSE) and the Raven's Colored Progressive Matrices, and their data were compared with those for age- and sex-matched voluntary patients. Involuntary patients performed worse in all MacCAT-T subscales. Capacity to consent to treatment varied widely within each group. Overall, involuntary patients have worse consent-related mental capacity than those treated voluntarily, despite capacity to consent to treatment showing a significant variability in both groups.

Although dystonias are a common group of movement disorders, the mechanisms by which brain dysfunction results in dystonia are not understood. Rapid-onset Dystonia-Parkinsonism (RDP) is a hereditary dystonia caused by mutations in the ATP1A3 gene. Affected individuals can be free of symptoms for years, but rapidly develop persistent dystonia and Parkinsonism-like symptoms after a stressful experience. Using a mouse model, we found that an adverse interaction between the cerebellum and basal ganglia can account for the symptoms of these individuals. The primary instigator of dystonia was the cerebellum, whose aberrant activity altered basal ganglia function, which in turn caused dystonia. This adverse interaction between the cerebellum and basal ganglia was mediated through a di-synaptic thalamic pathway that, when severed, alleviated dystonia. Our results provide a unifying hypothesis for the involvement of cerebellum and basal ganglia in the generation of dystonia and suggest therapeutic strategies for the treatment of RDP.

Opening of connexin hemichannels in the plasma membrane is highly regulated. Generally, depolarization and reduced extracellular Ca2+ promote hemichannel opening. Here we show that hemichannels formed of Cx50, a principal lens connexin, exhibit a novel form of regulation characterized by extraordinary sensitivity to extracellular monovalent cations. Replacement of extracellular Na+ with K+, while maintaining extracellular Ca2+ constant, resulted in >10-fold potentiation of Cx50 hemichannel currents, which reversed upon returning to Na+. External Cs+, Rb+, NH4+, but not Li+, choline, or TEA, exhibited a similar effect. The magnitude of potentiation of Cx50 hemichannel currents depended on the concentration of extracellular Ca2+, progressively decreasing as external Ca2+ was reduced. The primary effect of K+ appears to be a reduction in the ability of Ca2+, as well as other divalent cations, to close Cx50 hemichannels. Cx46 hemichannels exhibited a modest increase upon substituting Na+ with K+. Analyses of reciprocal chimeric hemichannels that swap NH2- and COOH-terminal halves of Cx46 and Cx50 demonstrate that the difference in regulation by monovalent ions in these connexins resides in the NH2-terminal half. Connexin hemichannels have been implicated in physiological roles, e.g., release of ATP and NAD+ and in pathological roles, e.g., cell death through loss or entry of ions and signaling molecules. Our results demonstrate a new, robust means of regulating hemichannels through a combination of extracellular monovalent and divalent cations, principally Na+, K+, and Ca2+.

Repeated episodes of spontaneous large-scale neuronal bursting and calcium influx in the developing brain can potentially affect such fundamental processes as circuit formation and gene expression. Between postnatal day 3 (P3) and P7, the immature cortex can express one such form of activation whereby a wave of neuronal activity propagates through cortical networks, generating massive calcium influx. We previously showed that this activity could be triggered by brief stimulation of muscarinic receptors. Here, we show, by monitoring large cortical areas at low magnification, that although all areas respond to muscarinic agonists to some extent, only some areas are likely to generate the coordinated wave-like activation. The waves can be triggered repeatedly in frontal areas where, as we also show, waves occur spontaneously at a low frequency. In parietal and occipital areas, no such waves are seen. This selectivity may be related in part to differences in the cortical distribution of dopaminergic signaling, because we find that activation of dopamine receptors enables the response. Because M1 muscarinic receptors are typically coupled with G-αq/11, we investigated whether other receptors known to couple with this G-protein (group I glutamate metabotropic receptors, neurotensin type 1) could similarly elicit wave-like activation in responsive cortical areas. Our results suggest that multiple neurotransmitter systems can enable this form of activation in the frontal cortex. The findings suggest that a poorly recognized, developmentally regulated form of strong network activation found predominantly in the frontal cortex could potentially exert a profound influence on brain development.

Loss-of-function mutations in the α3 isoform of the Na+/K+ATPase (sodium pump) are responsible for rapid-onset dystonia parkinsonism (DYT12). Recently, a pharmacological model of DYT12 was generated implicating both the cerebellum and basal ganglia in the disorder. Notably, partially blocking sodium pumps in the cerebellum was necessary and sufficient for induction of dystonia. Thus, a key question that remains is how partially blocking sodium pumps in the cerebellum induces dystonia.In vivorecordings from dystonic mice revealed abnormal high-frequency bursting activity in neurons of the deep cerebellar nuclei (DCN), which comprise the bulk of cerebellar output. In the same mice, Purkinje cells, which provide strong inhibitory drive to DCN cells, also fired in a similarly erratic manner.In vitrostudies demonstrated that Purkinje cells are highly sensitive to sodium pump dysfunction that alters the intrinsic pacemaking of these neurons, resulting in erratic burst firing similar to that identifiedin vivo. This abnormal firing abates when sodium pump function is restored and dystonia caused by partial block of sodium pumps can be similarly alleviated. These findings suggest that persistent high-frequency burst firing of cerebellar neurons caused by sodium pump dysfunction underlies dystonia in this model of DYT12.

BACKGROUND AND PURPOSE:Flow disruption with the WEB-DL device has been used safely for the treatment of wide-neck bifurcation aneurysms, but the stability of aneurysm occlusion after this treatment is unknown. This retrospective multicenter European study analyzed short- and midterm data in patients treated with WEB-DL.MATERIALS AND METHODS:Twelve European neurointerventional centers participated in the study. Clinical data and pre- and postoperative short- and midterm images were collected. An experienced interventional neuroradiologist independently analyzed the images. Aneurysm occlusion was classified into 4 grades: complete occlusion, opacification of the proximal recess of the device, neck remnant, and aneurysm remnant.RESULTS:Forty-five patients (34 women and 11 men) 35-74 years of age (mean, 56.3 ± 9.6 years) with 45 aneurysms treated with the WEB device were included. Aneurysm locations were the middle cerebral artery in 26 patients, the posterior circulation in 13 patients, the anterior communicating artery in 5 patients, and the internal carotid artery terminus in 1 patient. Forty-two aneurysms were unruptured. Good clinical outcome (mRS < 2) was observed in 93.3% of patients at the last follow-up. Adequate occlusion (complete occlusion, opacification of the proximal recess, or neck remnant) was observed in 30/37 patients (81.1%) in short-term follow-up (median, 6 months) and in 26/29 patients (89.7%) in midterm follow-up (median, 13 months). Worsening of the aneurysm occlusion was observed in 2/28 patients (7.1%) at midterm follow-up.CONCLUSIONS:The results suggest that the WEB endovascular treatment of wide-neck bifurcation aneurysms offers stable occlusion in a class of aneurysms that are historically unstable. Additionally, our data show that opacification of the WEB recess can be delineated from true neck or aneurysm remnants., JOURNAL ARTICLE, SCOPUS: ar.j, info:eu-repo/semantics/published

El presente artículo es el resultado de una búsqueda de los trabajos, investigaciones y aplicaciones de la realidad virtual y la metodología de trabajo BIM (Building Information Modeling) en la industria de la construcción, los centros de investigación y la academia, con el propósito sustentar la importancia y necesidad de su inclusión como parte fundamental dentro de los currículos y contenidos programáticos de la academia, en lo que corresponde a la enseñanza de la Ingeniería civil, como nuevas tecnologías para responder con innovación, creatividad y competitividad a las nuevas economías del conocimiento

O inter-relacionamento de dados ambientais e sanitários, necessário na avaliação da exposição de grupos populacionais a fatores de risco, é dificultado pela defasagem no tempo e espaço destes conjuntos de dados. Neste trabalho utilizaram-se como bases de dados georreferenciadas: os setores censitários, que contêm informações sobre a forma com que são abastecidos os domicílios; a rede de abastecimento de água, seus principais mananciais e reservatórios; a qualidade da água, segundo programa de monitoramento. Mediante operações espaciais entre estas camadas, foram localizados e quantificados grupos populacionais submetidos a risco, de acordo com diferentes critérios. Grande parte dos riscos associados ao abastecimento de água encontram-se localizados na encosta norte do Maciço da Tijuca, e na Zona Oeste, onde a população procura formas alternativas de abastecimento. Em razão das diferentes origens, objetivos e estruturas dos dados, os Sistemas de Informações Geográficas (SIG) podem ser utilizados como instrumento de organização, de validação destes dados e de verificação de possíveis inconsistências. Exposure assessment of population groups is based on linkage of environmental and health data. This relationship can be hard to establish due to spatial and temporal lags in data sets. GIS can be used as a basis for organizing health-related and environmental data sets. We examined potential health risk in the Rio de Janeiro city water supply based on the overlay of information layers containing data on the presence and quality of water supply services. We used census tracts as the primary georeferenced data, since they contain information on how households are supplied, water supply pipes, sources, and reservoirs, and water quality according to the monitoring program. Population groups exposed to risks were located and quantified using spatial operations among these layers and adopting different risk criteria. The main problems related to water supply are located on the northern slope of the Tijuca Mountain Range and in the western area of the city of Rio, where the population relies on alternative water supply sources. The different origins, objectives, and structures of data have to be analyzed critically, and GIS can be used as a data validation tool as well as an instrument for detailed identification of inconsistencies.

A literature survey and analysis of the use of neural networks for the classification of remotely-sensed multi-spectral imagery is presented. As part of a brief mathematical review, the backpropagation algorithm, which is the most common method of training multi-layer networks, is discussed with an emphasis on its application to pattern recognition. The analysis is divided into five aspects of neural network classification: (1) input data preprocessing, structure, and encoding, (2) output encoding and extraction of classes, (3) network architecture, (4) training algorithms, and (5) comparisons to conventional classifiers. The advantages of the neural network method over traditional classifiers are its nonparametric nature, arbitrary decision boundary capabilities, easy adaptation to different types of data and input structures, fuzzy output values that can enhance classification, and good generalization for use with multiple images. The disadvantages of the method are slow training time, inconsis...

Tesis (Ingeniero en Administración de Empresas) El significado de retail corresponde a comercialización de ventas por departamento de productos o servicios masivos, de una gran diversidad de productos con el fin satisfacer las necesidades de diversos consumidores. La industria del retail esta compuesto por supermercados, tiendas por departamento, farmacias, comerciantes minoristas, multitiendas, tiendas para el mejoramiento del hogar y tiendas especializadas. El sector retail en los últimos 15 años ha desarrollado un vertiginoso crecimiento, siendo este sector industrial el más dinámico de la economía chilena. Este crecimiento se fundamenta en los cambios económicos y socioculturales que ha sostenido nuestro país, en las últimas décadas. SITUACIÓN DEL PROBLEMA La industria del retail, durante el primer semestre del 2009 ha sufrido una importante caída en sus ventas, obteniendo un descenso en las utilidades de los principales actores, por la intensa y constante serie de liquidaciones que ha afectado directamente los márgenes de sus participantes, además se suma una devaluación de las monedas en los mercados sudamericanos, especialmente en argentina, la actual crisis ha marcado el periodo con la caída en la rentabilidad sobre el patrimonio, los principales actores de la industria. Falabella, D&S, Cencosud. Ripley, La Polar e Hites, han mostrado un retroceso en sus retornos.

At high altitudes barometric pressure is reduced and, thus, less oxygen is inhaled. Reduced oxygen concentration in brain tissue can lead to cerebral damage and neurological and cognitive deficits. The present study was designed to explore the effects of high-altitude exposure using a quantitative MRI technique, voxel-based morphometry.We studied nine world-class mountain climbers before (baseline) and after (follow-up) an extremely high-altitude ascent of Everest and K2. We investigated the effects of repeated extremely high-altitude exposures by comparing mountain climbers' scans at baseline with scans of 19 controls. In addition, we measured the effects of a single extremely high-altitude expedition by comparing mountain climbers' scans at baseline and follow-up.A region of reduced white matter density/volume was found in the left pyramidal tract near the primary (BA 4) and supplementary (BA 6) motor cortex when mountain climbers at baseline were compared with controls. Further, when mountain climbers' scans before and after the expedition were compared, a region of reduced grey matter density/volume was found in the left angular gyrus (BA 39).These findings suggest that extremely high-altitude exposures may cause subtle white and grey matter changes that mainly affect brain regions involved in motor activity.

Considerando la alta incidencia de vulvovaginitis en la consulta de ginecología pediátrica y de adolescentes, y los aspectos únicos de la microbiología y endocrinología de la paciente prepúber se presenta una revisión de la literatura con lo más relevante de los últimos 5 años, en lo que se refiere a epidemiología, etiología, diagnóstico y tratamiento de la vulvovaginitis bacteriana específica de la niña prepúber. No existe claridad acerca de la microflora vaginal normal, lo cual dificulta en gran medida la interpretación de muestras. De acuerdo con la evidencia actual podemos decir que ante la vulvovaginitis específica de la prepúber debemos tener en consideración como principales agentes causales: patógenos respiratorios, epidérmicos y entéricos; higiene defectuosa, cuerpos extraños, irritantes, enfermedades dermatológicas vulvares, defectos anatómicos y abuso sexual. Streptococcus hemolitico del grupo A y Haemophilus influenzae son patógenos prevalentes Having into account the high frequency of vulvovaginitis in the pediatric and adolescent gynecology setting and the unique aspects of the microbiology and endocrinology of the pre pubertal patient, we present a review of the most relevant aspects in the last 5 years, concerning epidemiology, etiology, diagnosis and treatment of specific bacterial vulvovaginitis in the pre pubertal girl. There's no consensus regarding the normal vaginal microflora, which makes difficult the interpretation of swabs. According to actual evidence we could say that in approaching prepubertal vulvovaginitis we must consider as main etiologic agents: respiratory, enteric and epidermic pathogens; deficient hygiene, foreign bodies, irritants, vulvar dermatologic diseases, anatomical abnormalities and sexual abuse. Group A - hemolytic Streptococcus and Haemophilus influenzae are prevalent pathogens

SUMMARY Having into account the high frequency of vulvovaginitis in the pediatric and adolescent gynecology setting and the unique aspects of the microbiology and endocrinology of the pre pubertal patient, we present a review of the most relevant aspects in the last 5 years, concerning epidemiology, etiology, diagnosis and treatment of specific bacterial vulvovaginitis in the pre pubertal girl. There’s no consensus regarding the normal vaginal microflora, which makes difficult the interpretation of swabs. According to actual evidence we could say that in approaching prepubertal vulvovaginitis we must consider as main etiologic agents: respiratory, enteric and epidermic pathogens; deficient hygiene, foreign bodies, irritants, vulvar dermatologic diseases, anatomical abnormalities and sexual abuse. Group A - hemolytic Streptococcus and Haemophilus influenzae are prevalent pathogens.

Publisher Summary This chapter outlines a hypothesis t explaining some of the ontogenetic causes of emotional and cognitive disturbances characteristic of psychiatric disorders in terms of deviations in activity-dependent processes that may occur during the initial wiring of specific cortical circuits. It is postulated that a combination of proximal factors generating excessive activation of circuits related to cognition and emotion, if present during a specific developmental period that also coincides with a period when these circuits are exceedingly plastic, could irreversibly alter the developmental program required for proper connectivity in these circuits, such that their functional capacity is rendered suboptimal thereafter. Another postulate states that a key element of the vulnerability of specific cognitive and emotional circuits is the ability of their neurons to exhibit the property of sustained firing. The physiology and pharmacology of waves of network activation are also reviewed. The chapter also discusses the muscarinic activation of developing cortical networks.

Gomortega keule (Mol.) Baillon es un árbol endémico de Chile, que se encuentra actualmente en peligro de extinción. Aunque los patrones de regeneración de la especie se desconocen, algunos autores aluden a una generalizada escasez de plántulas. Este artículo presenta una investigación de la estructura poblacional y los patrones de regeneración de G. keule en un bosque antiguo en Caramávida, Cordillera de Nahuelbuta. Los objetivos fueron (i) determinar el patrón de regeneración que esta especie ha presentado en el pasado, (ii) verificar si existe actualmente regeneración sexual de G. keule y (iii) caracterizar los ambientes lumínicos en que ésta se produce. En una parcela de 0,24 ha se midió el diámetro a la altura de pecho (DAP) y la posición espacial de cada uno de los árboles de G. keule y de dos de las especies más comunes asociadas (Aextoxicon punctatum y Eucryphia cordifolia). Se usaron dos analizadores de doseles LAI-2000 para medir los ambientes lumínicos sobre cada plántula de G. keule. La irregularidad en la distribución diamétrica de G. keule y la asociación de las plántulas con un claro reciente en la parcela sugieren un patrón de regeneración episódica por apertura de claros. Aunque actualmente hay plántulas en el rodal, los bajos niveles de luz prevalecientes en el sotobosque hacen dudar de sus posibilidades de supervivencia. Al parecer G. keule sería una especie más intolerante a la sombra que las otras dos especies analizadas que muestran evidencias de regeneración más continua. La conservación y restauración de poblaciones de esta especie requerirá complementar esta primera investigación demográfica con otras semejantes, además de mejorar el conocimiento de otros aspectos de su biología Gomortega keule is an endemic Chilean tree currently in danger of extinction. Although the regeneration patterns of the species are poorly-understood, some authors have alluded to a widespread lack of seedlings in established populations. Past regeneration patterns were inferred from diameter distributions in a population of G. keule in an old-growth stand at Caramávida in south-central Chile. These data were compared with those of two of its most common associates, Aextoxicon punctatum and Eucryphia cordifolia. Seedling light environments were also measured in order to identify the conditions that favour sexual regeneration of the species. Results suggest that sexual regeneration of G. keule requires considerable canopy opening. On the other hand, A. punctatum shows evidence of continuous regeneration and E. cordifolia shows a strong tendency to reproduce by suckering. G. keule appears to be more shade-intolerant than the other two species studied. The irregularity of G. keule `s diameter distribution, and the association of seedlings with a recent canopy opening on the plot, suggest a strongly discontinuous regeneration pattern. Although seedlings of G. keule were present on the plot, these seem unlikely to survive in the low light levels now prevailing in the partially closed gap where they established. G. keule appears to be less shade tolerant than the other two species studied, which show evidence of more continuous regeneration. Conservation and restoration of populations of G. keule will require further demographic studies, as well as research on other aspects of the biology of the species

This report describes the diagnosis and management of a 16-year-old boy who developed neurological signs and symptoms suggestive of cerebral aspergillosis following a haploidentical bone marrow transplant. A new sandwich enzyme-linked immunosorbent assay (ELISA) for the detection of Aspergillus galactomannan circulating antigens (Platelia Aspergillus, Sanofi Diagnostic Pasteur, France) was used on serum and cerebrospinal fluid to obtain a presumptive diagnosis and to monitor the course of the disease. Having failed conventional therapy with amphotericin B, the patient received compassionate treatment with voriconazole for a period of 37 days. High levels of voriconazole were observed in both serum and cerebrospinal fluid (CSF), with a trend toward accumulation. After 7 days a marked improvement in the patient's neurological symptoms was noted, and ELISA data indicated a corresponding decrease in Aspergillus galactomannan levels in both serum and CSF. Voriconazole was well tolerated, with only transient increases in ALT/AST recorded during therapy. Although the patient survived the acute Aspergillus infection, he subsequently died of an unrelated infection.