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We report new occurrences of Testudinidae and Chelidae from 11 different fossil sites in the Huayquerías and Tunuyán formations (late Miocene-Pliocene) in the Huayquerías del Este, Mendoza, Argentina. A total of 36 specimens were collected, representing at least three taxa from two different clades: 80.6% Testudinidae and 19.4% Chelidae. Testudinids are present throughout the stratigraphic succession, in alluvial, fluvial, and interdune sedimentary environments, represented by dorsal and plastron carapace plates, with some remains of the appendicular skeleton. A complete articulated plastron with some peripheral plates of the carapace was also recognized and is assigned to the extant species Chelonoidis chilensis, representing the oldest record for this taxon (late Miocene, Messinian). Another possible morphotype was recognized in the form of a large scapular girdle and femur that likely corresponded to an individual with a dorsal carapace of about 80 cm. This assemblage of small and large tortoise species is recognized for first time in the Messinian Age/Stage of Mendoza. Chelids are mostly restricted to fluvial deposits in the upper part of the Huayquerías Formation, except for two specimens which appear in the lower part. One specimen is represented by a right half plastron of an indeterminate Chelidae species which could correspond to a carapace of up to 24 cm in length with plastral lobes narrower than those observed in Phrynops species. Another specimen is characterized by a large costovertebral tunnel in the carapace, peripheral plates of the posterior margin of the carapace with ornamentation of fine grooves forming irregular polygons. more...

The vertebrate fossil record of the Pampean Region of Argentina occupies an important place in South American vertebrate paleontology. An abundance of localities has long been the main basis for constructing the chronostratigraphical/geochronological scale for the late Neogene–Quaternary of South America, as well as for understanding major patterns of vertebrate evolution, including the Great American Biotic Interchange. However, few independently-derived dates are available for constraining this record. In this contribution, we present new 40Ar/39Ar dates on escorias (likely the product of meteoric impacts) from the Argentinean Atlantic coast and statistically-based biochronological analyses that help to calibrate Late Miocene–Pliocene Pampean faunal successions. For the type areas of the Montehermosan and Chapadmalalan Ages/Stages, our results delimit their age ranges to 4.7–3.7 Ma and ca. 3.74–3.04 Ma, respectively. Additionally, from Buenos Aires Province, dates of 5.17 Ma and 4.33 Ma were recovered for “Huayquerian” and Montehermosan faunas. This information helps to better calibrate important first appearances of allochthonous taxa in South America, including one of the oldest records for procyonids (7.24–5.95 Ma), cricetids (6.95–5.46 Ma), and tayassuids (> 3.74 Ma, oldest high-confidence record). These results also constrain to ca. 3 Ma the last appearances of the autochthonous sparassodonts, as well as terror birds of large/middle body size in South America. South American faunal turnover during the late Neogene, including Late Pliocene extinctions, is interpreted as a consequence of knock-on effects from global climatic changes and initiation of the icehouse climate regime. Fil: Prevosti, Francisco Juan. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de la Rioja. Secretaria de Ciencia y Tecnología; Argentina Fil: Romano Muñoz, Cristo Omar. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; Argentina Fil: Forasiepi, Analia Marta. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; Argentina Fil: Hemming, Sidney. Columbia University; Estados Unidos Fil: Bonini, Ricardo Adolfo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Investigaciones Arqueológicas y Paleontológicas del Cuaternario Pampeano. Universidad Nacional del Centro de la Provincia de Buenos Aires. Investigaciones Arqueológicas y Paleontológicas del Cuaternario Pampeano; Argentina Fil: Candela, Adriana Magdalena. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. División Paleontología Vertebrados; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina Fil: Cerdeño Serrano, Maria Esperanza. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; Argentina Fil: Madozzo Jaén, María Carolina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto Superior de Correlación Geológica. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Departamento de Geología. Cátedra Geología Estructural. Instituto Superior de Correlación Geológica; Argentina. Museo Paleontológico Egidio Feruglio; Argentina Fil: Ortiz, Pablo Edmundo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto Superior de Correlación Geológica. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Departamento de Geología. Cátedra Geología Estructural. Instituto Superior de Correlación Geológica; Argentina Fil: Pujos, François Roger Francis. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; Argentina Fil: Rasia, Luciano Luis. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. División Paleontología Vertebrados; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina Fil: Schmidt, Gabriela Ines. Provincia de Entre Ríos. Centro de Investigaciones Científicas y Transferencia de Tecnología a la Producción. Universidad Autónoma de Entre Ríos. Centro de Investigaciones Científicas y Transferencia de Tecnología a la Producción. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Centro de Investigaciones Científicas y Transferencia de Tecnología a la Producción; Argentina Fil: Taglioretti, Matias Luciano. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Geología de Costas y del Cuaternario. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Instituto de Geología de Costas y del Cuaternario; Argentina. Litoral Atlántico Norte. Observatorio Patrimonio Arqueológico y Paleontológico; Argentina Fil: Macphee, Ross Douglas Earle. American Museum of Natural History; Estados Unidos Fil: Pardiñas, Ulises Francisco J.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto de Diversidad y Evolución Austral; Argentina. Instituto Nacional de Biodiversidad; Ecuador more...

Purpose To evaluate the safety and 1-year effect of pattern scanning laser photocoagulation treatment for pedunculated papillomatous and sessile conjunctival lesions in a low-resource setting with extremely limited operating room access. Methods Adult patients with clinical diagnosis of conjunctival papilloma underwent complete ophthalmologic exam including anterior segment photography. After topical anesthesia and toluidine blue 1% instillation, the lesion was treated by pattern scanning photocoagulation using a duration time that varied from 20 to 100 ms and power from 600 to 1800 mW, treating the entire lesion surface with a 2 mm margin. Patients were examined weekly for a month then monthly and underwent retreatment as necessary. Results Six patients and seven eyes that had clinically significant non-malignant pedunculated or sessile papillomatous lesions were treated. All lesions responded to treatment, with complete resolution after an average of 2.3 sessions. Procedures were well tolerated with only minor mild discomfort persisting up to two days post-treatment. Patients were followed for a mean follow-up time of 13 months with no recurrences reported. Conclusion Short-term results of the pattern scanning laser photocoagulation approach, with toluidine blue for papillomatous conjunctival lesions are favorable with a 100% success rate in this cohort. This rate is comparable to surgical excision. This novel strategy proved to be a less resource intensive alternative that not only could demonstrate its usefulness in settings with chronic operating room shortages, but also in recurrent cases. Longer follow-ups with a larger sample size and cost-analysis are necessary to confirm our findings. more...

Aims: Guidelines recommend down-titration of loop diuretics (LD) once euvolaemia is achieved. In outpatients with heart failure (HF), we investigated LD dose changes in daily cardiology practice, agreement with guideline recommendations, predictors of successful LD down-titration and association between dose changes and outcomes. Methods and results: We included 8130 HF patients from the ESC-EORP Heart Failure Long-Term Registry. Among patients who had dose decreased, successful decrease was defined as the decrease not followed by death, HF hospitalization, New York Heart Association class deterioration, or subsequent increase in LD dose. Mean age was 66 ± 13 years, 71% men, 62% HF with reduced ejection fraction, 19% HF with mid-range ejection fraction, 19% HF with preserved ejection fraction. Median [interquartile range (IQR)] LD dose was 40 (25–80) mg. LD dose was increased in 16%, decreased in 8.3% and unchanged in 76%. Median (IQR) follow-up was 372 (363–419) days. Diuretic dose increase (vs. no change) was associated with HF death [hazard ratio (HR) 1.53, 95% confidence interval (CI) 1.12–2.08; P = 0.008] and nominally with cardiovascular death (HR 1.25, 95% CI 0.96–1.63; P = 0.103). Decrease of diuretic dose (vs. no change) was associated with nominally lower HF (HR 0.59, 95% CI 0.33–1.07; P = 0.083) and cardiovascular mortality (HR 0.62,. 95% CI 0.38–1.00; P = 0.052). Among patients who had LD dose decreased, systolic blood pressure [odds ratio (OR) 1.11 per 10 mmHg increase, 95% CI 1.01–1.22; P = 0.032], and absence of (i) sleep apnoea (OR 0.24, 95% CI 0.09–0.69; P = 0.008), (ii) peripheral congestion (OR 0.48, 95% CI 0.29–0.80; P = 0.005), and (iii) moderate/severe mitral regurgitation (OR 0.57, 95% CI 0.37–0.87; P = 0.008) were independently associated with successful decrease. Conclusion: Diuretic dose was unchanged in 76% and decreased in 8.3% of outpatients with chronic HF. LD dose increase was associated with worse outcomes, while the LD dose decrease group showed a trend for better outcomes compared with the no-change group. Higher systolic blood pressure, and absence of (i) sleep apnoea, (ii) peripheral congestion, and (iii) moderate/severe mitral regurgitation were independently associated with successful dose decrease. © 2020 European Society of Cardiology more...

Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P ≤ 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P = 0.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P 75 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF ≤45%. © 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology more...

Aims: We assessed the interplay between hyperkalaemia (HK) and renin–angiotensin–aldosterone system inhibitor (RAASi) use, dose and discontinuation, and their association with all-cause or cardiovascular death in patients with chronic heart failure (HF). We hypothesized that HK-associated increased death may be related to RAASi withdrawal. Methods and results: The ESC-HFA-EORP Heart Failure Long-Term Registry was used. Among 9222 outpatients (HF with reduced ejection fraction: 60.6%, HF with mid-range ejection fraction: 22.9%, HF with preserved ejection fraction: 16.5%) from 31 countries, 16.6% had HK (≥5.0 mmol/L) at baseline. Angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) was used in 88.3%, a mineralocorticoid receptor antagonist (MRA) in 58.7%, or a combination in 53.2%; of these, at ≥50% of target dose in ACEi: 61.8%; ARB: 64.7%; and MRA: 90.3%. At a median follow-up of 12.2 months, there were 789 deaths (8.6%). Both hypokalaemia and HK were independently. associated with higher mortality, and ACEi/ARB prescription at baseline with lower mortality. MRA prescription was not retained in the model. In multivariable analyses, HK at baseline was independently associated with MRA non-prescription at baseline and subsequent discontinuation. When considering subsequent discontinuation of RAASi (instead of baseline use), HK was no longer found associated with all-cause deaths. Importantly, all RAASi (ACEi, ARB, or MRA) discontinuations were strongly associated with mortality. Conclusions: In HF, hyper- and hypokalaemia were associated with mortality. However, when adjusting for RAASi discontinuation, HK was no longer associated with mortality, suggesting that HK may be a risk marker for RAASi discontinuation rather than a risk factor for worse outcomes. © 2020 European Society of Cardiology more...

Aims: Classification of acute heart failure (AHF) patients into four clinical profiles defined by evidence of congestion and perfusion is advocated by the 2016 European Society of Cardiology (ESC)guidelines. Based on the ESC-EORP-HFA Heart Failure Long-Term Registry, we compared differences in baseline characteristics, in-hospital management and outcomes among congestion/perfusion profiles using this classification. Methods and results: We included 7865 AHF patients classified at admission as: ‘dry-warm’ (9.9%), ‘wet-warm’ (69.9%), ‘wet-cold’ (19.8%) and ‘dry-cold’ (0.4%). These groups differed significantly in terms of baseline characteristics, in-hospital management and outcomes. In-hospital mortality was 2.0% in ‘dry-warm’, 3.8% in ‘wet-warm’, 9.1% in ‘dry-cold’ and 12.1% in ‘wet-cold’ patients. Based on clinical classification at admission, the adjusted hazard ratios (95% confidence interval) for 1-year mortality were: ‘wet-warm’ vs. ‘dry-warm’ 1.78 (1.43–2.21) and ‘wet-cold’ vs. ‘wet-warm’ 1.33 (1.19–1.48). For profiles resulting from discharge classification, the adjusted hazard ratios (95% confidence interval) for 1-year mortality were: ‘wet-warm’ vs. ‘dry-warm’ 1.46 (1.31–1.63) and ‘wet-cold’ vs. ‘wet-warm’ 2.20 (1.89–2.56). Among patients discharged alive, 30.9% had residual congestion, and these patients had higher 1-year mortality compared to patients discharged without congestion (28.0 vs. 18.5%). Tricuspid regurgitation, diabetes, anaemia and high New York Heart Association class were independently associated with higher risk of congestion at discharge, while beta-blockers at admission, de novo heart failure, or any cardiovascular procedure during hospitalization were associated with lower risk of residual congestion. Conclusion: Classification based on congestion/perfusion status provides clinically relevant information at hospital admission and discharge. A better understanding of the clinical course of the two entities could play an important role towards the implementation of targeted strategies that may improve outcomes. © 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology more...

Objective: The aim of this study was the evaluation of maternal outcomes and of the associated risk factors occurred in Abruzzo region, Italy, from 2009 to 2013. Methods: The study considered all the deliveries performed from 2009 to 2013 in Abruzzo region, Italy. Data were collected from all hospital discharge records. Univariate logistic regression analyses were performed to calculate crude odds ratios for each comorbidity. Stepwise multiple logistic regression models with backward selection were performed to identify predictors of the most frequent outcomes. Results: 57, 260 deliveries were analyzed. Severe complication occurred in 0.9% of all deliveries. The most frequent complications were “Severe Hemorrhage”, “Hysterectomy”, “Uterine rupture” and “Severe pre-eclampsia/eclampsia”. Malignant cancer (OR=55.76), coagulation disorders (OR=37.21), acute pulmonary disease (OR=29.75), placenta previa (OR=26.51), caesarean section (OR=3.24) and age (OR=1.08) were associated with a higher risk of hysterectomy. Anemia (OR=14.64), coagulation disorders (OR=10.31), cardiac disease (OR=12.74), pregnancy hypertension (OR=2.66), major pre-eclampsia/eclampsia (OR=2.78), placenta previa (OR=9.42) and multiple pregnancy (OR=3.69) were associated to severe hemorrhage. Thrombocytopenia (OR=26.04) and diabetes (OR=5.05) were associated to uterine rupture. Overweight or obesity (OR=25.88) and pregnancy cardiovascular disease (OR=25.85) were associated to pre-eclampsia. Conclusions: Maternal comorbidities are associated with increased risk of complications and may result in substantial costs to the health care system. more...

A utilização de policarboxilatos em concretos é pratica comum no setor de construção civil, visto que esses aditivos auxiliam na dispersão das partículas, possibilitam a redução da quantidade de água de amassamento, permitem melhorar as propriedades no estado fresco e endurecido. Entretanto, é sabido que apesar de possibilitar a produção de concretos de alto desempenho, a presença dos policarboxilatos pode afetar a cinética de reação do cimento e de aglomeração das partículas durante a consolidação. Ao mesmo tempo em que o fluxo de calor liberado durante a reação pode ser quantificado em calorímetros de condução isotérmica, a aglomeração pode também, ser acompanhada a partir de ensaios reológicos oscilatórios com controle de freqüência e deformação. Os resultados obtidos separadamente, quando avaliados conjuntamente podem melhor ilustrar o efeito da presença dos aditivos durante o endurecimento do cimento, abordagem que é apresentada como objetivo principal deste trabalho. Para tanto, pastas cimentícias formuladas com CPIIE-32 foram avaliadas em função da variação do teor de policarboxilato e os resultados mostraram que a taxa de consolidação(promovida pela ação conjunta da reação química e da aglomeração)apresenta relação direta com o teor do aditivo.Polycarboxylates are frequently used as additives to concrete production in the construction industry. The additive increases the dispersion of the particles, reduces the amount of water, and improves the mechanical properties of concrete in the fresh and settled state. However, although it is well known that polycarboxylate additives enable the production of high performance concretes, their presence may affect on both kinetics and thermodynamics of cement's particles during hydration reaction through consolidation. While the flow of heat released by the hydration reaction can be measured by isothermal calorimetry, concrete consolidation can be measured by oscillatory rheometry. The results obtained separately, when considered together could better illustrate the effect of the additives on the cement setting. This was the main subject in this work. Therefore, cement pastes containing commercial CPIIE-32 were evaluated by simultaneous heat of hydration and rheological measurements with different amounts of polycarboxylate. The results obtained separately, when considered together can better illustrate the effect of additive content during the hardening, and this approach is presented as a main objective of this work. For this, cement pastes formulated with CPII-32 were evaluated according to the variation of the content of polycarboxylate and the results showed that the rate of consolidation(promoted by the joint action of the chemical reaction and particle agglomeration)has direct relation with the level of the additive. more...

Summary Objectives The most commonly used schedules are 5-FU in combination with CDDP with or without epirubicin (ECF) or docetaxel (TCF) in treatment of MGA patients (pts), independently of HER status. We evaluated the efficacy of FOLFIRI regimen in a large retrospective series of MGA pts. Methods Two hundred and twelve pts from 13 French centers were treated with at least one cycle of FOLFIRI (irinotecan 180 mg/m 2 intravenous (i.v.) over 90 minutes on day 1 with folinic acid (FA) 400 mg/m 2 i.v. over two hours followed by 5-FU 400 mg/m 2 i.v. bolus then 5-FU 2400 mg/m 2 continuous infusion over 46 hours on day 1, repeated every 14 days). Primary tumour sites were 120 (58%) stomach and 92 (42%) gastroesophageal junction. FOLFIRI was administered as first-line in 137 (65%) pts and as later-line in 75 (35%) pts for MGA. Results There was no difference between chemonaive and not chemonaive pts treated as first-line in terms of response rate 37% (95% CI: 25–50) vs 44% (95% CI: 21–69), median PFS, 6.7 (95% CI: 5.5–9.9) vs 5.3 months (95% CI: 3.6–6.9) ( P = 0.25), and OS, 13.1 (95% CI: 11.7–18.7) vs 8.8 months (95% CI: 7.3–15.6) ( P = 0.19), respectively. There was no difference between pts treated as second or later-line in terms of response rate 20% (95% CI: 8–39) vs 22% (95% CI: 6–48), median PFS, four months (95% CI: 2.8–5.4) vs 3.5 months (95% CI: 2.3–4.5) ( P = 0.56), and OS, 10.4 months (95% CI: 5.4–14.4) vs 5.3 months (95% CI: 3.5–11.3) ( P = 0.58), respectively. The global grade 3–4 toxicities were: diarrhea 11%, vomiting 9%, neutropenia 18%, febril neutropenia 4% (one toxic death). Conclusions This retrospective study confirms the activity and good tolerance of FOLFIRI regimen in MGA as first-line as well as later-line. more...

Background: Investigating the latent structure of conduct disorder (CD) can help clarify how symptoms related to aggression, property destruction, theft, and serious violations of rules cluster in individuals with this disorder. Discovering homogeneous subtypes can be useful for etiologic, treatment, and prevention purposes depending on the qualitative or quantitative nature of the symptomatology. The aim of the present study is twofold: identify subtypes of CD in young adolescents based on latent class analysis (LCA) and investigate the two-year predictive validity of CD subtypes on deviant and criminal lifestyles. Methods: Adolescent-reported CD symptoms were collected using the National Longitudinal Survey of Children and Youth. Three cohorts of 12–13-year-olds were assessed during 1994–1995, 1996–1997, and 1998–1999 (N = 4,125). Results: Latent class analyses yielded 4 distinct subtypes: No CD (82.4%); Non-Aggressive CD (‘NACD’, 13.9%); Physically Aggressive CD (‘PACD’, 2.3%); and SevereMixed CD (‘SMCD’, 1.4%). Predictive validity at age 14–15 was non-specific, although the SMCD type had, by far, the highest odds of deviant and criminal lifestyle outcomes in comparison to youth with PACD or NACD. NACD and PACD had similar odds of deviant outcomes, even if most NACD youth were subthreshold CD (fewer than three symptoms). Conclusion: In early adolescence, CD is qualitatively and quantitatively heterogeneous, suggesting multiple developmental pathways. However, they appear to predict similarly violent and non-violent outcomes. Keywords: DSM-V, Conduct disorder, latent class analysis, adolescence, predictive validity. Abbreviations: CD: conduct disorder; NACD: nonaggressive conduct disorder; PACD: physically aggressive conduct disorder; SMCD: severe-mixed conduct disorder; DSM: Diagnostic Statistical Manual; CBCL: Child Behavior Checklist; ABQ: Antisocial Behavior Questionnaire; LCA: latent class analysis; BIC: Bayesian information criterion. Conduct disorder (CD) is a psychiatric syndrome beginning in childhood or adolescence and defined by a pattern of repetitive and persistent behavior that violates others’ rights of others and/or ageappropriate social norms and rules. This syndrome includes behavior symptoms related to heterogeneous dimensions, such as: 1) verbal or physical aggression toward people or animals; 2) destruction of property; 3) deceitfulness or theft; and 4) serious more...

The erythrocyte is a cell highly exposed to oxygen pressure that, in turn, provokes oxidative stress involving loss of SH-groups, cell shrinkage by activation of K(+)-Cl(-) cotransport (KCC) and membrane destabilization which plays an important role in the premature haemolysis of red blood cells (RBCs). Oxidative stress provoked by chemicals frequently occurs in human erythrocytes. The aim of this study was to test whether the antibiotics alter the redox state and investigate their influences on band 3 protein that is involved in the facilitated electro neutral exchange of Cl(-) for HCO(3)(-) across the membrane of mammalian erythrocytes. Normal erythrocytes were treated with some antibiotics and thiol oxidizing agent N-ethylmaleimide (NEM) and tested for sulphate uptake, K(+) efflux and for glutathione (GSH) concentration as an index of oxidative stress. The rate constant of SO(4)(=) uptake measured in erythrocytes treated with antibiotics as well as NEM was decreased with respect to control cells as a result of band 3 SH-groups oxidation or the stress-induced K(+)-Cl(-) symport-mediated cell shrinkage. In fact, this hypothesis was verified by increased K(+) efflux and decreased GSH values measured in treated erythrocytes compared to controls. more...

Hepatosplenic gammadelta T-cell lymphoma (HSTL) is a clinicopathological entity associated with an immunocompromised status in approximately 25% of patients. Herein is described a case of HSTL in a 53-year-old Brazilian man with seven previous malaria infections, initially misdiagnosed as a hyperreactive splenomegaly due to chronic malaria. A characteristic lymphoid infiltrate was observed in spleen, liver and bone marrow sinusoids/sinuses. Neoplastic cells had a CD45RO+, CD2+, CD7+, CD3+, CD5-, CD8+, CD56+, perforin+, FasL-negative, T-cell receptor (TCR)alphabeta-negative, TCRgammadelta+ profile. Analyses of gamma and delta TCR rearrangements confirmed diagnosis of gammadelta T-cell lymphoma by detecting VgammaI/Vdelta1-Jdelta1 clonal rearrangements. Sensitive polymerase chain reaction (PCR) for Plasmodium falciparum, Epstein-Barr virus and herpesvirus-8 failed to demonstrate infection. The disease progressed to a fatal outcome following cutaneous infiltration and leukemic proliferation. The authors also comment on the association of lymphoma and infection, focusing on PCR diagnosis of TCRgamma and delta clonal rearrangements and the presumed pathogenic events leading to HSTL in the context of chronic malaria infection. Initial lymphomagenic stages might not be direct consequences of antigenic stimulation of Vdelta1 T-cells, but might depend on interactions between gammadelta T and B cells during cooperative or regulatory responses to Plasmodium sp. more...

OBJECTIVE: The study investigated histories of child maltreatment and psychiatric disorder in a high-risk sample of pregnant adolescents. METHOD: Cross-sectional data were obtained for 252 pregnant adolescents from high school, hospital, and group home settings in Montreal (Canada). Adolescents completed a child maltreatment questionnaire and a psychiatric interview on lifetime conduct and major depressive disorders. Latent class analysis was used to model the association between child maltreatment and psychiatric disorder. RESULTS: Analyses indicated two latent classes: pregnant adolescents with no reported child maltreatment history (79%) and those with multiple forms of maltreatment (21%). There was no association between the child maltreatment latent variable and major depressive disorder. Rather, depression was related specifically to one form of maltreatment (i.e., sexual abuse, odds ratio = 2.60). Depression also showed a significant relationship with conduct disorder (odds ratio = 3.70). Pregnant adolescents with multiple forms of child maltreatment had a fourfold risk of also having conduct disorder, compared with nonmaltreated adolescents. CONCLUSIONS: In this sample of pregnant adolescents, prior experience of multiple forms of child maltreatment was prevalent, as were depression and conduct disorder. Clinicians need to screen for histories of child maltreatment and psychiatric disorder and to introduce effective interventions for pregnant adolescents and their children. Language: en more...

We herein present a technical strategy to optimize DNA isolation from paraffin-embedded tissue (PET). This includes the choice of adequate buffers for proteinase K digestion and multiplex PCR amplifications for assessing the appropriateness of DNA extracts for subsequent PCR assays for detecting clonality. We found that the association of proteinase K digestion in nonionic buffer and subsequent extract dilutions accounted for 79% of successful amplifications. A final efficiency of 88% was achieved by additional organic extractions and/or re-extractions. Comparisons were carried out with control DNA extracts from fresh samples to assess the efficiency of each clonality assay. Immunoglobulin CDRIII rearranged region amplification was more efficient for pregerminal center B-cell lymphomas in contrast to CDRII rearrangement detection, which was more effective for germinal and postgerminal lymphomas. T-cell clonality detection by TCRgamma PCR was less efficient in PET samples than in fresh tissues showing that DNA integrity is more critical for TCR than for IGH amplification. Two inconclusive cases without phenotypic markers and two other atypical lymphoproliferations masked by reactive T cells were diagnosed as plasmablastic lymphomas and as monoclonal B-proliferations, respectively, due to IGH rearrangements. more...

Despite the increasing awareness of sexual victimization involving males, there remain a number of factors (e.g., stigma of homosexuality, male ethic of self-reliance) that continue to contribute to the underreporting of such cases. Nonetheless, there appears to be growing recognition of male sexual abuse as a serious problem with potentially numerous debilitating consequences. The clinical and research literature presently contains a number of articles on issues pertaining to males who have experienced sexual abuse during childhood. The purpose of the present paper is to review some of the more recent literature on the short- and long-term effects commonly found among sexually abused males. These effects, which include depression, self-blame, low self-esteem, anger, anxiety, and sexuality problems, are also compared with findings commonly reported among sexually abused females. In addition to sexual abuse effects, the present paper also reviews a number of important sexual abuse characteristics (e.g., age of abuse onset, duration of the abuse, nature of the sexual activity), examines the relationship of these characteristics to later psychological functioning, and explores gender similarities and differences. Finally, the implications of the findings with regard to treatment interventions are briefly discussed. more...

EBV-associated post transplant lymphoproliferative disorder of the ‘loser’ graft cell origin following double unrelated umbilical cord blood transplantation

Cumulative concentration-response curves (CRC) to prostaglandin E1 (PGE1), PGE2, PGD2 and PGF2α (0.01–30 μM) and to the thromboxane A2 (TXA2) receptor agonist U-46619 (0.01–30 μM) were constructed in human isolated detrusor muscle strips both in basal conditions and during electrical field stimulation. All the agonists tested contracted the detrusor muscle. The rank order of agonist potency was: PGF2α>U-46619>PGE2 whereas weak contractile responses were obtained with PGD2 and PGE1. Any of the agonists tested was able to induce a clear plateau of response even at 30 μM. The selective TXA2 antagonist, GR 32191B (vapiprost), antagonized U-46619-induced contractions with an apparent pKB value of 8.27±0.12 (n=4 for each antagonist concentration). GR 32191B (0.3 μM) did not antagonize the contractile responses to PGF2α and it was a non-surmountable antagonist of PGE2 (apparent pKB of 7.09±0.04; n=5). The EP receptor antagonist AH 6809 at 10 μM shifted to the right the CRC to U-46619 (apparent pKB value of 5.88±0.04; n=4). Electrical field stimulation (20 Hz, 70 V, pulse width 0.1 ms, trains of 5 s every 60 s) elicited contractions fully sensitive to TTX (0.3 μM) and atropine (1 μM). U-46619 (0.01–3 μM) potentiated the twitch contraction in a dose-dependent manner and this effect was competitively antagonized by GR 32191B with an estimated pKB of 8.54±0.14 (n=4 for each antagonist concentration). PGF2α in the range 0.01–10 μM (n=7), but not PGE2 and PGE1 (n=3 for each), also potentiated the twitch contraction of detrusor muscle strips (23.5±0.3% of KCl 100 mM-induced contraction) but this potentiation was unaffected by 0.3 μM GR 32191B (n=5). Cumulative additions of U-46619 (0.01–30 μM) were without effect on contractions induced by direct smooth muscle excitation (20 Hz, 40 V, 6 ms pulse width, trains of 2 s every 60 s, in the presence of TTX 1 μM; n=3). Moreover, pretreatment of the tissue with 0.3 μM U-46619 did not potentiate the smooth muscle response to 7 μM bethanecol (n=2). We concluded that TXA2 can induce direct contraction of human isolated urinary bladder through the classical TXA2 receptor. Prostanoid receptors, fully activated by PGE2 and PGF2α are also present. All these receptors are probably located post-junctionally. The rank order of agonist potency and the fact that GR32191B, but not AH6809, antagonized responses to PGE2 seem to indicate the presence of a new EP receptor subtype. Moreover, we suggest the presence of prejuctional TXA2 and FP receptors, potentiating acetylcholine release from cholinergic nerve terminals. more...

Empirical findings indicate that many adult sexual offenders experienced sexual abuse during childhood. It has been suggested that characteristics of offenders' sexual perpetrating behaviors may resemble their own victimization experiences, although there has been minimal empirical investigation in this area. The purpose of the present study was to provide preliminary data on the relationship between childhood sexual abuse and characteristics of sexual offending behavior. A sample of adult male sexual offenders with histories of sexual abuse completed the Sexual Victimization Survey as well as a measure on their sexual offenses. Such characteristics as the nature of sexual activities, duration and frequency of experiences, and age and relationship of participants were examined. Results showed trends in the hypothesized direction and revealed a variety of similarities between childhood sexual abuse and adult sexual perpetration. Findings of this exploratory study suggest the importance of addressing the nature of victimization in the treatment of sexually abused boys and offenders with histories of sexual abuse. more...

Epstein-Barr virus (EBV) is an important environmental factor associated to the development of Burkitt lymphoma (BL) in endemic and intermediate risk regions. However, little is known about the contribution of genetic constitution to the development and clinical response of the disease. The aim of this work was to investigate the role of EBV and Interleukin 10 (IL10) single nucleotide polymorphisms (−1082A/G, −819C/T, −592C/A) and microsatellites (IL10.R and IL10.G) in susceptibility and clinical outcome in pediatric BL patients, in a region with intermediate EBV association frequency. The frequencies of IL10 promoter Single nucleotide polymorphisms −1082A/G, −819C/T, −592C/A, and IL10.R and IL10.G microsatellites were compared in 62 pediatric patients and 216 healthy donors. IL10 −1082GG and GCC/GCC genotypes were more frequent in patients than in controls, and associated to a higher risk of BL development (GG genotype OR 2.62, 95% CI, 1.25–5.51; P = 0.008; Pc = 0.024). EBV was detected in tumor samples by EBER-ISH in 54.1% of cases. EBV+ patients exhibited a better event free survival (EFS) (P = 0.019) than EBV− patients. Carriers of IL10 R3-GCC had worse EFS (P = 0.028). Our results suggest a risk effect and an independent prognostic value of IL10 polymorphisms and EBV in childhood BL patients. more...

Sorafenib increases median survival and time to radiological progression in patients with advanced hepatocellular carcinoma, but its benefit for Child-Pugh B patients remains uncertain.To evaluate the safety and efficacy of sorafenib in real-life clinical practice conditions and to assess the influence of Child-Pugh class B on safety and efficacy.All patients treated with sorafenib for advanced hepatocellular carcinoma in our institution were included prospectively. Adverse events, overall survival and time to progression were recorded. A case control study was performed to compare outcome of patients with comparable stages of hepatocellular carcinoma, but a different Child-Pugh class.From March 2007 to May 2009, 120 patients were included. Overall survival was 11.1 months, Child-Pugh A patients (n=100) had significantly higher median survival than Child-Pugh B patients (n=20) (13 vs. 4.5 months, P=0.0008). In multivariate analysis, Child-Pugh class B, α-fetoprotein level and total size of lesions were independent predictive factors of death. Patients with radiological progression in the first 3 months had shorter median survival (5.4 vs. 17.4 months). In a case control study, time to symptomatic progression (2.5 vs. 3.6 months), frequency of adverse events and discontinuation of sorafenib were not correlated with Child-Pugh class.Patients with advanced hepatocellular carcinoma treated with sorafenib had a median survival of 11 months. Sorafenib therapy must be considered with caution in Child-Pugh B patients due to their poor survival. Radiological assessment of tumour progression at an early stage may be advantageous when tailoring sorafenib therapy. more...

Summary Selection indices were developed for combining marker information and animal model PTA for offspring, grandoffspring, and great-grandoffspring of sires. The sires had marker-QTL linkages identified in granddaughter designs (GDD). Effects of size and s. e. of marker effects and of weight given to own and progeny records in PTA on gain in accuracy of selection due to a marker were quantified. Gains were negligible for high weight or large s. e., even if the marker effect was substantial. Gains were compared among offspring (O), grandoffspring (GO), and great-grandoffspring (GGO), when the marker effect in the sire was the only marker information. Gains decreased strongly for GO and were smallest for GGO. Assuming that progeny test (PT) daughters of some sons of the sire were also marker genotyped, the selection index was mo dified to incorporate this marker information on sons in addition to that on the sire from the GDD for selection of GO. For the current size of the PT, gain from including marker data on PT daughters was negligible, requiring 200 to 1000 PT daughters. Polymorphism Information Content (PIC) was computed as the fraction of O, GO, and GGO with marker allelic inheritance traceable to the sire. PIC in GO exceeded .8 and approached PIC in O only if a marker had at least 10 alleles at equal frequencies. Zusammenfassung Verwendung von genetischen Markern bei Enkelin-Selektionsplanen Selektionsindices wurden hergeleitet, um Information von Markergenorten zu kombinieren mit Tiermodell-Zuchtwerten fur Nachkommen der ersten, zweiten und dritten Generation von Vatertieren. Die Vatertiere hatten Marker-QTL Kopplungsbeziehungen, die in “granddaughter designs (GDD)” nachgewiesen worden waren. Die Einflusse von Grose und Standardfehlern der Markereffekte und der Gewichtung von Eigen- und Nachkommenleistungen im Tiermodell-Zuchtwert auf die Verbesserung der Selektionsgenauigkeit durch die Markerinformation wurden ermittelt. Verbesserungen waren gering fur hohe Gewichtung oder grose Standardfehler. Verbesserungen wurden verglichen fur Nachkommen der ersten, zweiten und dritten Generation, wenn die Markerinformation nur aus dem GDD stammte. Verbesserungen waren stark reduziert bzw. sehr gering fur Nachkommen der zweiten bzw. dritten Generation. Der Selektionsindex wurde modifiziert, um begrenzte Markerinformation von Tochtern aus der Nachkommenprufung von Sohnen eines Vatertieres miteinzubeziehen. Diese Information war nur hilfreich, wenn mindestens 200 bis 1000 Tochter getestet waren. Der Polymorphismus-Informationsgehalt (PIC) wurde berechnet als der Anteil von Nachkommen der ersten, zweiten und dritten Generation, fur den die Vererbung eines Markeralleles zum Vatertier zuruckverfolgt werden konnte. Zumindest 10 Allele mit gleichen Frequenzen waren notwendig, um ein PIC von .8 und ein PIC in Nachkommen der zweiten Generation von ahnlich hohen Wert wie fur Nachkommen der ersten Generation zu erhalten. more...

Retroperitoneal tumors are rare. Most of these tumors arise from mesothelial or connective tissues in the retroperitoneum. We report the first case, for us, of a cystic neuroendocrine retroperitoneal carcinoma in a 71-year-old woman. The discussion is focused on the radiographic findings, immunohistochemical studies and the controversial diagnosis. more...

Conservative endourological treatment of transitional cell carcinoma of renal pelvis and ureter is controversial. The treatment should be reserved for selected cases and for low grade, low stage, monofocal tumors. Personal experience with endourological treatment of a transitional cell carcinoma of the lower tract of the ureter is presented. more...