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Resumen Objetivo Evaluar e identificar aquellas variables relacionadas con la tasa de exito en el manejo con el histeroscopio de energia mecanica Truclear System 5.0® de los restos ovulares retenidos. Material y metodos Estudio descriptivo prospectivo realizado en el Hospital de Igualada con periodo de inclusion de enero del 2015 a diciembre del 2016. Incluye a todas aquellas pacientes con diagnostico de restos ovulares a las que se les realizo en el quirofano una histeroscopia diagnostico-terapeutica con el histeroscopio de energia mecanica Truclear System 5.0®. Resultados Se incluyeron un total de 42 pacientes de las cuales se excluyeron 12 por no cumplir los criterios de inclusion. De las 30 pacientes analizadas, 21 (70%) presentaban perdidas discontinuas en el momento del diagnostico, mientras que 9 (30%) permanecian asintomaticas. La morcelacion completa de los restos se consiguio en el 77% de las pacientes (23). No hubo ninguna complicacion evidente intraoperatoria ni en el postoperatorio inmediato. Conclusiones La reseccion selectiva histeroscopica con energia mecanica parece ser un buen metodo terapeutico para la retencion de los restos ovulares, con unos porcentajes de exito del 77%. Esta tecnica nos ofrece una alternativa al tradicional legrado uterino evacuador que minimiza los riesgos y complicaciones que supone un acto quirurgico invasivo para la paciente. Se plantea, como futura hipotesis de trabajo, la seguridad y el beneficio en la realizacion de la histeroscopia ambulatoria en todas aquellas pacientes con restos ovulares que cumplan unos criterios especificos.

The highly siderophile elements (HSE: Os, Ir, Ru, Rh, Pt, Pd, Re, Au) exist in solid solution in accessory base-metal sulfides (BMS) as well as nano-to-micron scale minerals in rocks of the subcontinental lithospheric mantle (SCLM). The latter include platinum-group minerals (PGM) and gold minerals, which may vary widely in morphology, composition and distribution. The PGM form isolated grains often associated with larger BMS hosted in residual olivine, located at interstices in between peridotite-forming minerals or more commonly in association with metasomatic minerals (pyroxenes, carbonates, phosphates) and silicate glasses in some peridotite xenoliths. The PGM found inside residual olivine are mainly Os-, Ir- and Ru-rich sulfides and alloys. In contrast, those associated with metasomatic minerals or silicate glasses of peridotite xenoliths consist of Pt, Pd, and Rh bonded with semimetals like As, Te, Bi, and Sn. Nanoscale observations on natural samples along with the results of recent experiments indicate that nucleation of PGM is mainly related with the uptake of HSE by nanoparticles, nanominerals or nanomelts at high temperature (> 900 °C) in both silicate and/or sulfide melts, regardless of the residual or metasomatic origin of their host minerals. A similar interpretation can be assumed for gold minerals. Our observations highlight that nanoscale processes play an important role on the ore-forming potential of primitive mantle-derived magmas parental to magmatic-hydrothermal deposits enriched in noble metals. The metal inventory in these magmas could be related with the physical incorporation of HSE-bearing nanoparticles or nanomelts during processes of partial melting of mantle peridotite and melt migration from the mantle to overlying continental crust., We thank Laurie Reisberg, Hannah Hughes and an anonymous referee for their criticism, which greatly improved the quality of our manuscript. We also are indebted to Prof. Sisir K. Mondal for Editorial handling of this work and their constructive edits. This research was supported by Spanish projects: RTI2018-099157-A-I00 , CGL2015-65824-P and CGL2016-81085-R granted by the “ Ministerio de Ciencia, Innovación y Universidades ” and Ministerio de Economía y Competitividad ” (MINECO), respectively. Additional funding was provided by the Ramón y Cajal Fellowship RYC-2015-17596 and Junta de Andalucía project B-RNM-189-UGR18 to JMGJ, and the BES-2017-079949 fellowship to ES. This work was also supported by the Mexican research programs CONACYT-Ciencia Básica ( A1-S-14574 ) and UNAM-PAPIIT grant IA-101419 awarded to VC. A. Jiménez-Franco also acknowledge a postdoctoral grant (CVU 350809 ) from the National Council on Science and Technology (CONACYT) of Mexico. Research grants, infrastructures and human resources leading to this research have benefited from funding by the European Social Fund and the European Regional Development Fund. We are grateful to Prof. José Jorge Aranda Gómez who provided the xenolith samples of La Breña (Durango Volcanic Field, Central Mexico). María del Mar Abad, Isabel Sánchez Almazo and Rocío Márquez Crespo (CIC, University of Granada) are acknowledged for her assistance with HRTEM, and HR-SEM and FE-SEM analysis, respectively. We are also indebted to Miguel Ángel Hidalgo Laguna from CIC of University of Granada and Xavier Llovet from the Centres Científics i Tecnològics of the Universitat of Barcelona (CCiTUB) for their careful help with EMPA.

Resumen El Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) se emplea como herramienta de cribado en la deteccion de consumidores de drogas que necesitan una intervencion breve. Este test podria ser empleado en dispositivos de atencion temprana. El test fue traducido al espanol por el mismo equipo que desarrollo la version inglesa original, pero carece de los necesarios estudios de validez en la version espanola. Objetivo El objetivo de esta investigacion es estimar la fiabilidad del test asi como conocer su estructura latente, como forma de obtener evidencias de validez del test para el uso propuesto. Metodo La muestra se compone de 1176 personas que consumen cocaina y que completaron la version on line del test. La fiabilidad fue estimada mediante el procedimiento alfa de Cronbach. Se aplico un analisis factorial exploratorio y otro confirmatorio para analizar la estructura factorial del ASSIST. Resultados El test ha mostrado una alta fiabilidad y una bondad de ajuste adecuada a una estructura unidimensional, proporcionando evidencia de validez del uso de la suma de los items para la interpretacion de puntuaciones propuesta. Conclusiones Los resultados obtenidos en este test avalan la utilizacion de este instrumento con este tipo de muestra, desde el punto de vista de la fiabilidad y la estructura factorial. No obstante, es necesario realizar nuevos estudios que aporten evidencias de validez basadas en la relacion con otras variables, para determinar su utilidad como instrumento de screening .

Objective To report our experience of laparoscopic heminephroureterectomy (Hnu) in pediatric patients with duplex anomalies, in comparison to open surgery. Patients and methods Retrospective review of data from patients who underwent Hnu from 2005 to 2008 was performed. The patients were divided into two groups: laparoscopic (LHnu) and open surgery (OHnu). Laparoscopic surgery was performed by transperitoneal approach in majority of cases. Open surgery was performed by retroperitoneal approach in all cases. Results Group LHnu: nine patients (8 females, 1 male) with median age of 14 months (range 3–205). Transperitoneal approach was performed in eight patients. Mean operative time was 182 min (CI 95% 146–217). No conversion to open surgery was necessary and there were no complications. Mean hospital stay was 2.44 days (CI 95% 1.37–3.52). Group OHnu: eight patients (3 females, 5 males) underwent nine heminephrectomies at median age of 6.9 months (range 1–12). Mean operating time was 152 min (CI 95% 121–183). There were no complications and mean hospital stay was 4.38 (CI 95% 2.59–6.16) days. Statistical analysis showed no statistically significant difference ( P > 0.05) in operating time between groups while mean hospital stay was significant ( P = 0.021). Conclusion The laparoscopic approach is feasible, safe, reduces hospital stay, does not increase operating time and has better cosmetic results. We believe this should be the first option for heminephrectomy.

To characterize the endocrine cell types of the pancreas of Rana temporaria, conventional staining, silver impregnation, and immunocytochemical methods for light and electron microscopy have been applied to paraffin, thin and semithin sections, many of them serial pairs. Quantitative data on the frequency and distribution (insular, extrainsular among the exocrine cells, or within the pancreatic ducts) of each endocrine cell type are also reported. Four distinct endocrine cell types have been identified: insulin (B) cells, which are also immunoreactive for [Met]enkephalin; glucagon/PP (A/PP) cells, also immunoreactive for GLP1; somatostatin (D) cells; and a fourth endocrine-like cell type (X cells) of unknown content and function. X cells display characteristic ultrastructure and tinctorial traits but are nonimmunoreactive for all of the 37 antisera tested. The presence of [Met]enkephalin in amphibian pancreatic endocrine cells is now reported for the first time. Almost half (44.9 +/- 7.9) of the total endocrine cell population lies outside the islets, mainly spread among the exocrine cells. Approximately 37.2 +/- 4.6% of the total endocrine cell population was immunoreactive for insulin, 48.8 +/- 6.9% was immunoreactive for glucagon/PP, and 14.0 +/- 4.9% was immunoreactive for somatostatin; 79.2 +/- 6.4% of glucagon/PP cells are found within the exocrine parenchyma, representing the majority (86.4 +/- 4.3%) of extrainsular endocrine component. On the contrary, most B cells (94.2 +/- 2.1%) are located within the islets; 30.8 +/- 12.9% of D cells are found outside the islets.

ResumenLa regulación de los medicamentos por parte de las administraciones públicas es una actividad que se produce en los países de manera independiente del modelo sanitario que posean. En el ámbito de la financiación pública de los medicamentos se han experimentado diversas medidas para mejorar la eficiencia en su utilización. Sin embargo, el análisis del impacto de estas medidas es complejo y quizá ello justifique la escasez de resultados objetivables, especialmente a largo plazo.El objetivo de este trabajo es realizar una revisión sistemática de dichas medidas dada la necesidad de disponer de información sobre las distintas alternativas previo a la toma de decisión.El planteamiento de una medida aislada es en muchas ocasiones compensada por cambios en otros ámbitos reguladores o asistenciales lo que aconseja una estrategia integral afectando a distintos ámbitos (oferta/demanda de medicamentos y prescriptores).Parece necesario proponer un debate social a partir de la información científica de que se dispone y promover la toma de decisiones que conduzca a la utilización racional de los recursos farmacológicos disponibles.SummaryRegulation of drugs from the public administration is an activity which is produced in different countries independently from the sanitary model they own. In the field of public financing of drugs there have been several measures to improve the efficiency of their use.However, the analysis of the impact of these measures is complex and this may justify the shortage of objectivable results, especially at long term.The objective of this study is to perform a systematic review of such measures due to the need to have information about the different alternatives before making a decision.The introduction of an isolated measure is in many cases compensated by other changes in other regulating or aiding fields wich suggests the creation of an integral strategy which affects different fields (supply/demand of drugs and prescribers).It seems necessary to suggest a social debate taking as a basis the scientific information available at the moment and promote the taking of decisions which lead to a rational use of the available pharmacological resources.

The gastric wall of Rana temporaria tadpoles consists of a well-developed mucosa and thin muscular and serosa layers. Three cellular types--mucous, ciliated and endocrine cells--make up the lining epithelium. Different types of endocrine cells exist. Argyrophylic endocrine cells can be recognized in semithin sections of plastic-embedded material while non-argyrophylic endocrine cells can only be identified under the electron microscope. Glands are composed mainly of well-differentiated oxyntic cells and, occasionally, scarce endocrine cells. Oxyntic cells show abundant mitochondria and smooth endoplasmic reticulum, but do not contain zymogen granules as do those present in adults. Secretory canaliculi with microvilli are also well-developed. The lamina propria contains numerous vascular sinuses and nerve bundles which innervate the endothelium and some endocrine cells. The neuroendocrine regulation of frog gastric functions seems therefore to have developed in young tadpoles. Nerve fibers also innervate the muscular propria, which is composed of a single layer of smooth muscle cells. Underlying the muscle, connective fibers and a flattened layer of mesothelial cells make up the serosa. In summary, the structure of the frog larval stomach shows a well-differentiated histological pattern, especially referring to surface epithelium and glands. Some of the histological traits will also be present in adult frogs while others are characteristic of the tadpole's stage.

Endocrine cells have been identified in the intestine of the frog Rana temporaria after application of the Grimelius and Masson-Fontana techniques. These endocrine cells were examined using immunocytochemical techniques on paraffin and semithin sections for light microscopy. After testing 19 antisera. 12 immunoreactivities were identified. Numerous serotonin-, somatostatin- and GLP-1-immunoreactive cells; a moderate number of PYY-, glucagon-VIP-, gastrin/CCK-immunoreactive cells and few human PP-, bombesin-, substance P- and neurotensin-immunoreactive cells were found. VIP- and met-enkephalin were identified in nerve fibers of the muscular layer. Using semithin-thin sections five types of endocrine cells (serotonin-, somatostatin-, gastrin/ CCK-, glucagon- and bombesin-immunoreactive cells) have been characterized according to their immunocytochemical reaction and the ultrastructure of the secretory granules.

The distribution equilibria of 3-phenyl-3-methyl-2-mercaptopropenoic acid (PhMMP) and the titanium(IV)-PhMMP complex have been studied. An extraction-photometric method for the determination of microamounts of titanium has been developed. We have investigated the influence of pH, the reagent, and the presence of electrolytes and masking agents in the aqueous phase on the equilibrium. From the slope analysis of the distribution curves the composition of the extracted species has been found to be Ti(OH) 2 (HR) 2 . The complex is extracted quantitatively. Beer's Law is followed over the range 0.09–3.74 μg ml −1 of titanium(IV), the molar absorptivity is 1.65 × 10 4 liters mol −1 cm −1 , and the Sandell sensitivity is 2.8 ng cm −2 at 439 nm. This method has been applied to the determination of titanium in a bauxite.

In the last 10 years, four children with adrenocortical tumors were treated in our hospital. Three of them had symptoms of adrenogenital virilizing syndrome, and another, nonfunctional, was found during a routine examination. A diagnosis of adrenocortical tumor was established given the symptoms, hormonal tests, and radiologic studies. Two of the tumors were located in the left side, and the histologic diagnosis was pleomorphic cortical adenoma; the ones that affected the right side were adenocarcinomas. All the patients were treated by surgery and none received chemotherapy. At both presurgical and postsurgical stages, the patients were treated with cortisol. All four children have had a favorable course, with normal growth and the disappearance of public hair and hirsutism; however, macrogenitals still persist.

We report a case of agenesis of the trachea type III of Floyd that survived for 2 days with an esophageal intubation. Surgical treatment consisted of a distal esophageal binding, cervical esophagostomy in double-barrelled shotgun, and gastrostomy. Death occurred on the third day after surgery.