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Objective: Vocal fold paralysis is an uncommon problem in children. Clinical presentation covers a wide range of signs and symptoms. Our objective is to evaluate de efficacy and security of the Endoscopic Arytenoid Abduction Lateropexy (EAAL) in pediatric patients with vocal cord paralysis and to present the results. Material and method: From January 2011 to September 2018 10 patients with vocal fold paralysis underwent examination and treatment. The mean age at treatment was 4.87 years old (2-16). The parameters considered at the pre-/postsurgical time for the clinical assessment of each patient were as follows: the presence or absence of stridor and respiratory distress, the existence or nonexistence of previous tracheostomy, voice alterations, and feeding aspiration events. The mean follow-up was 49.5 months (5-104). Results: EAAL were realized successfully in 10 patients. There were no complications associated with the surgical procedure. In terms of sequelae, we noted 2 cases of minimal liquid-feeding difficulties that were alleviated within three weeks of the surgery with the help of phoniatrics reeducation, and 5 cases of mild dysphonia. In 4 cases tracheostomy was avoided, in 4 cases patients with prior tracheostomy were successfully decannulated following EAAL. Conclusions: EAAL may be selected as a first-line technique in management of vocal cord paralysis, since it is minimally invasive, easy to perform, and produces satisfactory results.

A microvolumetric method for surface hydrophobicity (H

The photoelectrochemical conversion of CO2 into valuable products represents an attractive method to decrease the external electrical bias required in electrochemical approaches. In this work, TiO2 nanoparticles with enhanced optical properties, large surface area, appropriate morphology, and superior crystallinity are synthesized in supercritical medium to manufacture light-responsive photoanodes. The photoelectrochemical CO2 reduction tests are carried out in continuous mode using a photoanode-driven filter-press cell illuminated with UV LED lights (100 mW cm-2), consisting on TiO2 nanoparticles synthesized in supercritical medium (3 mg cm-2) supported onto porous carbon paper as the photoanode, a Cu plate cathode, and 1 M KOH aqueous solution as the reaction medium. The main products obtained from CO2 are ethylene in the gas phase, together with methanol in the liquid phase. The results show that reaction performance is improved under UV irradiation towards ethylene (r = 147.4 μmol m−2 s−1; FE = 46.6%) and methanol (r = 4.72 μmol m−2 s−1; FE = 15.3%) in comparison with the system performance in the dark (ethylene: r = 24.2 μmol m−2 s−1 and FE = 38.2%; methanol not detected), which can be mainly ascribed to the superior photocurrent densities reached that affect the selectivity of the reaction. Besides, the maximum solar-to-fuels values achieved for ethylene (5.4%) and methanol (1.9%) are markedly superior to those observed with illuminated TiO2-P25 photoanodes under the same reactor configuration and experimental conditions (3.7% and 1%, respectively). Therefore, these results demonstrate the benefits of using TiO2-based materials synthesized in supercritical medium for a more efficient continuous photoelectroreduction of CO2 to value-added products. The authors gratefully acknowledge the financial support from Ministerio de Ciencia e Innovación (MCIN), under Ramón y Cajal programme (RYC-2015-17080), and Spanish Ministry of Economy and Competitiveness (MINECO), projects PID2019-104050RA-I00 funded by MCIN/AEI/10.13039/501100011033 and CTQ2016-76231-C2-1-R (MINECO). V.R., R.C., and J.R. wish to thank the Regional Government of Castilla-La Mancha (Project SBPLY/19/180501/000318 and Grants for the training of research personal in public research centers and companies [2016/9989]), as well as the project PID2019-111416RB-I00 funded by MCIN/AEI/10.13039/501100011033. I.H. also acknowledges the funding by the Spanish Ministry of Science, Grant No. MAT2016-80438-P.

In solid-phase peptide synthesis using the Fmoc/tBu strategy (SPPS-Fmoc/tBu), an orthogonal protection scheme of amino acids is used; specifically, the alpha-amine group is protected by the 9-fluorenylmethyloxycarbonyl (Fmoc) group, which is removed by weak bases, while side chains are protected by groups that are acid labile. We demonstrated that hydrazine hydrate is an efficient reagent for eliminating the Fmoc group in SPPS-Fmoc/tBu. First, experimental conditions were established for Fmoc group removal from Fmoc-Val-OH in solution. It was determined that the Fmoc group was completely removed with 16% hydrazine hydrate in DMF after 60 min at rt. Second, SPPS-Fmoc/tBu using hydrazine hydrate for Fmoc group removal was standardized. The Fmoc group removal was completed using 16% hydrazine hydrate in DMF for 10 min at rt (twice). When the reaction of Fmoc group removal was microwave-assisted, the reaction only required 30 s to efficiently remove the Fmoc group in SPPS-Fmoc/tBu. The method reported here can be routinely used, and it is equivalent to conventional SPPS-Fmoc/tBu methodologies where 4-methylpiperidine or piperidine is used.

Ethnopharmacological relevance Salvia sessei Benth, popularly known as “pipilolxochitl” or “sabanito”, is a plant utilized in Mexico in traditional medicine for the treatment of erysipela. To date, only one report, to our knowledge, has been found in which a royleanone-type diterpene of the aerial parts of the species was isolated but, again to our knowledge, studies have not been conducted on the pharmacological activity of extracts and compounds isolated from this plant. Aim of the study The objective of the study was to evaluate the anti-inflammatory, antibacterial and antioxidant activity of the organic extracts of the aerial parts of Salvia sessei Benth and sessein and isosessein isomers isolated from this. Materials and methods Anti-inflammatory activity was evaluated in a model of edema in mouse ear at 1 mg/ear of the isolated extracts and compounds (1 and 2), a dose-response curve was performed on these latter and one-half of the effective dose (ED50) was determined; antibacterial activity was determined through minimal inhibitory concentration (MIC) by microdilution at 100, 50, 25, and 12.5 µg/mL, and antioxidant capacity, by means of DPPH, ABTS, and FRAP assays where, for the first two assays noted, the inhibitory concentration 50% (IC50) was calculated for the extracts as well as for the compounds isolated. Results The hexanic extracts (40.55 ± 0.5%), dichloromethanic (56.01 ± 1.1%) and methanolic (66.05 ± 0.3%), as well as isolated compounds 1 (79.85 ± 3.5%) and 2 (54.36 ± 1.7%), demonstrated anti-inflammatory activity; the methanolic extract presented the greatest percentage of inhibition, while isolated compounds 1 and 2 did not present a difference in their ED50; additionally, compound 1 exerted a similar effect to that of the drug-of-reference at the same dose (75.24 ± 2.4%). The antibacterial activity of the extracts and compounds was principally against Gram-positive bacteria: the hexanic extract presented activity against Staphylococcus hominis and the methanolic and dichloromethanic extracts, and compound 1 exhibited activity against Staphylococcus haemolyticus, S. hominis, E. faecalis, in addition to that Escherichia coli was sensitive to compound 1, while isomer 2 showed activity against Staphylococcus aureus, Staphylococcus haemolyticus, Staphylococcus epidermis and Streptococcus pyogenes bacteria related to erysipela. In the three assays, the extract demonstrating greatest antioxidant capacity was the methanolic extract, while that of the isolated compounds was compound 1. Conclusions The results show that the three extracts evaluated in the three models presented activity and the chromatographic separation of the dichloromethanic extract permitted the isolation of compounds 1 and 2 royleanone-type isomers, which also presented significant activities such as anti-inflammatory, antibacterial and antioxidant, thus validate the use of this species in traditional medicine.

There is interest in the use of dried blood spots (DBS) to monitor lead (Pb) exposure yet concerns raised about the methods used have yet to be rigorously researched. Here, a systematic review and narrative synthesis of the literature was performed to increase understanding of the current state of methods, their performance against QC benchmarks, and common areas of concern across studies. Through keyword searches in databases (years 1972–2021), 208 articles were found of which 36 were deemed eligible. The included studies hailed from 11 countries, and most used Whatman 903 (31%) or Schleicher and Schuell (33%) filter cards . The studies included a range of DBS subsample sizes with 1/4″ (24%) and 3/16″ (15%) being most common. Most earlier studies used GF-AAS (39%), and since the 2000 s there has been a shift towards ICP-MS (33.3%) and more recently XRF. The mean limit of detection across studies using GF-AAS was 1.0 µg/dL versus 0.6 µg/dL for ICPMS. In synthesizing the results, more research is needed on the limit of detections achieved by the various methods, potential differences in Pb concentrations between capillary and venous blood, the influence of the hematocrit effect, and the potential contamination of samples with Pb.

In Mexico, millions of tons of mining wastes are deposited in the open pit. Their content in potentially toxic elements (PTE) represents an environmental risk. In the tailings, pioneer plant communities are established, associated with a determined diversity of fungi; plants, and fungi are fundamental in the natural rehabilitation of mining wastes. The objective was to evaluate the impact of the natural establishment of two plant species on the microbial activity, on the composition of the fungal community, and on the mitigation of the effect of PTE in a contaminated mine tailing. In a tailing, we selected three sites: one non-vegetated; one vegetated by Reseda luteola, and one vegetated by Asphodelus fistulosus. In the substrates, we conducted a physical and chemical characterization; we evaluated the enzymatic activity, the mineralization of the carbon, and the concentration of PTE. We also determined the fungal diversity in the substrates and in the interior of the roots, and estimated the accumulation of carbon, nitrogen, phosphorus and PTE in plant tissues. The tailings had a high percentage of sand; the non-vegetated site presented the highest electric conductivity, and the plant cover reduced the concentration of PTE in the substrates. Plants increased the carbon content in tailings. The enzymatic activities of β-glucosidase and dehydrogenase, and the mineralization of carbon were highest at the site vegetated with A. fistulosus. Both plant species accumulated PTE in their tissues and exhibited potential in the phytoremediation of lead (Pb), cadmium (Cd), and copper (Cu). Fungal diversity was more elevated at the vegetated sites than in the bare substrate. Ascomycota prevailed in the substrates; the substrates and the plants shared some fungal taxa, but other taxa were specific. The plant coverage and the rhizosphere promoted the natural attenuation and a rehabilitation of the extreme conditions of the mining wastes, modulated by the plant species.

Pyriform sinus fistulas are rare anomalies of the branchial arches. Most of them are located on the left side. They extend from the apex of the pyriform sinus of the hypopharynx to the thyroid gland or adjacent tissues. The diagnosis is suspected in the presence of acute suppurative thyroiditis or recurrent cervical abscesses, and is confirmed by endoscopic visualization of the fistula hole. The traditional treatment consists of excision of the fistulous tract, with or without thyroid lobectomy, by cervical approach. However, less invasive alternatives that obliterate the path of the fistula have been developed, such as endoscopic electrocautery. We describe our experience with 7 patients with this condition, who were treated with endoscopic cauterization using radiofrequency electrocautery, and we evaluate the effectiveness and safety of the treatment performed.

Pyriform sinus fistulas are rare anomalies of the branchial arches. Most of them are located on the left side. They extend from the apex of the pyriform sinus of the hypopharynx to the thyroid gland or adjacent tissues. The diagnosis is suspected in the presence of acute suppurative thyroiditis or recurrent cervical abscesses, and is confirmed by endoscopic visualisation of the fistula hole. The traditional treatment consists of excision of the fistulous tract, with or without thyroid lobectomy, by cervical approach. However, less invasive alternatives that obliterate the path of the fistula have been developed, such as endoscopic electrocautery. We describe our experience with 7 patients with this condition, who were treated with endoscopic cauterization using radiofrequency electrocautery, and we evaluate the effectiveness and safety of the treatment performed.

Carbon-fibre reinforced polymers (CFRPs) present outstanding mechanical performance per unit of mass; however, they also fail in a brittle manner, with little or no warning of their forthcoming catastrophic failure. In this study, a ‘brick-and-mortar’ design inspired by the structure of nacre was implemented by automated tape lay-up for the first time with the aim of changing the failure response of CFRPs. Standard procedures and materials already implemented in the aerospace industry have been used to produce bio-inspired CFRPs laminates, providing the first example of bio-inspired concepts scaled-up to industrial level. The effects of the proposed automated manufacturing process on the morphology and tensile properties of the laminates were investigated. A non-linear response was observed when the bio-inspired laminates were subjected to tensile forces. This type of response agrees with those of previous studies on lab-scale manufactured aligned discontinuous CFRPs.

An integrated reactive distillation process for biodiesel production is proposed. The reactive separation process consists of two coupled reactive distillation columns (RDCs) considering the kinetically controlled reactions of esterification of the fatty acids (FFA) and the transesterification of glycerides with methanol, respectively. The conceptual design of the reactive distillation columns was performed through the construction of reactive residue curve maps in terms of elements. The design of the esterification reactive distillation column consisted of one reactive zone loaded with Amberlyst 15 catalyst and for the transesterification reactive column two reactive zones loaded with MgO were used. Intensive simulation of the integrated reactive process considering the complex kinetic expressions and the PC-SAFT EOS was performed using the computational environment of Aspen Plus. The final integrated RD process was able to handle more than 1% wt of fatty acid contents in the vegetable oil. However, results showed that the amount of fatty acids in the vegetable oil feed plays a key role on the performance (energy cost, catalyst load, methanol flow rate) of the integrated esterification–transesterification reactive distillation process.

Previous works with titanium dioxide based photocatalysts synthesized with supercritical fluids led to improved catalyst properties in comparison to those prepared by traditional methods, but still insufficient CO2 reduction rates. In this work, in order to upgrade this type of catalysts, two supercritical methods have been used to prepare CNT/TiO2 and CNT/TiO2/Cu nanocomposites. The effect on photocatalytic performance of CNT/TiO2 ratio and Cu load has been investigated. Decreasing photocatalytic activities were observed when the CNT/TiO2 relationship separated from unit. Regarding the effect of copper doping, it was overshadowed by the effect of CNT support. Finally, because of the excellent properties of CNTs, synthesized composites showed greater catalytic activities than bare TiO2. Specifically, the catalyst with largest activity led to CO and CH4 production rates of 8.1 and 1.1 μmol g−1 h−1, which were much higher than those on P25 (4 times for CO and 15 times for CH4).

A group of sixteen iridoids isolated from plants used as anti-inflammatory remedies in Mexican folk medicine were evaluated for their potential to inhibit cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes. From these assays, loganic acid (10) was identified as the most promising compound with both COX-1 (36.0 ± 0.6%) and COX-2 (80.8 ± 4.0%) inhibition at 10 μM. Compound 10 shows a better inhibition against the COX-2 enzyme. Other iridoids tested in the present study showed weak or no inhibition against these enzymes. Furthermore, herein are presented key interactions of iridoid 10 with COX-1 and COX-2 enzymes through molecular docking studies. These studies suggest that 10 exhibits anti-inflammatory activity due to COX inhibition.

This contribution analyses a complex sinkhole cluster buried by urban elements in the mantled evaporite karst of Zaragoza city, NE Spain, where active subsidence has caused significant economic losses (~ 0.3 million Euro). The investigation, conducted after the development of the area, has involved the application of multiple surface and subsurface techniques. A detailed map of modern surface deformation indicates two active coalescing sinkholes, whereas the interpretation of old aerial photographs reveals the presence of two additional dormant sinkholes beneath human structures that might reactivate in the near future. DInSAR (Differential Interferometry Synthetic Aperture Radar) displacement data have limited spatial coverage mainly due to high subsidence rates and surface changes (re-pavement), and the Electrical Resistivity Tomography (ERT) and trenching investigations were severely restricted by the presence of urban elements. Nonetheless, the three techniques consistently indicate that the area affected by subsidence is larger than that defined by surface deformation features. The performance of the Ground Penetrating Radar (GPR) technique was adversely affected by the presence of highly conductive and massive anthropogenic deposits, but some profiles reveal that subsidence in the central sector of one of the sinkholes is mainly accommodated by sagging. The stratigraphic and structural relationships observed in a trench dug across the topographic margin of one of the sinkholes may be alternatively interpreted by three collapse events of around 0.6 m that occurred after 290 yr BP, or by progressive fault displacement combined with episodic anthropogenic excavation and fill. Average subsidence rates of > 6.6 mm/yr and 40 mm/yr have been calculated using stratigraphic markers dated by the radiocarbon method and historical information, respectively. This case study illustrates the need of conducting thorough investigations in sinkhole areas during the pre-planning stage including a geomorphic approach. A sound geomorphic model is essential for the proper design of the site investigation, the interpretation of the data and application of effective mitigation measures. Once sinkhole areas are developed, urban elements largely restrict the applicability and performance of multiple techniques, substantially decreasing the feasibility and benefit/effort ratio of the investigations.

Aim of the study To isolate compounds with anti-inflammatory activity from Bursera cuneata by a bioassay-guided fractionation. Materials and methods Three extracts of different polarities were elaborated by maceration. These extracts were assayed for their inhibitory effects on phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA) induced edema in mice. The dichloromethane extract was subjected to activity guided fractionation using successive chromatographic procedures. Additionally, the levels of histamine were determined in the ear samples obtained from the TPA assay, which were determined by high-performance liquid chromatography (HPLC). Effect of moronic Acid on RAW 264.7 stimulated with LPS was evaluated for NO and TNF secretion. Results The dichloromethane extract had the highest anti-inflammatory effect (89.1 ± 2.2% inhibition) over that of the hexane (53.3 ± 1.2%) and methanolic (77.4 ± 1.8%) extracts at a dose of 0.1 mg/ear. The FS-3 fraction, obtained from the dichloromethane extract, comprised triterpenes β-sitosterol (1), α-amyrin (2), moronic acid (3), and ursolic acid (4), and all the compounds showed significant activity in comparison with that of indomethacin (41.5 ± 0.6%) at 0.1 mg/mouse ear. However, moronic acid displayed the highest inhibitory effect (68.1 ± 1.3%). Additionally, levels of histamine were determined by HPLC in the treated tissues. moronic acid was the most active (73.3 ± 1.1%, indomethacin 33.8 ± 0.8%). The bio-guided isolation resulted in the identification of moronic acid as the principal anti-inflammatory and antihistaminic compound present in B. cuneata. To confirm a general anti-inflammatory effect, moronic acid was evaluated on the activation of RAW 264.7 cell stimulated with LPS. At 30 and 15 mg/mL a significant reduction of ON was observed (36% and 28% respectively) but had no significant effect on TNFα production. Conclusions Our study showed that the organic extracts and isolated compounds from the aerial parts of B. cuneata had topical anti-inflammatory and antihistaminic activities in vivo, but in vitro only modified the production of ON in RAW cells. The results of this study validated the use of B. cuneata in folk medicine for the treatment of inflammatory diseases.

Fractionation guided by the cytotoxic activity of the methanolic extract of Veronica americana led to the isolation of two new iridoids identified as 4β-hydroxy-6-O-(p-hydroxybenzoyl)-tetrahydrolinaride (1) and 10-O-protocatechuyl-catalpol (2), together with four known aromatic acids, veratric acid (3) p-methoxybenzoic acid (4), p-hydroxybenzoic acid (5) and protocatechuic acid (6). The structure of these compounds was determined by spectroscopic analysis. Iridoid glycosides 1 and 2 showed selective cytotoxic activity against the human cancer cell lines HF-6 (IC50 = 0.031 and 0.066 μM, respectively) and PC-3 (IC50 = 0.721 and 0.801 μM, respectively), with less sensitivity in normal MRC-5 cells (IC50 = 77.103 and 1451.562 μM, respectively). Compound 1 was 9.9 times more potent than camptothecin against HF-6 cell line, while compound 2 was 4.7 times, more potent, against the same cell line, than camptothecin. The found biological efficacy of 1 and 2 allow us to propose these compounds as candidates for the development of effective anticancer therapeutic agents.

A simple computational procedure to determine reactive critical points of kinetically controlled reacting mixtures was developed. The thermodynamic analysis considers the simultaneous calculation of the reactive and non-reactive residue curve maps using the Peng–Robinson equation of state and the Heidemann and Khalil method for the computation of critical points. Two kinetically controlled reactive systems were considered: (i) the reversible esterification reaction of acetic acid with ethanol in the presence of CO2 and, (ii) the irreversible hydrodesulfurization (HDS) of 4,6-dimethyldibenzothiophene with tetralin as solvent for the production of ultra low sulfur diesel. It was found that the amount of catalyst loaded (α) into the reacting vessel plays a key role for the existence of the reactive critical points for the deep HDS of diesel while for the esterification reactions has little significance. Also, results showed that, while the catalyst loaded does not have any influence on the existence of the reactive critical point for the esterification reactive system (TC ∼ 566 K; PC ∼ 68 atm; xHAc ∼ 0.39, xEtOH ∼ 0.26, xEtAc ∼ 0.15, x H 2 O ∼ 0 .19 , and x CO 2 ∼ 0 .01 ), it moves the range of temperature where a maximum liquid composition of ethyl acetate can be obtained. Several critical points for the hydrodesulfurization of 4,6-DMDBT were found with different α values.

Vogt–Koyanagi–Harada syndrome is an autoimmune multisystem disease, characterized by the association of ocular inflammatory manifestations (uveitis and retinal detachment) and extraocular lesions such as meningismus and tegumentary or auditory findings. We report the case of a Hispanic woman with this syndrome.

Resumen El sindrome de Vogt Koyanagi Harada corresponde a una enfermedad autoinmune multisistemica que se caracteriza por la asociacion de manifestaciones inflamatorias oculares (uveitis, desprendimiento de retina) y lesiones extraoculares como meningismo, afectacion dermica y afectacion del VIII par craneal. Presentamos el caso de una mujer hispana con este sindrome.

Resumen Introduccion La enfermedad de Meniere se caracteriza por vertigo, hipoacusia y acufeno. Existen diversos estudios sobre la evolucion del vertigo y la audicion pero son escasos los referidos al comportamiento del acufeno, siendo este el objetivo de nuestro estudio. Metodos Se realiza, en un hospital terciario, un estudio descriptivo transversal sobre el comportamiento del acufeno en 88 pacientes con enfermedad de Meniere que se encontraban en distinta fase de la enfermedad. Analizamos las caracteristicas del mismo: la intensidad con una escala analogico-visual, la tonalidad subjetiva con referencias tonales, la repercusion sobre su calidad de vida con un cuestionario de autoevaluacion, y el nivel de incapacitacion con el test Tinnitus Handicap Inventory. Se valoran tambien factores epidemiologicos, antecedentes personales, umbral de audicion y evolucion de las crisis vertiginosas en los ultimos 6 meses. Resultados El promedio de anos de evolucion de la enfermedad fue 15,4 anos. Se evidencio un acufeno de intensidad moderada (5/10), con una leve repercusion en la calidad de vida y de frecuencia predominantemente grave (46%). Se observo un empeoramiento en la calidad de vida en relacion a la afectacion auditiva y/o estadio de la enfermedad. Factores de mal pronostico fueron la tonalidad aguda, antecedentes de depresion y la corta edad. No encontramos relacion con los anos de evolucion de la enfermedad, ni con las crisis de vertigo. Conclusion En muestras grandes, y con largo tiempo de evolucion, el acufeno no es considerado por los pacientes con enfermedad de Meniere como un problema que repercuta de forma importante en su calidad de vida.

Resumen Introduccion La mastoiditis aguda es una complicacion infecciosa otitica que plantea una problematica especifica en el caso de pacientes implantados. Objetivo Revisar los casos de mastoiditis aguda en el programa de implantes cocleares para valorar su incidencia y los problemas asociados. Materiales y metodos Se realizo un estudio retrospectivo en 248 ninos implantados con edades entre los 8 meses y 14 anos desde 1994 hasta 2009 en nuestro programa de implantes cocleares. Se analizan los datos demograficos, clinicos y su tratamiento. Resultados Cinco pacientes desarrollaron mastoiditis aguda (incidencia de 2,01%), 3 de ellos con absceso subperiostico (incidencia de 1,21%), La edad media de implantacion de estos ninos fue de 2 anos y 4 meses, y la complicacion se presento entre 1 – 33 meses postimplante (media 11,6 meses). Cuatro pacientes habian presentado episodios de otitis media secretora previos al implante. La edad media de presentacion de la mastoiditis fue de 3 anos y 4 meses. Todos eran portadores de implante coclear tipo Nucleus, que es el implante mas frecuentemente utilizado en ninos, en nuestro programa. Conclusiones Tendemos a ser mas conservadores en el manejo de la mastoiditis aguda y del absceso subperiostico en la poblacion infantil con implante coclear. Consideramos que se debe prescindir del tratamiento quirurgico mientras sea posible, para evitar la contaminacion del implante, extremando el tratamiento intravenoso y utilizando el drenaje simple mediante puncion, ya que este procedimiento ha mostrado buenos resultados. En el caso de drenaje quirurgico, debe realizarse un estudio radiologico para delimitar la situacion de los electrodos.

Introduction Meniere's disease is characterised by vertigo, hearing loss and tinnitus. Various studies assess the problem of vertigo and audition deficit in Meniere's disease, but only a few of these relate to the clinical characteristics of tinnitus, the aim of this study. Material and methods A transversal descriptive study of the behaviour of tinnitus in 88 patients in different stages of Meniere's disease treated in a tertiary hospital was carried out. The different characteristics of disease were analysed: intensity was evaluated with an analoguevisual scale, subjective tonality through tonal shade references, the impact on the patient's quality of life was tested by a self-appraisal questionnaire, and competence level was evaluated with the Tinnitus Handicap Inventory. Epidemiologic factors, personal records, hearing thresholds and evolution in the number of vertiginous crises in the previous six months were also taken into account. Results The average time of evolution of the disease was 15.4 years. The results evidence the development of tinnitus of moderate intensity (5/10) and low frequency (46%), with a slight impact on quality of life. Worsening in the quality of life related to hearing affectation and/or advanced stages of the disease was also observed. We identified high frequency tonality, a medical record of depression and youth as unfavourable prognostic factors. There was no relationship found with the years of evolution of the disease or with the number of vertigo crises. Conclusion In large samples of long evolution Meniere's disease, patients do not perceive tinnitus as a problem that produces serious impairment in their quality of life.

Introduction Acute mastoiditis (AM) is a paediatric infectious complication that raises a specific problem in case of implanted patients. Objective To review the cases of AM in a paediatric cochlear implant (CI) programme to study its incidence and associated problems. Materials and methods A retrospective study was conducted on 248 children aged between 8 months and 14 years who underwent CI from 1994 to 2009. The demographics, clinical data and their treatment were analyzed. Results Five patients developed acute mastoiditis (2.01%), three of them with subperiosteal abscess (1.21%). The mean age of implantation was 2 years and 4 months, and the complication presented between 1 and 33 months post-implantation (mean, 11.6 months). Four patients had episodes of serous otitis preimplantation. The mean age of AM patients was of 3 years and 4 months. The CI type was nucleus in all cases. Conclusions Conservative management is suggested for AM and subperiosteal abscess in children with cochlear implants. Surgical treatment should be avoided to prevent CI contamination. The first option is intravenous antibiotics and simple puncture of the abscess. If surgical drainage is needed, radiological study should be performed to locate the CI electrodes.

There is increasing worldwide interest in land-use allocation and management within the sphere of rural planning and development. The study of land-use patterns mainly focuses on understanding the practices and values of individuals involved, and no debate of this issue would be complete without taking into account non-industrial private forest (NIPF) ownership as a key component in most rural areas worldwide. This paper empirically explores and assesses NIPF owners' management in terms of analysing dynamics in farming and forestry practices (past conversions from forestland to meadow and from marginal meadow to woodland, and intentions to change the current productive forest species and to extend the area of woodland) and landholding attributes (size and degree of parcellation in productive forestland). Logistic regression models were also used to investigate the probabilities and influencing factors involved in transforming marginal meadows to woodland, and attempts on the part of NIPF owners to change the current productive forest species and increase productive forestland. For this, a total of 103 NIPF owners in Northern Spain were interviewed in person, in March 2004, about their commitment to and involvement in land management during 1999–2003. The models correctly explained 73.3%, 83.7% and 73.3% of the variability in having converted marginal meadow in woodland and of future intentions to change the productive forest species and increase the area of productive forestland, respectively. The results of the study indicate that forest management mainly responds to investment and increasing the productivity of the land as a capital asset, which is directly influenced by the size and degree of parcellation of the holding, and directly or indirectly related to the owner's interest in timber production. The results may be used by forest professionals, researchers and policymakers in order to design and execute successful forest policies related to land management and planning.

Public field-afforestation schemes have been designed and widely implemented as a measure to alleviate uneven distribution, generate economic growth in rural areas and maintain or improve natural resources. The literature on forest management and planning has improved land-related information systems, allowing policy-makers to design and implement future policies on the allocation of forestland uses, and to forecast the land requirements of the target population more closely. The aim of this article is to empirically examine and validate the temporal and spatial land use changes and the socioeconomic effects linked to field-afforestation on private lands in the province of Lugo (Galicia, Northern Spain) at the municipal, parish and individual farm holding levels. Two main top-down field-afforestation programmes are reviewed in the study area: the national programme of public afforestations started with the implementation of Ley de Patrimonio Forestal del Estado (National Forest Estate Act; NFE) from 1941 to 2000, and the European aid scheme for forestry measures established under European Council Regulation No. 2080/1992 from 1993 to 1997. The results of a survey, targeted at 1355 farmers and conducted through questionnaires in the province of Lugo in 2004, complete the analysis of public intervention in forest management. The results indicate that the specific social, economic and environmental context of an agricultural and forestry area involves a differential heritage of land customs that determines a differential response model to forest programmes of land allocation and planning. Therefore, this must not be underestimated by the quantitative or qualitative general objectives of large-scale policies.

Optically pure 4-alkyl-pyrrolin-2-ones were synthesized from chiral N -allyl-α-bromoacetamides in high selective and stereo-controlled fashion, via a sequential 5- exo - trig radical cyclization-hydrogen or bromine atom-transfer process, under non-tin conditions. Interestingly, when N -allyl-α-bromoacetamides were treated with triethylborane/MeOH(excess)/BF 3 ·OEt 2 in toluene at −78 °C, a tandem 5- exo - trig radical cyclization-hydrogen atom-transfer reaction operated, on the other hand, a tandem 5- exo - trig radical cyclization-bromine atom-transfer reaction proceeded in good yield and high stereoselectivity when the reaction was carried out with equimolar amounts of MeOH in THF at −78 °C. Thus, optically pure 4-alkyl-pyrrolin-2-ones were synthesized via this tin-free radical pathway and transformed to their corresponding biologically active GABA-derivatives, Pregabalin and CAMP.

A practical stereoselective 5- exo - trig radical cyclization procedure was developed in order to prepare enantiomerically pure GABA derivative precursors (4-alkyl-pyrrolidin-2-ones). This procedure allows much more rapid access to optically pure GABA derivatives, such as the powerful antiepileptic agent ( S )-(+)-3-aminomethyl-5-methylhexanoic acid (Pregabaline).

The purpose of the present investigation was to assess the pharmacological properties of Tournefortia hartwegiana Steud (Boraginaceae), used in traditional medicine for the treatment of diabetes, diarrhea and kidney pain in Morelos, Mexico. Administration of methanol extract from aerial parts of Tournefortia hartwegiana (310 mg/kg body weight/day) for 10 days, to normoglycemic and alloxan-induced diabetic rats, significantly lowered their blood glucose levels (37 and 36%, respectively, p0.05). The anti-diabetic and hypoglycemic activities due to the MeOH extract were similar to those produced by metformin at 120 mg/kg (positive control, p0.05). In contrast, the hexane, dichloromethane and MeOH extracts from the same species showed no significant spasmolytic effect and did not have activity in antibacterial and Artemia salina toxicity bioassays.

Resumen El linfoma anaplasico de celulas grandes es una patologia rara en la infancia. La localizacion mas frecuente es en la piel y nodulos linfaticos, siendo infrecuente la afectacion del pabellon auricular. Presentamos el caso de un nino de 6 anos con tumoracion en el lobulo de la oreja. Se realizo tratamiento quirurgico y el resultado de la anatomia patologica mostro linfoma anaplasico de celulas grandes. Los estudios radiologicos fueron negativos y no hubo afectacion sistemica.

Free radical precursors 4a and 4b were synthesized and treated under reductive or oxidative conditions to obtain the corresponding optically pure pyrrolidinones 5–8, which were subsequently transformed into corresponding optically pure GABA derivatives 9–11. When reductive radical conditions (4a→7 and 8) were used, a Ph1–5 migration product 14 was obtained; presumably depending upon the specific conformation of the rotamer precursor and also 14 was found to be a kinetic product.

Resumen La histiocitosis de celulas de Langerhans es una enfermedad de causa desconocida con compromiso focal o diseminado y que afecta con frecuencia a la cabeza y el cuello; el compromiso craneal es una de las manifestaciones mas comunes en ninos mayores de 5 anos. Presentamos el caso de una nina de 3 anos, sin antecedentes otologicos de interes remitida por sospecha de absceso subperiostico y diagnosticada posteriormente de granuloma eosinofilico. Se describe el manejo y su evolucion.

Objetivo: Presentación de un caso de sarcoma fibromixoide renal. Caso clínico: Varón de 28 años de edad, visto en consulta de urología por presentar varicocele izquierdo acompañado de dolor abdominal, astenia y pérdida de peso. Conclusiones: El sarcoma fibromixoide renal de bajo grado es una neoplasia infrecuente. El tratamiento de elección es la cirugía. El diagnóstico definitivo lo da el análisis anatomopatológico.