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Introducao A sifilis e uma infeccao sistemica causada pelo Treponema pallidum, cuja transmissao pode ser atraves do sangue. Para eliminar esta possibilidade, se utiliza testes sensiveis e especificos na triagem sorologica dos doadores. Os testes utilizados sao usualmente os treponemicos ou os nao treponemicos. No IHEBE foi utilizado, em periodos distintos, os dois tipos de testes: nao treponemico, por metodo floculacao, e o treponemico, por metodo quimioluminescencia. Objetivo Verificar o impacto de descarte sorologico de bolsas de sangue e componentes por metodologias distintas. Material e metodos Levantamento retrospectivo de dados estatisticos no periodo de janeiro de 2016 a julho de 2021. No periodo de 2016 a janeiro de 2020 foi realizado teste nao treponemico (floculacao-VDRL) e de fevereiro de 2020 a julho de 2021 teste treponemico (quimioluminescencia). Os dados foram obtidos atraves dos indices de controles mensais por marcador sorologico. Resultados Descarte sorologico por Sifilis teste nao treponemico, metodo floculacao-VDRL nos anos: 2016 foi de 0,7% (n = 7.486 doadores), 2017 foi de 1% (n = 7.722 doadores), 2018 foi de 0,9% (n = 8.731 doadores), 2019 foi de 0,9% (n = 12.460 doadores), janeiro de 2020 foi de 0,9% (n = 1.221 doadores). Descarte sorologico por Sifilis teste treponemico, metodo quimioluminescencia no periodo de fevereiro a dezembro de 2020 foi de 2,7% (n = 12.662 doadores) e de janeiro a julho de 2021 foi de 2,71% (n = 8.732 doadores). Discussao Os testes nao treponemicos sao realizados pela metodologia de floculacao. Os resultados, quando positivos, sao liberados na forma classica de titulos. Os resultados falso-positivos sao as principais desvantagens deste teste, que podem acontecer devido a reacao cruzada com outras infeccoes, gravidez, doencas autoimunes e uso de drogas ilicitas. Resultados falso-negativos podem ocorrer em casos de infeccao muito precoce ou tardia. Os testes treponemicos detectam anticorpos especificos que podem permanecer positivos por toda a vida. Observou-se que em virtude da especificidade do metodo, o aumento do descarte sorologico por Sifilis era esperado. Isso fez com que o IHEBE, no momento do planejamento para mudanca de teste, estabelecesse um aumento da meta de comparecimento e coleta/dia; logo, novas estrategias na captacao foram implementadas para garantia e seguranca no atendimento aos pacientes. Em virtude deste aumento, o numero de doadores inaptos em investigacao tambem se elevou, e o consultorio de atendimento aos inaptos precisou rever seus procedimentos operacionais padrao – POP. Conclusao Apos analise, observou-se incremento consideravel de descarte por sifilis com a mudanca de metodologia. Apesar da boa sensibilidade do teste nao treponemico e de seu baixo custo, optou-se pela mudanca para o teste treponemico devido a especificidade. Quando o Instituto decidiu que estava no momento de automatizar a pesquisa para Sifilis, fez-se necessario uma reuniao de planejamento envolvendo os setores de captacao, coleta, e liberacao para elaboracao de um plano de acao visando minimizar os impactos previsiveis da mudanca de metodologia.

Introducao O IHEBE e um servico de hemoterapia privado, localizado em Belem/Para, responsavel pela cobertura transfusional de 21 hospitais e clinicas da regiao metropolitana, incluindo os municipios de Belem e Ananindeua. Possui 6 Agencias Transfusionais sediadas em hospitais-âncora e 1 Agencia Transfusional extra-hospitalar responsavel pelo atendimento das demais instituicoes atendidas pelo IHEBE. Recebe media de 15.500 doacoes anuais e realiza em torno de 22.000 transfusoes/ano. Objetivo Verificar as estrategias adotadas para gestao do estoque de componentes sanguineos do IHEBE. Material e metodos Estudo retrospectivo, descritivo, realizado no IHEBE no periodo de 01/01/2021 a 31/06/2021. Foram selecionados todos os doadores considerados aptos que compareceram ao IHEBE neste periodo e todas as transfusoes de concentrado de hemacias realizadas neste intervalo de tempo. Para fornecimento dos dados sobre a entrada de doacoes utilizou-se o relatorio emitido pelo sistema informatizado de gerenciamento de banco de sangue RealBlood, versao 10.0.17763.0. Os demais dados foram obtidos atraves de um aplicativo de mensagens instantâneas no qual os supervisores das agencias transfusionais comunicam o fornecimento dos componentes sanguineos e sinalizam as validades das bolsas com previsao de vencimento no intervalo 10 dias, favorecendo troca destas unidades entre os hospitais, visando reducao do descarte, racionalizacao do estoque e a captacao de tipos sanguineos especificos, garantindo a manutencao da rastreabilidade. Todos os dados foram tabulados em planilhas do programa Microsoft Office Excel 2013 para analise. Resultados Dos 7.733 doadores que compareceram neste periodo, doaram em janeiro 1.494, fevereiro 1.004, marco 1.266, abril 1,435, maio 1.430 e junho 1.104. Dos 6.165 doadores considerados aptos, foram transfundidos 6.918 concentrados de hemacias, sendo em janeiro 65% (n = 967), fevereiro -14% (n = 1.149), marco 91% (n = 1.148), abril 99% (n = 1,427), maio 77% (n = 1.108) e junho 101% (n = 1.119). Discussao Analisando a variacao percentual de doacoes e transfusoes, observa-se em janeiro excedente de 35% sobre o estoque de componentes sanguineos, pois a equipe de captacao manteve sua rotina no mes que ocorreu queda transfusional devido pandemia por Coronavirus. No mes de fevereiro a gestao estrategica sinalizou o evento excedente e sugeriu a limitacao na busca de doadores, sendo entao transfundido -14% do estoque, melhorando o status gerencial. Nos meses seguintes com a monitorizacao do fornecimento de componentes sanguineos e a orientacao para o servico de captacao observou-se equilibrio de entrada e saida dos componentes sanguineos, mantendo o estoque minimo necessario para os meses subsequentes. Conclusao Apesar da criticidade do estoque de componentes sanguineos normalmente encontrada em Servico de Hemoterapia, neste estudo foi observado que a gestao estrategica baseada na analise da triade: controle da entrada de doacoes, monitorizacao do fornecimento de componentes sanguineos e mecanismo de sinalizacao sobre a validade destas unidades, foi eficaz para a manutencao regular do nivel do estoque e reducao do descarte.

Introducao A hemovigilância consiste em um conjunto de metodologias de vigilância referente ao ciclo do sangue, a qual objetiva obter e disponibilizar informacoes sobre as Reacoes Adversas ocorridas dentro do processo, visando prevenir sua ocorrencia ou repeticao, melhorando e aumentando a seguranca do doador e receptor. Sobretudo, em relacao as reacoes transfusionais que podem repercutir como complicacoes agudas graves no quadro paciente. Objetivo Avaliar as reacoes transfusionais (RT) notificadas ao Sistema de Notificacao em Vigilância Sanitaria - NOTIVISA em um hospital privado de Belem atendido pelo IHEBE e o papel do enfermeiro na seguranca do paciente. Metodo Estudo descritivo retrospectivo, com analise das RTs notificadas para o NOTIVISA no periodo de Janeiro de 2019 a dezembro de 2020 de um hospital privado de Belem. Os dados foram tabulados em planilhas e graficos do Microsoft Office Excel 2016. Resultados Neste periodo foram realizadas 11.143 transfusoes e notificadas 54 reacoes transfusionais (RT) (0,48%), destas 02 foram reacoes do tipo tardias e 42 do tipo imediatas. Estavam associadas as hemacias 35%, plasma 1% e plaquetas 64%. As RTs mais prevalentes foram Reacao Febril nao Hemolitica (40%) e alergica (33%). Os sinais e sintomas mais relatados foram febre, urticaria, calafrios, prurido e hipertensao. Em relacao ao sexo e idade nao foram observadas diferencas significativas. Discussao Durante a analise das RTs 54 foram confirmadas e 06 nao foram confirmadas, ficando 01 como improvavel, 2 como possivel, 1 como inconclusiva e 2 foram descartadas. O descarte da bolsa pos transfusao impossibilitou a realizacao da hemocultura, o que levou a dificuldade em concluir efetivamente as respectivas RTs. Alem do registro de alteracao dos sinais e sintomas incomuns, como formigamento, vertigem e rebaixamento do nivel de consciencia. Conclusao Conclui-se a necessidade constante de treinamentos junto a equipe de saude do hospital, com destaque a equipe de enfermagem, a qual, em sua maioria, realiza a notificacao e acompanha o paciente 24h, com enfase nas condutas frente as reacoes transfusionais. O que proporcionara maior qualidade na investigacao da RT e maior seguranca e qualidade aos pacientes submetidos a transfusao sanguinea.

Uma grande vantagem do sorgo e sua caracteristica xerofita, o que lhe atribui um potencial, como sucessao as culturas de verao, na producao de graos, sendo fundamental a utilizacao de hibridos adaptados aos diferentes ambientes de cultivo. Assim, o objetivo deste trabalho foi gerar parâmetros a respeito da capacidade adaptativa de hibridos de sorgo granifero pelo metodo GGE biplot. Os ensaios foram conduzidos, na safrinha de 2017, em sistema de plantio direto, em quatro ambientes, Rio Verde, Sete Lagoas, Teresina e Sinop. Todos os ensaios foram conduzidos, no delineamento em blocos casualizados, com tres repeticoes e trinta e seis hibridos. Foram avaliadas as caracteristicas: florescimento, altura de plantas e produtividade de graos. Os dados foram submetidos as analises de variância individuais e conjunta, aplicado posteriormente o criterio de agrupamento de Scott-Knott e estimados os parâmetros de adaptabilidade e estabilidade. Os hibridos promissores quanto as caracteristicas avaliadas e em funcao dos parâmetros de adaptabilidade e estabilidade foram 1610001, 1610006,1610051 e o 1G100.

Introducao Em 1970 Friedman et al. descreveram pela primeira vez a pratica de reservar componentes sanguineos para pacientes que se submeteriam a procedimentos cirurgicos. No ano de 2000, o IHEBE foi inaugurado e logo apos, a OMS (2002) sugeriu que as instituicoes criassem protocolos de acordo com a realidade de cada servico. Posteriormente (2015), o IHEBE elaborou o Protocolo de Reserva Cirurgica de Componentes Sanguineos (CS), atraves de reunioes com a equipe de enfermagem e com os medicos de cada clinica do Bloco Cirurgico dos hospitais a fim de evitar o desperdicio de materiais medico-hospitalares, consumo de reagentes imunohematologicos e de tempo dos recursos humanos, alem de reduzir a possibilidade da equipe estar executando um procedimento e ser surpreendida com a necessidade de transfusao de um CS em que nao foi solicitado reserva. Objetivo Avaliar a adesao das equipes hospitalares ao Protocolo de Reserva Cirurgica de Sangue e CS. Metodologia Estudo retrospectivo, descritivo, realizado no IHEBE no periodo de 01/01/2017 a 31/12/2020 em 02 hospitais privados de Belem/PA. Foram selecionados todos os procedimentos cirurgicos que constam no Protocolo de Reserva Cirurgica CS. Todos os dados foram tabulados em planilhas do programa Microsoft Office Excel 2013. Com isso, foram realizadas analises comparativas do quantitativo solicitado pela equipe medica e o quantitativo preconizado no Protocolo para verificacao da sua efetividade e adesao. Resultados e discussao Em 2017, no hospital A, foram avaliados 737 reservas de CS para cirurgias eletivas, destes 578 (66%) apresentaram conformidade com a quantidade constante no Protocolo de Reserva Cirurgica de CS; No ano de 2018 foram avaliados 941 reservas, sendo 639 (69%) conformes; No ano de 2019 foram avaliados 1.177 reservas, sendo 881 (75%) conformes e no ano 2020 foram avaliados 877 reservas, sendo 663 (76%) conformes. Em 2017, no hospital B, foram avaliados 252 reservas de CS para cirurgias eletivas, no ano de 2017, destes 162 (63%) apresentaram conformidade com a quantidade constante no Protocolo de Reserva Cirurgica de CS; No ano de 2018 foram avaliados 259 reservas, sendo 169 (65%) conformes; No ano de 2019 foram avaliados 351 reservas, sendo 259 (74%) conformes e no ano 2020 foram avaliados 275 reservas, sendo 215 (78%) conformes. A construcao deste indicador demonstra que em ambos os hospitais houve um incremento na taxa de conformidade ao Protocolo demonstrando melhor adesao sobre esta boa pratica e maior organizacao por parte da Agencia Transfusional e conscientizacao mais efetiva da equipe medica acerca do uso racional dos CS. Conclusao A implantacao do Protocolo de Reserva Cirurgica de Sangue e CS contribuiu para minimizacao das solicitacoes em carater de emergencia durante o procedimento e no pos-operatorio para garantir a seguranca transfusional do paciente e das Instituicoes envolvidas. Melhores taxas de adesao ao Protocolo sao asseguradas atraves de revisoes periodicas do documento, alem de sua inclusao no programa de educacao continuada de modo a manter as equipes cirurgicas atualizadas.

Drought stress is a serious obstacle for crop production, especially in arid and semi-arid areas of the world. Sorghum is a useful crop to grow in areas with erratic, poorly distributed or inadequate rainfall. To help determine the best alternatives, we evaluated 30 sorghum cultivars with and without water stress in the post-flowering plant stage. The work was carried out at the Experimental Station of Gorutuba, in Nova Porteirinha, MG, Brazil, during 2013 and 2014 seasons. The experimental design was a randomized complete block, with three replications and two water regimes. The traits evaluated were grain yield, number of days to flowering, plant height and 1,000 grain mass. Water restriction reduced the grain yield by 68.9% in 2013, 31.2% in 2014 and 50.1% in the average of the two years. The genotypes with best grain yield stability were B.Tx635, SC 720 and BR012RxSC566. Water stress significantly reduced plant height and grain mass.

Cowpea cultivars, which are indicated for irrigated cropping, are recommended without proper assessment of their productive potential and water use efficiency in response to water regimes in the soil from different production environments. The aim of this study was to evaluate the production components, the yield performance and the efficiency of water use of cowpea cultivars in response to the application of irrigation depths under the soil and climate conditions of Bom Jesus, PI. The experiment was performed from June to August 2011 in a soil classified as sandy-textured Fluvic Neosol. The study was conducted in a randomized blocks design, with four replicates. The treatments were arranged in subdivided plots (irrigation depths in plots and cultivars in subplots). The cultivars BRS Aracê (semi-prostrate) and BRS Tumucumaque (semi-erect) were submitted to five irrigation depths (108.2, 214.7, 287.9, 426.1 and 527.7 mm). The number of pods per plant and the weight of one hundred grains are the main components related to grain yield. The cultivar BRS Tumucumaque presented a better yield performance (1697.2 kg ha-1) than the cultivar BRS Aracê (1233.8 kg ha-1), with the application of the irrigation depths of 527.7 and 522.4 mm, respectively. The highest water use efficiency (0.420 kg m-3) is obtained with the application of the irrigation depth of 108.2 mm in both cultivars.

We analyzed productivity data obtained from experiments on grain sorghum conducted in 7 locations of its cultivation in Brazil. A total of 25 hybrids were analyzed, of which 22 were pre-commercial and 3 were cultivars. The Wricke and Purchase et al. methods were highly consistent in identifying individuals with low contributions to genotype x environment interactions. The Lin and Binns method proved to be easily applicable and interpretable but it was not efficient in detecting individuals with specific adaptations. An additive main effect and multiplicative interaction (AMMI) model indicated the suitability of cultivar 1G282 for the cities of Guaíra, Sete Lagoas, and Vilhena, and hybrids 0307087 and 0307091 for the southeast of Goiás. The associations of the Eberhart and Russell method with AMMI indicated that 0307071, 0307131, 0307511, and 0307651 showed adaptability to favorable environments. Hybrid 0009061 stood out as the most adaptable and stable cultivar.

The aim of this study was to identify sorghum hybrids that have both high yield and phenotypic stability in Brazilian environments. Seven trials were conducted between February and March 2011. The experimental design was a randomized complete block with 25 treatments and three replicates. The treatments consisted of 20 simple pre-commercial hybrids and five witnesses of grain sorghum. Sorghum genotypes were analyzed by the genotype main effects + genotype environment interaction (GGE) biplot method if significant genotype x environment interaction, adaptability, and phenotypic stability were detected. GGE biplot methodology identified two groups of environments, the first composed of Agua Comprida-MG, Montividiu-GO, and Vilhena- RO and the second of Guaira-SP and Sete Lagoas-MG. The BRS 308 and 1G282 genotypes were found to have high grain yield, adaptability, and phenotypic stability and are thus indicated for cultivation in the first and second groups of environments, respectively.

The lack of knowledge on the degradation of layer-by-layer structures is one of the causes hindering its translation to preclinical assays. The enzymatic degradation of chitosan/hyaluronic acid films in the form of ultrathin films, freestanding membranes, and microcapsules was studied resorting to hyaluronidase. The reduction of the thickness of ultrathin films was dependent on the hyaluronidase concentration, leading to thickness and topography variations. Freestanding membranes exhibited accelerated weight loss up to 120 h in the presence of the enzyme, achieving complete degradation. Microcapsules with around 5 μm loaded simultaneously with FITC-BSA and hyaluronidase showed that the coencapsulation of such enzyme and protein mixture led to a FITC-BSA release four times higher than in the absence of hyaluronidase. The results suggest that the degradation of LbL devices may be tuned via embedded enzymes, namely, in the controlled release of active agents in biomedical applications., This work was supported by Fundação para a Ciência e Tecnologia (FCT, Postdoctoral Grants SFRH/BPD/95446/ 2013 and SFRH/BPD/96797/2013, and Projects PTDC/ CTM-BIO/1814/2012 and EXPL/CTM-BIO/0646/2013), “Fundo Social Europeu” (FSE), and “Programa Operacional de Potencial Humano” (POPH).

Background Upper respiratory tract infections are known to be a significant precipitant of acute asthma exacerbations. The aim of this study was to evaluate seasonal trends and the role of these pathogens in asthma exacerbations in school-aged children from Oporto (Portugal). Methods Nasal aspirates were collected from children aged 6 to 12 years old with asthma exacerbations attended in the Pediatric Emergency Department one day per week from January 1 to December 31, 2003. Demographic data, severity of asthma and asthma exacerbations, and current treatment were recorded. Samples were obtained through nasal wash with 1 ml saline and were processed by immunofluorescence assays (respiratory syncytial virus, adenovirus, parainfluenza and influenza virus), retrotranscription polymerase chain reaction (rhinovirus) and polymerase chain reaction (enterovirus, Chlamydia pneumoniae and Mycoplasma pneumoniae ). Results In 54 eligible children, 37 nasal samples were obtained. Infectious agents were detected in 78% of the patients. Rhinovirus was detected in 70.3%, Mycoplasma pneumoniae in 16.2 %, enterovirus in 10.8%, and Chlamydia pneumoniae in 2.7 %. Coinfection was identified in 21.6 % of the samples. There was no significant correlation between current treatment status, severity of asthma or exacerbations and the isolated agents. Two distinct peaks of asthma exacerbation were found: 27 % in autumn and 24.3 % in spring. The highest number of cases was recorded in March and the lowest in August. Rhinoviruses were detected between March and May in 46 % of the patients, and between September and November in 30.8%. Conclusions These results confirm the previously reported high frequency of rhinovirus detection in asthma exacerbations in children and provide evidence that asthma exacerbations and rhinovirus infections follow a seasonal pattern, occurring mostly in spring and autumn. The findings also underscore the frequency of Mycoplasma pneumoniae detection, and emphasize the importance of this agent as a possible trigger of asthma exacerbations.

This paper introduces a novel method for inferring spatially varying regularisation in non-linear registration. This is achieved through full Bayesian inference on a probabilistic registration model, where the prior on the transformation parameters is parameterised as a weighted mixture of spatially localised components. Such an approach has the advantage of allowing the registration to be more flexibly driven by the data than a traditional globally defined regularisation penalty, such as bending energy. The proposed method adaptively determines the influence of the prior in a local region. The strength of the prior may be reduced in areas where the data better support deformations, or can enforce a stronger constraint in less informative areas. Consequently, the use of such a spatially adaptive prior may reduce unwanted impacts of regularisation on the inferred transformation. This is especially important for applications where the deformation field itself is of interest, such as tensor based morphometry. The proposed approach is demonstrated using synthetic images, and with application to tensor based morphometry analysis of subjects with Alzheimer's disease and healthy controls. The results indicate that using the proposed spatially adaptive prior leads to sparser deformations, which provide better localisation of regional volume change. Additionally, the proposed regularisation model leads to more data driven and localised maps of registration uncertainty. This paper also demonstrates for the first time the use of Bayesian model comparison for selecting different types of regularisation.

Antecedentes: El virus respiratorio sincitial (VRS) es el principal agente de la bronquiolitis y presenta dos subtipos distintos (A y B). Los trabajos acerca de la relación entre el subtipo de virus y la gravedad de la enfermedad obtienen resultados discordantes. Propósito: Analizar si el subtipo de este virus constituye una variable independiente en la gravedad clínica de la enfermedad. Pacientes y métodos: Estudio prospectivo que incluye niños previamente sanos menores de 2 años de edad, hospitalizados por infección respiratoria por VRS durante un brote epidémico anual. Se comparan la presentación y evolución clínica, las exploraciones complementarias y la radiografía pulmonar en los pacientes infectados por los subtipos A y B de VRS. Los indicadores clínicos de gravedad incluyen el grado y duración del distrés respiratorio, la necesidad de oxígeno suplementario, la admisión en cuidados intensivos, la ventilación mecánica y la duración del ingreso hospitalario. Resultados: De los 85 enfermos incluidos (35 mujeres, 50 varones; edad media, 4,8 6 4,3 meses), 59 casos pertenecían al subtipo A. Ambos grupos no se diferenciaban en cuanto a sexo, edad y antecedentes, excepto en la lactancia materna que fue menos frecuente en el subtipo B. La presentación clínica, analítica y radiológica fue semejante en los dos grupos. Los indicadores clínicos de gravedad no difirieron de forma significativa en los dos grupos. La edad por debajo de los 3 meses se asoció a mayor duración del distrés respiratorio y de la estancia hospitalaria. Conclusión: Los resultados no apoyan la hipótesis de que la infección por el subtipo A del VRS se asocie a mayor gravedad clínica. : Background: Respiratory syncytial virus (RSV) is the most frequently implicated agent in bronchiolitis. The virus presents two antigenic subtypes (A and B). The results of studies on the relationship between viral subtype and clinical severity are conflicting. Purpose: To evaluate whether the subtype of this virus constitutes an independent variable in the severity of clinical expression of RSV infection. Patients and methods: We prospectively studied previously healthy children aged less than 2 years admitted for RSV infection during an epidemic season. Clinical presentation and evolution, laboratory and radiological aspects were compared in subsets of children infected with RSV subtype A or B. Clinical severity parameters included score and duration of respiratory distress, oxygen requirements, admission to the intensive care unit, mechanical ventilation and length of hospital stay. Results: Eighty-five patients were enrolled in the study (50 boys and 35 girls; mean age 4.8 6 4.3 months). Fifty-nine children were infected with RSV subtype A. No differences were found in age, sex or antecedents but children with subtype B were less likely to have been breast-fed. Clinical presentation and laboratory and radiological findings were similar in both groups. No statistically significant differences in clinical severity parameters were found between subsets A and B. Age less than 3 months was associated with greater duration of respiratory distress and longer hospital stay. Conclusion: The results do not support the hypothesis that subtype A infection is associated with more severe respiratory syncytial virus disease.

Background The descriptions of early axonal damage in patients with multiple sclerosis (MS) prompted the search of body fluid markers. However, the studies addressing this issue in MS present conflicting results. Aim To assess the levels of tau protein in patients with definite MS. Patients and methods Cerebrospinal fluid (CSF) samples from 50 patients with definite diagnosis of MS (33 F, 17 M; mean age: 33.6 years) and from 19 age-matched individuals without organic neurological diseases (11 F, 8 M), entered this study. With regard to the clinical course, the MS patients were classified as follows: 32 relapsing-remitting (RR); two secondary progressive (SP), and four primary progressive (PP). Twelve patients had clinical isolated syndromes (CIS). The mean duration was 36.1 months (range: 15 days to 20 years). Tau protein was measured in the CSF by double antibody sandwich ELISA. Results The median tau and the cut-off values of the controls were 104.9 and 175.3 pg/mL, respectively. We found that most MS patients presented normal values. In addition, the clinical features-course, duration, Expanded Disability Status Scale (EDSS) value, Poser index of progression, Multiple Sclerosis Severity Score-did not significantly influence the tau levels in the MS group. Conclusion Our study showed similar CSF tau concentrations in MS patients with different clinical characteristics. This suggests that tau protein does not seem to be a useful routine clinical marker of axonal damage.

Previous studies of the spontaneous activity of the EEG indicate that women present bigger absolute spectral power in the alpha band than men, but few studies have been done during cognitive activity.To check possible gender differences in the EEG frequency domain during a visuo-spatial attentional task to understand better the temporary dynamics of alpha.A classic oddball paradigm was used whose stimuli (90% standard-10% objectives) were complex. In each block (10 with 100 trials) it was requested to the subjects (20, 10 of each gender) to attend to one of the visual fields (left and right, with random stimuli and identical probability). Power spectral density values were calculated applying the fast Fourier transform in the alpha band (9-11 Hz) in two overlapped windows (sliding windows): of 0-512 ms and of 412-924 ms.The normalized data were analyzed by means of ANOVAs, with the following factors: gender, attention, hemisphere, visual field and electrodes.Different modulations were obtained attending to the gender variable: men showed smaller alpha or bigger suppression of the rhythm in posterior electrodes and women exhibited smaller power in anterior electrodes.

The event related potentials (ERPs) allow to study the evolution of the cerebral electric activity related with the diverse sensorial, motors and cognitive processes. However, the ERPs and the spectral analyses based in Fast Fourier Transform, are not able to show the variations along the time of the spectral content of the electroencephalogram (EEG).The present work will show the necessary methodology to obtain the temporal dynamics of the frequency (TSE) in the EEG, a technique described by Salmelin and Hari (1994) that allows the analysis of the modulations of any spectral band along the time.The presented data correspond to the electroencephalographic registration of 20 human subjects during an experiment of visual spatial attention.The modulations of the ERPs differ of the observed by the spectral techniques in latency and topography. Likewise, comparing different spectral techniques is proven that the TSE allows to define with more temporal precision the variations on the spectral content.The application of the TSE technique to the same EEG signal that is used for obtaining the ERPs, allows the inclusion of the variable time in the spectral analysis of the EEG, what can be crucial to understand the physiological bases of some neuropathologies.

The present report studied the contingent negative variation during Gap and Non-Gap conditions using visual stimulation and manual responses. The reaction times during the Gap condition were facilitated compared with those of the Non-Gap condition. The contingent negative variation component was obtained during the preparatory period from electrodes placed at 58 scalp sites for both Gap and Non-Gap conditions. The comparison between both conditions: Gap and non-gap did not show statistically significant differences during the preparatory period. The topography of the voltage and current source density maps showed three different foci: (i) an early negativity centred in electrodes overlying the supplementary motor area and cingulate motor areas, (ii) an activation over the primary motor cortex contralateral to the finger movement, and (iii) a bilateral activation on posterior sites. All these results suggest that the facilitation induced by the warning stimuli occurs in neural circuits that would be recruited for the subsequent processing of the imperative stimulus. The facilitation of the reaction times during the gap condition with respect to non-gap condition must be justified by neural events occurring during the gap period.

The common menopausal symptoms of a growing number of women treated for breast cancer poses difficult therapeutic decisions to the Gynaecologist. It has been extensively demonstrated that hormonal replacement therapy (HRT) is the most effective treatment of such symptoms, as well as protecting women from cardiovascular disease, osteoporosis and increased mortality related to these disorders. However, breast cancer is classically considered a contraindication to HRT. In this paper we review the existing evidence regarding the influence of HRT on breast cancer. A computerized bibliographical search (MEDLINE) of literature in the English-language literature published in the last 15 years was conducted, followed by a hand search of references found in these papers. Evidence on the response of breast cancer cells to HRT is derived from animal studies, tissue growth system experiments, indirect epidemiological data and clinical data. While the bulk of experimental evidence points towards a proliferative effect of estrogen on breast cancer cells, almost all clinical reports have found no adverse effects of HRT on these patients. In our opinion, currently existing evidence does not justify the denial of HRT to breast cancer patients whose quality of life is at stake. Such is the case of women with intense menopausal symptoms unresponsive to alternative therapies. This opinion is shared by numerous other authors and a small number of eminent institutions. We believe it is safer to avoid HRT, in asymptomatic women as long-term regimens would be needed for protection against cardiovascular disease and osteoporosis, and the risks of such regimens have yet to be evaluated. We also believe that large randomized trials are now ethically justified and greatly needed to obtain safer data on this subject.

Adaptive Neonatal Brain Segmentation: Application to Ventriculomegaly and Excess Extra-Axial Cerebral-Spinal Fluid