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RESUMEN Actualmente nos encontramos ante una situacion excepcional de pandemia por SARS-CoV-2 que requirio el confinamiento de la poblacion general durante semanas. Presentamos 6 casos de afectacion esporadica de nervio peroneal en la rodilla remitidos al servicio de Neurofisiologia Clinica del Hospital General Universitario de Castellon que ocurrieron durante el estado de alarma (desde el 14 de marzo al 21 de junio de 2020), lo cual constituye un incremento del 50% con respecto a los 3 anos anteriores. La mayoria fueron varones jovenes sin antecedentes medicos. Tres refirieron posturas mantenidas durante horas. El EMG descarto otras afectaciones y objetivo una neuroapraxia moderada-grave con leve-moderada degeneracion axonal. Es importante evitar posturas inadecuadas de forma prolongada (cruce de piernas o apoyo de rodilla sobre superficies duras) para prevenir la compresion del nervio peroneal en la rodilla. El estudio EMG es util para confirmar el diagnostico, descartar otros procesos y emitir un pronostico temprano.

The original online version of this article was revised because a number of authors had the wrong affiliation number next to their names. © 2021, Springer Nature B.V.

An individual's initial interest in a topic may quickly fade, or it may become deeper and more enduring. One factor that may support an emerging interest is to discover utility value (or usefulness) in the topic. Instructional materials that emphasize the utility value of a topic can enhance learning and motivation, but whether these materials can foster interest development among individuals who show initial interest in a topic is uncertain. Across two studies, we tested utility-value manipulations under conditions in which we expected the manipulations to promote the development of interest. In Study 1, we manipulated whether participants received utility-value information during a learning session and found that such information triggered a state of interest for participants who had reported higher levels of interest at the outset of the session. In Study 2, we provided all participants with the same utility-value information provided to some students in Study 1, and then manipulated whether they wrote one of three kinds of essays about the utility value of the task (or a control topic). For participants with higher interest, we found that subsequent reflection on the usefulness of the material for the distant future in a writing activity (rather than the present or near future) further promoted interest development. In addition, engaging in any type of utility-value writing improved performance on a test of the material - overall, and specifically for less confident participants - replicating previous research. Findings suggest that, under the right conditions, emphasizing utility value can catalyze the interest-development process.

PURPOSE OF REVIEW: Previous studies suggest an association between depression and increased risk of various type of infections, including acute bacterial skin and skin structure infections (ABSSSI). Here, we review the latest advancement in our understanding of immunity in patients with depression and its relevance to disease management and diagnosis, with a special focus on patients suffering from ABSSSI. RECENT FINDINGS: Recent studies have highlighted the role of hypothalamic-pituitary-adrenal axis, neuro-endocrine stress signaling pathways and behavioral attitudes (substance abuse and homelessness) in the pathogenesis of infections in depressed patients. Furthermore, acute bacterial infections, in turn, have emerged as a possible risk for depression development because of different mechanisms including antibiotic-driven changes in the microbiota. SUMMARY: Recent evidences have emphasized the threat that comanagement of depression and infection pose to infectious disease physician and psychiatrist. Depressed patients with ABSSSI must be closely monitored for drug side-effects, drug-drug interactions, toxicity, and adequate compliance. New management strategies including new long-acting antibiotics (e.g., dalbavancin) are welcome.

Digitaria radicosa is reported for the first time from the New World. The voucher specimens are from lawn gardens and sidewalks in Caracas, the capital city of Venezuela, and can be identified by its essentially smooth rachis margin. Additionally, Digitaria velutina is reported new for the Venezuelan flora. The specimens came from disturbed sites of the Andes and Coastal Cordillera, above 1500 m elevation. Digitaria velutina is recognized by its inflorescence ramification, clearly branched in the lowest racemes, and also by having the smallest spikelets among the Venezuelan species of section Digitaria. A key is provided for the section.

Objectives To evaluate the presence of tubal serous intraepithelial neoplasia and p53 expression in women submitted to bilateral salpingectomy due to benign disease. Methods Histological and immunohistochemical study of the distal portion of the uterine tubes of women submitted to bilateral salpingectomy due to benign diseases. Results We studied uterine tubes of 82 patients submitted to benign gynecological surgery and who agreed to perform prophylactic salpingectomy. Tubas were studied histologically with hematoxylin/eosin staining and by p53 immunohistochemistry. None of studied tuba presented a histological alteration suggestive of tubal serous intraepithelial neoplasia. Of these 82 cases studied 33 (40.24%) presented positivity (strong and diffuse) for p53. Conclusions Although p53 positivity was high in the present study (40.24%), no tubal serous intraepithelial neoplasia was diagnosed (p53 signature). New data are needed to evaluate the effectiveness of p53 research in the STIC.

Seven years ago, some operators in the United States began geo-engineering completions to more efficiently stimulate unconventional horizontal wells. Typically, engineers and geoscientists rely on expensive open-hole logs or the over-simplified use of gamma ray to infer mechanical rock properties along the lateral. Engineers then select treatment stage intervals and place perforation clusters in similarly-stressed, "like rock" to minimize the geomechanical variability. Instead of traditional open-hole logging, this paper discusses geo-engineering applications of drill bit geomechanics. Drill bit geomechanics is an innovative method for formation evaluation and reservoir characterization. It uses direct, continuous, high-resolution measurements of drilling vibrations recorded downhole. Using earthquake seismology models, one can infer rock properties from the measured drilling vibrations. These rock properties include Poisson's Ratio, Young's Modulus of Elasticity, and the presence of fractures perpendicular to the horizontal well. In this study, the Operator collected drill bit geomechanics data while drilling a new well ~8-34 ft below three existing horizontal wellbores, with over seven years of continuous production. The study well was a 9,500-ft lateral in the Bakken Formation in North Dakota. Using drill-bit-geomechanics-derived rock properties, the operator could confidently geo-engineer a completion, accounting for reservoir depletion from the older wells. The drill bit geomechanics data showed dramatic changes in mechanical properties and fracturing where the study well intersected the older wells’ stimulated reservoir volumes (SRVs). The operator had a general idea of the wells’ SRVs from microseismic data acquired during two wells’ stimulations. Using the drill bit geomechanics data from the study well, the operator could more effectively constrain the drainage ellipses from the sparse microseismic data. The operator geo-engineered a 27-stage completion by combining "like rock" of the same reservoir pressure. Measured Instantaneous Shut-In Pressures (ISIPs) during the completion showed significantly lower ISIPs for the partially-depleted stages closest to the older wells. Thus, combining similarly-pressured stages was critical to the completion's success. Well performance has proven to be excellent for the area, even when compared to wells without depletion from older producing wellbores. As shown in this case study, drill bit geomechanics is an economic, useful tool to identify depletion and accurately measure rock properties and fractures at a very high resolution.

This paper focuses on anti-collision best practices developed and implemented by Liberty Resources for horizontal drilling across pre-existing horizontal wellbores within the same horizon in the Williston Basin. These multidisciplinary collaborative workflows have allowed Liberty Resources to successfully drill multiple complex horizontal wellbores traversing as close as 10 feet wellbore-to-wellbore to existing laterals. As the horizontal infill development of unconventional reservoirs progresses, complex wellbore trajectories with heightened collision concerns will be required. To achieve this requires advancing the industry's anti-collision standard practices with new and more precise anti-collision methods, detailed planning, and near perfect execution. In the Williston Basin alone there are over 13,000 vertical wells, 15,000 horizontal wells, and over 1,000 re-entry and directional wells drilled to date, with the first horizontal wells introduced to the basin over 30 years ago. Historically, the horizontal wells were drilled using a vast array of well designs and orientations due to the limitations of technology, industry practices and standards, and the insufficient understanding of the reservoir. Advancements in drilling and completions technologies and a better understanding of the reservoir now allow leases to be reassessed for infill potential. This increased infill development has led to increasingly complex wellbore trajectories with collision concerns not only for existing vertical wellbores but now also for existing horizontal wellbores within the same or proximal horizons. The anti-collision best practices include directional and geologic planning considerations, operational tolerances and requirements including zonal determination, communication protocols, and risk management practices. Creating a broad framework that allows for flexibility to adjust for distinct operational constraints. These workflows and tolerances have been implemented in three horizontal wellbores traversing seven same-formation pre-existing horizontal wellbores. The anti-collision method was successfully applied in both the Middle Bakken and Three Forks formations, each with their own varied and unique geologic characteristics, demonstrating applicability for a wide range of reservoirs. The ability to execute complex wellbores opens new opportunities to access additional resources in previously considered "fully developed" acreage. The methods presented in this paper have allowed the routine drilling of horizontal laterals as close as 10 feet to existing laterals. This technology can be applied to a variety of reservoirs opening new opportunities to access additional resources previously considered unrecoverable due to existing wellbores.

Aims The aim of this work was to investigate the interaction between two Helicobacter pylori strains in promoting genetic transfer, when grown in the biofilm mode. Methods and Results Biofilms produced by H. pylori 9/10 (A), H. pylori 15/4 (B) and their mixture (C) were studied for biomass production and cell viability. The genetic heterogeneity of 45 clones, coming from mature biofilm of co-cultured H. pylori strains was studied by both RAPD and cagA (EPIYA motifs)/vacA virulence genes analysis. Helicobacter pylori A, B and C developed a well-structured biofilm without significant differences in viability. No significant differences were recorded between A and B biomass measurement, whereas C biofilm expressed a significant (P

Aims: The effect of different concentrations of 2-hydroxyethyl methacrylate (HEMA) was evaluated on biofilm formation and preformed biofilm of Streptococcus mitis, Streptococcus mutans and Streptococcus oralis, alone or combined to each other. Methods and Results: Twofold serial dilution of HEMA ranged from 12 to 0·75 mmol l−1 was added to Streptococcal broth cultures and mature biofilms in 96-well-microtitre plates to evaluate bacterial biomass and cell viability. HEMA affected the Streptococcal population in a strain-specific way producing few significant effects. A reduction on biofilm formation and a detachment of preformed biofilm was recorded in Strep. mitis ATCC 6249, whereas in mixed cultures, the monomer expressed a general aggregative effect on mature biofilms. A reduction in cell viability was also recorded in an HEMA-concentration-dependent way in each experimental condition studied. Conclusions: These results suggest that the HEMA prevalent effects are both the reduction of bacterial adhesion to a polystyrene surface and the increase in dead cells also characterized by an aggregative status. Significance and Impact of the Study: Understanding the potential effect of HEMA, released from resin-based materials, on oral bacteria may furnish information for surveillance of the risk reduction in secondary caries via hindering biofilm generation.

Aims: This study detected and characterized the extracellular DNA (eDNA) in the biofilm extracellular polymeric substance (EPS) matrix of Helicobacter pylori and investigated the role of such component in the biofilm development. Methods and Results: Extracellular DNA was purified and characterized in a 2-day-old mature biofilm developed by the reference strain H. pylori ATCC 43629, the clinical isolate H. pylori SDB60 and the environmental strain H. pylori MDC1. Subsequently, the role of eDNA in the H. pylori biofilm was evaluated by adding DNase I during biofilm formation and on mature biofilms. Extracellular DNA was detected in the 2-day-old EPS biofilm matrix of all analysed H. pylori strains. The DNA fingerprintings, performed by RAPD analysis, on eDNA and intracellular DNA (iDNA), showed some remarkable differences. The data obtained by microtitre biofilm assay as well as colony forming unit count and CLSM (confocal laser scanning microscopy) qualitative analysis did not show any significant differences between the DNase I-treated biofilms and the corresponding not treated controls both in formation and on mature biofilms. Conclusions: In this study, we provide evidence that eDNA is a component of the EPS matrix of H. pylori biofilm. The different profiles of eDNA and iDNA indicate that lysed cells are not the primary source of eDNA release, suggesting that other active mechanisms might be involved in this process. Moreover, the biomass assay suggests that eDNA may not be the main component of biofilm matrix, suggesting that it could be primarily involved in other mechanisms such as recombination processes, via transformation, contributing to the wide genomic variability of this micro-organism defined as a 'quasi-species'. Significance and Impact of the Study: The presence of eDNA in H. pylori biofilm can contribute to the active dynamic exchange of information aimed to reach the best condition for the bacterial survival in the host and in the environment.

Se presenta el caso de un osteoblastoma recidivante del hueso ganchoso y se revisa el tratamiento de esta lesion. Paciente varon joven con dolor y tumefaccion en el dorso de la mano de seis meses de evolucion sin respuesta al tratamiento sintomatico. A la exploracion radiologica se aprecio una tumoracion litica del hueso ganchoso, y la RM mostro una tumoracion con edema. Por biopsia incisional se diagnostico que se trataba de un osteoblastoma, por lo que fue intervenido para practicar curetaje intralesional con aporte de esponjosa de cresta iliaca autologa. A los seis meses se observo una recidiva local, por lo que fue reintervenido mediante reseccion en bloque, con resultado final satisfactorio. A case of recurrent osteoblastoma of the hamate is presented in order to review the treatment options. It is selected a case of a young male with hand pain of six months evolution without response to nonoperative treatment. In the X-ray examination it was observed a lytic lesion of the hamate bone and the MRI demonstrated a tumour with oedema involving the hamate. We performed an incisional biopsy to reach the diagnosis of osteoblastoma of the hamate, so we do curettage with bone grafting with autologous iliac crest. Six months after the curettage we observed a local recurrence, so the final treatment applied was the en bloc resection with successful result.

We examined whether individuals return favors even when the initial favor giver will never know of their behavior. A confederate gave undergraduate participants in one condition an unexpected bottle of water, whereas other participants received no favor. Later the confederate asked participants to take a survey home with them and return it to a specified place during a specified time 2 or 3 days later. Half the participants believed the confederate herself would be present to receive the survey, and half were told to return the survey to a drop‐off box. Participants who received a favor were more likely to return the survey than those who received no favor. Moreover, this reciprocity effect was found regardless of whether the requester would know of the participant's behavior. The results lend support to an internalized social norm explanation for the reciprocity effect. Thanks are extended to Lauren Baines and Janene Lopez‐Fairfield for their help with some of the data collection. This research was prese...

Aims: To investigate the main genotypic virulence markers and the phenotypic features of an environmental Helicobacter pylori strain, named MDC1. Methods and Results: The H. pylori MDC1 genotypic status was evaluated by PCR amplification. The mosaicism in vacA alleles was expressed by the s1m1 allelic combination, as found in strains which are strong vacuolating cytotoxin producers; the number of cagA variable EPIYA motifs displayed P1P2P3P3 pattern and the iceA1 was recorded between the iceA allelic types and the babA2 gene found in strains causing more severe disease. The biofilm formation was evaluated on a polystyrene surface in static conditions by scanning electron microscopy and confocal scanning laser microscopy. Helicobacter pylori MDC1 displayed a dense mature biofilm with cells in a coccoid morphology persistent in time in which the expression of the luxS gene, related to the quorum-sensing signalling, was always detected. Conclusions: Helicobacter pylori MDC1 strain had the main virulence markers closely related to gastric pathogenesis and displayed a well-structured biofilm which allowed this bacterium to be more protected in the environment. Significance and Impact of the Study: The persistence of the environmental virulent H. pylori strain in a clustered state suggests a long-term survival of this bacterial community outside of the host, enabling the bacterial transmission with important clinical repercussions.

To investigate the dynamic behaviour of Helicobacter pylori in the colonization of the human gastric mucosa in patients previously treated for H. pylori infection.Twenty-one dyspeptic patients were included in the study. Biopsies from each individual were taken and analysed for H. pylori detection using cultural, molecular and ultrastructural methods.Through culture, H. pylori was isolated in 7 out of 21 patients and the detection of the minimum inhibitory concentration (MIC) against drugs commonly used in H. pylori therapy revealed a susceptibility panel in which only one strain was multidrug resistant. By studying the expression of the H. pylori glmM constitutive gene, viable H. pylori cells were detected in 19 out of 21 analysed biopsies. In these positive cases, the expression of the Quorum-Sensing related gene, luxS, was always detected. The analysis of glmM and luxS sequences confirmed the H. pylori identity. Scanning electron microscopy (SEM) analysis of biopsies from patients harbouring culturable bacteria showed a prevalent "S-shape" H. pylori morphotype co-existent with coccoid aggregated bacteria embedded in an abundant matrix; while samples from patients shown as H. pylori-positive only through the molecular method showed clustered coccoid bacteria arranged in a microbial biofilm.In the present work we describe a new scenario in H. pylori mucosa colonization suggesting, in infection recalcitrance, the planning of more efficacious protocols in order also to identify camouflaged and protected clustered bacteria, taking into account this serious microbial problem in medicine in the recommendation of therapeutic regimens.

This study assessed the bio-toxicological assays efficacy in the control of effluent waters deriving from purification plants, such as industrial or wastewater discharge and marine sediment collected from the Adriatic sea on the Italian Coast. The analysis was performed using either Acute Toxicity Test containing bioluminescent bacteria or Algal Growth Inhibitory Test (used on sediments only). Furthermore, samples were also characterized by microbiological parameters to search for indicators of faecal contamination. From the 29 samples collected from effluent waters, 6 showed an inhibition of bacterial luminescence higher than 20% and the analysis of EC50 expressed a strong toxicity for 4 of them, whereas 9 of the remaining 23 samples exhibited a bioluminescence stimulation defined as "hormesi." No samples of marine sediments displayed a reduction of luminescence exceeding 20% with respect to the control. Toxicity tests can represent efficacious tools to detect the presence of pollutants for the preservation of the aquatic system and human health.

We prove a characterization of locally summable functions with bounded Stepanofi norm through the maximal function Mf(x) = sup t>0 j(f ⁄`t)(x)j; whereis a suitable function in the class of Schwartz.

SummAry Introduction: Exposure to low frequency noise (LFN) can lead to vibroacoustic disease (VAD), recognized as a systemic disease with lesions in a broad spectrum of organs. Although gastrointestinal complaints are common among individuals exposed to noise, only few studies tried to evaluate the digestive lesions. The authors performed this study in order to investigate gastric lesions in an animal model of VAD. Material and methods: Adult Wistar rats were exposed to continuous LFN. After five weeks they were sacrificed. The stomachs were studied by light microscopy and scanning electron microscopy, and compared with stomachs of animals kept in silence. Results: Superficial erosions were present in the noise-exposed animals. Massive cell death of the gastric epithelium was observed, both by light and electron microscopy. Discussion: The erosions, reflecting cellular degeneration and death, occurred without inflammation, similar to what has been observed in other LFN-exposed organs.

Propolis and Zingiber officinale have been shown to be specifically targeted against Helicobacter pylori strains, to possess antiinflammatory, antioxidant and antitumoral activity and to be used in traditional medicine for the treatment of gastrointestinal ailments. Considering that these natural products could potentially serve as novel therapeutic tools also in combination with an antibiotic, the aim of this work was to evaluate their effect when combined with clarithromycin on clinical H. pylori isolates (n = 25), characterized in respect to both clarithromycin susceptibility and the presence of the cagA gene. The results showed that the combinations of propolis extract + clarithromycin and Z. officinale extract + clarithromycin exhibited improved inhibition of H. pylori with synergistic or additive activity. Interestingly, the susceptibility to combinations was significantly independent of the microbial clarithromycin susceptibility status. Only one H. pylori strain showed antagonism towards the Z. officinale extract + clarithromycin combination. The data demonstrate that combinations of propolis extract + clarithromycin and Z. officinale extract + clarithromycin have the potential to help control H. pylori-associated gastroduodenal disease.

The work environment of cotton mill rooms of modern textile plants is characterized by noise pollution. We have taped and reproduced this noisy environment to study its effects on experimentally exposed rats. Because we have previously documented that chronic noise causes alterations in the respiratory epithelium, we have focused our investigation on the morphology of the tracheal lining. Wistar rats were exposed to the textile-type noise from 1 up to 7 months, with an average 40 hours weekly exposure of the animals. The rats were sacrificed monthly and the tracheas were studied by scanning electron microscopy (SEM) to quantify the areas of the airway lining that were covered by ciliated, serous or other cells of the epithelium. We found that noise exposure of the rats caused a significant loss of tracheal ciliated cells; an increased density of serous cells on the epithelium balanced this change. This modification of the rat trachea was already established after 1 month of noise treatment of the animals; it did not change significantly throughout the 7-month course of the herein investigation. Loss of ciliated cells was more intense in areas of the tracheal epithelium located between the regions of cartilage rings. We conclude that the ciliated cell is an elective target for damage caused on the respiratory epithelium by the workplace noise occurring in cotton mill rooms. This modification of the respiratory epithelium is likely to impair clearance of the airways since this function depends on the activity of ciliated cells.

Prolonged tracheal intubation of patients often leads to tracheal stenosis (TS), which may require surgical removal of the narrowed portion of the airway. We studied 20 patients with TS who underwent surgical ablation of the stenotic portion of trachea. The morphology of the tracheal segments was characterized and compared with clinical data and with the prognosis for the disease. We found that TS was usually due to an increase in the width of the mucosa as a result of the fibrosis associated with the chronic inflammation. Plasma cells were the predominant leukocyte type seen in the inflammatory infiltrates of the surgically removed portions of narrowed trachea. In the majority of TS samples, the epithelial surface was intact and presented cilia; in contrast, cilia disappeared when the tracheal lumen was completely obliterated. Mucosal cells and glands were also well preserved in TS samples. The need to remove TS segments was often related to previous tracheal surgery, which was also associated with closing of the tracheal lumen and ossification of cartilage rings. We conclude that (a). chronic inflammation and fibrosis are responsible for the narrowing of trachea in TS patients, (b). metaplastic ossification of cartilage rings only occurs after complete obliteration of the tracheal lumen, and (c). loss of cilia and presence of metaplastic bone tissue are indicators of a poor prognosis for TS.

Objectives Our goal was to offer a comprehensive cytological study of the changes in the trachea after experimental transplantation of the organ. Study Design Autografting of four tracheal rings was done in rabbits and tracheal samples were observed by electron microscopy from 1 week to 6 months after the surgery was performed. Methods Transmission and scanning electron microscopy were used to investigate the fine structure of tracheal samples of rabbits submitted to autotransplantation, and quantitative methods were used to compare several cytological parameters of the different groups of animals. Results We found that tracheal autografting was associated with acute injury of ciliated cells expressed by loss of more than 90% of cilia density on the tracheal epithelium 1 week after the transplantation was performed. The loss of cilia was balanced by an increase in mucous cells present on the tracheal lumen. Recovery of ciliated cells was observed 1 month after the tracheal autografting was performed. In contrast, only mild cytological modifications were seen in the cartilage tissue of the autografted trachea during the first weeks of transplantation; the structural alterations of the cartilage progressed up to the third month after transplantation, resulting in a moderate tracheal stenosis. Conclusions The data indicate that 1) autotransplantation of four tracheal rings is a viable surgical procedure; 2) tracheal grafting causes severe acute changes of the epithelium that are, however, reversible in nature; whereas 3) the initial mild alterations induced by the autografting in the cartilage may evolve into tracheal stenosis.1

The long arm of the Y chromosome contains genes mapped in loci involved in male infertility, short stature and gonadoblastoma. However, many of these genes have not been fully characterized, and are not currently investigated in patients affected by such diseases. We report a study aimed to the genomic characterization of 5 genes mapped within the Y chromosome: BPY2, PRY, TTY1, TTY2, and VCY. Exon-intron boundaries were detected for each gene, and PCR analysis was carried out to investigate the involvement of these genes in different re-arrangements of the Y chromosome. It was found that BPY2 and PRY are lost in some infertile patients with Yq microdeletions, suggesting that they could play a role in male gametogenesis. On the other hand, these patients retain some copies of TTYI and TTY2 genes, due to the presence of copies in Yp, and of VCY, which has homologous copies on the X chromosome. On the basis of their localization, these genes could be candidate for the gonadoblastoma locus (TTY1, TTY2) and for the control growth locus (VCY).

STM is a very useful tool to study the vortex state, and the local density of states (LDOS), in superconducting samples. It is interesting to study the vortex LDOS in different surface conditions: in flat, clean and free-of-defects regions, or in the vicinity of a terrace or defects. In order to observe these situations, it is necessary to be able to probe large and different regions of the sample. We have built a low-temperature STM with an X – Y positioning system, which allows us to cover an entire area of 2×2 mm 2 in steps as small as a few tens of nanometers, without impairing its mechanical stability. This capability is also of great interest for the study of the local distribution of the order parameter and other electronic properties in microscopic and mesoscopic scale structures. In these preliminary studies, we investigate the evolution of the conductance (d I /d V vs. V ) curves, taken along the transition from tunneling to point-contact regime, on a NbSe 2 single crystal. In the presence of an external magnetic field, the evolution observed in the conductance curves suggests the creation of a pinning center when the tip contacts the sample.

At birth, the index weight/height is the highest correlated with weight, height and cephalic perimeter, for the index of Quetelet (BMI) the correlations are also significant although lower. In both cases, the variation with age is significant.

The authors studied the circulatory alterations observed in the upper limbs of patients showing muscular atrophy due to flaccid paralysis of traumatic origin. Ten patients who had suffered avulsion of the nerve roots from C4 to D1 that occurred 9 to 216 months previously, presented a significant degree of muscular atrophy of the affected upper limb, despite physiotherapy. We performed echo-doppler examinations of the patients to measure the lumen of the subclavian, axillary, brachial, radial and ulnar arteries and also of the veins of both upper limbs. The measurements from both upper limbs in each patient were statistically compared. The data revealed a significant reduction of the width of the lumen of the arteries and veins and a reduced arterial blood flow in the affected limb in comparison with the normal one. The greater echogenicity and the abnormal Doppler waves of the affected vessels suggest that they presented an increased thickness and a hardened wall. The authors propose that this finding may be related to an intimal hyperplasia brought about by muscular atrophy or by the observed blood flow reduction.

The incidence of spina bifida in the Community of Madrid (Spain) has been assessed during an eleven-year period, since 1970 to 1980: 0.37 per 1,000 newborns over a total of 272,332 newborns, dead and alive, of simple births. The sex ratio at birth was 94. Maternal variables have been studied (maternal age, menarche, parity, etc.), obstetric variables (number of abortions, medication during pregnancy, etc.) and also neonatal variables (weight, gestational age, state at birth, etc.). Seasonal variations were observed.