Eficacia del diagnóstico prenatal no invasivo por células fetales libres en sangre materna 1990-2014. Revisión sistemática

ANTECEDENTES: El aislamiento de células fetales libres o ADN fetal en sangre materna abre una ventana de posibilidades diagnósticas no invasivas para patologías monogénicas y cromosómicas, además de permitir la identificación del sexo y del RH fetal. Actualmente existen múltiples estudios que evalúan la eficacia de estos métodos, mostrando resultados costo-efectivos y de menor riesgo que el estándar de oro. Este trabajo describe la evidencia encontrada acerca del diagnóstico prenatal no invasivo luego de realizar una revisión sistemática de la literatura. OBJETIVOS: El objetivo de este estudio fue reunir la evidencia que cumpla con los criterios de búsqueda, en el tema del diagnóstico fetal no invasivo por células fetales libres en sangre materna para determinar su utilidad diagnóstica.  MÉTODOS: Se realizó una revisión sistemática de la literatura con el fin de determinar si el diagnóstico prenatal no invasivo por células fetales libres en sangre materna es efectivo como método de diagnóstico.  RESULTADOS: Se encontraron 5,893 artículos que cumplían con los criterios de búsqueda; 67 cumplieron los criterios de inclusión: 49.3% (33/67) correspondieron a estudios de corte transversal, 38,8% (26/67) a estudios de cohortes y el 11.9% (8/67) a estudios casos y controles. Se obtuvieron resultados de sensibilidad, especificidad y tipo de prueba. CONCLUSIÓN: En la presente revisión sistemática, se evidencia como el diagnóstico prenatal no invasivo es una técnica feasible, reproducible y sensible para el diagnóstico fetal, evitando el riesgo de un diagnóstico invasivo.

Datos para la validación del cuestionario de Conductas Problemáticas del Asma de Creer et al.(1989) en una muestra española.

Se estudió la fiabilidad y validez del Cuestionario de Conductas Problemáticas del Asma con población asmática infanto-juvenil y el resultado obtenido es que sí que es un instrumento fiable y válido para detectar problemas conductuales asociados al asma en niños y jóvenes afectados de esta enfermedad.

Algunas consideraciones sobre el sencillo ejercicio propuesto por D. Gil et al. en un artículo reciente de esta revista.

Consideraciones que pueden resultar de utilidad sobre el 'sencillo ejercicio', tanto en el propio planteamiento, como en la resolución detallada. Se ha tratado de poner en evidencia lo rico y sencillo que resulta el análisis de este ejercicio, una vez familiarizados con el formalismo, en contraste con la complejidad, confusión y artificialidad, que siempre generan las simplificaciones apriorísticas; todo ello, mediante el estudio aparentemente simple de un movimiento; aspecto no trivial, el del estudio en movimiento, que está en el origen de la propia Física, desde los griegos. Para concluir, se expone la respuesta a estas consideraciones de J. Félix Fuertes, ya que el sencillo ejercicio no fue propuesto por los autores, sino que fue extraído de un texto de EGB.

Associação entre aptidão cardiorespitratória, pré-obesidade e obesidade no 4º ano do 1º ciclo do Ensino Básico Agrupamento de Escolas Professor Armando Lucena

RESUMO: Objectivo: Face à exiguidade de estudos em Portugal nesta temática, o objectivo do estudo foi a análise entre a aptidão cardiorrespiratória (ACR), e a prevalência da pré-obesidade e obesidade em crianças do 4º ano do 1º ciclo. Método: Foi efectuada uma revisão sistemática da literatura (RSL), evocando-se estudos tranversais e de RCT, cruzando-se com resultados do estudo observacional, do Agrupamento de Escolas Professor Armando Lucena, do concelho de Mafra, distrito de Lisboa. Do estudo de RSL, e estudo observacional, fez-se a análise da verificação da associação inversa, entre a “aptidão cardiorespiratória, a pré-obesidade e obesidade”. O estudo observacional, foi transversal, incidindo sobre 143 crianças, (73 raparigas) dos 9-12 anos de idade do concelho de Mafra. Foram utilizados os pontos de corte da International Obesity Task Force (IOTF), para definir a pré-obesidade e obesidade. Registou-se o IMC e a % Massa Gorda por bioimpedância. A avaliação da ACR foi efectuada através do teste Vaivém 20 metros Fitnessgram, utilizando-se equação de Fernhall et al., (1998). Os alunos foram avaliados por questionário sobre actividade física (AF) extra-curricular (QAD, Telama et al., 1997); os pais sobre os níveis AF (IPAQ, Bauman et al., 2009) e estatuto sócio-económico (ESE). Resultados: Os resultados do estudo observacional, corroboram os de outros estudos RSL. Não houve diferenças entre géneros na prevalência de pré-obesidade e obesidade: rapazes (20.55% e 8.21%) e raparigas (34.28% e 5.71%) (p<0.176). As crianças com maior ACR têm menor IMC (p<0.01) e MG (p<0.001) e a idade não esteve associada à ACR. Os pré-obesos são na sua maioria insuficientemente activos, e os normoponderais são insuficientemente activos (p=0.033). Não houve associação entre o ESE e AF dos pais e o IMC, ACR ou QAD dos alunos. Com base nos resultados encontrados na revisão, procurou-se situar diferentes abordagens teóricas sobre a actividade física, dando ênfase principal à importância “ da promoção (acesso) da actividade física através da educação física orientada pedagogicamente em todos os ciclos de ensino. Conclusão: As crianças que tiveram maior ACR registaram menor IMC e MG, independente da idade e do sexo. Verificou-se ainda que as variáveis de ESE e AF dos pais, não está associada aos resultados da ACR, IMC e MG das crianças. ABSTRACT: Objective: Given the paucity of studies in Portugal on this theme, the goal of the study was to analyse the of cardiorespiratory fitness (CRF), and the prevalence of overweight and obesity in children attending the fourth year of primary school. Method: A systematic literature review was conducted, in which cross-cutting studies and RCT were covered and, intersected with observational results obtained, from the group of Schools Professor Armando Lucena, located in, the municipality of Mafra, Lisbon district. From the systematic review of literature (SRL), plus the observational study, the verification analysis of the inverse association between 'cardiorespiratory fitness, pre-obesity and obesity' was performed.The observational study was cross-sectional, focusing on 143 children (73 girls) of 9-12 years old. To define overweight and obesity the IOTF cutoffs were used. BMI and percentage of fat mass were recorded by means of bioelectrical impedance. The assessment was made through the CRF test shuttle Fitnessgram 20 meters, using the equation proposed by Fernhall et al., (1998). Students were assessed by questionnaire on physical activity (PA), extra-curricular PA (PAF Telama et al., 1997); parents were questioned regarding their PA levels (IPAQ, Bauman et al., 2009) and socio-economic status (SES). Results: The results of the observational study, corroborate, other SRL studies. There were no gender differences in the prevalence of overweight and obesity: men (20. 55% and 8.21%) and girls (34.28% and 5.71%) (p <0.176). Children with higher BMI have a lower CRF (p <0.01) and MG (p <0.001). Age was not observed to be associated with CRF. The pre-obese are mostly insufficiently active, and the normalweight are insufficiently active (p = 0.033). There was no association between the PA, the ESS, the parents, and the BMI, the CRF or the PAF of the students. Based on the results found in the review, different theoretical approaches regarding physical activity were. Emphasis was given to the importance of promoting the access to physical activity through pedagogically oriented physical education in all cycles of education. Conclusion: Children who had higher ACR showed lower FAT and BMI, regardless of age and sex. Furthermore, it was found that parents’ SES and PA variables are, not associated to children’s CRF, BMI and FAT.

Reply to "Mega-highstand or megatsunami? Discussion of McMurtry et al. "Elevated marine deposits in Bermuda record a late Quaternary megatsunami": Sed. Geol. 200 (2007) 155-165" by Paul J. Hearty and Storrs L. Olson

Our recent paper [McMurtry, G.M., Tappin, D.R., Sedwick, P.N., Wilkinson, I., Fietzkc, J. and Sellwood, B., 2007a. Elevated marine deposits in Bermuda record a late Quaternary megatsunami. Sedimentary Geol. 200, 155-165.] critically re-examined elevated marine deposits in Bermuda, and concluded that their geological setting, sedimentary relations, micropetrography and microfaunal assemblages were inconsistent with sustained intertidal deposition. Instead, we hypothesized that these deposits were the result of a large tsunami that impacted the Bermuda island platform during the mid-Pleistocene. Hearty and Olson [Hearty, P.J., and Olson, S.L., in press. Mega-highstand or megatsunami? Discussion of McMurtry et al. "Elevated marine deposits in Bermuda record a late Quaternary megatsunami": Sedimentary Geology, 200, 155-165, 2007 (Aug. 07). Sedimentary Geol. 200, 155-165.] in their response, attempt to refute our conclusions and claim the deposits to be the result of a +21 m eustatic sea level highstand during marine isotope stage (MIS) 11. In our reply we answer the issues raised by Hearty and Olson [Hearty, P.J., and Olson, S.L., in press. Mega-highstand or megatsunami? Discussion of McMurtry et al. "Elevated marine deposits in Bermuda record a late Quaternary megatsunami": Sedimentary Geology, 200, 155-165, 2007 (Aug. 07). Sedimentary Geol. 200,155-165.] and conclude that the Bermuda deposits do not provide unequivocal evidence of a prolonged +21 m eustatic sea level highstand. Rather, the sediments are more likely the result of a past megatsunami in the North Atlantic basin. (c) 2008 Elsevier B.V. All rights reserved.

Theory and practice in value management: a reply to Ellis et al (2005)

The constructivist model of 'soft' value management (VM) is contrasted with the VM discourse appropriated by cost consultants who operate from within UK quantity surveying (QS) practices. The enactment of VM by cost consultants is shaped by the institutional context within which they operate and is not necessarily representative of VM practice per se. Opportunities to perform VM during the formative stages of design are further constrained by the positivistic rhetoric that such practitioners use to conceptualize and promote their services. The complex interplay between VM theory and practice is highlighted and analysed from a non-deterministic perspective. Codified models of 'best practice' are seen to be socially constructed and legitimized through human interaction in the context of interorganizational networks. Published methodologies are seen to inform practice in only a loose and indirect manner, with extensive scope for localized improvization. New insights into the relationship between VM theory and practice are derived from the dramaturgical metaphor. The social reality of VM is seen to be constituted through scripts and performances, both of which are continuously contested across organizational arenas. It is concluded that VM defies universal definition and is conceptualized and enacted differently across different localized contexts.

Reclassification of Bacteroides putredinis (Weinberg et al., 1937) in a New Genus Alistipes gen. nov., as Alistipes putredinis comb. nov., and description of Alistipes finegoldii sp nov., from human sources

During studies on the bacteriology of appendicitis in children, we often isolated from inflamed and non-inflamed tissue samples, an unusual bile-resistant pigment-producing strictly anaerobic gram-negative rod. Phenotypically this organism resembles members of Bacteroides fragilis group of species, as it is resistant to bile and exhibits a special-potency-disk pattern (resistance to vancomycin, kanamycin and colistin) typical for the B. fragilis group. However, the production of brown pigment on media containing haemolysed blood and a cellular fatty acid composition dominated by iso-C15:0, suggests that the organism most closely resembles species of the genus Porphyromonas. However, the unidentified organism differs from porphyromonads by being bile-resistant and by not producing butyrate as a metabolic end-product. Comparative 16S ribosomal RNA gene sequencing studies show the unidentified organism represents a distinct sub-line, associated with but distinct from, the miss-classified species Bacteroides putredinis. The clustering of the unidentified bacterium with Bacteroides putredinis was statistically significant, but they displayed >4% sequence divergence with each other. Chromosomal DNA-DNA pairing studies further confirmed the separateness of the unidentified bacterium and Bacteroides putredinis. Based on phenotypic and phylogenetic considerations, it is proposed that Bacteroides putredinis and the unidentified bacterium from human sources be classified in a new genus Alistipes, as Alistipes putredinis comb. nov. and Alistipes finegoldii sp. nov., respectively. The type strain of Alistipes finegoldii is CCUG 46020(T) (= AHN2437(T)).

Description of Enterococcus canis sp nov from dogs and reclassification of Enterococcus porcinus Teixeira et al. 2001 as a junior synonym of Enterococcus villorum Vancanneyt et al. 2001

Strains from anal swabs and chronic otitis externa in dogs were shown to be phylogenetically related to the Enterococcus faecium species group. They shared a number of phenotypic characteristics with these species, but they could be easily differentiated by biochemical reactions. In addition, the canine strains were unusual in their nearly complete failure to grow on sodium azide-containing enterococci-selective media and in their Voges-Proskauer reactions (usually negative). By using 16S rRNA sequencing and DNA-DNA hybridization of representative strains, as well as tDNA interspacer gene PCR and SDS-PAGE of whole-cell proteins, the group of canine strains was shown to constitute a novel enterococcal species. The name Enterococcus canis sp. nov. is proposed for this species, with LMG 12316(T) (= CCUG 46666(T)) as the type strain. Concurrently, the taxonomic situation and nomenclatural position of Enterococcus porcinus were investigated. As no phenotypic or genotypic differences were found between this species and Enterococcus villorum, the name E. porcinus is considered to be a junior synonym of E. villorum.

Comment on: Fruit and seed biomineralization and its effect on preservation by E. Messager et al.; in: Archaeological and Anthropological Sciences (2010) 2:25–34. DOI 10.1007/s12520-010-0024-1

This article provides a brief critique of a recent article on biomineralisation and preservation. It gives a summary of the difference between biomineralisation and mineral replacement, and addresses problems with the interpretation of FT-IR data. The lack of contextual information for the samples studied is another problem which is highlighted.