Prevalencia de agentes etiológicos de meningitis bacteriana en población adulta en el Hospital San Martín de Quillota entre los años 2012-2018 / Prevalence of etiological agents of acute bacterial meningitis in adult population at the Quillota's San Martin Hospital between years 2012-2018

Resumen Introducción: La Meningitis Bacteriana Aguda (MBA) corresponde a la inflamación de las leptomeninges por presencia de bacterias piógenas. La epidemiología es variable y depende multifactorial. A pesar de los avances en medicina la mortalidad de la MBA se ha mantenido estable, evidenciando la necesidad de estudiar esta patología para orientar estrategias de prevención y tratamiento. Objetivos: Determinar la prevalencia de los agentes etiológicos de MBA confirmadas en adultos en el Hospital San Martín de Quillota (HSMQ) entre los años 2012 y 2018. Establecer la tasa de resistencia a antibióticos. Determinar el perfil de los pacientes, y establecer la relación entre perfil, agente etiológico identificado y desenlace. Métodos: c muestra de 38 casos, se estableció la prevalencia de los patógenos involucrados y se realizó un análisis estadístico considerando los factores de riesgo, sus días de estadía y su condición al egreso hospitalario. Resultados: 15 casos en que no se aisló patógeno en LCR (líquido cefalorraquídeo), 13 MBA por neumococo, 4 por Haemophilus spp, 3 por meningococo, 2 por Staphylococcus spp y 1 por Mycobacterium tuberculosis. En el grupo sin agente aislado se observó un mejor pronóstico, valores de PCR (proteína C reactiva) en sangre menores y valores de glucorraquia mayores. Se registraron 6 fallecimientos por MBA. Conclusión: La prevalencia de los agentes etiológicos fue similar a la descrita en la literatura, con neumococo como el microorganismo más frecuente, no se reportaron casos de Listeria monocytogenes. Probablemente en el grupo sin agente aislado se incluyeron casos de meningitis virales.

Introduction: Acute bacterial meningitis (ABM) is denifed as the inflammation of leptomeninges due to the presence of pyogenic bacteriae. Epidemiology is variable and multifactorial. In spite of advance in medicine, ABM's mortality has remained stable, hence the need to study the causative microorganisms in order to guide prevention and treatment strategies. Objectives: To determine the prevalence of the etiological agents of ABM confirmed in adults in a medium complexity hospital located in Quillota, Chile, between 2012 and 2018, to establish the rate of resistance of these to antibiotics. Determine the profile of the patients and establish the relationship between profile, etiological agent identified and outcome. Methods: A sample of 38 cases with ABM was evaluated during, the prevalence of the pathogens involved was established and a statistical analysis was carried out considering the risk factors of patients, their days of in-hospital stay and their condition at hospital discharge. Results: We analyzed 38 cases, 15 without isolated pathogens, 13 of Streptococcus pneumoniae, 4 of Haemophilus spp., 3 of Neisseria meningitidis, 2 of Staphylococcus spp. and we obtained one case of Mycobacterium tuberculosis. In the group without isolated pathogens, a better prognosis was observed, lower blood CRP values and higher glucose on spinal fluid values. 6 deaths per ABM were recorded. Conclusion: The prevalence of etiological agents was similar to that described in the literature, with pneumococcus as the most frequent microorganism, no cases of Listeria monocytogenes were reported. Probably in the group in which no agent was isolated, cases of viral meningitis were included.

Efectividad de hongos micorrizo-arbusculares nativos en suelos con diferentes usos agropecuarios / Native arbuscular mycorrhizal fungi effectiveness in soils with different agricultural uses

RESUMEN Objetivo. Determinar la efectividad de hongos micorrizo-arbusculares (HMA) de suelos con diferentes usos agropecuarios, en el valle medio del río Sinú, Colombia. Materiales y métodos. Bajo condiciones de invernadero se realizó el experimento, donde se utilizó como planta indicadora Leucaena leucocephala, la cual se sembró en materos con suelo de un Andisol (horizonte B) usado como sustrato. Este sustrato, se inoculó separadamente con muestras de siete suelos (horizonte Ap), como fuente de HMA, provenientes del Centro de Investigación Turipaná de Agrosavia. Como controles se incluyeron inoculación con HMA Glomus fasciculatum y uno no-inoculado El efecto de la inoculación micorrizal se evaluó mediante el monitoreo del contenido de P foliar en las plantas de L. leucocephala, en función del tiempo hasta 64 días cuando se determinó la masa seca de su parte aérea y la colonización micorrizal. Resultados. El crecimiento de L. leucocephala y el contenido de P foliar fue significativamente superior cuando el suelo se inoculó con G. fasciculatum, en comparación a aquel observado con los demás tratamientos. De igual forma, la colonización micorrizal fue muy alta en las raíces de L. leucocephala que crecieron en el suelo inoculado con G. fasciculatum e inferior en los otros tratamientos. Conclusiones. Los resultados indican que los HMA nativos de suelos con diferentes usos, provenientes del C.I Turipaná de Agrosavia, exhibieron bajo potencial para desarrollar simbiosis micorrizal, lo que limitó el crecimiento y la concentración de P foliar en la planta hospedera.

ABSTRACT Objective. To determine the effectiveness of mycorrhizal-arbuscular fungi (AMF) of soils with different agricultural uses, in the middle valley of the Sinú river, Colombia. Materials and methods. The experiment was carried out under greenhouse conditions, where Leucaena leucocephala was used as the indicator plant, which was planted in masons with an Andisol soil (horizon B) used as a substrate. This substrate was inoculated separately with samples from seven soils (Ap horizon), as a source of AMF, from the Turipaná Research Center in Agrosavia. As controls we included inoculation with HMA Glomus fasciculatum and one non-inoculated one. The effect of mycorrhizal inoculation was evaluated by monitoring the foliar P content in L. leucocephala plants, as a function of time to 64 days, when the dry mass of its aerial part and mycorrhizal colonization was determined. Results. The growth of L. leucocephala and the foliar P content was significantly higher when the soil was inoculated with G. fasciculatum, in comparison to that observed with the other treatments. Likewise, mycorrhizal colonization was very high in the roots of L. leucocephala that grew in the soil inoculated with G. fasciculatum and lower in the other treatments. Conclusions. The results indicate that the native AMF of soils with different uses, from Turipaná, exhibited low potential to develop mycorrhizal symbiosis, which limited the growth and concentration of leaf P in the host plant.

Depresión y ansiedad en mujeres histerectomizadas no oncológicas posterior a la cirugía / Depression and anxiety in non-cancer hysterectomized women after surgery

RESUMEN Introducción y objetivo: La histerectomía es la segunda cirugía ginecológica más frecuente, después de la cesárea, afectando a un importante porcentaje de la población femenina, con un gran impacto emocional. El objetivo de esta revisión es describir las consecuencias psiquiátricas y sus factores predisponentes, en las mujeres histerectomizadas no oncológicas posterior a la cirugía. Material y métodos: Se incluyeron investigaciones en inglés, español y portugués, con un máximo de 15 años de antigüedad. Se excluyeron investigaciones realizadas en mujeres histerectomizadas oncológicas y/o con antecedentes psiquiátricos previos a la cirugía. Resultados: Posterior a la histerectomía por causa benigna, aparecen trastornos depresivos y/o ansiosos en las mujeres en frecuencias variadas. En el post-operatorio inmediato de la histerectomía, se reportan prevalencias de hasta un 84% para depresión y hasta un 92% para ansiedad, respectivamente. En cuanto a los factores que predisponen a la incidencia de estos problemas, se encuentran; la paridad relacionado con la cantidad de hijos engendrados y el deseo de tener más hijos, la nuliparidad, la edad, la falta de información y educación previa a la cirugía, la soledad y escaso apoyo familiar, los mitos y creencias sociales en torno al procedimiento, entre otros. Conclusiones: El significado social del útero y el enjuiciamiento que vive la mujer histerectomizada, son factores relevantes en la aparición de trastornos depresivos y/o ansiosos. La importancia de la educación es esencial para el afrontamiento eficaz por parte de la mujer en este procedimiento.

ABSTRACT Introduction and objective: Hysterectomy is the second most frequent gynecological surgery, after caesarean section, affecting an important percentage of the female population, with a great emotional impact. The objective of this review is to describe the psychiatric consequences and their predisposing factors in non-oncological hysterectomized women after surgery. Material and methods: Research was included in English, Spanish and Portuguese, with a maximum of 15 years old. We excluded investigations carried out in oncological hysterectomized women and / or with psychiatric antecedents prior to surgery. Results: After hysterectomy due to benign cause, depressive and / or anxious disorders appear in women at varied frequencies. In the immediate postoperative period of the hysterectomy, prevalences of up to 84% are reported for depression and up to 92% for anxiety, respectively. As for the factors that predispose to the incidence of these problems, they are found; parity related to the number of children conceived and the desire to have more children, nulliparity, age, lack of information and education prior to surgery, loneliness and poor family support, myths and social beliefs about the procedure, among others. Conclusions: The social meaning of the uterus and the judgment of the hysterectomized woman are relevant factors in the appearance of depressive and / or anxious disorders. The importance of education is essential for effective coping by women in this procedure.

Marcadores de recambio óseo en mujeres postmenopáusicas: utilidad clínica / Bone remodelling markers in postmenopausal women: clinical utility

Bone metabolism is a dynamic process, which includes formation and resorption. Osteoblast and osteoclast are responsible of replacing 20 percent of bone each year. Bone Markers are fragments of bone matrix; these peptides are released in the process of formation and resorption, later accumulated in body compartments (bone and blood) and finally excreted in the urine, reflecting bone dynamic. The international Federation of Osteoporosis and the International Federation of Laboratory and Clinical Chemistry recommend the use of these two markers (one representing bone formation and the other bone resorption) to evaluate bone turnover, especially in high-risk groups such as postmenopausal women. The collagen C-terminal telopeptide or carboxi-terminal collagen crosslinking (CTX) is one of the most used, among different bone markers. This is a blood biomarker that can be measured to assess bone turnover; this marker increases when the bone resorption is accelerated. On the other hand, osteocalcin (a non-collagen protein) is a bone formation marker, which has been widely studied and can be measured in venous blood during bone formation. Both markers are important for monitoring anti-resorptive therapy, and they have been validated to predict fracture risk complementing densitometry in osteoporosis diagnosis. Main disadvantages are variability of the laboratory techniques and lack of information about normal reference values in different populations. Therefore it is necessary to establish normal reference values for each population before its incorporation as a clinical tool.

Cribado de parto prematuro con progesterona salival / Screening of premature labor with salivary progesterone

Preterm birth is the most frequent cause of perinatal morbidity and mortality, especially before 34 weeks. Current screening methods include medical history of preterm delivery and ultrasound assessment of cervix length during the second trimester of pregnancy, which give a detection rate of approximately 65 percent with a false positive rate of 10 percent. Vaginal progesterone therapy has proved to reduce the risk of early preterm delivery by 50 percent in patient under risk. This might suggest that preterm pregnancies have lower levels of progesterone compared to term pregnancies. Although, the prediction of prematurity using biomarkers, including plasma progesterone, has been researched for several years, none of them have proved to be associated with preterm delivery. However, measuring salivary progesterone has already been suggested to be a potential biomarker associated with prematurity in pregnancies at high risk of preterm delivery. Saliva is a fluid that reflects only the free fraction of the biologically active steroidal hormone, and thus is more representative measure than the total plasma progesterone, which is the one usually measured in laboratories. For these reasons, the aim of our study is to evaluate whether the assessment of salivary progesterone can be used as a screening test for prediction of preterm delivery less than 34 weeks in pregnant women who attended at our Fetal Medicine Unit at 11-14 and 20-25 weeks of gestation.

Detección de cortisol salival nocturno en una muestra de sujetos de Santiago de Chile, mediante la técnica deelectroquimioluminicencia / Night salivary cortisol measurement in a sample of volunteers from Santiago using an electroquimioluminicence technique

Cortisol is a glucocorticoid hormone with circadian cycle, it shows high levels in the morning and lower in the night. The salivary cortisol is the biologically active fraction and night measurement has been very useful for improving the diagnosis of Cushing’s syndrome, an endocrine disorder characterized by high levels of cortisol and loss of their circadian cycle. A disadvantage of this measurement is the establishment of reference ranges, which depends on the population and technique. Therefore the night salivary cortisol values were determined in a sample of 75 healthy volunteers, aged 18-75 years old. Each volunteer collects two samples in consecutive days and these samples were analyzed by electrochemiluminescence. The average of night salivary cortisol of volunteers was 0.165 +/- 0.059 ug/dL with a range from 0.082 to 0.352 ug/dL and no significant differences were found between two samples of cortisol in day 1 and 2. Our results suggest that the proposed cut-off limit 0.32 ug/dL between patients with and without Cushing Syndrome would be suitable for this technique and in our population.

Tumores de la pared torácica / Chest wall tumors

Los tumores de pared torácica,tanto en el esqueleto como los tejidos blandos,son poco frecuentes.La mayoría son benignos.Se presentan 142 tumores tratados enter 1987 y 1998,de los cuales 15 resultaron malignos.Se operaron 122 de los cuales en 91 ocasiones se realizó tumorectomía(G1)En los 31 restantes fue necesario además realizar algún tipo de reconstrucción de la pared(G2)colgajo muscular en 20,plancha protésica en 7 y tratamiento combinado en 4.La mortalidad global fue del 3,2 por ciento,todos pacientes del G2y las complicaciones fueron del 65 por ciento en el G1 y 12,9 por ciento en el G2(seromas,infecciones y neumotórax)

Cromoblastomicose do membro inferior : um caso tratado cirurgicamente com sucesso

Uma mocambicana de 35 anos apresentou-se com duas neoformacoes cutaneas vegetantes localizadas no membro inferior esquerdo. As neoformacoes - de superficie irregular; sangrando facilmente ao toque e simulando uma neplasia maligna - foram excisadas cirurgicamente e o seu exame histologico e microbiologico revelou tratar-se de cromoblastomicose (por Fonsecaea pedrosoi); uma micose profunda relativamente rara