Consulta en servicio de urgencia y reingreso hospitalario después de una cirugía bariátrica primaria / Emergency department visit and Hospital Readmission after Primary Bariatric Surgery

Resumen Introducción: Las consultas en el servicio de urgencia (CU) y el reingreso (RI) hospitalario después de una cirugía bariátrica (CB) son importantes indicadores de calidad y seguridad. Sin embargo, existe escasa información de estos indicadores en nuestro medio nacional. En este trabajo analizamos las CU y RI de pacientes sometidos a una CB primaria en un centro universitario de alto volumen, y buscamos variables asociadas a estos indicadores. Materiales y Método: Estudio observacional retrospectivo que incluyó a todos los pacientes sometidos a bypass gástrico (BPG) o gastrectomía en manga (GM) laparoscópica primaria realizados de forma consecutiva en nuestra institución durante el período 2006-2007 y 2012-2013. Utilizando nuestros registros clínicos y base de seguimiento prospectivo, identificamos aquellos pacientes con CU o RI en nuestro hospital durante los primeros 30 días después del alta. Resultados: Se incluyeron 1.146 CB primarias, 53% (n = 613) fueron BPG y 47% (n = 533) GM. Un 8,03% (n = 92) de los pacientes tuvo al menos una CU y un 3,7% (n = 42) un RI. Las variables independientes asociadas tanto a CU como RI fueron el tiempo operatorio e índice de masa corporal (IMC) preoperatorio. No se encontró asociación estadística, en el periodo estudiado, para el tipo de CB realizada con la CU ni con el RI. Conclusión: Existe una baja proporción de pacientes que requieren CU y RI posterior a la CB, lo que demuestra la seguridad de estas intervenciones.

Introduction: Emergency department visits (EDV) and hospital readmission (HR) after bariatric surgery (BS) are important indicators of quality and safety in surgery, however there is little information on their characteristics in our national environment. Aim: In this work we analyze EDV and HR in patients undergoing a primary BS in a high-volume university center, and identify variables that could be associated with these indicators. Materials and Method: A retrospective observational study where we identified all patients undergoing Roux-in-Y gastric bypass (RYGBP) or primary laparoscopic sleeve gastrectomy (SG) performed consecutively at our institution during the period 2006-2007 and 2012-2013. Using our clinical records and prospective follow-up database, we identify those patients with EDV and/or HR in our hospital during the first 30 days after discharge. Results: 1146 primary BS were included, of these 53% (n = 613) were RYGBP and 47% (n = 533) SG. 8,03% (n = 92) of the patients had at least one EDV, of these 3,7% (n = 42) had an HR. The independent variables associated with EDV and HR were the operative time and preoperative body mass index (BMI). No statistical association was found, in the period studied, for the type of BS performed with EDV or HR. Conclusion: There is a low proportion of patients who require EDV and HR after BS, which demonstrates the safety of these interventions.

Curva de aprendizaje para el diagnóstico ecográfico específico de masas anexiales / Learning curve for the specific ultrasound diagnosis of adnexal masses

OBJETIVO: Determinar el tiempo que requiere una curva de aprendizaje para diagnóstico ecográfico específico histopatológico en masas anexiales basándonos en cálculos estadísticos no influidos por la prevalencia según diferentes grados de experiencia. MÉTODOS: Estudio observacional, descriptivo, transversal. Se estudiaron imágenes de 108 masas anexiales. La prueba estándar de oro fue el reporte histopatológico definitivo. Se comparó el rendimiento diagnóstico de 4 examinadores con la siguiente experiencia en diagnóstico ecográfico de patología anexial: A > 20 años, B ≤ 20 hasta > 10 años, C ≤ 10 hasta > 5 años y D ≤ 5 años, analizando solo imágenes y sin datos clínicos de las pacientes, para emitir un diagnóstico específico a libre escritura. RESULTADOS: Prevalencia de masas malignas 17,2 % (15/87). Nivel de confianza en los examinadores se consideró según falta de respuesta diagnóstica: alto (<6 %) con experiencia de más de 10 años y moderado a bajo ≤ 10 años. Examinadores con más de 5 años siempre mostraron likelihood ratio positivo mayor a 10, exactitud diagnóstica mayor a 90 % y Odds ratio diagnóstica mayor a 46, no así para examinador con menor tiempo de experiencia, quién presentó resultados con mala utilidad clínica. El cambio de probabilidad de acierto específico pre-test a post-test mejoró consistentemente con los años de experiencia. CONCLUSIÓN: Se necesitarían más de 10 años de experiencia con especial dedicación a ecografía ginecológica avanzada para un rendimiento diagnóstico específico deseado junto con alta confianza en ecografía de masas anexiales.

OBJECTIVE: To determine the time required for a learning curve of histopathological specific ultrasound diagnosis in adnexal masses based on statistical calculations not influenced by prevalence according to different degrees of experience. METHODS: Observational, descriptive, cross-sectional study. Images of 108 adnexal masses were studied. The gold standard test was the definitive histopathological report. The diagnostic performance of 4 examiners with the following experience in ultrasound diagnosis of adnexal pathology: A > 20 years, B ≤ 20 to > 10 years, C ≤ 10 to > 5 years and D ≤ 5 years was compared, analyzing only images and blinded of clinical data of the patients, to issue a specific diagnosis with free writing. RESULTS: Prevalence of malignant masses 17.2% (15/87). The level of confidence in the examiners was considered according to the lack of diagnostic response: high (<6%) with experience of more than 10 years and moderate to low ≤ 10 years. The examiners with more than 5 years always showed likelihood ratio positive greater than 10, diagnostic accuracy greater than 90% and diagnostic Odds ratio greater than 46, not so for the examiner with less experience time who presented results with little clinical utility. The change in specific probability from pre-test to post-test improved consistently with years of experience. CONCLUSION: More than 10 years of experience with special dedication to advanced gynecological ultrasound are probably needed for a desired specific diagnostic performance coupled with high confidence in adnexal mass ultrasound.

Autopercepción de capacidades de autocuidado para prevención de enfermedades crónicas no transmisibles en estudiantes universitarios / Self-perception on self-care capacity in preventing noncommunicable chronic diseases among university students / Autopercepção de capacidades de autocuidado para prevenção de doenças crónicas não transmissíveis em estudantes universitários

Introducción: La incidencia de enfermedades crónicas no transmisibles (ECNT), va en aumento entre la población más joven. La autopercepción de capacidades de autocuidado (CAC), es un punto de partida para el desarrollo de habilidades y destrezas para el propio cuidado. Objetivo: Identificar el nivel de autopercepción de CAC para la prevención de enfermedades crónicas no transmisibles en estudiantes universitarios de nuevo ingreso, para establecer estrategias que permitan un mejor conocimiento de su salud. Métodos: Estudio cuantitativo, descriptivo, transversal y analítico. Muestra aleatorizada, obtenida por cálculo de poblaciones finitas. Se aplicó el Instrumento para identificar las capacidades de autocuidado en enfermedades crónico-degenerativas, salud sexual-reproductiva y prevención de adicciones; análisis descriptivo y analítico, con pruebas paramétricas y no paramétricas. Resultados: La autopercepción de CAC fue muy buena en un 8%, buena en 54%, regular en 36% y mala en 2%. Las diferencias entre áreas de conocimiento y el nivel de autopercepción fueron significativas (p=0.025). La licenciatura en medicina tuvo mejor puntaje de autocuidado ( x -=27.51). Discusión: Los principales resultados encontrados coinciden con diversos estudios que evalúan la dimensión de autopercepción. Existen claras divergencias entre el autocuidado percibido y el realizado, lo que hace evidente la necesidad de desarrollo de CAC. Conclusiones: Es necesario promover estilos saludables para mitigar efectos, costos e implicaciones sociales. Se puede incidir desde la consultoría de enfermería, para favorecer el desarrollo de capacidades de autocuidado en estudiantes universitarios.

Introduction: The incidence of non-communicable chronic diseases among younger populations is on the rise. Self-perception of self-care capacity is a beginning point to develop abilities and skills to address the own care. Objective: To identify the level of self-perception of self-capacity to prevent non-communicable chronic diseases among newly enrolled university students in order to establish strategies which convey a better understanding of this population's health. Methods: This is a quantitative, descriptive, transversal, and analytic study which used a random sample gathered by finite populations calculation. The Identification instrument on the capacity of self-care regarding chronic-degenerative diseases, sexual-reproductive health, and addiction prevention was administered. A descriptive and analytic analysis calculating parametric and non-parametric tests was carried out. Results: Self-perception on self-capacity showed to be very good in 8% of the sample, good in 54%, fair in 36%, and poor in 2%. The differences between the knowledge level and the self-perception level were significant (p=0.025). Students enrolled in Medicine had the highest mean score. Discussion: The main results of this study reflect agreement with other studies assessing the dimension of self-perception; nevertheless, a clear gap between perceived self-care and performed self-care, still remains. Conclusions: It is necessary to promote healthy lifestyles among university students in order to enhance their health self-perception and consequent self-care.

Introdução: A incidência de doenças crónicas não transmissíveis (ECNT), vai em aumento entre a população mais jovem. A autopercepção de capacidades de autocuidado (CAC), é um ponto de partida para o desenvolvimento de habilidades e destrezas para o cuidado próprio. Objetivo: Identificar o nível de autopercepção de CAC para a prevenção de doenças crónicas não transmissíveis em estudantes universitários de ingresso novo, para estabelecer estratégias que permitam um melhor conhecimento de sua saúde. Métodos: Estudo quantitativo, descritivo, transversal e analítico. Amostra aleatorizada, obtida por cálculo de populações finitas. Aplicou-se o Instrumento para identificar as capacidades de autocuidado em doenças crônico-degenerativas, saúde sexual-reprodutiva e prevenção de dependência; análise descritiva e analítica, com probas paramétricas e não paramétricas. Resultados: A autopercepção de CAC foi muito boa em um 8%, boa em 54%, regular em 36% e precária em 2%. As diferenças entre áreas de conhecimento e o nível de autopercepção foram significativas (p=0.025). A licenciatura em medicina teve melhor pontuação de autocuidado ( x -=27.51). Discussão: Os principais resultados encontrados coincidem com diversos estudos que avaliam a dimensão de autopercepção. Existem divergências manifestas entre o autocuidado percebido e o realizado, o que faz evidente a necessidade de desenvolvimento de CAC. Conclusões: É necessário promover estilos saudáveis para mitigar consequências, custos e implicações sociais. Pode influir desde a consultoria de enfermagem, para favorecer o desenvolvimento de capacidades de autocuidado em estudantes universitários.

First molecular and serological detection of Epizootic Hemorrhagic Disease virus in white tailed deer ( Odocoileus virginianus ) from Tamaulipas, Mexico / Primeira detecção molecular e sorológica do vírus Doença Hemorrágica Epizoótica em veados de cauda branca (Odocoileus virginianus) de Tamaulipas, Mexico

Epizootic hemorrhagic disease viruses (EHDV) are dsRNA arboviruses transmitted by biting midges of the genus Culicoides that cause disease in domestic and wild ruminants. Epizootic hemorrhagic disease (EHD) is considered the most important infectious disease of white tailed deer (WTD) in North America, some studies in Northeast Mexico reported EHDV-seropositive WTD and EHDV-infected Culicoides vectors. The increasing population of WTD that share habitat with livestock in Northeast México highlights the importance of EHD for the livestock industry in the transboundary region with the U.S. One hundred and twenty two samples from WTD in Tamaulipas state, Mexico were tested by ELISA and RT-PCR for EHDV antibodies and nucleic acid, respectively. Twelve animals were seropositive to ELISA and eleven animals were positive by RT-PCR. This is the first report of EHDV nucleic acid detection in WTD from Mexico. It is hypothesized that applying the transboundary disease approach to interdisciplinary research will help fill knowledge gaps, which could help develop countermeasures to mitigate the threat of EHDV infection in wildlife and livestock along the U.S.-Mexico border.(AU)

Virus da doença hemorrágica epizoótica (EHDV) são arbovírus dsRNA transmitidos por mordidas do genus Culicoides que causam doenças em ruminantes domésticos e selvagens. Doença hemorrágica epizoótica (EHD) é considerada uma das doenças infecciosas mais importantes dos veados de cauda branca (WTD) na América do Norte. Alguns estudos no Nordeste do México relatam soropositividade para EHDV em WTD e vetores Culicoides infectados com EHDV. A crescente população de WTD que compartilham hábitats com pecuária no Nordeste do México realçam a importância de EHD para a indústria pecuária na região de fronteira com os Estados Unidos. Cento e vinte duas amostras de WTD no estado de Tamaulipas, Mexico, foram testados por ELISA e RT-PCR para anticorpos e ácido nucleico de EHDV, respectivamente. Esse é o primeiro relato de detecção de ácido nucleico de EHDV em WTD do México. A hipótese é de que a aplicação de uma resposta transfronteira e pesquisa interdisciplinar ajudará a preencher lacunas de conhecimento levando a medidas reativas para mitigar a ameaça de infecção por EHDV na pecuária e animais selvagens na fronteira entre os Estados Unidos e o Mexico.(AU)

Pérdida celular endotelial corneal asociada a facoemulsificación y experiencia del oftalmólogo: análisis prospectivo de datos secundarios individuales / Corneal endothelial cell loss associated to phacoemulsification and ophthalmologist experience: prospective analysis of individual secondary data

Resumen Introducción La facoéresis es el procedimiento en que se extrae quirúrgicamente el cristalino para tratar las cataratas. La pérdida endotelial corneal es una complicación reconocida. Si bien se han descrito diversos factores asociados a este daño, la experiencia del cirujano ha sido poco explorada. Objetivos Evaluar la asociación entre la experiencia del cirujano y otras variables asociadas a la pérdida celular endotelial en el contexto de la facoéresis. Métodos Se analizaron registros clínicos de 198 cirugías de cataratas, evaluando el efecto de la experiencia del cirujano y otras variables asociadas: energía disipada acumulada, tipo de viscoelástico empleado, uso de azul tripán, cantidad de fluídica, tiempo de ultrasonido, energía de facoemulsificación combinada y recuento celular endotelial pre y postoperatorio. Resultados No se observaron diferencias en el conteo postoperatorio de células endoteliales. Los oftalmólogos con más de cinco años de experiencia presentaron menor uso de azul tripán pero mayor cantidad de energía disipada acumulada en cada procedimiento, mientras que los oftalmólogos con menor experiencia utilizaron mayor cantidad de fluídica. Conclusiones Aunque hubo diferencias en el manejo de algunos factores influyentes sobre la pérdida endotelial cornal según la experiencia de los oftalmólogos, no se hallaron diferencias en relación a dicha pérdida como resultado final.

Abstract Introduction Phacoeresis is the procedure through which the lens is surgically removed to treat cataracts. A corneal endothelial loss is a recognized sequel. Although several factors associated with this harm have been described, the surgeon's prior experience has been scarcely evaluated. Objectives To assess the association between the surgeon's experience and other variables associated with a corneal endothelial cell loss in the context of phacoeresis. Methods Clinical records of 198 patients undergoing cataract operations were prospectively reviewed. The experience of the surgeon and other variables were recorded, including cumulative dissipated energy, viscoelastic type, the use of trypan blue, amount of fluidics, ultrasound time, combined phacoemulsification energy, and pre- and postoperative corneal endothelial cell counts. Results No differences were observed in the postoperative corneal endothelial cell count between surgeons with more or less than five years of experience. Nevertheless, ophthalmologists with more than five years' experience used less trypan blue, but more cumulative dissipated energy in each procedure, while less experienced ophthalmologists used less fluidics. Conclusions Although there were differences in the surgical management regarding the surgeons' experience in factors known to influence corneal endothelial cell loss, no differences in endothelial cell loss were observed as an outcome.

Ronda clínica y epidemiológica. Análisis de datos longitudinales / Clinical and epidemiological round. Longitudinal data analysis / Ronda clínica e epidemiológica. Análise de dados longitudinais

El denominado análisis de datos longitudinales (ADL) se refiere a los métodos para evaluar de manera apropiada las medidas de un mismo sujeto que se repiten en el tiempo. El ADL es una herramienta adecuada para entender indicadores de cambio en procesos de salud y enfermedad y para la evaluación del efecto de diversas intervenciones terapéuticas. Se presentan los principales modelos de ADL, sus ventajas y algunos ejemplos recientes de la literatura médica.

Longitudinal data analysis (LDA) refers to the methods designed to evaluate repeated measurements within an individual. LDA is an appropriate tool to address the process of change in health and disease and also to evaluate the efficacy of interventions. We present the main LDA models as well as their advantages and some clinical examples from recent medical literature.

A denominada análise de dados longitudinais (ADL) refere-se aos métodos para avaliar de maneira apropriada as medidas de um mesmo sujeito que se repetem no tempo. O ADL é uma ferramenta adequada para entender indicadores de mudança em processos de saúde e doença e para a avaliação do efeito de diversas intervenções terapêuticas. Apresentam-se os principais modelos de ADL, suas vantagens e alguns exemplos recentes da literatura médica.

La vía de transducción de señales TOR de mamíferos está presente en Trypanosoma cruzi: Reconstrucción in silico y posibles funciones / The mammalian TOR pathway is present in Trypanosoma cruzi: In silico reconstruction and possible functions

La vía TOR ("Target Of Rapamycin") de mamíferos es una red proteica de regulación para una amplia gama de procesos involucrados en el crecimiento y la diferenciación celular, constituyendo un interruptor funcional entre el metabolismo anabólico y catabólico de la célula. El Trypanosoma cruzi, agente etiológico de la enfermedad de Chagas, tiene un ciclo de vida muy complejo con diferentes estadios morfológicos en varios hospedadores. Este ciclo de vida implica que los parásitos enfrentan grandes fluctuaciones en el medio extracelular que deben ser detectadas y a las cuales deben responder adaptando su metabolismo. Un candidato a ser el mediador entre los receptores/sensores del medio y la respuesta adaptativa celular es la vía TOR. En este trabajo integramos los datos bibliográficos de la vía TOR de organismos tripanosomátidos con un análisis in silico (simulación computacional de procesos o estructuras biológicas) del genoma del parásito. Se proponen además posibles efectores y procesos regulados por esta ruta metabólica. Teniendo en cuenta que existe muy poca información sobre los mecanismos de transducción de señales en tripanosomátidos, consideramos que el mapa presentado en este trabajo puede ser una referencia para futuros trabajos experimentales.

The mammalian TOR pathway ("Target Of Rapamycin") is a regulatory protein network involved in a wide range of processes including cell growth and differentiation, providing a functional switch between anabolic and catabolic cell metabolism. Trypanosoma cruzi, the etiologic agent of Chagas disease, has a complex life cycle with different morphological stages in various hosts. This life cycle implies that parasites have to deal with fluctuations in the extracellular medium that should be detected and counteracted adapting their metabolism. A candidate to be the mediator between the receptors / sensors of the environment and cellular adaptive response is the TOR pathway. In this paper we integrate the bibliographic data of the TOR pathway in trypanosomatids by in silico analysis (computer simulation of biological structures and processes) of the parasite's genome. Possible effectors and processes regulated by this metabolic pathway are also proposed. Given that the information on the mechanisms of signal transduction in trypanosomatids is scarce, we consider the model presented in this work may be a reference for future experimental work.

Endometriosis profunda: desafío actual para el ultrasonografista: revisión de la literatura y casos clínicos / Deep endometriosis: clinical cases and literature review

The Endometriosis is defined as the presence of endometrial tissue out of the uterine cavity. Three different types exist of endometriosis: peritoneal, ovary and infiltrating deep (DIE), the latter is characterized for presenting endometriotic lesions that spread more than 5 mm of depth below the peritoneum. The motive of the following publication is to announce the different diagnostic capacities up to the date known about the different technologies of images and in addition to present 5 DIE’S clinical cases, which diagnosis was possible by transvaginal ultrasonography with bowel preparation and intravaginal ultrasound gel. Both technologies of images more used for DIE’S diagnosis are the magnetic Resonance (RM) and the Transvaginal Ultrasonography. The Sensibility and Specificity brought for Nuclear Magnetic Resonance in DIE are: Sensibility 76 percent to 88 percent and Specificity 97 percent in regions retrocervical and rectosigmoid respectively. For the ECO TV there are brought Senbilities and Specificities that go from 74 percent to 95 percent and from 50 percent to 98 percent respectively, depending on the region of commitment, author and used technology. Conclusion: there is demonstrated that the ECO TV with intestinal preparation and use of solid gel intravaginal is a good diagnostic tool for the study and DIE’S diagnosis pre operatively.

La Endometriosis se define como la presencia de tejido endometrial fuera de la cavidad uterina. Existen tres diferentes tipos de endometriosis: peritoneal, ovárica e infiltrante profunda (DIE), ésta última se caracteriza por presentar lesiones endometriósicas que se extienden más de 5 mm de profundidad por debajo del peritoneo. El motivo de la siguiente publicación es dar a conocer las distintas capacidades diagnósticas, hasta la fecha conocidas de las distintas técnicas imagenológicas y además presentar 5 casos clínicos de DIE, cuyo diagnóstico fue posible mediante ecotomografía transvaginal con preparación intestinal y gel para ultrasonido intravaginal. Las dos técnicas imagenológicas más usadas para el diagnóstico de DIE son la resonancia magnética (RM) y la ecotomografía transvaginal (ECO TV) en sus distintas variantes. La Sensibilidad y Especificidad reportada para RM en DIE son: Sensibilidad 76 por ciento a un 88 por ciento y Especificidad de un 83 a un 97 por ciento en regiones retrocervicales y rectosigmoides respectivamente. Para la ECO TV se reportan Senbilidades y Especificidades que van desde un 74 por ciento a un 95 por ciento y de un 50 por ciento a un 98 por ciento respectivamente, dependiendo de la región de compromiso, autor y técnica utilizada. Conclusión: Se demuestra con este trabajo, que la ECO TV con preparación intestinal y uso de gel sólido intravaginal es una buena herramienta diagnóstica para el estudio y diagnóstico de DIE pre operatorio.

Acalasia en obesos mórbidos: reporte de casos / Achalasia in morbidly obese patients: report of two cases

Achalasia is uncommon in morbidly obese patients. We report two patients with both conditions. A 71 years old diabetic male with a body mass Índex (BMI) of 36 kg/m . He consulted for dysphagia and a manometry showed a lack of relaxation of the lower esophageal sphincter. He was subjected to unsuccessful pneumatic dilatations in two occasions. Finally the patient was subjected to a total gastrectomy and Roux en Y esophago-jejunal anastomosis. Eight months after surgery the patient reports slight dysphagia and lost 24 kg. A 66 years old male with a BMI of 44 kg/m² consulting for regurgitation. Manometry confirmed the diagnosis of achalasia. The patient was subjected to a esophagomyotomy, subtotal gastrectomy and Roux en Y gastro jejunal and jejuno-jejunal anastomosis. Two years after surgery the patient had a slight dysphagia and lost 20 kg.

La acalasia es un trastorno de la motilidad esofágica que tiende a producir baja de peso, siendo rara su presentación en obesos mórbidos. Existen pocos reportes de casos en la literatura. Se presentan 2 casos de pacientes con el diagnóstico de acalasia y obesidad mórbida, uno de ellos tratado con Gastrectomía total y el otro con Esofagomiotomía asociada a Bypass gástrico. Ambos pacientes evolucionaron en buenas condiciones. Finalmente se realiza un análisis de la literatura.

Genotypic variation in morphology and freezing resistance of Eucalyptus globulus seedlings subjected to drought hardening in nursery / Variación genotípica en la morfología y resistencia a la congelación del Eucalyptus globulus a la sequía sometido al endurecimiento en vivero

Eucalyptus globulus Labill is one of the most planted species in Chile, because of its fast growth and superior pulp qualities. Nevertheless, the incidence of drought and frost damage immediately after planting is frequent. The purpose of this work was to study the effect of drought hardening on frost resistance and on variations in morphological traits that may increase drought resistance at nursery phase in four genotypes of E. globulus Labill. Drought hardening treatments consisted in induced water stress by watering restriction, until pre-dawn stem xylem water potentials (Psi pd) reached -0.2, -1.8 and -2.6 MPa. Two water stress-rewatering cycles were applied during 54 days of hardening. Plant and root biomasses were affected by the interaction of drought hardening and genotypes. The rest of morphological and alometrical traits were affected independently by drought or genotype. Plant height, leaf area, specific leaf area (SLA), stem, and leaf biomasses decreased with drought hardening, while collar diameter was not affected. Genotypes responded differentially to drought hardening in plant height, leaf area, SLA, and stem, and leaf biomasses. Ice nucleation temperature (INT), and freezing temperatures (FRT), and 50 percent freezing damage index of leaves (LT50) were affected by the interaction between drought hardening and genotypes. EG-13, EG-23 and EG-22 genotypes became freezing tolerant with drought hardening (-2.6 MPa). Additionally, EG-14 genotype increased its freezing resistance at -1.8 MPa. Therefore, freezing resistance levels and mechanism depend on genotype and drought hardening treatment. The success in tree breeding by genetic selection should be facilitated by improved understanding of the physiology of stress resistance development and survival during water supply limitations. The knowledge of morphological and freezing resistance dependency on the interaction between genotype and drought hardening may be useful...

Enfrentamiento terapéutico del trastorno por déficit atencional en una población infantil escolar perteneciente a la Región Metropolitana de Chile / Attentional deficit disorder treatment at a school children population in Region Metropolitana of Chile

An evaluation was made of a retrospective evolution presented by the patients from to 14 years and 11 month old (average 9,2 years old), with a diagnostic of attentional hyperactive disorder (AHD), treated with metilfenidate in Huechuraba during the year 2007. A revision of every clinic history showed the principal results: a high positive response (higher than the 76 percent of the measured parameters). The evaluated parameters were, academic response, self report of subjective opinion from the patient, opinion from the tutor of the child in relationships with his/her conduct at home and teacher's evaluations of the child conduct at school. No differences were found between the evolution of the clinic parameters, in children with and without comorbilities. It was found a 52, 7 percent of comorbility. Specific learning disease, adaptative disorder, anxious disorder, and depression were more frequent diagnoses. This study concludes that the high percent of success in the treatment of the student group is similar to the one found in literature. The presence of comorbility won't cause to down of the treatment efficiency. This is conditioned by the presence of psychosocial factors like maternal psychopathology and familiar violence.

Se realizó una evaluación restrospectiva de la evolución presentada por los pacientes desde 6 a 14 años 11 meses de edad (edad media de 9,2 años) con diagnóstico de Trastorno por déficit atencional (TDA) bajo tratamiento con metilfenidato en la comuna de Huechuraba durante el año 2007. Se hizo la revisión y el análisis de cada ficha clínica, encontrándose como principales resultados el alto porcentaje de mejoría, igual o mayor al 76 por ciento de los parámetros medidos, consistentes en evolución del rendimiento académico; autoreporte de sensación subjetiva del niño; reporte del cuidador principal en relación a la conducta del niño (a) en el hogar y evaluación del profesor en cuanto su conducta en el colegio. No se encontraron diferencias entre la evolución de los parámetros clínicos entre los niños con comorbilidad y sin comorbilidad, se encontró un 52,7 por ciento de esta, siendo los diagnósticos más frecuentes Trastorno específico del aprendizaje, trastorno adaptativo, trastorno ansioso y del ánimo. Se concluye que el alto porcentaje de éxito del tratamiento en el grupo estudiado es similar al encontrado en la literatura; que la presencia de comorbilidad no condiciona la disminución de la eficiencia del tratamiento y que esta es condicionada por presencia de factores psicosociales como psicopatología materna y violencia intrafamiliar.

Trypanosoma cruzi: Transporte de metabolitos esenciales obtenidos del hospedador / Trypanosoma cruzi: Transport of essential metabolites acquired from the host

El Trypanosoma cruzi es el agente causal de la enfermedad de Chagas, endémica en Argentina y en toda América Latina. Presenta numerosas características metabólicas diferenciales respecto a sus hospedadores insectos y mamíferos. Algunas de estas diferencias fueron consecuencia de millones de años de adaptación al parasitismo en los cuales estos organismos protozoarios reemplazaron, a lo largo de su evolución, muchas rutas metabólicas de biosíntesis por sistemas de transporte de metabolitos desde el hospedador. En esta revisión se describen los avances en el conocimiento de los sistemas de transporte tanto bioquímicos como también de las moléculas involucradas en dichos procesos. Se aborda con especial énfasis los transportadores de aminoácidos y poliaminas de T. cruzi de la familia AAAP (Amino Acid/Auxin Permeases) ya que parece ser exclusiva de los tripanosomátidos. Teniendo en cuenta que estas moléculas se encuentran completamente ausentes en mamíferos podrían ser consideradas como potenciales blancos contra el Trypanosoma cruzi.

Trypanosoma cruzi is the etiological agent of Chagas disease, a disease endemic not only in Argentina but also in all of Latinamerica. T. cruzi presents several metabolic characteristics which are completely absent in its insect vectors and in mammalian hosts. Some of these differences were acquired after millions of years of adaptation to parasitism, during which this protozoan replaced many biosynthetic routes for transport systems. In the present review, we describe the advances in the knowledge of T. cruzi transport processes and the molecules involved. In particular, we focus on aminoacid and polyamine transporters from the AAAP family (Amino Acid/Auxin Permeases), because they seem to be exclusive transporters from trypanosomatids. Taking into account that these permeases are completely absent in mammals, they could be considered as a potential target against Trypanosoma cruzi.

Changes in morpho-physiological attributes of Eucalyptus globulus plants in response to different drought hardening treatments

Morpho-physiological attributes exhibited in response to drought hardening at the end of the growing season of Eucalyptus globulus Labill under nursery conditions were studied to evaluate the effect of three drought hardening treatments in morpho-physiological traits used as suitable indicators of drought hardiness, such as, plant growth, root growth potential, plant water relationships and survival. Freezing resistance of drought hardened plants was also studied in order to evaluate cross hardening effects in cuttings of Eucalyptus globulus Labill. Drought hardening consisted in induced water stress by watering restriction, until plant stem xylem water potentials (psipd) reached to-0.2, -1.3 and -2.4 MPa. Two water stress-rewatering cycles were applied during 54 days of treatment. The hardening treatments caused a significant reduction in plant height, leaf area, specific leaf area, plant, leaf, stem and root biomass. However, stem diameter was not affected. Root growth potential increased with the exposure to moderate water stress (-1.3 MPa). Drought hardening treatments have not effect on water relationship parameters such as saturation osmotic potential (psipisat), volumetric module of elasticity (e), relative water content (RWCtlp) and osmotic potential (psitlp) at the turgor loss point. Only 1.7 percent and 6 percent of dehydrated dead plants were observed on treatments at -1.3 and -2.4 MPa respectively. Finally, the freezing damage index of leaves (LT50) was not significantly affected by drought hardening treatments. Furthermore, a reduction of 1.1ºC of supercooling capacity was observed at -2.4 MPa. As a conclusion, drought hardening is an important step of plants production programs during the final phase of nursery, because changes in morphological attributes caused by exposure to moderate drought, enable the plants to maintain the balance between transpiration and absorption areas and increase the capacity of plants to generate n...

Tumores anexiales: ¿qué se espera de la ultrasonografía? / Adnexal tumors: what is expected of the ultrasonography?

Objectives: To confirm the high capacity of gynecologic ultrasound in defining the etiology of an adnexal mass. Methods: We studied 192 adnexal masses in 171 patients. By using a subjective Pattern Recognition System an experienced gynecological ultrasonographer established an etiologic diagnosis. Results: By using transvaginal or transrectal ultrasound (TVUS), an adequate etiological diagnosis was obtained in 88% of cases. The positive predictive value and negative predictive value for adnexal cancer was 61 and 100%, respectively. Conclusion: A trained operator can subjectively characterize an adnexal mass using TVUS, with an accuracy of about 90 percent, identifying with reasonable security benign functional masses, benign structural pathology, and malignant pathology.

Objetivos: Confirmar la alta capacidad de la ultrasonografía ginecológica para definir la etiología de una masa anexial. Material y Método: Se incluyó 192 masas anexiales en 171 pacientes, a las que mediante caracterización subjetiva por parte de operadores entrenados, se hizo un diagnóstico presuntivo etiológico. Resultados: En la población total estudiada, se logró un diagnóstico etiológico correcto mediante la ultrasonografía transvaginal o transrectal en el 88% de los casos. El VP(+) y (-) para Ca anexial fue de 61 y 100% respectivamente. Conclusión: Un operador entrenado puede caracterizar, subjetivamente, una masa anexial mediante ultrasonografía transvaginal o transrectal, con precisión cercana al 90 por ciento.

Fracturas de la columna toracolumbar en Cali, Colombia / Thoracolumbar spine fractures in Cali, Colombia

En un estudio retrospectivo de 12 años se evaluaron en el Hospital Universitario del Valle, Cali, Colombia, 210 casos con diagnóstico de fractura de columna vertebral toracolumbar. El sexo más afectado fue el masculino con una proporción de 2:1 siendo el grupo de edad más frecuente entre 20-45 años (52%) . La caída de altura fue la causa más frecuente de fractura (54%) posiblemente debido al ineficiente sistema de seguridad industrial de Colombia. Las fracturas en el área lumbar fueron 60%; el modelo más frecuente fue la luxofractura (44%). Las instrumentaciones largas como las de Harrington y Luque no son las ideales en el tratamiento de las fracturas de la columna toracolumbar porque alteran sus curvas fisiológicas y disminuyen notablemente su movilidad. La fractura de la columna vertebral a nivel toracolumbar ha sido una causa común de consulta en el servicio de urgencias del hospital Universitario del Valle (HUV), Cali, Colombia y por su alta frecuencia se decidió en el departamento de Ortopedia y Traumatología de esta institución, hacer un estudio retrospectivo de tipo descriptivo de los últimos 12 años.

Initial interaction of the P22 phage with the Salmonella typhimurium surface

OBJECTIVES: The goals of these studies were to characterize the interaction of the P22 phage particle with the Salmonella cell surface and to determine the phage elements involved in this interaction by mutational analysis. BACKGROUND: The phage P22 has been characterized extensively. The gene and protein for the phage P22 tailspike, which is the phage adsorption organelle, have been intensively studied. The kinetics of the interaction of the tailspike protein with the cell surface has been studied in detail, surprisingly no mutational analysis has ever been reported that has defined these components and their interaction between themselves and the cell surface. The main and perhaps only component needed for this cell surface interaction is the tailspike protein. METHODS: Adsorption to the cell surface has been measured in the wild type phage and in mutant derivatives, isolated in this study. Phage mutants have been isolated after hydroxylamine mutagenesis. RESULTS: The adsorption of P22 to the cell surface is a temperature-independent event. Forty putative phage adsorption mutants have been isolated. A sample of them have been further analyzed. These divide the adsorption process into at least two stages. One stage contains mutants that absorb with essential wild type phage kinetics to the cell surface while the other stage with delayed adsorption kinetics. CONCLUSIONS: The interaction of the phage P22 with the Salmonella cell surface has been shown to be a complicated one which is temperature-independent and multi-stage. Mutants isolated in this study may help dissect this process even further

Susceptibility of spiny rats (Proechimys semispinosus) to Leishmania (Viannia) panamensis and Leishmania (Leishmania) chagasi

The role of Proechimys semispinosus as reservoir of Leishmania (Viannia) panamensis on the Colombian Pacific coast was experimentally evaluated. The susceptibility to L. chagasi also was assessed to determine the utility of this rodent as a model for studying reservoir characteristics in the laboratory. Wild-caught animals were screened for natural trypanosomatid infections, and negative individuals were inoculated intradermally (ID) in the snout or feet with 10(7) promastigotes of L. panamensis. L. chagasi was inoculated intracardially (10(7) promastigotes) or ID in the ear (10(8) promastigotes). PCR-hybridization showed that 15 percent of 33 spiny rats were naturally infected with L. Viannia sp. Animals experimentally infected with L. panamensis developed non-ulcerated lesions that disappeared by the 7th week post-infection (p.i.) and became more resistant upon reinfection. Infectivity to sand flies was low (1/20-1/48 infected/fed flies) and transient, and both culture and PCR-hybridization showed that L. panamensis was cleared by the 13th week p.i. Animals inoculated with L. chagasi became subclinically infected and were non-infective to sand flies. Transient infectivity to vectors of spiny rats infected with L. panamensis, combined with population characteristics, e.g., abundance, exploitation of degraded habitats and high reproductive rates, could make them epidemiologically suitable reservoirs