Evaluación del control del Asma en República Dominicana: una perspectiva clínica / Evaluation of Asthma Control in the Dominican Republic: a Clinical Perspective

Introducción: El asma es una patología respiratoria caracterizada por inflamación cró-nica y reversible de las vías aéreas. Esta se asocia con factores de riesgo modificables y no modificables que influyen sobre su control y exacerbaciones. En países como Puer-to Rico y Cuba, la prevalencia del asma es significativamente mayor a la global (22,8%, 23% y 6,6%, respectivamente).

Introduction: Asthma is a respiratory pathology characterized by chronic and reversible airway inflammation. It is associated with modifiable and non-modifiable risk factors that influence its control and exacerbations. In countries such as Puerto Rico (22.8 %) and Cuba (23 %), the prevalence of asthma is significantly higher than the global prevalence (6.6 %).

Spores of Beauveria bassiana and Trichoderma lignorum as a bioinsecticide for the control of Atta cephalotes

Background: The leafcutter ant (Atta cephalotes) is associated with losses in the agricultural sector, due to its defoliating activity; for its control, biological, mechanical and chemical methods have been developed, the latter associated with adverse effects on human and environmental health. This research validated in the field for the control of the leafcutter ant (A. cephalotes) using a mixture of Beauveria bassiana and Trichoderma lignorum spores. Methods: The effectiveness from the combination of spores of B. bassiana and T lignorum with an initial concentration of 2 × 109 spores/ml, in the following proportions of B. bassiana and T. lignorum, A (1:1), of each fungus. It was evaluated within the university campus, comparing it with two commercial formulations, Mycotrol (B. bassiana) and Mycobac (T. lignorum). Additionally, this formulation was evaluated in 49 nests distributed 16 in 14 locations in Colombia. The formulation application was carried out by direct application, using a pump at a speed of 10 ml/m2. The effectiveness was estimated from the reduction of the flow of ants, evaluating the statistically significant differences using the ANOVA and Tukey-test. Results: Effective control of 90% of the nests was observed in the field phase in 60 days, except in nests with areas > 50 m2 that were located in regions with high rainfall (annual average precipitation above 7000 mm), such as Buenaventura. Conclusions: In this work, it was demonstrated that the combination of B. bassiana and T. lignorum spores represent a viable alternative for the control of the leafcutter ant, in which the effectiveness is related to several factors, including the size of the nest and the rainfall in the area.

Características clínicas del trastorno depresivo mayor en tratamiento en el nivel secundario de atención / Clinical features of major depressive disorders treated in secondary health care facilities in Chile

Background: Depression is considered the second leading cause of disability worldwide. Aim: To describe the clinical characteristics and the evolution of major depressive disorder (MDD) in secondary care. To evaluate the association between socio-demographic and clinic variables with the first or recurrent major depressive events (MDE). Material and Methods: Clinical features, treatment, remission and duration of MDE were evaluated during a follow up lasting 12 months in 112 participants aged 44 ± 15 years (79% women). Patients were assessed as outpatients every three months at three psychiatric care centers of Chile. Clinical interviews were carried out using DSM-IV diagnostic criteria checklists and the Hamilton Depression Scale was applied. Results: Most patients were referred from primary care. The mean time lapse for referral to the secondary level was 10.8 months. Most patients had episodes that were recurrent, severe, with a high rate of psychosis, with suicide attempts and melancholic features and with psychiatric and medical comorbidities. Remission rate was 27.5%. In only 16 % of patients, the episode lasted six months or less. The group with recurrent episodes had different age, sex and clinical features. Conclusions: MDD treated at the secondary care level is severe and its symptoms are intense. The time lapse prior to referral was prolonged. Primary care management and referral of these patients should be studied more closely.

Articulación neuropática de Charcot en un niño / Articulation neuropathique de Charcot chez un enfant / Charcot neuropathic arthopathy in a child

La artropatía neuropática de Charcot es muy rara en niños. Este trabajo tiene como propósito fundamental presentar el tratamiento seguido en un infante con esta enfermedad. Se presenta un escolar masculino de seis años de edad y raza negra, procedente de La Habana que es traído al Complejo Científico Ortopédico Internacional Frank País por presentar aumento de volumen y deformidad del tobillo y el pie izquierdo de más de seis meses de evolución. Se muestran los hallazgos de laboratorio clínico (todos dentro de valores normales) e imagenológicos (radiografías, tomografía axial computarizada y gammagrafía ósea), así como el tratamiento impuesto (conservador y quirúrgico). Seis meses posteriores al diagnóstico se logró la remodelación del tobillo y la curación de las úlceras del pie izquierdo. Pero un año más tarde, apareció un cuadro similar en el derecho tras un trauma escolar. El caso presentado, inusual por la edad del paciente al momento del diagnóstico, nos demuestra lo difícil y complejo que resulta el tratamiento de la artropatía neuropática de Charcot y la necesidad de su seguimiento continuo y activo(AU)

Charcot neuropathic arthropathy is very rare in children. The present paper is mainly aimed at presenting the treatment applied to a child suffering from this disease. A black six-year-old school boy is brought to Frank País International Scientific Orthopedic Complex with enlargement and deformity of his left ankle and foot of more than six months' evolution. Clinical laboratory results (all within normal ranges) and imaging findings (radiography, computerized axial tomography and bone scintigraphy) are provided. The treatment indicated (conservative and surgical) is described. Six months after diagnosis the ankle had been remodeled and the ulcers on the left foot had healed. However, a year later a similar situation presented, now on the right foot, as a result of a trauma in school. The case presented, unusual as it is due to the patient's age at diagnosis, illustrates the difficulty and complexity of the treatment of Charcot neuropathic arthropathy, and the need for permanent, active follow-up(AU)

L'arthropathie neurogène de Charcot est une affection très rare chez les enfants. Le but de ce travail est de présenter le traitement de la neuro-arthropathie de Charcot chez un enfant. Un écolier âgé de 6 ans et de la race noire, provenant de La Havane, est vu en consultation au Centre scientifique orthopédique international Frank Pais , dû à une augmentation du volume et une difformité de sa cheville et son pied gauches avec plus de six mois d'évolution. Les résultat du laboratoire clinique (en normalité) et d'imagerie (radiographies, tomographie axiale informatisée et gammagraphie osseuse), ainsi que le traitement indiqué (conservateur et chirurgical), sont montrés. Six mois après le diagnostic, le remodelage de la cheville et la guérison des ulcères du pied gauche sont réussis. Un an après un tableau similaire apparaît, mais au pied droit. Le cas présenté, peu fréquent chez un enfant, nous montre combien le traitement de l'arthropathie neurogène est difficile et complexe, et combien un suivi continue et actif est nécessaire dans ces cas(AU)

Response of Millepora alcicornis (Milleporina: Milleporidae) to two bleaching events at Puerto Morelos reef, Mexican Caribbean

Two naturally occurring colonies of Millepora alcicornis were monitored during 1997 and 1998, both years in which this species bleached in the Mexican Caribbean. One colony (HL) was naturally exposed to a high light environment and another nearby colony (LL) was exposed to 5.9 times lower light levels due to shadowing by a pier. For 10 days in August 1997, seawater temperatures in the surrounding reef lagoon rose up to 1.5 degrees C above the 6-year August average. The HL colony bleached to white during this period, whereas, the LL colony remained dark-brown colored. The HL colony recovered its normal dark-brown coloration (reversible bleaching) within several weeks, during which time the seawater temperatures returned to average. The following year, for 10 days, seawater temperatures rose up to 3 degrees C above the 7-year August average and both colonies bleached to white and neither colony recovered (irreversible bleaching). Both colonies were rapidly overgrown by algae and hydroids and, as of June 2003, no recovery has taken place. Prior to the 1997 bleaching, experiments using solar radiation showed that the quantum yield of photosystem II charge separation of branches from HL and LL colonies were affected for several hours by exposure to ultraviolet radiation (UVR, 280 to 400 nm), but recovered by the same evening, suggesting that UVR does not have long-term effects on photochemistry in M. alcicornis. In situ effective quantum yield of photosystem II charge separation (deltaF/Fm') measurements before the 1998 bleaching event indicate that both colonies were healthy in terms of the physiological status of their endosymbionts. During and after the 1998 bleaching event, both colonies showed a reduction in deltaF/Fm' and consequently an increase in excitation pressure on photosystem II. The data suggest that temperature is not the only factor that causes bleaching and that solar radiation may play an important role in coral bleaching.

Caracterizacion del Injerto Parietal / Characterization of the parietal graft

Se realizo un estudio descriptivo, longitudinal y prospectivo de 22 pacientes en los que se utilizo el injerto parietal autogeno para reconstruir defecto del craneo, en los servicios de Cirugia Maxilofacial y Neurocirugia del Hospital Clinicoquirurgico Docente "Saturnino Lora" de Santiago de Cuba, desde 1988 hasta 1991. El metodo de extraccion del injerto con division in situ resulto el mas empleado y el que ofrecio las mejores posibilidades de reconstruccion en cuanto a forma, volumen y flexibilidad, por lo que se recomienda en los defectos pequenos y medianos, sobre todo de la region frontal y areas adyacentes, donde el contorno y la simetria son los 2 aspectos fundamentales que se deben conseguir. El metodo de division, in vitro se utilizo en las reconstrucciones de las deformidades de grandes dimensiones, particularmente en aquellas que no incluian la frente. El indice de complicaciones fue bajo