Leiomioma vulvar em lobo-guará (Chrysocyon brachyurus) - relato de caso / Leiomyoma vulvar in maned wolf (Chrysocyon brachyurus) - case report

Descrição de leiomioma vulvar em lobo-guará (Chrysocyon brachyurus), fêmea, castrada, apresentando 10 anos de idade e mantida em cativeiro. Com base na avaliação clínica, no monitoramento de formação nodular de crescimento lento e progressivo e no diagnóstico preliminar sugestivo de neoplasia, procedeu-se à exérese da massa tumoral e à identificação anatomopatológica do leiomioma. Exames complementares radiográficos e ultrassonográficos não apontaram presença de metástases. A ressecção cirúrgica se mostrou satisfatória como conduta clínica, não havendo recidiva.(AU)

Description of leiomyoma vulvar in a female castrated Chrysocyon brachyurus, , ten years of age, and maintained in captivity. Based on the clinical evaluation, monitoring of nodular formation of slow and progressive growth, and preliminary diagnosis suggestive of neoplasia, the tumor mass was excised and anatomopathological identification of the leiomyoma was done. Complementary radiographic and ultrasound examinations did not indicate the presence of metastases. Surgical resection proved to be satisfactory as a clinical practice, and there was no relapse.(AU)

Detecção molecular de Neospora caninum em macaco-da-noite (Aotus azarae) de vida livre no estado do Mato Grosso: relato de caso / Molecular detection of Neospora caninum in azara's night monkey (Aotus azarae) of wildlife in the state of Mato Grosso: Case report

Estudos indicam, por meio de infecção experimental, que primatas não humanos são susceptíveis à infecção por Neospora caninum. Relata-se um caso de um macaco-da-noite (Aotus azarae infulatus), que apresentou sinais inespecíficos e não respondeu à terapêutica clínica de suporte, evoluindo a óbito, encaminhado em seguida para exame anatomopatológico. Amostras de tecidos foram coletadas e processadas rotineiramente para confecção de lâminas histológicas. Microscopicamente, a principal lesão foi observada no coração e consistia em miocardite necrótica multifocal por protozoário, com a presença de estruturas compatíveis com o estágio de taquizoítos de protozoários dos gêneros Neospora sp. ou Toxoplasma sp. No sistema nervoso central, predominantemente no tronco encefálico, havia estruturas semelhantes às descritas no coração. Os resultados da reação em cadeia pela polimerase (PCR) foram positivos para N. caninum e negativos para Toxoplasma gondii, usando DNA extraído do sangue e dos tecidos. Este relato de caso fornece evidências histológicas e moleculares de que o primata em questão foi susceptível a uma infecção natural, porém estudos devem ser realizados para investigar o real papel dos primatas no ciclo de vida de N. caninum.(AU)

Studies indicate through experimental infection that non-human primates are susceptible to infection by Neospora caninum. This report is of a case of a night monkey (Aotus azarae infulatus) that presented nonspecific signs and did not respond to supportive clinical therapy evolving to death, followed by a pathology examination. Tissue specimens were routinely collected and processed for the preparation of histological slides. Microscopically, the main lesion was observed in the heart and consisted of multifocal necrotic myocarditis by protozoa, with the presence of structures compatible with the stage of protozoan tachyzoites of the genus Neospora sp. or Toxoplasma sp. In the central nervous system, predominantly in the brainstem there were structures similar to those described in the heart. Polymerase chain reaction (PCR) results were positive for N. caninum and was negative for Toxoplasma gondii using DNA extracted from blood and tissues. This case report provides histological and molecular evidence that the primate in question was susceptible to a natural infection, but studies should be conducted to investigate the real role of primates in the life cycle of N. caninum.(AU)

Diagnóstico ecocardiográfico e tratamento de cardiomiopatia dilatada em tamanduá- bandeira ( Myrmecophaga trydactila ) mantido em cativeiro: relato de caso / Echocardiographic diagnosis and treatment of dilated cardiomyopathy in captive giant anteater (Myrmecophaga trydactila): case report

A cardiomiopatia dilatada é uma doença de caráter crônico, que compromete a função cardíaca, resultando em desequilíbrio da circulação sanguínea e da homeostase corporal do animal. Este relato apresenta a evolução do quadro clínico e o tratamento de cardiomiopatia dilatada em um exemplar cativo de tamanduá-bandeira. O animal apresentou quadro clínico de insuficiência cardíaca e foi submetido a duas baterias de exames laboratoriais e de imagem em um período de três meses. Posteriormente, foi iniciado o tratamento com pimobendan e suplementação de taurina, resultando em resposta positiva e melhora dos sinais clínicos do paciente. Os achados ecocardiográficos do caso foram compatíveis com cardiomiopatia dilatada com sinais evidentes de diminuição progressiva das frações de ejeção, bem como encurtamento e aumento expressivo das câmaras cardíacas, quando se comparou este caso ao de cães de grande porte e animais saudáveis da mesma espécie. O tratamento com inotrópico positivo, suplementação dietética de taurina e diuréticos se mostrou eficiente em controlar os sinais clínicos do animal.(AU)

The dilated cardiomyopathy it is a chronic disease that leads to a cardiac dysfunction, resulting in unstable blood circulation and specimen body homeostasis. This description shows the dilated cardiomyopathy evolution and treatment in a giant anteater captive model. The patient presented cardiac insufficient clinical condition and was submitted to two sets of laboratorial and image exams in three months. Furthermore, the treatment started with pimobendam and taurine supplementation, leading to satisfactory response to treatment and clinical improvement. The echocardiographic findings were compatible with dilated cardiomyopathy, moreover clear evidence of progressive reduction at the ejection portions and shortening and expressive increase of the cardiac chamber when compared to large dogs and healthy animals of the same species. Treatment with positive inotropic and taurine dietary supplement revealed as effective in clinical managementr.(AU)

Endoparasites of wild animals from three biomes in the State of Mato Grosso, Brazil / Endoparasitas de animais silvestres de três biomas do Mato Grosso, Brasil

The population of wild animals is regulated by many biotic and abiotic factors, and parasites are a biotic factor that affects the dynamic and density of host populations. From 2002 to 2014, 62 wild animals from the biomes Pantanal, Amazon, and "Cerrado" (or Savanna), which died in attendance in the veterinary hospital or have been road-killed, underwent necropsy for parasitological examination. Overall, 36 species of parasites were identified from 24 host species. Among the parasites, the most prevalent order was Oxyurida (29.1%), followed by Strongylida (20.9%), Spirurida (19.4%), Ascaridida (16.2%), Pentastomida (3.2%), Echinostomida (3.2%), Gygantorhynchia (3.2%), Rhabditida (1.6%), Plagiorchiida (1.6%), and Monilimorfida (1.6%), especially nematodes, which have more biotic potential and is more easily adapted to the environment than other classes. The occurrence of endoparasites was observed more frequently in endothermic than ectothermic animals, and herein is reported eleven new host occurrences for endoparasites in wild animals. The study has contributed to the knowledge on the biodiversity of parasites in wild animals from three biomes in central-western Brazil.(AU)

Populações de animais selvagens são reguladas por diversos fatores bióticos e abióticos, e parasitas são um fator biótico que afetam a dinâmica e a densidade de populações. De 2002 até 2014, 62 animais silvestres provenientes dos biomas Pantanal, Amazônia e Cerrado, que vieram a óbito no atendimento do hospital veterinário ou foram encontrados atropelados em rodovias, foram submetidos à necropsia parasitológica. Ao todo 36 espécies de parasitas foram identificadas em 24 espécies de hospedeiros. Entre os parasitas, a ordem mais prevalente foi Oxyurida (29,1%), seguida por Strongylida (20,9%), Spirurida (19,4%), Ascaridida (16,2%), Pentastomida (3,2%), Echinostomida (3,2%), Gygantorhynchia (3,2%), Rhabditida (1,6%), Plagiorchiida (1,6%) e Monilimorfida (1,6%), destacando-se os nematódeos, por seu maior potencial biótico e facilidade de adaptação ao meio do que as demais classes. A maior ocorrência de endoparasitas foi observada em animais endotérmicos que ectotérmicos, e este estudo registra onze novas ocorrências de hospedeiros para endoparasitas de animais selvagens. O estudo contribui para o conhecimento da biodiversidade de parasitas em animais silvestres dos três biomas do Centro-Oeste do Brasil.(AU)

Tumor de Krukenberg del ovario asociado a teratoma maduro / Krukenberg tumor of the ovary associated with mature teratoma

Se reporta un caso excepcional de tumor de Krukenberg ovárico bilateral asociado a teratoma maduro encontrado en una mujer de 54 años. La ecografía mostró al lado derecho tumor ovárico sólido de 55 mm y al lado izquierdo tumor quístico de 125 mm. Se realizó histerectomía total, salpingooforectomía bilateral, resección del epiplón mayor y muestras peritoneales. Al tercer día postcirugía, la paciente presentó signos de tromboembolismo pulmonar masivo y aunque recibió terapia anticoagulante falleció al quinto día postoperatorio. El estudio histológico mostró infiltración masiva de carcinoma de células en anillo positivas para citoqueratina en ambos ovarios. El ovario derecho mostró la forma sólida clásica del tumor de Krukenberg mientras que el ovario izquierdo correspondió a un quiste dermoide con infiltración tumoral de carcinoma de células en anillo en la pared.

An exceptional case of bilateral Krukenberg tumor of the ovary associated with mature teratoma presented in a 54 years old patient is reported. The ultrasound showed a 55 mm solid right ovarian tumor and a 125 mm left cystic ovarian tumor. Hysterectomy and bilateral salpingoophorectomy was performed including omental resection and peritoneal biopsies. Massive pulmonary embolism was detected in the third day after the surgery. Even anticoagulant therapy was established the patient died in the fifth postoperative day. The histological study revealed massive infiltration of signet ring cell carcinoma with positive expression for cytokeratin in both ovaries. The right ovary showed the classical solid form of the tumor. The left ovary was a dermoid cyst with signet ring cell carcinoma infiltrating the cystic wall.

Hallazgos en resonancia magnética de las malformaciones uterovaginales: datos imprescindibles previos a una intervención quirúrgica / Magnetic resonance imaging findings of uterovaginal malformations: essential data prior to surgical intervention

La caracterización de las malformaciones congénitas del aparato genital femenino ha adquirido gran relevancia, principalmente en mujeres jóvenes con problemas de fertilidad. El origen de estas malformaciones procede de una alteración en el desarrollo embriológico de los conductos de Müller. El manejo terapéutico de estas entidades dependerá tanto del tipo de anomalía como de su gravedad. En la actualidad los múltiples avances tecnológicos en imagen permiten un diagnóstico preciso de estas malformaciones así como una posible planificación quirúrgica. Este trabajo tiene como objetivo revisar la clasificación de las malformaciones müllerianas así como estudiar los hallazgos en resonancia magnética que el cirujano debe conocer previo a la cirugía.

Morphologic characterization of congenital malformations of the female genital tract has acquired great importance, especially in the evaluation of female infertility.The origin of these malformations comes from an alteration in the embryological development of the Müllerian ducts. Technological advances in the field of radiology allow the diagnosis of these malformations, its possible treatment and surgical planning. This paper aims to review the classification of Müllerian anomalies and study the magnetic resonance findings that the surgeon should know prior to possible surgery.

Epidemiologia de candidemia en Córdoba Republica Argentina. Estudio de vigilancia de cinco instituciones / [Candidemia epidemiology in Córdoba Argentina. Surveillance study of five institutions].

UNLABELLED: The incidence rate of invasive infections due to Candida species has increased drastically in the last 20 years, causing a 40

mortality rate in hospitalized patients. In order to comprehend the epidemiology of Candida bloodstream infection, the study was carried out. MATERIALS AND METHODS: A retrospective study was done based on microbiology laboratory reports from five terciary care hospitals from the city of Cordoba between January 2010 and August 2012. RESULTS: 158 patients had candidemia, the average age was 55,8 years, and 54

of patients were in the intensive care unit. Candida albicans (44

) and Candida tropicalis (12

) were the main fungi isolated. Candida parapsilosis was commonly associated with catether infections. CONCLUSIONS: The data from the city of Cordoba showed that C. albicans, C. parapsilosis y C. tropicalis were the more frequent species isolated from blood cultures. This is similar to what is seen in other series published from Argentina and Latinamerica. This study may have implications when it comes to deciding which empiric antifugal agent is best for the treatment of candidemia.

Mecanismos moleculares implicados en la destrucción ósea en la periodontitis: revisión de la literatura / Molecular mechanisms involved in bone destruction in periodontitis: literature review

La periodontitis es una enfermedad inflamatoria crónica multifactorial, la cual se inicia a partir de la biopelícula que se forma alrededor de los dientes y se acumula en margen gingival, colonizando el surco gingival. La complejidad de la biopelícula madura genera estímulos para las células epiteliales e inflamatorias y sobre las demás células del tejido conectivo activando los mecanismos de la respuesta inmune innata y adaptativa. Se reconoce que la acumulación de placa dental genera de forma indefectible gingivitis, pero se desconocen las señales específicas que disparan la periodontitis. Se reconoce también que microorganismos periodontopáticos como Aggregatibacter actynomicetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia, Prevotella nigrescens, entre otros, poseen mediadores osteolíticos que actúan directa o indirectamente en las células del hueso y que son responsables del proceso de remodelación ósea, lo cual desequilibra el eje RANKL-RANK/OPG. Los productos microbianos y la respuesta inflamatoria inducen la secreción de citoquinas específicas como IL-1B, TNFalfa y otros mediadores pro-inflamatorios como PGE2, metalloproteinases, MMP-8, MMP-3, RANKL, además los linfocitos T y B activados inducen la pérdida de hueso alveolar al sintetizar y secretar directamente RANKL. Debido a que la pérdida de hueso alveolar es uno de los signos patognomónicos de la enfermedad periodontal, se hace importante revisar los mecanismos moleculares que explican la destrucción ósea, así como algunos avances en el tratamiento óseo.

Periodontitis is a multifactorial chronic inflammatory disease started by biofilm accumulation around the teeth and the gingival margin including the gingival sulcus. Mature biofilm is complex in microbial nature and it triggers signals to the boundary connective tissue and epithelial cells activating mechanisms of innate and acquired immune response. It is known that the dental plaque accumulation indefectibly results in gingivitis. However the specific signals that lead to periodontitis are unknown. The main periodontopathic organisms are Aggregatibacter actynomicetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia, Prevotella nigrescens among others. Those microorganisms produce osteolytic mediators that act directly and indirectly on bone cells affecting the bone turnover rate, regulated by the axis RANKL-RANK/OPG. Microbial products and periodontal inflammation induce the release of specific cytokines IL-1B, TNFalpha, PGE2, metalloproteinases, MMP-8, MMP-3, RANKL, T and B lymphocytes elicit bone resorption. Indeed, alveolar bone loss is one of the most pathognomonic features of periodontal disease. Therefore it is essential to review the molecular mechanisms explaining periodontal destruction, as well as the advances in bone therapy.

Linfoma de células cutáneas de células T, tipo micosis fungoide folicular: reporte de un caso / Cutaneous T-cell lymphoma type mycosis fungoides follicular: case report

La Micosis Fungoide (MF) es el linfoma cutáneo más común de células T. Tiene un comportamiento indolente, llevando a algunos a utilizar el término de linfoma cutáneo de células T (LLCT) como sinónimo de la MF. Se caracteriza por una erupción cutánea crónica, generalizada, y clínicamente por la evolución de los parches en placas y tumores. A continuación se presentará un caso clínico que tras un diagnóstico de liquen plano refractario a tratamiento, se diagnostica micosis fungoide folicular.

Mycosis fungoides (MF) is recognized as the most common cutaneous T-cell lymphoma (CTCL). It has an indolent behavior, leading some to use the term cutaneous T-cell lymphoma as synonymous of MF. It is characterized by chronic, widespread rash, and clinically by the evolution of patches in plaques and tumors. We describe our experience with a case that after a diagnosis of lichen planus refractory to treatment, we diagnosed follicular mycosis fungoides.

Indicadores de severidad de la craneosinostosis no sindrómica: Cuantificación de malformaciones sagitales y metópicas / Severity indices for non-syndromic craniosynostosis: quantifying sagittal and metopic malformations

En este trabajo se presenta un nuevo conjunto de indicadores de severidad que combinan diversos rasgos craneales para cuantificar las craneosinostosis aisladas de tipo sagital y metópica. La utilidad de los indicadores se evaluó examinando las tomografías computarizadas del cráneo de un grupo de infantes afectados por craneosinostosis aislada y un grupo de infantes no afectados. La base de datos contiene estudios de 90 pacientes con craneosinostosis sagital, 40 con craneosinostosis metópica y 60 pacientes no afectados. Los indicadores de severidad se obtienen a partir de un conjunto de indices de severidad por medio de un método estadístico de regresión logística regularizada conocido como red elástica. Los índices de severidad son medidas univariadas de forma que se calculan a partir de tres planos de análisis. Los planos se estiman a partir de referencias anatómicas cerebrales radiológicamente identificables. El desempeño de los indicadores se midió estimando el grado de separación lineal (GSL), que cuantifica la capacidad de un indicador para distinguir cráneos sagitales o metópicos de cráneos no afectados. Los indicadores de severidad propuestos alcanzan un GSL del 95.83% y 98.9% en las poblaciones sagitales vs. controles y metópicos vs. controles, respectivamente. Los resultados obtenidos en este trabajo sugieren que es posible construir indicadores multivariables de severidad que son clínicamente reproducibles y cuantifican efectivamente aspectos de la morfología craneal codificada por medio de un conjunto de índices de severidad.

This work develops a new set of severity scores that combine several cranial features in order to quantify sagittal and metopic craniosynostosis. Computed tomography head scans were obtained from 90 children affected with single-suture sagittal synostosis, 40 children with single-suture metopic synostosis, and 60 age-matched nonsynostotic controls. Tridimensional reconstructions of the skull were used to trace image analysis planes defined in terms of skull-base plane and internal landmarks. For each patient, a new set of descriptive measures or severity indices of skull shape malformation were computed. A statistical classification approach (regularized logistic regression) was used for combining individual severity indices into summarizing severity scores. The linear separation index that measures the ability of a classification function to separate the affected (sagittal or metopic) and nonsynostotic populations was used to evaluate the severity scores. The proposed scores are sensitive measures of the calvarial malformation that achieve linear separation indices of 95.83% and 98.9% for sagittal vs. control and metopic vs. control populations, respectively. As opposed to individual severity indices, the summarizing severity scores encapsulate a number of distinctive calvarial features associated with sagittal and metopic synostoses crania. The proposed scores enable quantitative analysis in clinical settings of skull features observed in isolated sagittal and metopic synostoses that may not be accurately detected by separate analysis of individual severity indices.

Factores asociados a la recidiva de un neumotórax espontáneo primer episodio: estudio de casos y controles / Factors associated with recurrence of spontaneous pneumothorax first episode: case - control study

INTRODUCCIÓN: El neumotórax espontáneo (NEP) es la presencia de aire en la pleura sin etiología identificable. Después de un primer episodio 30 por ciento recidiva, aún sin consenso del manejo de ambos. Postulamos relación entre datos del paciente consultante por NEP con la recidiva de un neumotórax espontáneo primario primer episodio (NEPPE). OBJETIVO: Identificar características del paciente recidivado del NEPPE (RNEP) versus el paciente sin recidiva. MATERIAL Y MÉTODO: Estudio de casos y controles. Se analizaron datos de pacientes atendidos en el Servicio de Cirugía del Hospital Gustavo Fricke entre Enero de 2006 y Junio de 2010. Nuestro n=41 con 17 casos (16 hombres, mediana edad 21 años) de RNEP y 24 controles (23 hombres, mediana edad 20,5 años) para NEPPE no recidivados. Se describieron datos y se analizó asociación entre variables en función de los casos y controles a través de Odds Ratio. RESULTADOS: Se encontró que los pacientes que debutaron su NEPPE en la temporada de otoño tenían mayor recidiva que las otras temporadas con OR de 7,8 (IC 95 por ciento: 1,40-53,85). El tabaco no muestra asociación con OR de 0,297 (IC 95 por ciento:0,062-1,315). DISCUSIÓN: No se encontró significancia estadística entre otras variables y la recidiva o no del NEPPE. Concluimos que debutar un NEPPE en otoño predispone a RNEP, aunque faltarían estudios con una muestra mayor para establecer conductas. A pesar de que algunos estudios dan importancia al tabaco en la recidiva del NEPPE, no encontramos igual asociación que puede explicarse por la poca gente de nuestro grupo que fumaba.

INTRODUCTION: Spontaneous pneumotorax (SP) is defined as the presence of air into the pleura without recognizable cause. After a first episode of SP, 30 percent of them recur, without consensus about their management. We postulated a relationship between anamnesis and recurrence of a first episode of SP. OBJETIVE: Our aim was to identify characteristics of patients who recurred compared with patients without recurrence. MATERIAL AND METHOD: We analyzed information of patients attended treated in Surgery Service of Gustavo Fricke Hospital between January of 2006 and Juny of 2010. Our patients were 41, with17 patients (16 male, average age of 21) with recurred SP and 24 controls (23 male, average age of 20.5) with non recurred SP. Data were described and relationship between variables in cases and control patients using Odds Ratio was analyzed. RESULTS: Patients with their first episode of SP occurred in autumn were more likely to recur with an OR of 7,8 (CI 95 percent: 1.40-53.85). Smoking did not show relationship with recurrence (OR of 0.297, CI 95 percent 0.062-1.315). Other variables were not statistically significant for recurrence or not of first episode of SP. DISCUSSION: Although more studies with a larger amount of patients are needed to define a proper management, we concluded that a first episode of SP occurred in autumn predisposes a recurrence of this disease. In addition, we did not found relationship between smoking and SP recurrence, maybe because the low prevalence of smoking in our sample, in contrast with some studies which postulate it as a risk factor.

Tuberculosis determined by Mycobacterium bovis in captive waterbucks (Kobus ellipsiprymnus) in São Paulo, Brazil

Two waterbucks from São Paulo Zoo Foundation exhibited respiratory symptoms in July 2004. After euthanasia, granulommas in lungs and mediastinic lymph nodes were observed. Acid-fast bacilli isolated were identified as Mycobacterium bovis spoligotype SB0121 by PRA and spoligotyping. They were born and kept in the same enclosure with the same group, without any contact to other species housed in the zoo. This is the first detailed description of M. bovis infection in Kobus ellipsiprymnus.

Contractura axilar por quemadura tratada con Integra® / Axillary burn contracture treated with Integra®

Introduction: Severe axillary burn is an unusual accident that frequently evolves to contracture generating important cosmetic and functional deficiencies. Contracture scars in this region are difficult to treat because of the anatomic characteristics of the area that has multiple power vectors. Functional restoration has to be one of the main goals in the management of burns in the axilla and flaps have shown high rate of morbidity. Integra® provides satisfactory elasticity and dermal resistance which results in positive functional results. Objective: Analyze the results of the use of Integra® in axillary burn contracture scars at a specialized Burns Center. Materials and Methods: There were 4 patients who underwent reconstructive surgery using Integra® for axillary burn contractures between January 2002 and March 2006. Follow-up was divided into perioperative and late. Early follow-up checked general post-operative evolution and late follow-up was focused on functionality and patient independence evaluated using Barthel's index of daily living activities. Results: There were 3 males and 1 female, average age 27 (18-41) with a minimum follow up of 9 months. There were no perioperative complications and good or very good range of motion results. Conclusions: Our results are similar to artificial skin substitutes used in other anatomical regions.

Las quemaduras axilares severas son un accidente infrecuente que evolucionan a la retracción generando deficiencias cosméticas y funcionales. Estas cicatrices son difíciles de tratar por las características anatómicas del área, donde la corrección de un vector de movimiento puede alterar otro. Objetivo: Mostrar nuestros resultados utilizando el sustituto cutáneo Integra® en el tratamiento de cicatrices retráctiles axilares por quemadura. Pacientes y Métodos: Se recolectaron antecedentes médicos y fotográficos de pacientes portadores de cicatrices retráctiles axilares por quemadura entre enero de 2002 y marzo de 2006 en el Hospital del Trabajador de Santiago. Se evaluó pre y postoperatoriamente a los pacientes en forma subjetiva por fisiatra y con el Test de Barthel. Resultados: Se incluyeron 4 pacientes en el estudio (3 mujeres y 1 hombre), edad media 27 años (18-41). Todas las quemaduras fueron producidas por fuego. Índice de Barthel preoperatorio fue de 87,5 (levemente dependiente para las actividades de la vida diaria) y rango de movimiento moderadamente afectado. En el postoperatorio los pacientes fueron catalogados como independientes según el Test de Barthel y el rango de movimiento fue descrito como bueno o muy bueno por el fisiatra. No hubo complicaciones peri operatorias, Integra® prendió adecuadamente en todos los casos. Los pacientes fueron seguidos en promedio 16 meses (9-22). Conclusiones: Los sustitutos dérmicos han sido usados para la corrección de cicatrices de quemaduras con buenos resultados, pero no hay reportes en la axila. El pequeño número de pacientes que presentamos tienen un excelente resultado funcional, lo que nos estimula a seguir trabajando en este rumbo.

Escisión de la zona de transformación en lesiones de cérvix: análisis de 1.141 casos / Large loop excision of the cervical transformation zone: analysis of 1.141 cases

Objetivo: Analizar los resultados de la escisión de la zona de transformación del cérvix efectuadas en la Unidad de Patología Cervical del Hospital Guillermo Grant de Concepción. Método: Estudio descriptivo, retrospectivo, de los antecedentes clínicos e histológicos de 1.141 casos de escisión electro quirúrgica efectuados entre 1999 a 2005, con seguimiento mínimo de 18 meses. Resultados: De las 3.004 mujeres derivadas por citología positiva para neoplasia y/o HPV, a 1.141 (37,9%) se les realizó escisión de la zona de transformación; 1.113 con asa electroquirúrgica (97,5%) y 28 (2,5%) cono frío con bisturí. Las lesiones intraepiteliales (LIE) de alto grado fueron las más frecuentes (66,7%), seguidas por las LIE de bajo grado (7,8%); el 6,5% de las pacientes presentan etapas iniciales de carcinoma invasor; 33% de las piezas histológicaspresentaron bordes comprometidos; 18,4% no presentaron lesión histológica, que sumadas a 7,8% de LIE de bajo grado representan un 26,2% de mujeres consideradas como sobretratadas. El porcentaje a 18 meses de seguimiento en mujeres con LIE de alto grado fue de 85,5%. Necesitaron de una segunda intervención 194 pacientes (17%), 110 (9,6%) por persistencia y recidivas de la lesión. Conclusión: Los resultados presentados son satisfactorios en el porcentaje de curación de las LIE de alto grado como en el aporte al diagnóstico precoz de carcinomas del cérvix y similares a estudios publicados tanto nacionales como extranjeros.

Objective: To analyze the results of 1,141 cervical excisions. Method: Descriptive and retrospective study of the clinical charts and biopsies of 1,141 cases with surgical resection of the uterine cervix performed from 1999 to 2005. Only patients with a minimum of 18 months of follow up were included. Results: From 3,004 patients with a positive Papanicolaou smear for neoplastic cells and/or condyloma, 1,113 (97.5%) were treated with loop electrosurgical excisional procedure (LEEP) and 28 (2.5%) with cold-knife conization. The most frequent lesion (66.7%) found was high grade squamous intraepithelial lesions (SIL), follow by low grade SIL (7.8%); 74 patients (6.5%) presented with early stage of squamous cell carcinoma and 377 (33%) of the histological specimens revealed positive margins; 210 (18.4%) of the cases showed no histological lesion. There were a 26.2% of females that were considered to receive over treatment. After 18 months follow up 85.5% of patient were free of high grade SIL. A second surgical treatment was done in 194 patients (17%) including 110 cases (9.6%) with persistent or recurrence of the lesion. Conclusions: The results are satisfactory related to treatment of high grade SIL and it contributes to the early diagnosis of cervical cancer. The results are similar to other national and international series previously published.

Agonistic-like responses from the torus semicircularis dorsalis elicited by GABA A blockade in the weakly electric fish Gymnotus carapo

Findings by our group have shown that the dorsolateral telencephalon of Gymnotus carapo sends efferents to the mesencephalic torus semicircularis dorsalis (TSd) and that presumably this connection is involved in the changes in electric organ discharge (EOD) and in skeletomotor responses observed following microinjections of GABA A antagonist bicuculline into this telencephalic region. Other studies have implicated the TSd or its mammalian homologue, the inferior colliculus, in defensive responses. In the present study, we explore the possible involvement of the TSd and of the GABA-ergic system in the modulation of the electric and skeletomotor displays. For this purpose, different doses of bicuculline (0.98, 0.49, 0.245, and 0.015 mM) and muscimol (15.35 mM) were microinjected (0.1 æL) in the TSd of the awake G. carapo. Microinjection of bicuculline induced dose-dependent interruptions of EOD and increased skeletomotor activity resembling defense displays. The effects of the two highest doses showed maximum values at 5 min (4.3 ± 2.7 and 3.8 ± 2.0 Hz, P < 0.05) and persisted until 10 min (11 ± 5.7 and 8.7 ± 5.2 Hz, P < 0.05). Microinjections of muscimol were ineffective. During the interruptions of EOD, the novelty response (increased frequency in response to sensory novelties) induced by an electric stimulus delivered by a pair of electrodes placed in the water of the experimental cuvette was reduced or abolished. These data suggest that the GABA-ergic mechanisms of the TSd inhibit the neural substrate of the defense reaction at this midbrain level.

Effect of the establishment of dominance relationships on cortisol and other metabolic parameters in Nile tilapia (Oreochromis niloticus)

The objective of the present study was to investigate the influence of the establishment of dominance relationships and social stress on plasma cortisol and metabolite levels in Nile tilapia (Oreochromis niloticus). During the 30-day experiment, the fish weighing 236 ± 29 g were kept in individual aquaria, except for two pairings lasting 6 h each. Blood samples were taken from the animals before and after pairing. Display, approach, attack, rebuff, chase flight, and coloration were carried out on days 16 and 30. Activities and behaviors characteristic of the establishment of dominance relationships were described. It was possible to classify all experimental fish (N = 30) as dominant or subordinate. No differences were detected between dominant (N = 15) and subordinate (N = 15) fish during isolation or after pairing in cortisol (isolated: 5.76 ± 0.98 vs 5.42 ± 0.63; paired: 10.94 ± 1.62 vs 11.21 ± 2.45 æg/dl), glucose (isolated: 60.02 ± 4.9 vs 67.85 ± 16.16; paired: 110.44 ± 15.72 vs 136.26 ± 22.46 mg/dl), triglyceride (isolated: 167.87 ± 5.06 vs 185.68 ± 7.24; paired: 210.85 ± 13.40 vs 221.82 ± 12.70 mg/dl) or total protein levels (isolated: 7.01 ± 0.42 vs 6.69 ± 0.59; paired: 9.21 ± 0.62 vs 9.51 ± 0.66 g/dl). However, when isolated (N = 30) and paired (N = 30) tilapia were compared, there were significant differences in cortisol and metabolite levels. The similar response presented by dominant and subordinate tilapia indicates that establishment of dominance relationships was a stressor for both groups.

Tratamiento de la infertilidad por síndrome de ovario poliquístico mediante electropunciones ováricas múltiples vía laparoscópica / Treatment of the infertility caused by polycystic ovary syndrome using laparoscopic ovarian electrocautery

Se presentan los resultados, en función de recuperación de la ovulación y embarazo, de la electrocauterización o electropunción múltiple laparoscópica de los ovarios (EPOM) en pacientes infértiles anovulatorias con síndrome de ovarios poliquísticos (SOP), refractarias al citrato de clomifeno (CC). Se estudiaron fichas de 27 pacientes con un período de observación de 18 meses para evaluar resultados. Veinticinco pacientes completaron el período de observación; 2 abandonaron el control. Se logró embarazo en 15 pacientes (60 por ciento). El 60 por ciento de éstos se produjo antes de 6 meses y 85 por ciento en el lapso de 10 meses post EPOM. Veinte pacientes recuperaron la ovulación (74 por ciento). se confirma, como en otras publicaciones, que la electropunción ovárica por laparoscopia es efectiva y se presenta como una alternativa de tratamiento en las pacientes con infertilidad anovulatoria por SOP refractaria al CC y sin otros factores de infertilidad

Cáncer de uretra femenino / Cancer of the female urethra

Se presentan dos casos de pacientes portadoras de cáncer de uretra, ambos carcinomas de células transicionales, en diferente etapa de propagación tumoral, presentación clínica, tratamiento y resultado final. Se comenta incidencia, principales tipos histológicos y diferentes vías de tratamiento de acuerdo a la literatura médica

Estudio del grado de satisfacción con el equipo de salud de pacientes portadoras de patología de cuello uterino / Study of satisfaction grades with health staff of uterine cervix pathology patients

El objetivo del estudio fue evaluar a través de una encuesta, midiendo calidad, el grado de satisfacción que relatan 253 pacientes tratadas y controladas entre 1989-1998. 82 pacientes tenían neoplasia intraepitelial (NIE), 63 con cáncer cérvico-uterino y 108 con patología no neoplásica, grupo control (GC). Los resultados de 46 variables se analizaron en tablas de contingencia aplicando chi cuadrado. En general la información es dada por el médico en 82,6 por ciento y por la matrona en el grupo NIE en 50,4 por ciento de casos. Solo en 34,4 por ciento de casos es informada la pareja, cifra que aumenta en el grupo de cáncer, en que el médico conversa o explica a 41,3 por ciento de cónyuges o familiares. La información fue considerada incomprensible o parcialmente comprensible por el 29,6 por ciento de las pacientes. El 5,1 por ciento de pacientes (13/253) son analfabetas, 11 de las cuales consideraron incomprensible la información. Las pacientes del GC mostraron mayor confianza en el equipo de salud, comparadas con los otros 2 grupos. Se concluye que es necesario mejorar la información entregada, complementando con otros métodos educativos escritos o audiovisuales, principalmente en el grupo de cáncer, con el fin de optimizar la atención