Factores de riesgo cardiometabólico y tratamiento antitrombótico en población mexicana con fibrilación auricular e insuficiencia cardiaca con fracción de expulsión reducida / Cardiometabolic risk factors and antithrombotic treatment in a Mexican population with atrial fibrillation and heart failure with reduced ejection fraction

Resumen Introducción: La insuficiencia cardiaca en pacientes con fibrilación auricular no valvular (FANV) es de dos a tres veces más frecuente que en individuos sin FANV. Objetivo: Identificar los factores de riesgo cardiometabólico (FRCM) y el tratamiento antitrombótico de pacientes con FANV e insuficiencia cardiaca con fracción de expulsión reducida (IC-FEr), y determinar si existen diferencias conforme al sexo. Métodos: En forma global y de acuerdo con el sexo se analizaron FRCM, riesgo protrombótico, riesgo de sangrado y terapia antitrombótica. Resultados: De 1423 pacientes con FANV, 336 tuvieron IC-FEr. Las mujeres promediaron mayor edad que los hombres. No hubo diferencia entre los sexos respecto al tipo de FANV o uso de anticoagulantes orales directos. La hipertensión arterial sistémica fue más frecuente en mujeres. Un 3.6 % de los pacientes reportó antecedente de ataque isquémico transitorio y 10 % de evento vascular cerebral, sin diferencias en cuanto al sexo. El porcentaje de hombres con riesgo embólico elevado fue mayor, pero sin tratamiento antitrombótico, en comparación con las mujeres. Conclusiones: Se encontraron diferencias significativas de acuerdo con el sexo en pacientes con FANV e IC-FEr, tanto en FRCM y algunas comorbilidades, como en el tratamiento antitrombótico de acuerdo con el riesgo embólico y de sangrado.

Abstract Introduction: Heart failure in patients with non-valvular atrial fibrillation (NVAF) is two to three times more common than in individuals without NVAF. Objective: To identify cardiometabolic risk factors (CMRF) and antithrombotic treatment in patients with NVAF and heart failure with reduced ejection fraction (HFrEF), and to determine if there were differences according to gender. Methods: CMRF, pro-thrombotic risk, bleeding risk, and antithrombotic therapy were globally analyzed and according to gender. Results: Out of 1,423 patients with NVAF, 336 had HFrEF. On average, females were older than males. There was no difference between genders with regard to the type of NVAF or direct oral anticoagulants use. Hypertension was more common in women. History of transient ischemic attack was reported in 3.6% of the patients and cerebrovascular event in 10%, without differences in terms of gender. The percentage of men with elevated embolic risk was higher, but without antithrombotic treatment, in comparison with women. Conclusions: Significant differences were found according to gender in patients with NVAF and HFrEF, both in CMRF and some comorbidities, as well as in antithrombotic treatment according to embolic and bleeding risk.

Reports of Guillain–Barre Syndrome Following COVID-19 Vaccination in the USA: An Analysis of the VAERS Database

Background@#and PurposeAn association between Guillain–Barre syndrome and its variants (GBS/V) and vaccines has led to hesitancy toward vaccination. COVID-19 vaccines could theoretically provoke GBS/V via immune activation. We analyzed reports of GBS/V after COVID-19 vaccination in the vaccine adverse event reporting system (VAERS). @*Methods@#The VAERS database is a surveillance system used to report vaccination events in the USA, and is open for consumers and physicians to access. It was queried for reports of GBS/V following COVID-19 vaccination. Reports were reviewed by four neurologists. Modified diagnostic criteria were used to classify reports into definite, possible, and not GBS/V or insufficient data. Descriptive statistics were used to describe the sample, chi-square tests and one-way ANOVAs were used to compare intergroup differences, and t-test were used to compare group means. @*Results@#In 2021, 815 reports of GBS/V were filed. The completion rate for the variables in VAERS was 93.5%. The median age was 55 years (interquartile range [IQR]=5–86 years) and 50% of the subjects were male. The median time of onset was 10 days (IQR=0–298 days), 11% reported onset on the day of vaccination, and 13% reported onset after 6 weeks. Hospitalization was reported by 77%, with a median stay of 7 days (IQR=1–150 days). Lack of recovery, permanent disability, and death constituted 57%, 46%, and 2% of the reports, respectively. Based on GBS/V criteria, 47% of the cases were definite, 16% were possible, and 37% were not GBS/V or insufficient data. An alternate diagnosis was provided in 9% of cases. @*Conclusions@#GBS/V reports following COVID-19 vaccination were common, but many occurred outside of the expected timelines for GBS/V. Only 47% of cases represented definite GBS/V.

Risk factors for failure after primary vitrectomy with no scleral buckling for rhegmatogenous retinal detachment / Fatores de risco para falha de tratamento após vitrectomia primária sem retinopexia com introflexão escleral

ABSTRACT Objective To assess pre-operative conditions that could influence primary anatomical success rate in a cohort of patients with rhegmatogenous retinal detachments (RRD) treated with primary vitrectomy and no scleral buckling. Methods A retrospective analysis was performed in a group of patients that underwent primary pars plana vitrectomy with gas tamponade and without scleral buckling for RRD between 2014 and 2019, with a minimum follow-up of 4 months. Results 305 eyes of 301 patients were included; 59.01% eyes were phakic, 39.01% were pseudophakic and 1.96% aphakic. 13.11% of patients had proliferative vitreoretinopathy grade B and 3.28% proliferative vitreoretinopathy grade C at the time of diagnosis while 83.61% had proliferative vitreoretinopathy grade 0 or A. 53.1% had superior breaks, 15.4% inferior breaks and 31.5% a combination of both. Primary success rate was obtained in 90.82% of eyes (95%CI 87.58-94.06). 9.18% of eyes (95%CI 5.94-12.42) re-detached. In 3.27% the cause of re-detachment was proliferative vitreoretinopathy, and in the remaining 5.90% because of a new or a missed break, the leakage of a previously treated break, or an area of shallow peripheral detachment with no detectable break. Of 181 phakic eyes, 10.49% re-detached, whereas in over 126 aphakic or pseudophakic eyes 7.75% re-detached (p=0.42). 16.39% eyes of the entire cohort had preoperative grade B or C proliferative vitreoretinopathy, whereas 32.14% of re-detached eyes had preoperative grade B or C proliferative vitreoretinopathy (95%CI 17.29-46.99; p=0.02). Th eyes that re-detached after the first surgery had a mean of 2.5 (95%CI 1.86-3.13) retinal tears, against a mean of 1.87 (95%CI 1.73-2.00) retinal tears of those that did not re-detach after the first surgery (p=0.02). Conclusion We found location of breaks and lens status to be independent factors not related to a lower single operation success rate, whereas the number or size of breaks and preoperative proliferative vitreoretinopathy stages B or C were independent factors related to a higher likelihood of re-detachment.

RESUMO Objetivo Avaliar condições pré-operatórias que poderiam influenciar a taxa de sucesso anatômico primário em uma coorte de pacientes com descolamento de retina regmatogênico tratada com vitrectomia primária e sem introflexão escleral. Métodos Foi realizada uma análise retrospectiva em um grupo de pacientes submetidos a vitrectomia primária pars plana com tamponamento gasoso e sem introflexão escleral por desprendimento de retina regmatogênico entre os anos 2014 e 2019, com monitoramento mínimo de 4 meses. Resultados Foram incluídos 305 olhos de 301 pacientes; 59,01% dos olhos eram fáquicos, 39,01% eram pseudofáquicos, e 1,96% era afáquico; 13,11% dos pacientes tinham vitreorretinopatia proliferativa grau B, e 3,28%, vitreorretinopatia proliferativa grau C no momento do diagnóstico, enquanto 83,61% tinham vitreorretinopatia proliferativa grau 0 ou A; 53,1% tinham rasgaduras superiores; 15,4%, rasgaduras inferiores e 31,5%, uma combinação de ambas. A taxa de sucesso primário foi obtida em 90,82% dos olhos (IC95% 87,58-94,06); 9,18% dos olhos (IC95% 5,94-12,42) se redestacaram. Em 3,27%, a causa do redescolamento foi vitreorretinopatia proliferativa e, nos 5,90% restantes, por causa de uma ruptura nova ou perdida, o vazamento de uma ruptura previamente tratada, ou uma área de descolamento periférico superficial sem ruptura detectável. Dos 181 olhos fáticos, 10,49% redestacaram-se, enquanto em mais de 126 olhos afáquicos ou pseudofáquicos 7,75% redestacaram-se (p=0,42); 16,39% dos olhos de toda a coorte tinham vitreorretinopatia proliferativa pré-operatória grau B ou C, enquanto 32,14% dos olhos redescolados tinham vitreorretinopatia proliferativa pré-operatória grau B ou C (IC95% 17,29-46,99) (p=0,02). Os olhos que se redescolaram após a primeira cirurgia tiveram média de 2,5 (IC95% 1,86-3,13) lágrimas retinianas, contra uma média de 1,87 (IC95% 1,73-2,00) lágrima retiniana daqueles que não se redestacaram após a primeira cirurgia. (p=0,02). Conclusão A localização das rasgaduras e o status da lente são fatores independentes não relacionados a uma menor taxa de sucesso da operação, enquanto o número ou o tamanho das rasgaduras e estágios vitreorretinopatia proliferativa pré-operatórios B ou C foram fatores independentes relacionados a uma maior probabilidade de redescolamento.

Incidence of perioperative delirium at the hospital nacional arzobispo loayza, october to December 2021, Lima Peru / Incidencia de delirium perioperatorio en el Hospital Nacional Arzobispo Loayza, octubre a diciembre 2021, Lima Perú

OBJETIVO: Determinar la incidencia de delirium perioperatorio (DPO) en el Hospital Nacional "Arzobispo Loayza", de octubre a diciembre del 2021. MÉTODOS: Estudio observacional cualicuantitativo y prospectivo, realizado en una población de 910 pacientes, en los que se aplicó: AMT Test Confussion Assessment Method (CAM) y el cuestionario de Pfeiffer (Short Portable Mental Status Questionnaire, SPMSQ). Utilizamos Chi2 para demostrar la existencia de asociación y las pruebas de V de Cramer y Phi para cuantificar la intensidad de dicha relación en caso existiera. RESULTADOS: Del total de pacientes (910) el 18,46% presentaron de delirium perioperatorio. El sexo y la religión no influye en esta. La edad si influye en la presentación del DPO puesto que el 50% (145) de los pacientes de 61 años o más la presentaron, a diferencia de los que tenían entre 36 -60 años solo el 5,31 % y los de 18 ­ 35 solo el 0,88 % presentaron DPO. Según el nivel de instrucción: el 100% sin instrucción presentaron DPO, el 73,1 con primaria presentaron DPO, el 18,5 con secundaria presentaron DPO y el 5,8 % con educación superior presentaron DPO. Según la técnica anestésica se encontró DPO en el 28,9% (60) del tipo raquídea con sedación, el 22,4% (11) del tipo epidural con sedación, el 16,7% (83) del tipo General TIVA TCI, el 12,9% (4) del tipo Bloqueo con sedación, el 9,5% (10) del tipo General balanceada; para los tipos de anestesia General TIVA manual, General Multimodal y Raquídea sin sedación no se presentaron casos de DPO. Según el tiempo operatorio: el 100% (9) de los pacientes con más de 6 horas de tiempo operatorio, el 27,1% (38) de los pacientes que tienen de 3 a 6 horas de tiempo operatorio y el 16,5% (121) de los pacientes que tienen de 1 a 3 horas de tiempo operatorio presentaron casos de DPO. Según el tiempo de hospitalización previo a la cirugía: el 48% (36) de los pacientes con tiempo de hospitalización de 16 a 30 días, el 20,5% (26) de los pacientes con tiempo de hospitalización de 8 a 15 días y el 16% (97) de los pacientes con tiempo de hospitalización de 3 a 7 días presentaron casos de DPO. Según la presencia de comorbilidades: el 51,6% (16) que tienen HTA y ER, el 41,7% (30) que tienen Diabetes y el 40,8% (20) que tienen HTA y DM2 presentan casos de DPO. Según presencia de demencia: el 100% (6) de los pacientes que tienen historia de demencia y el 17,9% (162) de los pacientes que no tienen historia de demencia presentaron DPO. según historia de antecedentes psiquiátricos, el 68,4% (13) de los que si tienen historia de trastorno psiquiátrico y el 17,4% (155) de los que no tienen historia de trastorno psiquiátrico presentaron DPO. Según historia de tratamiento psiquiátrico: el 100% (6) de los que si tienen historia de tratamiento y el 17,9% (162) de los que no tienen historia de tratamiento psiquiátrico presentaron DPO. Según cuestionario PFEIFFER pre-quirúrgico y post-quirúrgico: el 100% de los que tienen deterioro cognitivo leve, moderado o severo según el cuestionario PFEIFFER PRE QX presentaron DPO. Según diagnóstico de delirio pre-quirúrgico y post-quirúrgico: el 100% presentaron DPO. CONCLUSIONES: No existe una asociación entre el sexo y la religión y la presentación de DPO. Si existe una asociación entre la edad, grado de instrucción, tipo de anestesia, tiempo operatorio, tiempo de hospitalización previo a la cirugía, comorbilidades, historia de demencia, historia de trastorno psiquiátrico, historia de tratamiento psiquiátrico, cuestionario Pfeiffer pre, post quirúrgico, delirio pre quirúrgico y delirio post quirúrgico y la presentación de DPO,

OBJECTIVE: To determine the incidence of perioperative delirium (POD) at the Hospital nacioanl Arzobispo Loayza, from October to December 2021. METHODS: Qualitative and prospective observational study, carried out in a population of 910 patients, in which the AMT Test Confusion Assessment Method (CAM) and the Pfeiffer questionnaire (Short Portable Mental Status Questionnaire, SPMSQ) were applied. We used Chi2 to demonstrate the existence of association and Cramer's V and Phi tests to quantify the intensity of said relationship if it existed. RESULTS: Of the total of patients (910), 18.46% presented perioperative delirium. Sex and religion do not influence this. Age does influence the presentation of POD since 50% (145) of the patients 61 years of age or older presented it, unlike those between 36 -60 years of age only 5.31% and those of 18 - 35 only 0.88% presented POD. According to the level of education: 100% with no education, 73.1% with primary education, 18.5% with secondary education and 5.8% with higher education, presented DPO. According to the anesthetic technique, POD was found in 28.9% (60) of the spinal type with sedation, 22.4% (11) of the epidural type with sedation, 16.7% (83) of the General TIVA TCI type, 12.9% (4) of the Block type with sedation, 9.5% (10) of the General balanced type; for the types of general anesthesia manual TIVA, General Multimodal and Spinal anesthesia without sedation there were no cases of POD. According to the operative time: 100% (9) of the patients with more than 6 hours of operative time, 27.1% (38) of the patients who have 3 to 6 hours of operative time and 16.5% (121) of the patients who have 1 to 3 hours of operative time presented cases of POD. According to hospitalization time prior to surgery: 48% (36) of patients with hospitalization time of 16 to 30 days, 20.5% (26) of patients with hospitalization time of 8 to 15 days and 16% (97) of the patients with hospitalization time of 3 to 7 days presented POD. According to the presence of comorbidities: 51.6% (16) with AHT and RD, 41.7% (30) with Diabetes and 40.8% (20) with AHT and DM2 present POD. According to the presence of dementia: 100% (6) of the patients with a history of dementia and 17.9% (162) of the patients with no history of dementia presented POD. According to psychiatric history, 68.4% (13) of those who did have a history of psychiatric disorder and 17.4% (155) of those who did not have a history of psychiatric disorder presented POD. According to history of psychiatric treatment: 100% (6) of those who do have a history of treatment and 17.9% (162) of those who do not have a history of psychiatric treatment presented POD. According to the pre-surgical and post-surgical PFEIFFER questionnaire: 100% of those with mild, moderate or severe cognitive impairment according to the PFEIFFER PRE QX questionnaire presented POD. According to diagnosis of pre-surgical and post-surgical delirium: 100% presented POD. CONCLUSIONS: There is no association between sex and religion and the presentation of POD. If there is an association between age, educational level, type of anesthesia, operative time, hospitalization time prior to surgery, comorbidities, history of dementia, history of psychiatric disorder, history of psychiatric treatment, pre-, post-surgical Pfeiffer questionnaire, pre-surgical delirium and post-surgical delirium and the presentation of POD,

Hepatocarcinoma sobre hígado ectópico intratorácico / Hepatocellular carcinoma in intrathoracic ectopic liver tissue

RESUMEN La presencia de tejido hepático ectópico es una situación inusual que se corresponde con alteraciones en la embriogénesis hepática. Suelen encontrarse de manera incidental y cobran particular importancia por su mayor potencial carcinogénico. El tratamiento de este tipo de patología es habitualmente quirúrgico. Se presenta el caso de una paciente femenina de 27 años que manifestó dolor torácico dorsal; por presentar además una formación evidenciable en la tomografía computarizada se decidió conducta quirúrgica. Asimismo se realiza una revisión bibliográfica del tema.

ABSTRACT Ectopic liver tissue is a rare finding due to aberrant migration of hepatic cells during embryonic development that is mostly found incidentally and has particular relevance because of its significant carcinogenic potential. Surgical management is usually indicated. We report the case of a 27-year-old female patient with thoracic back pain and a mass in the computed tomography scan who underwent surgery. A bibliographic review is also presented.

Chemical composition and antifungal properties of commercial essential oils against the maize phytopathogenic fungus Fusarium verticillioides / Composición química y propiedades antifúngicas de aceites esenciales comerciales contra el hongo fitopatógeno de maíz Fusarium verticillioides

ABSTRACT The aim of the present study was to analyze the chemical composition ofCurcuma longa,Pimenta dioica,Rosmarinus officinalis, andSyzygiumaromaticumessential oils (EOs) and their antifungal and anti-conidiogenic activity againstFusarium verticillioides. The chemical profile of the EOs was determined by GC/MS. The antifungal and anti-conidiogenic activities were evaluated by the agar dilution method. The tested concentrations were 1000ppm, 500ppm, 250ppm and 125ppm.S. aromaticumEO exhibited the highest antifungal effect, followed byP. dioicaand to a lesser extentC. longa. The major compounds of these EOs were eugenol (88.70% inS. aromaticumand 16.70% inP. dioica), methyl eugenol (53.09% inP. dioica), and α-turmerone (44.70%), β-turmerone (20.67%), and Ar-turmerone (17.27%) inC. longa.Rosmarinus officinalispoorly inhibited fungal growth; however, it was the only EO that inhibited conidial production, with its major components being 1,8-cineole (53.48%), α-pinene (15.65%), and (−)-camphor (9.57%). Our results showed that some compounds are capable of decreasing mycelial growth without affecting sporulation, and vice versa. However, not all the compounds of an EO are responsible for its bioactivity. In the present work, we were able to identify different major compounds or mixtures of major compounds that were responsible for antifungal and anti-conidiogenic effects. Further experiments combining these pure components are necessary in order to achieve a highly bioactive natural formulation against the phytopathogenic fungusF. verticillioides.

RESUMEN El objetivo del presente estudio fue analizar la composición química de los aceites esenciales (AE) deCurcuma longa,Pimenta dioica,RosmarinusofficinalisySyzygiumaromaticum, y su actividad antifúngica y anti-esporuladora contraFusarium verticillioides. La composición de los AE se analizó por CG-EM. La actividad antifúngica y anti-esporuladora se evaluó a través del método de dilución en agar usando las siguientes concentraciones: 1.000, 500, 250 y 125ppm. El AE deS. aromaticumdemostró el mayor efecto antifúngico, seguido del deP. dioicay, en menor medida, delC. longa. Los compuestos principales de estos AE fueron eugenol (88,70% enS. aromaticumy 16,70% enP. dioica), metileugenol (53,09% enP. dioica) y α-turmerona (44,70%), β-turmerona (20,67%) y Ar-turmerona (17,27%) enC. longa. El AE deR. officinalisfue el que menor efecto inhibitorio presentó sobre el crecimiento fúngico, pero fue el único que inhibió la producción de conidias; sus principales componentes fueron 1,8-cineol (53,48%), α-pineno (15,65%) y (−)-alcanfor (9,57%). Nuestros resultados demostraron que algunos compuestos son capaces de disminuir el crecimiento del micelio deF. verticillioidessin afectar la esporulación, y vice versa. Sin embargo, no todos los compuestos de un AE son responsables de su bioactividad. En el presente trabajo, pudimos identificar diferentes compuestos o mezclas de compuestos que fueron responsables de los efectos antifúngicos y anti-esporuladores. Se necesitan nuevos experimentos que evalúen la combinación de estos compuestos puros para lograr una formulación bioactiva y de origen natural para el control deF. verticillioides.

Tromboembolismo pulmonar como forma de presentación de neurofibrosarcoma cardíaco

RESUMEN Los tumores cardíacos pueden provocar síncope, falla cardíaca, fenómenos embólicos y muerte. Se requiere un elevado índice de sospecha debido a la similitud clínica con otras enfermedades sistémicas. Se describe el caso de una mujer de 26 años que empezó con dificultad respiratoria, tos, expectoración hemoptoica, hipotensión arterial y manifestaciones de insuficiencia cardíaca a predominio derecho. La ecocardiografía mostró una masa tumoral en aurícula derecha y múltiples imágenes de trombos a nivel del tronco de la arteria pulmonar, con signos de disfunción ventricular derecha e hipertensión pulmonar grave. Fue intervenida quirúrgicamente, pero el tumor era irresecable, pues infiltraba el pericardio y la vena cava inferior. La paciente falleció un día después de la operación. El estudio histológico confirmó que el tumor era un neurofibrosarcoma.

ABSTRACT Cardiac tumors can cause syncope, heart failure, embolic events, and death. A high index of suspicion is required due to the clinical similarity with other systemic diseases. Here is described the case of a 26-year-old woman who began with respiratory distress, cough, hemoptoic expectoration, low blood pressure and manifestations of heart failure predominantly on the right. The echocardiography showed a tumor mass in the right atrium and multiple images of thrombi at the level of the pulmonary artery trunk, with signs of right ventricular dysfunction and severe pulmonary hypertension. She underwent surgery, but the tumor was unresectable, as it infiltrated the pericardium and the inferior vena cava. The patient died one day after surgery. The histological study confirmed that the tumor was a neurofibrosarcoma.

Digital Planning on Guided Endodontics Technology

Abstract The aim of this review is to discuss the digital planning and the use of guided technology in Endodontics. The complexity of the root canals anatomy and the challenges in the microorganism's control represent risk factors for failure after the infected root canal's treatment. Scientific improvements associated with technological advances have enabled better predictability of therapeutic procedures results. The development of efficient and modern devices provided safer root canal treatments, with shorter clinical visits and greater patient comfort. Digital endodontics incorporated different tools and developed its own, advancing even further in resolving complex cases. The faithful copy of the internal anatomy provided by the advancement of CBCT devices and software's, associated with the digital resources of 3D planning and printing, enabled the advent of guided endodontics. This technique is used at different stages of endodontic treatment, with specific indications and greater result predictability. Therefore, this study critically reviewed the potential clinical application of this guided access technique, and the operative steps for its safe performance in managing complex endodontic cases. The main indications are accessing calcified root canals, performing endodontic surgeries in difficult access areas, removing fiberglass posts, and accessing teeth with developmental anomalies. In summary, guided endodontics has been a precise strategy, effective, safe, and clinically applicable. This procedure represents incorporating technological resources and digital planning in the Endodontist clinical practice, increasing predictability to complex cases.

Resumo O objetivo desta revisão é discutir o planejamento digital e o uso da tecnologia guiada em Endodontia. A complexidade e variabilidade da anatomia dos canais radiculares, em conjunto com o desafio no processo de sanificação e controle de micro-organismos representam fatores de risco ao fracasso após o tratamento dos canais radiculares infectados. O aprimoramento técnico-científico e os avanços tecnológicos tem possibilitado uma melhor previsibilidade de resultados nos procedimentos terapêuticos. O desenvolvimento de ferramentas de trabalho eficientes e modernas proporcionou tratamentos endodônticos seguros, com menor tempo clínico operacional e maior conforto ao paciente. A endodontia digital incorporou diferentes ferramentas e desenvolveu suas próprias, avançando ainda mais na resolução de casos complexos. A cópia fiel da anatomia interna proporcionada pelo avanço dos aparelhos e softwares de TCFC, associada aos recursos digitais de planejamento e impressão 3D possibilitaram o surgimento da endodontia guiada. Esta técnica é utilizada em diferentes etapas do tratamento endodôntico, com indicações específicas e maior previsibilidade de resultados. Este estudo revisou criticamente o potencial de aplicação clínica da técnica de acesso guiado, e os passos operatórios para sua realização de forma segura no manejo de casos endodônticos complexos. As principais indicações da Endodontia Guiada incluem o acesso a canais radiculares calcificados; as cirurgias parendodônticas em áreas de difícil acesso; a remoção de pinos de fibra de vidro; e o acesso a dentes com anomalias de desenvolvimento. Em síntese, a endodontia guiada é uma técnica precisa, eficaz e de fácil aplicação clínica. Esta técnica representa a incorporação dos recursos tecnológicos e planejamentos digitais do Endodontista, dando maior previsibilidade aos casos em que é aplicada na prática clínica.

Prepartum anionic diet induces hyperchloremic acidosis in high-producing dairy cows without preventing subclinical hypocalcemia / Dieta aniônica pré-parto provoca acidose hiperclorêmica em vacas leiteiras de alta produção mas não evita a hipocalcemia subclínica

In this study we evaluated the effects of the prepartum anionic diet on the electrolyte balance and calcemia of high producing dairy cows in the first days of lactation, and investigated the impact on the frequency of subclinical hypocalcemia (SCH). Sixty healthy Holstein cows, producing 30 kg of milk/day, handled in intensive system (compost barn), were distributed in groups (n=15) according to lactation order: first, second, third, and fourth to sixth. In the last three weeks before calving they received a diet with negative DCAD (-6mEq/100g DM) and high chloride content. After calving, they received a diet with positive DCAD (18mEq/100g DM). Urine pH was measured before calving. Serum Na+, Cl-, K+, and total Ca concentrations, and the strong ion difference (SID3) were determined in samples taken soon after calving (0h), 24, 48, 72 and 96h after. The frequencies of SCH were determined considering the critical value of 2.125mmol/L (8.5mg/dL). Two-way repeated measures ANOVA and chi-square test were used for comparisons. The cows eliminated acidic urine before calving. Na+, K+, Cl-, and SID3 values did not differ between groups. Na+ and K+ did not vary between days; Cl- was elevated at calving and decreased until 72h; and SID3 was reduced at calving and increased up to 48h. The Ca levels were reduced until 24h and increased up to 72h. Cows of third and fourth to sixth lactations presented lower values up to 24h. SCH was observed in almost half of the cows (43.3% to 55%) until 48h. The maintenance of hypocalcemia for three or more consecutive days occurred in 53.3% of third and fourth to sixth lactations cows. Ingestion of a high chloride prepartum anionic diet led to hyperchloremic acidosis and this imbalance was reversed on the second postpartum day. The induced effects on electrolyte and acid-base balances were not able to prevent the occurrence of SCH in the first days of lactation.(AU)

Os objetivos do estudo foram avaliar os efeitos que a dieta aniônica pré-parto provoca sobre o equilíbrio eletrolítico e sobre a calcemia de vacas leiteiras de alta produção nos primeiros dias de lactação, e verificar o impacto sobre a frequência da hipocalcemia subclínica (HSC). Sessenta fêmeas hígidas HPB, com produção de 30 kg de leite/dia, manejadas em sistema intensivo (compost barn), foram distribuídas por grupos (n=15) de acordo com a ordem de lactação: primeira, segunda, terceira e quarta a sexta. Nas três semanas pré-parto receberam dieta com DCAD negativa (-6mEq/100g MS) e teor de cloreto elevado. Após o parto receberam dieta com DCAD positiva (18mEq/100g MS). O pH da urina foi mensurado antes do parto. As concentrações séricas de Na+, Cl-, K+ e Ca total e a diferença de íons fortes (SID3) foram determinadas em amostras colhidas ao parto (0h), 24, 48, 72 e 96h após. As frequências de HSC foram determinadas considerando-se o valor crítico de 2,125mmol/L (8,5mg/dL). ANOVA de medidas repetidas e teste de qui-quadrado foram empregados para as comparações. As vacas eliminavam urina ácida antes do parto. Os valores de Na+, K+, Cl- e SID3 não diferiram entre os grupos. Na+ e K+ não variaram entre os dias; Cl- era elevado ao parto e diminuiu até 72h; e SID3 era reduzida ao parto e aumentou até 48h. A calcemia era reduzida até 24h e se elevou até 72h. Vacas de terceira e de quarta a sexta lactações apresentaram valores mais baixos até 24h. A HSC foi observada em quase metade das vacas (43,3% a 55%) até 48h. A manutenção de hipocalcemia por três ou mais dias seguidos ocorreu em 53,3% das vacas de terceira e de quarta a sexta lactações. A ingestão de dieta aniônica pré-parto com alto teor de cloreto provocou acidose hiperclorêmica e este desequilíbrio se reverteu no segundo dia pós-parto. Os efeitos induzidos sobre os equilíbrios eletrolítico e ácido base não foram capazes de prevenir a ocorrência de HSC nos primeiros dias da lactação.(AU)

Potential of a new cone-beam ct software for blooming artifact reduction

Abstract This study evaluated the dimensions of intraradicular posts using a new cone beam CT (CBCT) software, and verified the potential of blooming artifact reduction. Sixty-three single-rooted human teeth were shaped, obturated, prepared for intracanal post placement and distributed into three groups: G1: anatomically customized prefabricated glass fiber posts; G2: low-fusion alloy posts; G3: gold alloy posts. After post fabrication and luting with RelyX U200®, specimens were sectioned axially at 9 mm from the root apex, and markings were made on the root surfaces (X-, Y- and Z-axes). The dimensions of the original posts (control group) were measured using a digital micrometer. CBCT scans of the teeth were obtained using a PreXion 3D Elite® scanner. Posts were measured on CBCT scans using DICOM files and the e-Vol DX software. A specific filter, Blooming Artefact Reduction (BAR), was developed to analyze intracanal posts. Statistical data were evaluated using the Van de Waerden nonparametric analysis of variance and, after that, normalized data were analyzed using the Tukey test. The level of significance was set at α = 5%. The measures of the anatomical prefabricated, low-fusion alloy and gold alloy intracanal posts obtained using the e-Vol DX CBCT software and a micrometer were not significantly different (p>0.05). The use of the BAR filter of the e-Vol DX software application did not induce any dimensional differences on CBCT scans of intracanal posts when compared with measurements made with a micrometer on original posts. The use of the BAR filter eliminated blooming artifacts.

Resumo Este estudo avaliou as dimensões de pinos intrarradiculares usando um novo software de tomografia computadorizada de feixe cônico (TCFC) e um micrômetro digital, e verificou o potencial da redução do artefato de contraste do branco. Sessenta e três dentes humanos unirradiculares foram modelados, obturados, preparados para colocação de pinos e distribuídos em três grupos: G1: pino de fibra de vidro pré-fabricado anatômico; G2: pino metálico de liga de baixa fusão; G3: pino metálico de liga de ouro. Após a confecção e cimentação dos pinos com RelyX U200®, os espécimes foram cortados no sentido axial a 9 mm do ápice radicular, sendo efetuadas marcações em suas superfícies radiculares (eixos X, Y e Z) para orientação das medidas e sincronizações das imagens. Foi utilizado um micrômetro digital para a mensuração das dimensões dos pinos originais (grupo controle) associado ao microscópio operatório. Posteriormente, as imagens em TCFC foram obtidas usando o PreXion 3D Elite®. Para a mensuração dos pinos nas imagens de TCFC utilizou-se o arquivo DICOM e a ferramenta de medida do software e-Vol DX, configurada para medidas milesimais, com o filtro BAR (Blooming Artifact Reduction). Os dados estatísticos foram avaliados com a análise de variância não-paramétrica de Van der Waerden, seguida pelo Teste de Tukey aplicado aos dados normalizados. O nível de significância foi de α = 5%. Os resultados mostraram que as medidas dos diâmetros dos pinos intrarradiculares (fibra de vidro anatômico, metálico liga de baixa fusão, e em liga de ouro) usando o software e-Vol DX e o micrômetro não mostram diferenças significativas entre si. O uso do filtro BAR do software e-Vol DX não induziu diferenças dimensionais nas imagens de TCFC dos pinos quando comparadas às medidas realizadas com o micrômetro sobre os pinos originais. O uso do filtro BAR eliminou artefatos de contraste do branco.

Superiority of the triple combination of bortezomib, cyclophosphamide and dexamethasone versus cyclophosphamide, thalidomide and dexamethasone in patients with newly diagnosed multiple myeloma, eligible for transplantation

ABSTRACT Background: The treatment of multiple myeloma (MM) has evolved significantly in the past decade, and new drug combinations have improved the response rates and prolonged survival. Studies comparing different induction chemotherapy regimens have shown that triple combinations have better results than double combinations. However, comparisons among different triple combinations are rare in the literature. Methods: We retrospectively compared two triple combinations comprising bortezomib, cyclophosphamide and dexamethasone (VCD) versus thalidomide, cyclophosphamide and dexamethasone (CTD), and aimed at identifying which of the two combinations would yield better response rates following four induction cycles prior to hematopoietic cell transplantation in patients with untreated multiple myeloma. Results: We retrospectively reviewed the medical records of 311 patients from 24 different centers.The VCD regimen was used as induction therapy by 117 (37.6%) patients, whereas 194 (62.4%) patients received the CTD regimen. After four cycles of induction on an intention-to-treat basis, 54% of the patients in the VCD group achieved at least very good partial response versus 42.8% in the CTD group (p = 0.05). We observed no difference in neuropathy or thrombotic events rates among the two regimens. Conclusion: Our results corroborate the superiority of the triple combination regimes containing bortezomib over the triple combination with thalidomide as pre ASCT induction therapy in MM.

Peritoneal fluid collection in healthy cattle and evaluation of changes in cell morphology during storage in refrigerated and non-refrigerated samples / Colheita do fluido peritoneal de bovinos sadios e verificação das alterações na morfologia celular quando mantido refrigerado ou à temperatura ambiente

This study aimed to evaluate the appropriate sites of abdominocentesis for peritoneal fluid collection in cattle and to investigate the time of cell viability in vitro, comparing three methods of sample conservation. Twenty-one healthy cattle (19 females and 2 males) were subjected to a laparocentesis procedure to obtain peritoneal fluid, with punctures in three defined sites: left cranial, right cranial, and right caudal. The total peritoneal fluid collected was divided into three aliquots and maintained under three preservation conditions: room temperature (26°C), refrigeration (4°C), and room temperature (26°C) with the addition of 1µL of 10% formaldehyde per 1mL of peritoneal fluid. The peritoneal fluid analysis performed immediately after collection consisted of: physical examination (color, appearance, volume, and specific gravity), biochemical measures (pH, total protein, fibrinogen, creatinine, and glucose), and cellularity (total and differential counts). The determination of proteins and the examination of cells were repeated in each separate aliquot at two, four, six, and eight hours after harvest. Data were analyzed through repeated measures ANOVA or Friedman test. The harvest was productive in 67% of cattle. The left cranial and the right cranial puncture sites were the most appropriate. Peritoneal fluid analyzed after collection, the total protein concentration ranged from 1.4 to 3.6g/dL, and number of leukocytes ranged from 54 to 1,322 cells/µL; 60 to 95% of leukocytes were lymphocytes. The protein concentration decreased, but the absolute values of leukocytes, lymphocytes, and segmented neutrophils did not change up to eight hours after collection, independent of the maintenance method. Cell lysis was delayed by cooling, and the addition of formaldehyde did not help preserve the integrity of cellular morphology. Laparocentesis is a safe and secure procedure in cattle and maybe more productive when performed in specific sites on the left or right sides of the cranial abdominal wall. Peritoneal fluid samples may be analyzed with reliable results for up to eight hours after collection when kept refrigerated and for up to six hours when kept at room temperature.(AU)

O estudo teve como objetivo avaliar os locais adequados de laparocentese para a colheita de fluido peritoneal de bovinos e estabelecer o tempo de viabilidade celular in vitro, comparando três métodos de conservação. Vinte e um bovinos hígidos (19 fêmeas e 2 machos) foram submetidos ao procedimento de laparocentese para obtenção de fluido peritoneal, com punção em três pontos definidos: cranial esquerdo, cranial direito e caudal direito. O volume total do líquido peritoneal foi dividido em três alíquotas mantidas sob três métodos de conservação: temperatura ambiente (26°C); refrigeração (4°C); e temperatura ambiente (26°C) com adição de 1µL de formol 10% para cada 1mL de líquido peritonial. A análise do líquido peritoneal realizada imediatamente após sua obtenção consistiu em: exames físico (cor, aspecto, volume e densidade); bioquímicos (pH, proteína total, fibrinogênio, creatinina e glicose); e da celularidade (contagens total e diferencial). A determinação de proteínas e o exame da celularidade foram repetidos, em cada alíquota separada, as duas, quatro, seis e oito horas após a colheita. Análise de variâncias de medidas repetidas ou teste de Friedman foram empregados para avaliação ao longo do tempo. A colheita foi produtiva em 67% dos bovinos e os locais de punção craniais esquerdo e direito foram os mais adequados. A concentração de proteína total variou de 1,4 a 3,6g/dL e o número de leucócitos de 54 a 1.322 células/µL, com predomínio de linfócitos (60 a 95% das células) no fluido peritoneal analisado logo após a colheita. A concentração de proteínas diminuiu, mas os valores absolutos de leucócitos, de linfócitos e de neutrófilos segmentados não se modificaram até oito horas após a colheita, independente do método de manutenção das amostras. A lise celular foi retardada pela refrigeração e a adição de formol não contribuiu para preservar a integridade da morfologia celular. A laparocentese é um procedimento seguro e de execução fácil em bovinos sendo mais produtiva quando realizada em locais específicos à esquerda ou à direita craniais da parede abdominal. Amostras de fluido peritoneal podem ser analisadas com resultados confiáveis quando mantidas refrigeradas por até oito horas após a colheita e quando mantidas à temperatura ambiente por até seis horas.(AU)

Percutaneous Endovascular Aortic Aneurysm Repair with INCRAFT Endograft Guided by CO2 Digital Subtraction Angiography in Patients with Renal Insufficiency

Iodinated contrast is the most common contrast agent used during endovascular abdominal aneurysm repair (EVAR). However, its use may worsen kidney function in patients with renal insufficiency. Previous studies have demonstrated the safety and effectiveness of carbon dioxide (CO2)-EVAR. Here, we report cases of three male patients with mild renal insufficiency (mean age: 79 years) that successfully underwent CO2-EVAR using INCRAFT ultra-low profile endografts. CO2 angiography provided the necessary vascular roadmap for safe and effective percutaneous EVAR, eliminating the need for iodinated contrast media and preventing contrastinduced nephropathy.

Controlling Painters' Exposure to Volatile Organic Solvents in the Automotive Sector of Southern Colombia

BACKGROUND: Painters in the automotive sector are routinely exposed to volatile organic solvents, and the levels vary depending on the occupational health and safety controls enforced at the companies. This study investigates the levels of exposure to organic vapors and the existence of controls in the formal economy sector in southern Colombia. METHODS: This is an exploratory study of an observational and descriptive character. An analysis of solvents is conducted via the personal sampling of painters and the analysis of samples using the National Institute for Occupational Safety and Health 1501 method. The amount of solvents analyzed varied according to the budget allocated by the companies. The person in charge of the occupational safety and health management system was interviewed to learn about the exposure controls implemented at the companies. RESULTS: A medium exposure risk for toluene was found in one company. Another presented medium risk for carbon tetrachloride, xylene, ethylbenzene, and n-butanol. The others showed low risk of exposure and that the controls implemented were not sufficient or efficient. CONCLUSION: These results shed light on the working conditions of these tradespeople. The permissible limits established by Colombian regulations for the evaluated chemical contaminants were not exceeded. However, there were contaminants that exceeded the limits of action. The analysis of findings made it possible to propose improvements in occupational safety and health management systems to allow the optimization of working conditions for painters, prevent the occurrence of occupational diseases, and reduce costs to the country's health system.

Mammary gland health of Santa Inês ewes at the drying and puerperium and evaluation of a dry-off terapy with gentamicin / Sanidade da glândula mamária de ovelhas Santa Inês na secagem e no puerpério e avaliação da terapia intramamária com gentamicina na secagem

Mastitis represents an important health problem for Santa Inês breed, causing losses to the producer, due to loss of ewes or the decrease in weight gain of lambs. The aim of this work was to assess the health of the mammary gland of Santa Inês ewes at the drying and puerperium and to investigate the efficacy of a dry-off therapy with gentamicin. In this study, 64 ewes were divided in a control group (GC) and treatment group (GT), and the health of the mammary gland was assessed at the drying and puerperium. The GT ewes received 250mg of gentamicin (Gentocin® DryCow/Schering-Plough, product indicated for use in dairy cows) in each mammary half. For diagnosis, clinical examination, California Mastitis Test, somatic cell count and milk culture was performed. In the GC, of the 45 (70.3%) healthy mammary halves at the drying, 12 developed subclinical mastitis and nine clinical mastitis at the puerperium. In the GT, among 51 (79.7%) healthy mammary halves at the drying, six developed subclinical mastitis and 11 clinical mastitis at the puerperium. No association was observed between treatment and the occurrence of mastitis at puerperium. Of the 19 (29.7%) mammary halves of the GC that presented subclinical mastitis at the drying, three remained with subclinical mastitis and five developed clinical mastitis at the puerperium. In the GT, of the 13 (20.3%) mammary halves that had subclinical mastitis at the drying, four remained with subclinical mastitis and four developed clinical mastitis. No association was observed between treatment and cure or persistence of mastitis at the puerperium. The main microorganisms isolated, at the drying and puerperium, from animals with subclinical or clinical mastitis were Staphylococcus spp., predominantly coagulase negative Staphylococcus (CSN). At the puerperium, 29 cases of clinical mastitis occurred, 19 with isolation, where 10 were CNS and six S. aureus. Mannheimia haemolytica was isolated in one case of subclinical mastitis and other of clinical mastitis. News protocols and different ways of handling at drying and at puerperium must be investigated.(AU)

A mastite é um problema sanitário importante em ovelhas da raça Santa Inês, ocasionando prejuízo ao produtor em virtude do descarte de matrizes e da queda no ganho de peso dos cordeiros. O objetivo deste trabalho foi avaliar a saúde da glândula mamária de ovelhas da raça Santa Inês na secagem e no puerpério e pesquisar a eficácia da terapia intramamária com gentamicina na secagem. Sessenta e quatro ovelhas foram divididas em grupos controle (GC) e tratamento (GT), cada um contendo 32 animais, e a saúde da glândula mamária avaliada na secagem e no puerpério. As ovelhas do GT receberam 250mg de gentamicina (Gentocin® Mastite Vaca Seca/ Schering-Plough Veterinária, produto indicado pela empresa para utilização em vacas de leite) em cada metade mamária. Para o diagnóstico, foram realizados exame físico da glândula mamária, California Mastitis Test, contagem de células somáticas e cultura do leite. No GC, das 45 (70,3%) metades mamárias sadias na secagem, 12 desenvolveram mastite subclínica e nove mastite clínica no puerpério. No GT, das 51 (79,7%) metades mamárias sadias na secagem, seis desenvolveram mastite subclínica e 11 mastite clínica no puerpério. Não houve associação entre o tratamento e a ocorrência de mastite no puerpério. Das 19 (29,7%) metades mamárias do GC que apresentaram mastite subclínica na secagem, três permaneceram com mastite subclínica e cinco desenvolveram mastite clínica no puerpério. No GT, das 13 (20,3%) metades mamárias com mastite subclínica na secagem, quatro permaneceram com mastite subclínica e quatro desenvolveram mastite clínica. Não houve associação entre o tratamento e a cura ou persistência da mastite no puerpério. Os principais micro-organismos isolados, na secagem e puerpério, de animais com mastite subclínica ou clínica foram Staphylococcus spp., com predominância de Staphylococcus Coagulase Negativa (SCN). No puerpério, ocorreram 29 casos de mastite clínica, sendo 19 com isolamento, 10 com SCN e seis com S. aureus. Mannheimia haemolytica foi isolado em um caso de mastite subclínica e um caso de mastite clínica. Novos protocolos e diferentes formas de manejo na secagem e no puerpério devem ser pesquisados.(AU)

Histophilus somni-associated syndromes in sheep from Southern Brazil

Abstract Histophilus somni is a Gram-negative bacterium that is associated with a disease complex (termed histophilosis) that can produce several clinical syndromes predominantly in cattle, but also in sheep. Histophilosis is well described in North America, Canada, and in some European countries. In Brazil, histophilosis has been described in cattle with respiratory, reproductive, and systemic disease, with only one case described in sheep. This report describes the occurrence of Histophilus somni-associated disease in sheep from Southern Brazil. Eight sheep with different clinical manifestations from five farms were investigated by a combination of pathological and molecular diagnostic methods to identify additional cases of histophilosis in sheep from Brazil. The principal pathological lesions were thrombotic meningoencephalitis, fibrinous bronchopneumonia, pulmonary abscesses, and necrotizing myocarditis. The main clinical syndromes associated with H. somni were thrombotic meningoencephalitis (n = 4), septicemia (n = 4), bronchopneumonia (n = 4), and myocarditis (n = 3). H. somni DNA was amplified from multiple tissues of all sheep with clinical syndromes of histophilosis; sequencing confirmed the PCR results. Further, PCR assays to detect Pasteurella multocida and Mannheimia haemolytica were negative. These findings confirmed the participation of H. somni in the clinical syndromes investigated during this study, and adds to the previous report of histophilosis in sheep from Brazil.

Diagnóstico diferencial das doenças neurológicas dos bovinos no estado do Paraná / Differential diagnosis of neurologic diseases of cattle in the state of Paraná

O objetivo deste trabalho foi identificar as doenças neurológicas que acometeram bovinos no estado do Paraná entre os anos de 2009 e 2015. A investigação aconteceu, preferencialmente, nas propriedades rurais onde os casos ocorreram. Foram registradas as informações sobre a evolução das doenças nos bovinos afetados do rebanho, e os prováveis fatores de risco foram identificados. Todos os procedimentos de exame físico geral e neurológico foram realizados sistematicamente para a caracterização da síndrome neurológica presente. Amostras de sangue e de líquor foram colhidas para a realização de exames laboratoriais. De acordo com o tempo de evolução e com a gravidade dos sinais clínicos observados, os bovinos doentes eram mantidos vivos para acompanhamento da evolução ou da resposta ao tratamento, ou eram submetidos à eutanásia seguida de necropsia. Fragmentos do sistema nervoso e dos demais órgãos foram colhidos para exame histopatológico. O exame de imunofluorescência direta e a prova biológica em camundongos foram realizados em todos os bovinos que morreram, com a finalidade de confirmar ou descartar o diagnóstico de raiva. Métodos laboratoriais específicos das rotinas de virologia, bacteriologia e toxicologia foram empregados, como complementares, para o estabelecimento do diagnóstico diferencial. Foram investigados 236 bovinos com doença neurológica, sendo 85 casos de ocorrência individual e 151 casos distribuídos por surtos que ocorreram em 79 rebanhos. As encefalopatias (180/236; 76,2%) predominaram sobre as mielopatias (27/236; 11,4%). As doenças inflamatórias determinadas por infecções (98/236; 41,5%) e as doenças tóxicas (91/236; 38,6%) foram as principais, enquanto as causas degenerativas (10/236; 4,2%), metabólicas (9/236; 3,8%), físicas (9/236; 3,8%), neoplásicas (4/236; 1,7%), e os defeitos congênitos (1/236; 0,4%) ocorreram menos frequentemente. Os casos inconclusivos somaram 5,9% (14/236). A meningoencefalite por BoHV-5 e a raiva foram as doenças de frequência maior e podem ser consideradas as mais importantes. Dentre as causas tóxicas, as intoxicações por plantas se destacaram (63/91; 69,2%) e foram responsáveis por 26,6% de todos os casos. Destacaram-se ainda a polioencefalomalácia, a meningoencefalite trombótica por Histophilus somni e o botulismo. Essas informações contribuem para que os médicos veterinários adotem condutas mais efetivas de diagnóstico e de prevenção, e são valiosas para o sistema oficial de vigilância epidemiológica do estado.(AU)

The aim of this study was to identify the neurological diseases that affected cattle in Paraná state between the years 2009 and 2015. The investigation took place, preferably, in the farms where cases occurred. Information on the evolution of the diseases in the affected cattle of the herd was recorded, and the probable risk factors were identified. All general and neurological examination procedures were performed systematically for the characterization of the neurological syndrome in each case. Samples of blood and CSF for laboratory exams were also collected. According to the evolution features and the severity of the observed clinical signs, the diseased cattle were kept alive to follow the progress of the disease, or were submitted to euthanasia followed by necropsy. Fragments of tissues from nervous system and other organs were collected for histopathological examination. Direct immunofluorescence test and biological test were performed on all the cattle that died, in order to confirm or rule out the diagnosis of rabies. Specific virology, bacteriology and toxicology laboratory methods were used as complementary exams in order to establish differential diagnosis. A total of 236 cattle with neurological disease were investigated, 85 cases of individual occurrence and 151 cases distributed by outbreaks that occurred in 79 herds. Encephalopathies (180/236, 76.2%) predominated over mielopathies (27/236, 11.4%). Inflammatory diseases caused by infections (98/236, 41.5%) and the toxic diseases (91/236, 38.6%) were the main causes, while degenerative (10/236, 4.2%), metabolic (9/236; 3.8%), physical (9/236, 3.8%), neoplastic (4/236, 1.7%), and congenital defects (1/236, 0.4%) occurred less often. The inconclusive cases were 5.9% (14/236). BoHV-5 meningoencephalitis and rabies were diseases of higher frequency and may be considered the most important. Among the toxic causes, plant poisonings were highlighted (63/91, 69.2%) and were responsible for 26.6% of all cases. Polioencephalomalacia, thrombotic meningoencephalitis caused by Histophilus somni and botulism were also highlighted. This information helps veterinarians to adopt more effective diagnostic and preventive approaches and is valuable to the state's official epidemiological surveillance system.(AU)

Medicina traslacional e innovación en salud: mecanismos y perspectivas / Translational medicine and innovation in health: mechanisms and perspectives

Many new discoveries in Life Sciences cannot be translated into products, services or new applications to improve human health. Translational medicine, defined as "from bench to bedside", refers to the transfer of results or new knowledge achieved in the laboratory into health innovation. We aim to review the state of art of translational medicine, its relationship with innovation processes and the different perspectives to consider. Finally, we contextualize the situation of Research and Development (R&D) in Chile and the main issues of the biotechnology market in the country.