Radiographic measurement of Nasopharyngeal Depth from the Anterior Nasal Spine (ND-ANS) among Filipino adults

Objective@#To determine a normative value for the nasopharyngeal depth from the anterior nasal spine (ND-ANS) among normal adult Filipinos using Computed Tomography scans.@*Methods@#Design: Cross-sectional study. Setting: Tertiary National University Hospital. Participants: Of 516 adult patients that underwent facial, neck and temporal bone CT scans in our hospital between January 1 to June 30, 2019, 100 cases were randomized to be included in the study and 91 CT scans were analyzed.@*Results@#The mean nasopharyngeal depth from the anterior nasal spine among Filipino adults is 7.17 ± 0.42. There was a significant difference between sexes with a mean measurement of 7.23 cm ± 0.44 in males and 7.09 ± 0.37 cm in females. There was no statistically significant difference in mean nasopharyngeal depth across age groups.@*Conclusion@#A statistically significant difference was observed between sexes in our study sample. Our study provides initial normative values of nasopharyngeal depth among adult Filipinos, and additional studies may use this as a basis for further research.

Radial Artery Pseudoaneurysm following Transradial Artery Coronary Angiography: A case report

OBJECTIVE@#This report aims to raise physician clinical awareness of radial artery pseudoaneurysm (RAP) and promote early recognition of this potentially serious complication. The article highlights various proposed treatment strategies in the management of this condition. @*BACKGROUND@#Radial artery pseudoaneurysm is a rare potentially serious complication following transradial artery coronary angiography for left heart catheterization and percutaneous coronary intervention. Risk factors associated with the development of RAP include multiple arterial puncture attempts, use of systemic anticoagulation, inadequate hemostasis following post-procedural compression, vascular site infection, use of larger sheaths, female gender, age of 70 years and older, diabetes mellitus, obesity and/or patients with high body mass index.1-3 Conservative medical treatment and/or surgical repair are the primary therapeutic approaches in the management of RAP. @*CONCLUSION@#Transradial artery access is associated with a significantly lower risk of major bleeding and vascular access site complications, reduces morbidity and mortality compared with the transfemoral approach. It is important to recognize though that complications do still occur with the transradial approach. RAP is one such entity wherein prevention is key - with adequate post-procedural compression, frequent observation, and careful assessment of the radial access site.

Evaluación de la posición condilar mediante tomografía computarizada de haz cónico en pacientes Clase III sometidos a cirugía ortognática / Evaluation of the condylar position by conical beam computed tomography in Class III patients undergoing orthognathic surgery

Objetivo . El propósito de este estudio fue comparar los cambios mediante tomografía computarizada de haz cónico en el posicionamiento condilar de pacientes Clase III antes y después de una osteotomía sagital bilateral de rama mandibular indicada para la retro- posición mandibular. Métodos . Se analizaron 30 pacientes, 16 mujeres y 14 hombres con rango de edad de 15 a 40 años y deformidad dentofacial Clase III no tratada que asistieron a consulta de diagnóstico en el periodo del año 2013 al 2016 en el Hospital Regional "General Ignacio Zaragoza" (CDMX, México), realizándoseles mediciones de la posición condilar en tres tiempos: prequirúrgico, intermedio (4 días posquirúrgico) y final (9 meses posquirúrgico), en dos planos: corte sagital y corte coronal. Resultados . No se observó diferencia significativa en los espacios anterior, central y posterior antes (2,56 ± 0,55 mm; 1,78 ± 0,48 mm; 1,92 ± 0,36 mm) y después (2,68 ± 0,51 mm; 1,87 ± 0,43 mm; 2,01 ± 0,37 mm), diferencia de medias -0,120; -0,085; -0,090 p =0,921; 0,948 y 0,778, respectivamente. Del mismo modo, en el corte coronal no se observan cambios significativos en los ángulos condilares derecho antes (68,25 ± 1,56°) y después (68,77 ± 1,63°) p =0,217; e izquierdo antes (68,92 ± 1,63°) y después (69,30 ± 2°) p =0,215. Conclusiones . La osteotomía sagital bilateral de rama mandibular en pacientes Clase III es una técnica quirúrgica que ofrece mínimas alteraciones condilares, pues mantiene una estabilidad condilar en el posoperatorio a 9 meses.

Objective. The purpose of this study was to compare the changes by conical beam com- puted tomography in the condylar positioning of Class III patients before and after a sagittal osteotomy of the bilateral mandibular ramus in Class III indicated for mandibu- lar retroposition. Methods. Thirty patients were analyzed, 16 women and 14 men with an age range of 15 to 40 years and untreated Class III dentofacial deformity who were attended by diagnostic consultation during the period from 2013 to 2016 at the "Gen eral Ignacio Zaragoza" Regional Hospital (CDMX, Mexico), performing measurements of the condylar position in three stages: presurgical, intermediate (4 days after surgery) and final (9 months after surgery), in two planes: sagittal section and coronal section. Re - sults. No significant difference was observed in the anterior, central and posterior spaces before (2.56 ± 0.55 mm; 1.78 ± 0.48 mm; 1.92 ± 0.36 mm) and after (2.68 ± 0.51 mm; 1.87 ± 0.43 mm; 2.01 ± 0.37 mm), mean difference -0.120; -0,085; -0.090 p =0.921; 0.948 and 0.778, respectively. Similarly, in the coronal section there are no significant changes in the right condylar angles before (68.25 ± 1.56 °) and after (68.77 ± 1.63°) p =0.217; and left before (68.92 ± 1.63°) and then (69.30 ± 2°) p =0.215. Conclusions. Sagittal osteotomy of the bilateral mandibular ramus in Class III patients is a surgical technique that offers minimal condylar alterations, since it maintains a condylar stability in the postoperative period at 9 months.

The Use of Littoral Benthic Macroinvertebrates of the Martín Garcia Island Nature Reserve as Indicators of Water Quality

At Martín García Island—a Natural Reserve located at the confluence of the Paraná and Uruguay rivers—we used benthic-macroinvertebrate biotic indices to elucidate the structure and community parameters of the littoral benthos and their response to environmental variables and to evaluate the island's coastal water quality. Seasonal campaigns were carried out (March/1995-March/1996) at eight sites of the island's littoral sites, selected according to the substrate characteristics (fine sands, sandy-silty, reedbed, and silty with great hydrophyte development). From the sites with a soft substrate, triplicate samples were extracted using a 225-cm2 Ekman manual dredge. The relative abundances of 71 taxa were measured: Nematoda, Turbelaria, Oligochaeta (23 sps.), Mollusca (21 sps.), Crustacea (11 sps.), Insecta (12 families), and Tardigrada. Macroinvertebrate density: 15-58,800 ind.m-2. Analysis of variance revealed significant differences between the average annual macroinvertebrate-population densities among the five sites (F: 3.059; p<0.05). Site 7 exhibited the highest density at 38,700±19,000 ind.m-2 Community parameters: diversity (H'; 0.77-2.16 bits); equitability (J; 0.16-1.02), and species richness (S; 3-29). Canonical-correspondence analysis indicated the environmental variables experiencing the greatest fluctuation to be: dissolved-oxygen concentration, pH, temperature, and conductivity. The results of this analysis suggest that macroinvertebrate-species distribution involves the physicochemical conditions of the water. Of the correlation between species and environmental variables, 95.5% were distributed on the canonical-correspondence ordering diagram's Axis 1. Functional feeding groups: In all sites and seasons, the gathering collectors predominated, followed by the scrapers, filtering collectors, shredders, and predators. Macroinvertebrate Index of Pampean-Rivers: values generally ranged from weak to weak-to-very-weak to zero pollution, but there was a high degree of pollution (2.4 and 1.5) in the spring of 1995.

Lección MOODLE de anatomía e histología de la placenta humana / MOODLE lesson of the anatomy and histology of the human placenta

RESUMEN: La falta de muestras biológicas humanas existentes, debido principalmente a las limitaciones ético-morales relacionadas con su obtención, ponen en relieve la necesidad de buscar otras alternativas de enseñanza y aprendizaje de las ciencias morfológicas. En este sentido, la implementación de lecciones a través de la plataforma MOODLE proporciona la oportunidad al estudiante de interactuar en un entorno que simula una situación de aprendizaje propio del laboratorio tradicional. El objetivo del presente trabajo fue generar una lección MOODLE sobre la anatomía e histología placentaria humana, como complemento a la clase teórica presencial, para estudiantes de la carrera de Obstetricia y Puericultura. Para tal cometido, se realizó búsqueda de información, imágenes y recursos TIC en bibliotecas e internet. Paralelamente, se llevó a cabo un proceso de captura fotográfica de muestras histológicas de placenta, así como también la grabación de un alumbramiento. Posteriormente, se procedió a la articulación y montaje de las actividades en la plataforma MOODLE con un enfoque constructivista. Además, se elaboró una encuesta de satisfacción, la cual fue validada por 3 expertos. La muestra estuvo constituida por 137 estudiantes de la carrera de Obstetricia. Se confeccionó un laboratorio virtual MOODLE de anatomía e histología de la placenta humana, el cual esta constituido por múltiples actividades con orientación clínica, las cuales permiten autoevaluarse. El laboratorio virtual nos ha ayudado ha subsanar la carencia de muestras humanas y los resultados de la encuesta de satisfacción aplicada a los estudiantes señalan una valoración positiva de la iniciativa.

SUMMARY: The lack of existing human biological samples, mainly due to the ethical-moral restrictions related to obtaining these, highlights the need to search for other teaching and learning alternatives in morphological science. In this sense, the implementation of lessons by means of the MOODLE platform provides the students with the opportunity to interact in a setting that simulates a learning situation that belongs to traditional laboratories. The purpose of this work was to generate a MOODLE lesson on the anatomy and histology of the human placenta, as a complement of the traditional theoretical classroom for students of Obstetrics. To that end, TIC information, images, and resources were sought in libraries and in the Internet, and at the same time a set of histological photographs of placenta samples was made, as well as a video recording of a placental delivery. Later, the coordination and set up of activities was made in the MOODLE platform with a constructivist approach. Furthermore, a satisfaction survey was prepared which was validated by three experts. The total sample consisted of 137 students in the 2th year of obstetrics. A virtual MOODLE laboratory of the anatomy and histology of the human placenta was made, which is constituted by multiple activities with a clinical orientation that allow self-evaluation. The virtual laboratory has helped overcome the lack of human samples, and results of the satisfaction survey applied to the students indicate a positive evaluation of this initiative.

Clinical spectrum, susceptibility profile, treatment and outcome of culture-confirmed brucellosis from South India

Brucellosis, a common zoonosis, is under reported in India despite its endemicity and increased exposure to livestock among the population. This study was conducted to determine the clinical manifestations, antibiotic susceptibility pattern, treatment and outcome of culture confirmed brucellosis. Adult patients with culture confirmed brucellosis who presented to a large teaching hospital in South India between 2009 and 2015 were included. A diagnosis of brucellosis was confirmed on automated culture. Clinical profile, laboratory parameters, drug susceptibility, treatment and outcome were documented by reviewing the medical records. The cohort comprised of 22 patients with mean ± SD age of 42 ± 13 years. Twenty one (95.5%) was male. Thirteen (59%) patients were from rural area and risk of acquisition of brucellosis including occupational exposure or consumption of unpasteurized milk was evident in 16 (72.7%) patients. The mean duration of symptoms before presentation was 54.5 ± 52 days. The commonest clinical presentation was prolonged fever without a definite focus in 18 patients (82%), whereas 2 (9%) patients had osteoarticular involvement and one patient (4.5%) each had genital involvement and endocarditis. Eighteen patients (82%) with uncomplicated brucellosis were treated with aminoglycoside and doxycycline for 6 weeks. There was no relapse or mortality at 18 ± 9 months of follow up. Brucellosis in this cohort had acute or subacute presentation with prolonged fever and bacteremia. High index of clinical suspicion based on significant epidemiological history along with automated blood culture improves the efficiency of diagnosis. Cure with lack of relapse among these cases suggests a combination therapy with doxycycline and aminoglycoside is highly effective for the treatment.

Physical Activity Levels, Perceived Barriers to Exercise and Development of Secondary Conditions in Community Dwelling Persons with Spinal Cord Injury / Niveles de Actividad física, Barreras Percibidas para Ejercitar, y Desarrollo de Condiciones Secundarias en Personas con Lesión de la Médula Espinal que Viven en sus Comunidades

ABSTRACT Objective: To determine physical activity levels of community dwelling persons with spinal cord injury (SCI) who received inpatient rehabilitation at the Sir John Golding Rehabilitation Centre (SJGRC). This study also explored the perceived barriers to exercise and the development of secondary health complications. Methods: A non-experimental cross-sectional analysis of relationships was done. Participants were recruited from the SJGRC discharge files. Three questionnaires (The Physical Activity and Disability Scale, Spinal Cord Injury Secondary Conditions Scale and the Barriers to Exercise and Disability Scale) were administered via a telephone interview. Results: Only 58.3% of patients were engaged in some form of exercise and of that amount only 6% engaged in vigorous exercise. The main secondary conditions affecting both persons with paraplegia and quadriplegia were spasticity, chronic, muscle and joint pain. There were no significant differences between persons having paraplegia and quadriplegia in relation to physical activity levels, development of secondary conditions or barriers to exercise. Most persons were interested in an exercise programme but the most common barriers to exercise were cost and not knowing where they could go to exercise. Conclusion: Regardless of injury level, persons with spinal cord injury living in their communities in Jamaica are not engaged in adequate levels of exercise to confer health benefits and aid with healthy ageing. Barriers like cost, availability and accessibility of facilities must be addressed if this situation is to improve.

RESUMEN Objetivo: Determinar los niveles de actividad física de las personas con lesión de la médula espinal (LME) que viven en sus comunidades -es decir, en sus casas en vez de asilos o instituciones asistenciales-y que recibieron rehabilitación hospitalaria en el Centro de Rehabilitación Sir John Golding (SJGRC, en inglés). Este estudio también exploró las barreras percibidas para hacer ejercicios, y el desarrollo de complicaciones secundarias de salud. Métodos: Se realizó un análisis transversal no experimental de las relaciones. Los participantes fueron reclutados a partir de los archivos de altas del Centro SJGRC. Se aplicaron tres cuestionarios mediante entrevista telefónica (Escala de Actividad Física y Discapacidad, Escala de Condiciones Secundarias de la Lesión Medular, y Escala de Discapacidad y Barreras al Ejercicio). Resultados: Sólo el 58.3% de los pacientes se hallaban participando en alguna forma de ejercicio, y de este número sólo el 6% practicaba ejercicios fuertes. Las condiciones secundarias principales que afectaban a ambas personas con paraplejia y cuadriplejia eran la espasticidad, y el dolor muscular y articular crónico. No había diferencias significativas entre las personas que tenían paraplejia y cuadriplejia en lo referente a los niveles de actividad física, el desarrollo de condiciones secundarias o las barreras al ejercicio. La mayoría de las personas estaban interesadas en un programa de ejercicios, pero las barreras más comunes eran el costo y el no saber dónde ir a hacerlos. Conclusión: Independientemente del nivel de la lesión, las personas con lesión medular que viven en sus comunidades en Jamaica no participan en niveles adecuados de ejercicio que brinden beneficios de salud y ayuden a un envejecimiento saludable. Las barreras como el costo, la disponibilidad y la accesibilidad de las instalaciones deben ser abordadas, si se quiere mejorar esta situación.

Complicaciones en craneoplastias: hueso autólogo criopreservado vs. polimetilmetacrilato. Análisis retrospectivo de 63 pacientes / Complications in cranioplasties: autologous bone cryopreserved vs. Polymethylmethacrylate. Retrospective analysis of 63 patients

Introducción: se define como craneoplastia a la reparación quirúrgica de los defectos óseos craneanos. En nuestro medio el material utilizado mayormente es el hueso autólogo criopreservado (HACp) y, en caso de no contar con dicho tejido, el Polimetilmetacrilato (PMMA) es de elección. Objetivo: Se plantea un estudio retrospectivo observacional a fin de analizar y comparar complicaciones en pacientes sometidos a craneoplastias con HACp en comparación a un grupo de pacientes a los que se les realizó craneoplastia con PMMA. Materiales y métodos: Se incluyeron pacientes que fueron sometidos a craneopatías durante un periodo de 5 años (2008-2013). El seguimiento delos pacientes fue de al menos 12 meses. Se analizaron variables relacionadas a complicaciones tempranas y tardías. Resultados: 63 pacientes recibieron craneoplastia con HACp (31 pacientes, 52%) o polimetilmetacrilato (31 pacientes, 49%). La tasa de complicación global fue del 36,6%. Doce pacientes (19,04%) requirieron tratamiento quirúrgico. Las complicaciones más frecuentes fueron las colecciones subcutáneas no infectadas (19%), seguidas por las infecciones de heridas (17%). No existen diferencias estadísticamente significativas en cuanto a para complicaciones, tanto globales como en las distintas categorías (p>0,05), para ambas técnicas quirúrgicas. Conclusión: Las craneoplastias tanto con HACp como aquellas con PMMA presentan una alta tasa de complicaciones. En nuestra serie no se hallaron diferencias entre ambos grupos estudiados.

Introduction: cranioplasty is defined as the surgical procedure to cover a skull bone defect. In our institution, we mainly use cryopreserved autologous bone graft (HACp), and if it is not available, polymethylmethacrylate is chosen (PMMA). Objective: We performed an observational retrospective study to assess complications in both groups of patients. Materials and Methods: Patients who underwent cranioplasty between 2008 and 2013 were included. Minimum follow up was 12 months. Variables related with early and late complications were analyzed. Results: 63 patients received cranioplasty consisting of autologous bone graft (32 patients, 52%) or PMMA (31 patients, 48%). The global complications rate was 36.6%. 12 patients (19.04%) required surgical treatment for these complications. The most common complications were sterile persistent subcutaneous fluid collection (19%) and wound infection (17%). No differences in complications rates were found between both groups (p>0.05). Conclusions: Cranioplasty following craniectomy is associated with a high complication rate. In our series, both groups showed no differences in complications rates.

Does emotion and its daily fluctuation correlate with depression? a cross-cultural analysis among six developing countries

Utilizing a World Health Organization [WHO] multi-national dataset, the present study examined the relationships between emotion, affective variability [i.e., the fluctuation of emotional status], and depression across six developing countries, including China [N = 15,050]; Ghana [N = 5,573]; India [N = 12,198]; Mexico [N = 5,448]; South Africa [N = 4,227]; and Russia [N = 4,947]. Using moderated logistic regression and hierarchical multiple regression, the effects of emotion, affective variability, culture, and their interactions on depression and depressive symptoms were examined when statistically controlling for a number of external factors [i.e., age, gender, marital status, education level, income, smoking, alcohol drinking, physical activity, sedentary behavior, and diet]. The results revealed that negative emotion was a statistically significant predictor of depressive symptoms, but the strength of association was smaller in countries with a lower incidence of depression [i.e., China and Ghana]. The association between negative affective variability and the risk of depression was higher in India and lower in Ghana. Findings suggested that culture not only was associated with the incidence of depression, but it could also moderate the effects of emotion and affective variability on depression or the experience of depressive symptoms

Estimating the Burden of Acute Gastrointestinal Illness in Grenada.

This is the first study conducted in Grenada, with a population of approximately 108,000, to quantify the magnitude, distribution, and burden of self-reported acute gastroenteritis (AGE). A retrospective population survey was conducted in October 2008 and April 2009 and a laboratory survey from October 2008 to September 2009. The estimated monthly prevalence of AGE was 10.7% (95% CI 9.0-12.6; 1.4 episodes/ person-year), with a median of 3 days of illness. Of those who reported AGE, 31% sought medical care (stool samples were requested from 12.5%); 10% took antibiotics; 45% took non-prescribed medication; and 81% reported restricted activity. Prevalence of AGE was significantly higher among children aged <5 years (23.5%, p<0.001). Of the AGE stool samples submitted to the laboratory for analysis, 12.1% were positive for a foodborne pathogen. Salmonella enteritidis was the most common foodborne pathogen associated with AGE-related illness. The estimated percentage of underreporting of syndromic AGE to the Ministry of Health was 69%. In addition, for every laboratory-confirmed foodborne/AGE pathogen, it was estimated that there were 316 additional cases occurring in the population. The minimum estimated cost associated with treatment for AGE was US$ 703,950 each year, showing that AGE has a potentially significant economic impact in Grenada.

A study of chlorophyll-like and phycobilin pigments in the C endosymbiont of the apple- snail Pomacea canaliculata

Pigments present in the brown-greenish C morph of an intracellular endosymbiont of Pomacea canaliculata were investigated. Acetone extracts of the endosymbiotic corpuscles showed an absorption spectrum similar to that of chlorophylls. Three fractions obtained from silica gel column chromatography of the acetone extracts (C I, C II and C III), were studied by positive ion fast atom bombardment-mass spectrometry (FAB-MS) and hydrogen-nuclear magnetic resonance (H-NMR). Results indicated the presence of (1) a sterol in the yellow colored C I fraction; (2) a mixture of pheophorbides a and b in the major green fraction, C II; and (3) a modified pheophorbide a in the smaller green fraction, C III. Aqueous extracts of the C endosymbiont did not show evidence of the occurrence of C-phycocyanin, allophycocyanin or phycoerithrin (light absorption, fluorescence emission, and electrophoresis of the protein moieties) while cyanobacterial cells (Nostoc sp.) showed evidence of C-phycocyanin and allophycocyanin. The possible phylogenetic and functional significance of the pigments present in the C endosymbiont is discussed.

Recomendaciones para el análisis de datos acumulados de susceptibilidad antimicrobiana en instituciones de salud / Recommendations for the analysis of cumulated data in antimicrobial susceptibility in health institutions

Due to the great variability in antimicrobial resistance patterns, local reports of cumulative antimicrobial susceptibility data are necessary in every health center. The purpose is to guide clinical decisions and the early detection of patterns that allow preventive measures to avoid dissemination of resistant strains. The main objective of this guide is to provide recommendations for the analysis of antimicrobial susceptibility data and elaboration of a local report. Recommendations provided in this guide are based on the Clinical and Laboratory Standards Institute (CLSI) document "Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data" (3). Key aspects related to information gathering and data processing, analysis and presentation are described.

Considerando la gran variabilidad en la distribución de la resistencia microbiana, es una necesidad que cada centro de salud genere reportes locales de datos acumulados de susceptibilidad, con el propósito de guiar las decisiones clínicas y detectar tendencias que permitan establecer medidas de prevención para evitar la diseminación de cepas resistentes. Esta guía tiene como objetivo entregar recomendaciones para el análisis de susceptibilidad antimicrobiana y aportar datos útiles para la elaboración del informe local. Las recomendaciones que contenidas em este documento están basadas en el documento "Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data de Clinical and Laboratory Standards Institute (CLSI) (3). Se describen aspectos claves relacionados con los requerimientos de la información, el procesamiento de los datos, el análisis y presentación de éstos.

Plyometric training improves power and agility in Jamaica's national netball team / El entrenamiento pliométrico mejora la fuerza y agilidad del equipo nacional de netball de Jamaica

OBJECTIVE: Plyometric training is widely used in conditioning, power training and in prevention and rehabilitation of injuries in some sports. This study sought to investigate the effect of a three-week plyometric training programme on jump performance and agility in Jamaican national netball players. METHOD: Eighteen national netballers participated in a Plyometric training programme. Subjects were evaluated using the Vertical Jump Test, the Broad Jump Test and the Illinois Agility Test prior to the start of the programme and at week 3. DATA ANALYSIS: The data were analysed using SPSS version 12 for Windows. A One-Sample Kolmogorov-Smirnov Test showed normal distribution of data and a paired samples t-test was used to determine whether the mean change in jump performance and agility was significant. RESULTS: All eighteen subjects completed the three weeks of training. Three subjects were shown to be outliers at week 3 and this resulted in data from 15 subjects being analysed. At the end of the three weeks, there were significant improvements in Vertical Jump Scores (p = 0.023), Broad Jump Scores (p = 0.002) and Agility scores (p = 0.045). CONCLUSION: Three weeks of Plyometric training can lead to significant improvements in jump performance and agility and should be integrated into the national training programme at intervals yet to be determined.

OBJETIVO: El entrenamiento pliométrico se usa ampliamente para el acondicionamiento, y entrenamiento de fuerza, así como para la prevención y rehabilitación de lesiones en algunos deportes. Este estudio buscó investigar el efecto de un programa de entrenamiento pliométrico de tres semanas sobre el rendimiento en salto alto y la agilidad de las jugadoras del Equipo Nacional de Netball de Jamaica. MÉTODO: Dieciocho jugadoras nacionales de netball participaron en un programa de entrenamiento pliométrico. Las sujetos fueron evaluadas usando la prueba de salto vertical, la prueba de salto largo y la prueba de agilidad de Illinois, antes del comienzo del programa y a la semana 3. ANÁLISIS DE DATOS: Los datos fueron analizados usando la versión 12 de SPSS para Windows. La Prueba de Kolmogorov-Smirnov para una muestra mostró una distribución normal de los datos y una prueba t de muestras pareadas fue usada para determinar si el cambio promedio en el rendimiento del salto y la agilidad fue significativo. RESULTADOS: Las dieciocho sujetos completaron las tres semanas de entrenamiento. Tres sujetos mostraron tener valores atípicos en la semana 3, y esto trajo por resultado que se analizaran datos de 15 sujetos. Al final de las tres semanas, se produjeron mejoras significativas en las puntuaciones del salto vertical (p = 0.023), las puntuaciones del salto largo (p = 0.002) y las puntuaciones de la agilidad (p = 0.045). CONCLUSIÓN: Tres semanas de entrenamiento pliométrico pueden llevar a mejoras significativas en el rendimiento y agilidad, y deben integrarse en el programa de entrenamiento nacional a intervalos aún por determinar.

Estudio multicéntrico de la vigilancia de la susceptibilidad in vitro a tigeciclina en Santiago de Chile / Multicenter study on the monitoring of in vitro susceptibility to tigeeyeline in Santiago, Chile

The objective of this multicenter study was to determine tigeeyeline susceptibility rates, measured by agar diffusion, in nine hospitals in Santiago and to compare these rates with other antimicrobials. Each center studied 20 strains per month. All intermedíate and fully resistant strains as well as 10 percent of susceptibile strains were also studied by the broth microdilution method. Overall, 2301 strains were studied displaying the foliowing susceptibility rates for tigeeyeline: 100 percent for Streptococcus sp, Enterococcus sp, and E. coli respectively, 99.8 percent for Staphylococcus sp, 93 percent for Klebsiella and 80 percent for Acinetobacter baumarmii. For Proteus, Providencia and Morganella the susceptibility rates were 4 percent. For cefotaxime-resistant Klebsiella and imipenem-resistant A. baumarmii susceptibility rates were 95 percent and 80 percent respectively. The agar diffusion and broth dilution method were 100 percent concordant for tigeeyeline susceptible strains but only 27 percent for resistant or intermedíate strains represented mostly by Acinetobacter baumannii. The majority of these strains (57/59) proved to be susceptible after retesting. The great majority (96,6 percent) of strains tested from nine Chilean hospitals proved to be susceptible to tigeeyeline with exception for Proteus, Providencia and Morganella (66 percent resistance). Using the agar diffusion method for measuring tigeeyeline susceptibility to A. baumannii may be misleading.

Para conocer la susceptibilidad a tigeciclina por difusión en agar en nueve hospitales de Santiago y comparar la susceptibilidad con otros antimicrobianos, se diseñó este estudio multicéntrico. Cada centro estudió 20 cepas mensualmente. Las intermedias, resistentes y 10 por cientoo de las susceptibles se re-testearon y estudiaron por microdilución en caldo. Se incluyeron 2.304 cepas. Fueron susceptibles a tigeciclina Strep-tococcus sp (100 por cientoo), Enterococcus sp (100 por ciento), E. coli (100 por cientoo), Staphylococcus sp (99,8 por ciento), Klebsiella pneumoniae (93 por ciento) y Acinetobacter baumannii (80 por ciento). En Proteus, Providencia y Morganella la susceptibilidad fue 4 por cientoo. Klebsiella resistente a cefotaxima y Acinetobacter resistente a imipenem, 95 por cientoo y 80 por cientoo fueron susceptibles a tigeciclina, respectivamente. La concordancia en cepas susceptibles y en las enviadas como resistentes o intermedias (A. baumannii) fue 100 por cientoo y 27 por cientoo respectivamente. El re-testeo confirmó que la mayoría eran susceptibles. Los patrones de susceptibilidad bacteriana muestran muy buena actividad in vitro a tigeciclina. La resistencia in vitro de A. baumannii por difusión en agar debe interpretarse con precaución.

Tumor desmoplasico intrabdominal de celulas pequeñas redondas: hallazgos en imágenes y anatomía patológica: [revisión] / Intra-abdominal desmoplastic small round-cell tumor: radiological and histopathologic findings: [review]

Abdominal desmoplastic small round-cell tumor (DSRCT) is a rare and aggressive neoplasm characterized by a consistent histological appearance, a unique immunohistochemicalprofile, and a specific chromosomal translocation. Fewer than 200 cases have been reported in the literature. Most tumors afflicts mainly adolescent or young adult males. They present as bulky abdominal or pelvic masses that diffusely spread along the peritoneal surface. We report one case of intra-abdominal desmoplastic small round-cell tumor in a 22 year old man. Imaging and histopathologic findings are described. CT images showed a bulky pelvic mass with peritoneal involvement. Immunohistochemically, the tumor showed positivity for desmin, vimentin, and specific CAM 5.2 antigen. The differential diagnosis is discussed in relation to radiological findings, and a review of the literature data is performed.

El tumor desmoplásico abdominal de células redondas pequeñas es una neoplasia muy rara y agresiva, que se caracteriza por su apariencia histológica, su perfil inmunohistoquímico y una traslocación cromosómica específica. Se han descrito menos de 200 casos en la literatura. La mayoría de estos tumores aparece en varones adolescentes o adultos jóvenes, como una masa abdominal o pélvica que se extiende de forma difusa por la superficie peritoneal. Presentamos un caso de tumor intrabdominal desmoplásico de células redondas pequeñas en un varón de 22 años. Describimos los hallazgos imaginológicos e histopatológicos. La tomografía computada muestra una masa pélvica, voluminosa, con diseminación peritoneal. Inmonohistoquímicamente el tumor muestra positividad para la desmina, vimentina y fenotipo CAM 5.2 característico. Se analiza el diagnóstico diferencial en relación con los hallazgos radiológicos y se efectúa una revisión de la literatura.

The current and emerging role of cardiovascular magnetic resonance imaging in hypertrophic cardiomyopathy / 中华心血管病杂志

Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiomyopathy and the leading cause of sudden death in young people and a major cause of heart failure symptoms at any age. Due to its genetic etiology, there is substantial heterogeneity in the phenotypic expression and clinical course of patients with HCM. Traditionally, two-dimensional echocardiography has been the easiest and reliable technique for establishing a diagnosis of HCM. However, cardiovascular magnetic resonance (CMR) has emerged as a novel, 3-dimensional tomographic imaging technique, which provides high spatial and temporal resolution images of the heart (not limited by thoracic or pulmonary parenchyma), in any plane and without ionizing radiation. As a result, CMR is particularly well suited to provide detailed characterization of the HCM phenotype, including a precise assessment of the location and distribution of LV wall thickening (as well as other myocardial structures such as the right ventricle and papillary muscles). In this regard, CMR has been demonstrated to provide a diagnosis of HCM in cases where the echocardiogram was non-diagnostic. Furthermore, CMR provides an accurate assessment of total LV mass which is a more robust marker of hypertrophy, with potential implications for risk stratification. In addition, with the intravenous administration of gadolinium, first-pass perfusion sequences can identify myocardial perfusion abnormalities, while late gadolinium enhancement sequences can identify areas of myocardial fibrosis/scarring. Although the clinical implications of late gadolinium enhancement in HCM are still uncertain this information may, in the near-future, have important implications with regard to identifying HCM patients at high risk of sudden death and progressive heart failure, including evolution into the end-stage phase of HCM. Therefore, at present, CMR provides important information impacting on diagnosis and clinical management strategies in patients with HCM and will likely have an expanding role in the evaluation of patients with this complex disease.

Myocardial hypoperfusion due to microvascular dysfunction in hypertrophic cardiomyopathy: role of positron emission tomography / 中华心血管病杂志

Hypertrophic cardiomyopathy (HCM) is characterized by extreme clinical heterogeneity, ranging from sudden cardiac death to long-term disease progression and heart failure-related complications. Myocardial ischemia, occurring at the microvascular level, is a major determinant of clinical expression and outcome. Accordingly, the severity of this microvascular dysfunction has been shown to represent an early and powerful predictor of unfavorable outcome in HCM. The assessment of microvascular function in vivo is technically challenging, although critical to a truly comprehensive evaluation and risk stratification of HCM patients. Available technologies include positron emission tomography and cardiac magnetic resonance (CMR). Studies of regional myocardial blood flow using positron emission tomography have demonstrated that the vasodilator response to dipyridamole is impaired in most HCM patients, not only in the hypertrophied ventricular septum but also in the less hypertrophied or non-thickened left ventricular free wall. CMR also allows measurement of myocardial flow, although the technique is currently time-consuming and largely limited to research situations. CMR provides further insight into the effects of ischemia in HCM patients, by visualizing the distribution and extent of fibrosis at the intramyocardial level. Late gadolinium enhancement (LGE) is a potential predictor of risk in HCM patients, and is believed to largely reflect replacement fibrosis resulting from recurrent microvascular ischemia. LGE is associated with increased prevalence of ventricular arrhythmias, and associated with microvascular dysfunction. The present review is to provide a concise overview for the available evidence of microvascular ischemia and its consequences in HCM.

Individual growth of Heleobia piscium in natural populations (Gastropoda: Cochliopidae) from the multiple use natural Reserve Isla Martin Garcia, Buenos Aires, Argentina / Crescimento individual de Heleobia piscium em populações naturais (Gastropoda: Cochliopidae) da Reserva Natural de usos múltiplos Ilha Martín García, Buenos Aires, Argentina

The present work analyses the individual growth of Heleobia piscium in natural conditions in coastal drainage channels of the Multiple Use Natural Reserve Isla Martín García, Buenos Aires, Argentina. Isla Martín García is located in the Upper Río de la Plata, to the south of the mouth of the Uruguay river (34° 11' 25" S and 58° 15' 38" W). Monthly collections were made from July 2005 to July 2006 in the eastern part of the island (Arena Beach). The population of H. piscium showed a complex and dynamic structure of sizes during a long period of the annual cycle. Two cohorts could be detected. The Bertalanffy growth equation was: Lt = 6 (1-e -1.85 (t+0.38)) and Lt = 3.9 (1-e -0.19 (t+4.84)) for cohorts 1 and 2, respectively. The pattern of population growth displayed a staggered model, where the greatest growth is observed during the summer. The reproductive period occurred during six months, from the beginning of summer to middle of fall. Based on only one reproductive effort, this pattern is not similar to that of other cogeneric species already studied.

O presente trabalho analisa o crescimento individual de Heleobia piscium em condições naturais em poças costeiras da Reserva Natural de Usos Múltiplos Ilha Martín García, Buenos Aires, Argentina. A Ilha Martín García está localizada no Rio da Prata superior, ao sul da desembocadura do rio Uruguai (34° 11' 25" S e 58°15' 38" W). Amostras mensais foram analisadas entre os meses de julho de 2005 e julho de 2006, no setor este da ilha (Praia de Arena). A população de Heleobia piscium se caracterizou por uma complexa e dinâmica estrutura de talhas ao longo de grande parte do ciclo anual. Duas cohortes puderam ser detectadas. A equação de von Bertalanffy para a cohorte 1 foi: Lt = 6 (1-e -1.85 (t+0.38)). Para a cohorte 2: Lt = 3.9 (1-e -0.19 (t+4.84)). O padrão de desenvolvimento da população mostra um modelo escalonado, estendendo-se o período de maior crescimento durante toda a estação do verão. A temporada reprodutiva se manifestou durante seis meses, desde o princípio do verão até meados do outono. Este padrão baseado em um único esforço reprodutivo não se assemelha ao de outras espécies congenéricas já estudadas.