Plantas medicinales utilizadas en la región de Teziutlán, Puebla, México / Medicinal plants used in the region of Teziutlán, Puebla, México

The objective of this work was to collect information on the curative use of plants in the municipality of Teziutlán, Puebla through semi-structured interviews. Thus, 78 plants used for medicinal purposes were identified, of which 40 are native to Mexico and 38 introduced; The value of use (UV) of each one and the Informant's Consensus Factor (FCI) of 10 categories of diseases were calculated. The five most frequently used plants are Ruta chalepensis L., Rosmarinus officinalis, Arnica montana, Loeselia mexicana (Lam.) Brandegee and Sambucus cerulea var., Neomexicana, which underwent a chemical and pharmacological review. On the other hand, the most frequent preparations are infusion and decoction, using mainly leaves (49.34%) and flowers (19.51%). It is concluded that the inhabitants of Teziutlán have a fairly homogeneous ethnomedical knowledge, setting the standard for research on its pharmacological properties.

El objetivo del presente trabajo fue recopilar información sobre el uso curativo de las plantas del municipio de Teziutlán, Puebla por medio de entrevistas semiestructuradas. Así, se identificaron 78 plantas utilizadas con fines medicinales, de las cuales 40 son propias de México y 38 introducidas; se calculó el valor de uso (UV) de cada una y el Factor de Consenso del Informante (FCI) de 10 categorías de padecimientos. Las cinco plantas utilizadas con mayor frecuencia son Ruta chalepensis L., Rosmarinus officinalis, Arnica montana, Loeselia mexicana (Lam.) Brandegee y Sambucus cerulea var., neomexicana, a las que se les hizo una revisión química y farmacológica. Por otro lado, las preparaciones más frecuentes son infusión y decocción, utilizando principalmente hojas (49.34 %) y flores (19.51 %). Se concluye que los habitantes de Teziutlán cuentan con un conocimiento etnomédico bastante homogéneo, dando la pauta para investigaciones sobre sus propiedades farmacológicas.

Caracterización clínico-epidemiológica de las enterocolitis necrosantes neonatales de siete hospitales públicos

Resumen Introducción: Enterocolitis necrosante (ECN) representa una elevada mortalidad y morbilidad post-quirúrgica, gastrointestinal y del neuro-desarrollo. Existe limitada información en Chile. Objetivo: Describir el comportamiento clínico/epidemiológico de recién nacidos que cursaron con ECN. Pacientes y Métodos: Estudio multicéntrico descriptivo de pacientes con ECN de siete hospitales de Santiago, Chile, durante el 2016. Se realizó estadística descriptiva y análisis univariable/multivariable (software SPSS v22). Resultados: Se recolectaron 75 casos. Mediana de edad al diagnóstico fue 11 días, el promedio de edad gestacional 29 semanas y peso de nacimiento 1.285 g. La incidencia fue 2,6 por 1.000/recién nacidos vivos y letalidad de 18,6%, mayor en ≤ 750 g, ≤ 25 semanas y ECN quirúrgica. Hubo aislamiento microbiológico en 45,3% y se utilizaron 19 distintos esquemas antimicrobianos empíricos para el tratamiento de ECN. El análisis multivariable mostró tendencia a que la ECN fuese quirúrgica en usuarios de catéter umbilical arterial, PCR > 10 mg/L y aislamiento microbiológico, y hubo tendencia a fallecer en usuarios de catéter umbilical arterial. Discusión: Es el primer estudio multicéntrico que recopila información de datos locales. La incidencia fue similar a la descrita en la literatura médica, en cambio la letalidad fue algo menor. No existen consensos del tratamiento antimicrobiano a utilizar. Con estos resultados esperamos avanzar en mejorar el diagnóstico y unificar tratamientos antimicrobianos, para reducir cifras de morbimortalidad.

Abstract Background: Necrotizing enterocolitis (NEC) presents high mortality and postoperative, gastrointestinal and neurodevelopmental morbidity. There is limited information about NEC in Chile. Aim: To describe the clinical/epidemiological behavior of newborns who underwent NEC. Methods: Multicenter descriptive study of patients with NEC from seven hospitals of Santiago, Chile, during 2016. Descriptive statistics and univariate/multivariate analysis were performed (SPSS v22 software). Results: 75 cases were collected. Median days of life at diagnosis was 11, gestational age was 29 weeks, birth weight 1,114 g. The incidence was 2.6 per 1,000 live newborns and mortality was 18.6%, higher in ≤ 750 g, ≤ 25 weeks and surgical NEC. There was 45.3% microbiological isolation and 19 different empirical antibiotic schemes were used for the treatment of NEC. The multivariate analysis showed a higher risk of surgery in umbilical arterial catheter users, CRP > 10 mg/L and positive microbiological isolation. The highest risk of death was in umbilical arterial catheter users. Discussion: This ie the first multicenter study that collects local data information. The incidence was similar to that found in medical reports but with a lower mortality. There is no consensus of antibiotic treatment to use. With these results we hope to advance in improving the diagnosis and unify antimicrobial treatments, to reduce morbidity and mortality figures.

Antimicrobianos en neonatología. Parte I: Recomendaciones de dosificaciones basadas, en la más reciente evidencia en recién nacidos Comité Consultivo de Infecciones Neonatales, Sociedad Chilena de Infectología / Antibiotics in neonatology. Part I: Dosage recommendations based on the most recent evidence in newborns Advisory Committee on Neonatal Infections, Chilean Society of Infectious Diseases

Resumen Los antimicrobianos son los medicamentos más utilizados en los neonatos durante su primer mes de vida cuando se encuentran en unidades neonatales, principalmente por el alto riesgo que presentan de adquirir infecciones graves como la sepsis. La mayoría de estos antimicrobianos se utilizan con dosis extrapoladas en base a las recomendaciones en población adulta y niños mayores, a pesar de que la fisiopatología en los recién nacidos es absolutamente diferente. Lo anterior lleva a un mayor riesgo a que ocurran más efectos adversos los que pueden conducir a una mayor toxicidad y a fallas terapéuticas, entre otros. En la última década se han realizado mayores estudios farmacocinéticos de antimicrobianos en neonatos; esta reciente evidencia ha permitido nuevas recomendaciones de dosificación considerando el peso y la edad gestacional del recién nacido, entre otras variables, de acuerdo al antimicrobiano estudiado. En base a una mayor evidencia sobre el comportamiento farmacocinético de los antimicrobianos en neonatos, se ha elaborado este documento para así facilitar y promover su correcto uso en las unidades neonatales.

Abstract Antibiotics are the most widely used medications in neonates during their first month of life in neonatal units, mainly due to the high risk they present of acquiring serious infections such as sepsis. Most of these antibiotics are used with extrapolated doses based on the suggestions in the adult population and older children, despite the fact that the pathophysiology in newborns is absolutely different. This leads to a higher risk of more adverse effects occurring, which can lead to greater toxicity and therapeutic failures, among others. In the last decade more and more pharmacokinetic studies of antibiotics have been carried out in neonates, this recent evidence has led to new dosage recommendations taking into account the weight and gestational age of the newborn, among other variables, in agreement to the antibiotic studied. Therefore, based on the need to order and summarize the most up-to-date and most evidence-based information on antibiotics in neonates, this document was prepared to facilitate and promote its correct use in neonatal units.

Lesión de la rama anterior del nervio interóseo posterior / Injury of the anterior branch of the posterior interosseous nerve

Resumen: Introducción: El síndrome del nervio interóseo posterior, rama del nervio radial a nivel del antebrazo se caracteriza por la pérdida de función motora de algunos o todos los músculos inervados distalmente. Caso clínico: Masculino de 26 años con antecedente de fractura de radio proximal manejado con osteosíntesis que cursó con lesión del nervio radial siete años antes con recuperación completa, acude con dolor intenso a 4 cm distal a cabeza radial, acompañado de parálisis del extensor largo y corto del pulgar y del abductor del pulgar, con paresia del extensor propio del índice, en el que se efectúa diagnóstico de síndrome de atrapamiento de la rama anterior descendente del nervio interóseo posterior (SNIP). Discusión: El manejo conservador del SNIP está indicado durante las primeras ocho a 12 semanas, de no mostrar mejoría la indicación de exploración quirúrgica está indicada, siendo el retiro de material de osteosíntesis controvertido.

Abstract: Introduction: Posterior interosseous nerve syndrome, a branch of the radial nerve at the level of the forearm, is characterized by the motor function loss of some or all of the muscles innervated distally. Clinical case: A 26-year-old male with a history of proximal radius fracture associated to radial nerve injury, treated with osteosynthesis 7 years earlier, with full recovery, who currently presented intense pain 4 cm distal to the radial head, accompanied by paralysis of Extensor pollicis longus , Extesnor pollicis brevis and Abductor pollicis longus, with paresis of the Extensor indicis propius , in which a diagnosis of entrapment syndrome of the anterior descending branch of the posterior interosseous nerve (SNIP) was performed. Discussion: The conservative management of SNIP is indicated during the first 8-12 weeks, if no improvement is found, the indication for surgical exploration is indicated, and the removal of osteosynthesis material is controversial.

Lesiones de hombro en la tercera edad y su repercusión funcional en escala de DASH / Shoulder injuries in the elderly and their functional impact on the DASH scale

Resumen: Introducción: Los problemas discapacitantes de hombro en la tercera edad son frecuentes. Objetivo: Cuantificar los diagnósticos encontrados en 100 casos consecutivos en rehabilitación y su repercusión funcional en la escala de DASH. Material y métodos: 100 pacientes consecutivos con edad > 65 años recibidos en rehabilitación, se efectuó diagnóstico y valoración funcional en la escala de DASH. Resultados: La distribución por género con predominio del femenino (67%); la edad mostró variación de 65 a 98 años con promedio y DE 78 ± 12; los 10 diferentes diagnósticos correspondieron a ruptura del tendón supraespino (58%); artrosis glenohumeral (11%); síndrome de pinzamiento (9%); secuelas de fractura de tercio proximal de húmero (9%); artrosis acromioclavicular (7%); ruptura del tendón de la porción larga del bíceps (2%); fractura de la escápula (1%); necrosis avascular de cabeza humeral (1%); luxación escápulo-humeral recidivante inveterada (1%) y lesión del nervio circunflejo (1%). La distribución correspondió a 52% derechas, 40% izquierdas y 8% bilaterales. La escala de DASH mostró variación de 94 a 52% con promedio y DE 71 ± 22.3. Los problemas de hombro en la tercera edad se asocian siempre a discapacidad importante.

Abstract: Introduction: Disabling shoulder problems in the elderly are common. Objective: To quantify the diagnoses found in 100 consecutive shoulders cases in rehabilitation and its functional impact on the DASH scale. Material and methods: 100 consecutive patients with age > 65 years received in the Rehabilitation Department, performing diagnosis and functional assessment in the DASH scale. Results: Distribution by gender with predominance of the female (67%); the age showed variation from 65 to 98 years with average and SD 78 ± 12. Ten different diagnoses were found: supraspinatus tendon rupture (58%); gleno-humeral osteoarthritis (11%); impingement syndrome (9%); proximal humeral fracture (9%); acromio-clavicular osteoarthritis (7%); long biceps tendon rupture (2%); scapula fracture (1%); humeral head avascular necrosis (1%); neglected gleno-humeral dislocation (1%) and circumflex nerve injury (1%). The distribution corresponded to 52% right, 40% left and 8% bilateral. The DASH scale showed variation from 94 to 52% with mean and SD 71 ± 22.3. Elderly shoulder problems are associated with disability, its relation with DASH is not clear.

Foliar phenolic compounds of ten wild species of Verbenacea as antioxidants and specific chemomarkers / Compostos fenólicos das folhas de dez especies selvagem de Verbenaceae como antioxidantes e quimiomarcadores específicos

Abstract The family Verbenaceae hosts important species used in traditional medicine of many countries. The taxonomic controversies concerning the specific delimitation of several of its species make it difficult to guarantee the botanical origin of herbal preparations based on species of this family. To contribute to the development of both specific chemomarkers and a quality control tool to authenticate the botanical origin of herbal preparations of Verbenacea species, we determined the foliar HPLC-DAD phenolic profiles and the antioxidant properties of 10 wild species of this family occurring in Mexico. The contents of phenols and flavonoids varied significantly among species. Priva mexicana showed the highest levels of total phenolics (53.4 mg g-1 dry tissue) and Verbena carolina had the highest levels of flavonoids (17.89 mg g-1 dry tissue). Relevant antioxidant properties revealed by antiradical and reducing power were found for the analyzed species. These properties varied significantly in a species-dependent manner. The phenolic compounds accumulated were flavones and phenolic acids. Flavones were the only type of flavonoids found. The results of a cluster analysis showed that the compounds were accumulated in species-specific profiles. The phenolic profiles are proposed as valuable chemomarkers that can become a useful tool for the quality control concerning the botanical origin of herbal medicinal preparations based on the species analyzed. In addition, phenolic profiles could contribute importantly to solve the taxonomic controversies concerning species delimitation in the family Verbenaceae.

Resumo A família Verbenaceae compreende importantes espécies utilizadas na medicina popular de muitos países. As dificuldades taxonômicas relativas à delimitação específica de muitas das suas espécies face difícil a verificar a origem botânico das preparações herbales baseadas nas espécies desta família. Para fazer uma contribuição ao desenvolvimento de indicadores taxonômicos e dum método de controle de qualidade para verificar a origem botânico de preparações herbales das espécies de Verbenaceae, os perfis fenólicos, obtidos pares HPLC-DAD, e as atividades antioxidantes das folhas de 10 espécies selvagens Mexicanas desta família foram determinados. Os conteúdos dos compostos fenólicos totais e dos flavonoides foram significativamente diferentes entre as espécies. Priva mexicana apresentou a maior quantidade de compostos fenólicos totais (53.4 mg g-1 amostra seca) e Verbena carolina apresentou a maior quantidade de flavonoides (17.89 mg g-1 amostra seca). Verifica-se importantes propriedades antioxidantes, como os resultados dos ensaios da capacidade antiradical e do poder redutor indicaram. As propriedades antioxidantes foram significativamente diferentes entre as espécies. Verificou-se que os compostos fenólicos conteúdos nas folhas das espécies analisadas foram só flavonas e ácidos fenólicos. Os resultados das análises de agrupamento provarãn que os perfiles fenólicos foram espécie-específicos. Estes perfis podem ser considerados como indicadores químicos da qualidade relativa à origem botânico de preparações medicinais baseadas nas espécies analisadas e podem fazer importantes contribuições para a delimitação específica na família Verbenaceae.

Foliar phenolic compounds of ten wild species of Verbenacea as antioxidants and specific chemomarkers

Abstract The family Verbenaceae hosts important species used in traditional medicine of many countries. The taxonomic controversies concerning the specific delimitation of several of its species make it difficult to guarantee the botanical origin of herbal preparations based on species of this family. To contribute to the development of both specific chemomarkers and a quality control tool to authenticate the botanical origin of herbal preparations of Verbenacea species, we determined the foliar HPLC-DAD phenolic profiles and the antioxidant properties of 10 wild species of this family occurring in Mexico. The contents of phenols and flavonoids varied significantly among species. Priva mexicana showed the highest levels of total phenolics (53.4 mg g-1 dry tissue) and Verbena carolina had the highest levels of flavonoids (17.89 mg g-1 dry tissue). Relevant antioxidant properties revealed by antiradical and reducing power were found for the analyzed species. These properties varied significantly in a species-dependent manner. The phenolic compounds accumulated were flavones and phenolic acids. Flavones were the only type of flavonoids found. The results of a cluster analysis showed that the compounds were accumulated in species-specific profiles. The phenolic profiles are proposed as valuable chemomarkers that can become a useful tool for the quality control concerning the botanical origin of herbal medicinal preparations based on the species analyzed. In addition, phenolic profiles could contribute importantly to solve the taxonomic controversies concerning species delimitation in the family Verbenaceae.

Resumo A família Verbenaceae compreende importantes espécies utilizadas na medicina popular de muitos países. As dificuldades taxonômicas relativas à delimitação específica de muitas das suas espécies face difícil a verificar a origem botânico das preparações herbales baseadas nas espécies desta família. Para fazer uma contribuição ao desenvolvimento de indicadores taxonômicos e dum método de controle de qualidade para verificar a origem botânico de preparações herbales das espécies de Verbenaceae, os perfis fenólicos, obtidos pares HPLC-DAD, e as atividades antioxidantes das folhas de 10 espécies selvagens Mexicanas desta família foram determinados. Os conteúdos dos compostos fenólicos totais e dos flavonoides foram significativamente diferentes entre as espécies. Priva mexicana apresentou a maior quantidade de compostos fenólicos totais (53.4 mg g-1 amostra seca) e Verbena carolina apresentou a maior quantidade de flavonoides (17.89 mg g-1 amostra seca). Verifica-se importantes propriedades antioxidantes, como os resultados dos ensaios da capacidade antiradical e do poder redutor indicaram. As propriedades antioxidantes foram significativamente diferentes entre as espécies. Verificou-se que os compostos fenólicos conteúdos nas folhas das espécies analisadas foram só flavonas e ácidos fenólicos. Os resultados das análises de agrupamento provarãn que os perfiles fenólicos foram espécie-específicos. Estes perfis podem ser considerados como indicadores químicos da qualidade relativa à origem botânico de preparações medicinais baseadas nas espécies analisadas e podem fazer importantes contribuições para a delimitação específica na família Verbenaceae.

Ruptura del músculo cuadrado crural / Quadratus femoris muscle tear

Resumen: Antecedentes: La ruptura del músculo cuadrado crural es una lesión poco frecuente que se manifiesta por dolor en cadera y cuya incidencia se desconoce. El paciente puede manifestar dolor en región glútea y/o inguinal, su diagnóstico clínico es difícil por su rareza y porque el diagnóstico diferencial de problemas de cadera es amplio. Caso clínico: Masculino de 65 años con dolor en regiones glútea e inguinal derechas manifestadas durante la práctica de tenis, evaluado por neurología con resonancia magnética nuclear (RMN) lumbosacra (normal) y canalizado a rehabilitación. Se solicitó RMN de pelvis, la cual reveló ruptura del cuadrado crural derecho no sospechada previamente. Conclusión: La RMN por su capacidad para mostrar cortes multiplanares es el estudio de elección en problemas de tejidos blandos en cadera, ya que permite localización y auxilia en diagnóstico de problemas no sospechados.

Abstract: Background: Quadratus femoris tear is an uncommon injury that usually cause hip pain, it incidence is unknown. The patient can suffer of posterior gluteal pain or groin pain or both, which makes accurate diagnosis difficult, because the differential diagnosis of hip pain is broad. Clinical case: A 65 years old male, with gluteal and groin pain presented during tennis; evaluated by neurologist with lumbosacral magnetic resonance imaging (MRI) (normal) and referred to physical therapy, a pelvic MRI was required, finding an unsuspected quadratus femoris tear. Conclusion: MRI with its superior soft-tissue resolution and multiplanar capability is an excellent adjunct to physical examination because it shows the anatomic location of the abnormality, aiding the clinician to make unsuspected diagnoses.

Lesión del músculo ilíaco por ejercicio inadecuado / Iliacus muscle injury caused by inadequate exercise

Resumen: Antecedentes: La lesión traumática del músculo ilíaco es rara; generalmente es causada por trauma o ejercicio intenso, que ocasiona hematoma del músculo con neuropatía del nervio femoral como complicación. Los hematomas espontáneos del mismo ocurren en pacientes con trastornos de la coagulación. Caso clínico: Masculino de 45 años con 18 días de evolución, con dolor intenso en la nalga, ingle y fosa ilíaca derechas e incapacidad de realizar flexión de la cadera, originados durante la realización de movimientos repetitivos (flexión de la cadera con elevación bilateral de las extremidades inferiores en posición supina). A la exploración: dolor a la flexión y/o rotación interna de la cadera derecha, maniobra Thomas positiva, cuádriceps con fuerza muscular 2/5; zona de parestesias en el territorio del nervio femoral derecho. La resonancia magnética de pelvis mostró ruptura parcial del músculo ilíaco, con sangre entre sus fibras. El paciente fue tratado con reposo y analgésicos durante ocho días, extensión gradual de la cadera, muletas axilares con apoyo parcial; a los ocho días se inició con diatermia a fosa ilíaca, ejercicios activos asistidos de flexión-extensión de cadera, bicicleta ergométrica y fortalecimiento del cuádriceps. La evolución fue satisfactoria; fue dado de alta asintomático a las seis semanas.

Abstract: Background: Traumatic iliacus muscle injury is rare; it is usually caused by trauma or intense exercise involving the pelvic girdle; it can produce a hematoma with femoral nerve neuropathy. Spontaneous muscle hematomas occur in patients with coagulation disorders. Clinical case: A 45-year-old male with 18 days of evolution, with an intense pain in the right buttock, groin and iliac fossa, with an inability for hip flexion and ambulation caused by inadequate exercise (supine double leg lifts). On the physical examination: intense pain with bending and/or internal rotation of the right hip, positive Thomas maneuver, quadriceps rated 3/5; area of paresthesia in the right femoral nerve territory. Pelvic magnetic resonance imaging showed: right iliacus muscle tear with blood between its fibers. Initial treatment was rest and analgesics for eight days and gradual extension of the hip, axillary crutches with partial weight bearing and diathermy on the right abdominal lower quadrant, active hip exercises, bicycle and right quadriceps strengthening. The evolution was satisfactory, with full recovery in six weeks.

Bioaccumulation and Evidence of Hormonal Disruptions in Tilapia Fish (Oreochromis spp.) Exposed to Sub-lethal Concentrations of Pesticides in Sinaloa, Mexico.

Examination of endocrine disruption in tilapia fish (Oreochromis spp.) after exposure to sub-lethal concentrations of endosulfan, lindane, diazinon and malathion was evaluated by the quantification of 17-β-estradiol, progesterone and testosterone in fish. Female tilapia (96-110 g/fish) were exposed to 2.8, 15, 225 and 315 μg/l of endosulfan, lindane, diazinon and malathion, respectively; while, the male tilapia (same range weight) were exposed to 2.8 μg/l endosulfan and 315 μg/l of malathion separately for 21 days. The obtained results showed that the level of 17-β-estradiol and progesterone concentration in female, were significantly decreased in all treatment. Similarity, the level of testosterone was decreased significantly in the blood of male fish exposed to endosulfan and malathion pesticides when compared to the control fish group. The bioaccumulation of pesticides in muscular tissue of fishes were 760, 310, 41.3 and 11.9 (μg/g) for endosulfan, lindane, malathion and diazinon, respectively. Results suggest that pesticides assayed, are endocrine disruptors in tilapia, which can affect the reproduction and other biochemical and physiological functions controlled by hormones. On the other hand, pesticides accumulated in fish muscle represent a risk for public health, since tilapia is a popular food in Mexico like in others developing countries.

Angio TC en la identificación preoperatoria de vasos perforantes / CT angiography in preoperative identification of perforator vessels

Introducción: Los colgajos de perforantes se han convertido en una opción de cobertura válida cada vez más utilizada en cirugía reconstructiva. Se caracterizan porque requieren de la identificación preoperatoria y disección intraoperatoria del vaso perforante. El objetivo del presente trabajo fue evaluar el Angio TC en el estudio preoperatorio de los vasos perforantes y su correlación con los hallazgos intraoperatorios. Material y Métodos: Análisis retrospectivo de todos los colgajos de perforantes realizados en la Unidad de Cirugía Plástica del Hospital Clínico de la Universidad de Chile entre junio de 2009 y junio de 2012. A todos los pacientes se les solicitó un Angio TC según el protocolo de la Universidad de Gent (Bélgica). Se utilizaron puntos de referencias específicos y un sistema de coordenadas para localizar el punto en el cual la perforante cruza la fascia superficial. La información entregada por el Angio TC se comparó con los hallazgos quirúrgicos. Resultados: A un total de 41 pacientes se les realizó Angio TC para la planificación de un colgajo de perforante durante el período en estudio, 40 fueron operados: 18 mujeres y 22 hombres, edad promedio de 46,6 +/- 5,7 años. Se realizaron los siguientes colgajos: Anterolateral de Muslo (ALT) = 14, Epigástrica Inferior (DIEP) = 18, Glútea Superior (SGAP) = 5, Tibial Posterior (PTAP) = 4 y Toracodorsal (TDAP) = 2. En todos ellos el Angio TC ubicó una o varias perforantes en forma precisa y 100 por ciento concordante con los hallazgos intraoperatorios. Conclusiones: El Angio TC es un examen con alto rendimiento en la identificación preoperatoria del vaso perforante y su trayecto. Es una herramienta de gran ayuda al momento de planificar la realización de este tipo de colgajos.

Introduction: Perforator flaps have become a coverage option validated and increasingly used in reconstructive surgery. These flaps require preoperative identification and intraoperative dissection of the perforator vessels. The aim of this study was to evaluate the use of Angio CT in the preoperative assessment of perforating vessels and its correlation with intraoperative findings. Material and Methods: We retrospectively reviewed all perforator flaps performed at the Division of Plastic Surgery, University of Chile Clinical Hospital between June 2009 and June 2012. All patients were asked for an Angio CT according to the protocol of the University of Gent (Belgium). Data points were used and a specific coordinate system to locate the point at which the perforator vessel fenestrate the deep fascia. The information provided in the Angio CT was compared with surgical findings. Results: A total of 41 patients underwent perforator flap planning during the study period. 40 underwent surgery: 18 women and 22 men, with a mean age of 46.6 ± 5.7 years. Flaps were performed as follows: anterolateral thigh (ALT) = 14, inferior epigastric (DIEP) = 18, superior gluteal (SGAP) = 5, posterior tibial (PTAP) = 4 and thoracodorsal (TDAP) = 2. In all cases the Angio CT identified one or more perforator vessel with a 100% concordance with intraoperative findings. Conclusions: CT Angio is a test with high performance in preoperative characterization of perforator vessels. It is a helpful tool that must be considered whenever planning this type of flaps.

Resistencia a lambdacihalotrina y fenitrotión en una población de campo de Panstrongylus geniculatus (Hemiptera: Reduviidae: Triatominae) / Lambdacyhalothrin and fenitrothion resistance in a field population of Panstrongylus geniculatus (Hemiptera: Reduviidae: Triatominae)

Introducción: Panstrongylus geniculatus es un triatomino silvestre, vector del Trypanosoma cruzi, intruso en domicilios humanos. Determinar la susceptibilidad a insecticidas de uso común en esta especie es indispensable para detectar prematuramente cepas resistentes. Objetivo: Este estudio se propuso analizar la susceptibilidad a lambdacihalotrina y fenitrotión en dos cepas (laboratorio y campo) de P. geniculatus. Metodología: se estableció la susceptibilidad a lambdacihalotrina y fenitrotión por aplicación tópica, en la cepa de laboratorio-Molagavita 2003 y en la población de campo-Chorreras 2012 en ninfas del primer estadio de P. geniculatus. Se calcularon valores de dosis letal 50 y dosis letal 99 (DL50 y la DL99) para cada insecticida. También se determinaron valores de grado de resistencia (GR) para cada insecticida: DL50 población de campo/DL50 cepa de laboratorio. Resultados: Las DL50 y DL99 en la población de campo y la cepa de laboratorio (en ng/i), fueron: 1,194; 5,764 y 0,024; 0,131 para lambdacihalotrina y 1,476; 7,354 y 0,482; 5,471 para fenitrotión, respectivamente. Los grados de resistencia fueron: GR= 48,9 para lambdacihalotrina y GR= 3,06 para fenitrotión. Conclusiones: La población de campo mostró resistencia a lambdacihalotrina y fenitrotión, probablemente como consecuencia del uso de agroquímicos en la zona. Implementar medidas para la detección temprana de resistencia en triatominos es importante en el diseño de programas de control vectorial.

Introduction: Panstrongylus geniculatus, is a wild triatomine, vector of Trypanosoma cruzy, intruder in human homes. To determine the susceptibility to insecticides commonly used in this specie is essential to detect resistant strains prematurely. Objective: This study aimed to analyze the susceptibility to lambdacyhalothrin and fenitrothion in two strains (laboratory and field) of P. geniculatus. Methodology: susceptibility was established to lambdacyhalothrin and fenitrothion by topical application in the laboratory strain - Molagavita 2003 and field population - Chorreras 2012 in first instar nymphs of P. geniculatus. Values were calculated for lethal dosis 50 and lethal dosis 99 (LD50 and LD99) for each insecticide. Also values were determined to degree of resistance (GR) for each insecticide: field population LD50/LD50 laboratory strain. Results: The LD50 and LD99 in the field population and the laboratory strain (in ng/i) were: 1,194, 5,764 and 0,024, 0,131 for lambdacyhalothrin and 1,476, 7,354 and 0,482, 5,471 to fenitrothion, respectively. The degrees of resistance were: GR=48.9 for lambdacyhalothrin and GR=3.06 for fenitrothion. Conclusions: The field population showed resistance to lambdacyhalothrin and fenitrothion, probably as a result of the use of chemicals in the area. Implement measures for early detection of resistance in triatomines is important in the design of vector control programs.

Absceso del psoas tuberculoso, debut en paciente inmunodeprimido: presentación de un caso / Tuberculous psoas abscess, debut in immunocompromised patient: case report

INTRODUCCIÓN: El absceso del psoas (AP) es una patología infrecuente de difícil diagnóstico. Se clasifica en primario o secundario teniendo como factor de riesgo común la inmunodeficiencia. PRESENTACIÓN DEL CASO: Paciente masculino de 40 años sin antecedentes mórbidos. Consulta por cuadro de un mes de evolución caracterizado por dolor lumbar derecho que aumenta al flexionar el muslo ipsilateral. Se asocia compromiso del estado general, dolor abdominal, sensación febril no cuantificada y bradipsiquia. La Tomografía computada (TC) de abdomen y pelvis mostró hipodensidad en relación al músculo psoas derecho diagnosticándose AP primario. El paciente evoluciona con shock séptico, siendo manejado con antibióticos de amplio espectro sin mejoría. Se realizan exámenes generales, Punción lumbar (PL) y Test de Elisa para VIH (TEVIH), resultando la PL compatible con Tuberculosis meníngea y el TE positivo. Se inició tratamiento empírico anti-tísico en espera del cultivo de Koch. Paciente evoluciona favorablemente. Se realiza una TC de control luego de dos semanas de tratamiento, que muestra imagen similar a la inicial, agregándose compromiso vertebral L4-L5, diagnosticándose Enfermedad de Pott (EP) y AP secundario. Se realiza punción y drenaje del absceso y se toma cultivo de Koch que resulta positivo. Paciente evoluciona asintomático, con buena respuesta al tratamiento. DISCUSIÓN: El AP secundario a EP es una entidad poco sospechada. Sin embargo, con métodos diagnósticos como la TC es posible realizar un diagnóstico precoz. Mycobacterium tuberculosis es una causa infrecuente de abscesos del psoas, pero debido al aumento de la población VIH positiva, es probable que aumente su incidencia.

INTRODUCTION: Psoas abscess is an uncommon disease with difficult diagnosis. It can be primary or secondary; immunodeficiency is among risk factors. CASE REPORT: 40 year-old male with no past medical history. He presented to the emergency department with right lumbar pain worsened with flexion of ipsilateral thigh. Involvement of general condition, abdominal pain, unquantified fever and bradypsychia were also present. Computed tomography (CT) scan of the abdomen and pelvis showed an hypodense lesion in the right psoas muscle. Primary psoas abscess was first diagnostic impression. Patient evolved to septic shock and was treated with broad spectrum antibiotics without improvement. General examinations were performed, lumbar puncture supported meningeal tuberculosis and HIV ELISA test was positive. Empirical quintuple therapy for tuberculosis was started before cerebrospinal fluid culture results, with favorable clinical evolution. Control CT scan was similar compared to first one but with L4 – L5 vertebrae involvement. Pott disease and secondary psoas abscess was diagnosed. Koch’s Bacillus culture from abscess puncture were positive. Patient had clinical improvement with antituberculous therapy. DISCUSSION: Psoas abscess is a rarely suspected patology, but with diagnostic methods as CT is possible to make an early diagnosis. Even though Mycobacterium tuberculosis is a rarer cause of psoas abscess, but more cases are expected due to the increased incidence of HIV – positive patients, more cases are expected eventually.

Características biológicas del tejido adiposo: el adipocito como célula endocrina / Biological characteristics of the adipose tissue: adipocyte as an endocrine cell

La obesidad se caracteriza por un aumento de la masa adiposa secundaria a un balance energético positivo mantenido en el tiempo. El incremento en el volumen del tejido adiposo se acompaña de otros cambios en las características biológicas habituales de éste, que se vuelve disfuncional. El depósito visceral de la grasa, la hipertrofia y cambio del perfil secretor de los adipocitos, junto con la infiltración del tejido adiposo por células inflamatorias son algunas de las características que determinan una comunicación alterada del tejido adiposo con otros órganos. Se ha planteado que la disfunción del tejido adiposo, explicaría parte de la etiopatogenia de las enfermedades metabólicas y cardiovasculares asociadas a obesidad; sujetos obesos que mantienen un tejido adiposo funcional no presentan las alteraciones metabólicas propias de la malnutrición por exceso. La modulación de las características biológicas del tejido adiposo permitiría tener un menor riesgo cardiovascular asociado a obesidad.

Obesity is characterized by an increase in the adipose mass, which is due to the deposit of the fatty acids surplus in adipose cells, due to a positive energy balance maintained over the time. Along with the increase in the volume of adipose tissue, there are changes in its normal physiology, driving it toward a dysfunctional tissue. Such changes involve adipocyte hypertrophy and changes in its secretory profile, visceral deposit of fat, increased immune cell infiltration, among others. Adipose tissue dysfunction possibly plays a pivotal role in the pathophysiology of obesity-related metabolic and cardiovascular diseases. The understanding of these changes in adipose tissue function could provide a tool for modulating the metabolic and cardiovascular burden of obesity.

Ingesta y metabolismo energético en una muestra de adolescentes chilenos con sobrepeso y obesidad / Intake and energy metabolism in a sample of overweight and obese Chilean adolescents

Background: In the last decades, a seven to nine fold increase in the prevalence of teenage obesity and overweight has occurred. Aim: To assess energy intake and metabolism in a sample of overweight and obese adolescents. Material and Methods: In a sample of 113 overweight and obese Chilean adolescents (aged 13 to 16 years, 67 females) we studied anthropometry, body composition by deuterium isotope dilution water, resting energy expenditure by indirect calorimetry and 24-h diet and physical activity recalls. Results: Most participants (87 percent of men and 67.2 percent of women) had an intake that was adequate compared to requirements (fAO/WHO 2005). However, 82.6 percent of men and 83.6 percent of women showed reduced energy expenditure. The sample was classifed as sedentary, with a physical activity level of 1.29. Conclusions: In our sample of overweight and obese adolescents there was a sedentary behavior, resulting in low energy expenditure that would explain a sustained caloric retention. Preventive and therapeutic interventions should encourage the increase in physical activity.

Fenoles de interés farmacológico en hojas de vides silvestres (Vitis spp. ) de México / Phenols of pharmacological interest in leaves of wild grapevines (Vitis spp. ) of Mexico

Sedentary styles of life, along with inadequate nutritional habits, increase the risk to develop degenerative chronic diseases. Searching for possible alternatives of prevention for those risks, it has been investigated about the quality and nutraceutic properties of several agricultural commodities. The phenols are substances with important functions in vegetal organisms; and moreover they have antioxidants properties in the cellular metabolism of humans and animals. In order to quantify the content of three phenolic acids and a stilbene, it was performed analyses, by high performance liquid chromatography (HPLC-UV/Vis), on metanolic leave extracts of 97 wild grapevines (Vitis spp.) of Puebla, Mexico. Those plants were found growing in their natural environments from 207 to 2175 m. The gallic acid was the most common of the metabolites since it appeared in 96 of the 97 samples, rutin was the second most common substance and it was identified in 80 samples, the caffeic acid appeared in 29 and finally resveratrol only in 14. The leaves of wild grapevines contain diverse antioxidants substances that might have several benefits in the human health; in addition the suitable conservation, maintenance and correct advantage of this plant genus provide environmental services and the balance of ecosystems.

Estilos de vida sedentarios, conjugados con inadecuados hábitos alimenticios, incrementan el riesgo de contraer enfermedades crónicas degenerativas. En la búsqueda de posibles alternativas de prevención, se ha investigado en la calidad y aspectos nutracéuticos de productos agrícolas. Los fenoles son sustancias con importantes funciones en organismos vegetales que, además, poseen propiedades antioxidantes en el metabolismo celular de humanos y animales. Con objeto de cuantificar el contenido de tres ácidos fenólicos y un estilbeno, fueron realizados análisis por cromatografía de líquidos de alta resolución (HPLC-UV/Vis) en extractos metanólicos de hojas provenientes de 97 accesiones de vides silvestres (Vitis spp.) de Puebla, México que crecían en su ambiente natural desde 207 hasta 2175 msnm. El ácido gálico fue el más común de los metabolitos ya que se presentó en 96 de las 97 muestras, el rutín fue la segunda sustancia en común y se identificó en 80 muestras; el ácido caféico se presentó en 29 y finalmente el resveratrol en 14. Las hojas de vides silvestres poseen diversas sustancias antioxidantes que podrían tener múltiples beneficios en la salud humana; además la adecuada conservación, mantenimiento y aprovechamiento de este género provee servicios ambientales y el equilibrio de ecosistemas.

Perfil de metilación de genes supresores de tumores como factor pronóstico en pacientes con leucemia mieloide aguda / Promoter methylation profile in tumor suppressor genes as prognosis factor in patients with acute myeloid leukemia

Existe creciente evidencia que apoya la presencia de un perfil de metilación específico para Leucemia Mieloide Aguda (LMA). La metilación de los islotes CpG en las regiones promotoras de los genes supresores de tumores es un importante mecanismo de control epigenético y participa en el silenciamiento transcripcional. Esto puede contribuir a un nuevo entendimiento de la biología de la enfermedad y vislumbrar nuevas oportunidades terapéuticas. Identificar el perfil de metilación de las áreas promotoras de un grupo de genes supresores de tumores; (p15, p16, ESR1, IGSF4, SOCS1, RARB y DAPK), y relacionar el estatus de metilación gen especifica o combinada con diferentes parámetros clínico patológicos. Se utilizaron muestras de sangre o médula ósea obtenidas al momento del diagnóstico de 33 pacientes con LMA, infantil y del adulto, recolectadas entre los años 1997 y 2008 en el Hospital Hernán Henríquez de Temuco. Se evaluó la presencia de hipermetilación mediante una Reacción de Polimerasa en Cadena Metilación Específica (MSP), previa modificación con bisulfito de sodio. La frecuencia de metilación de los pacientes estudiados fue de 88 por ciento, 27 por ciento, 27 por ciento, 21 por ciento, 15 por ciento, 3 por ciento y 0 por ciento para ESR1, RARb, IGSF4, p15, SOCS1, DAPK, y P16, respectivamente. La hipermetilación de P15 y RARb presentó una asociación significativa para una menor supervivencia en forma individual (p=0,03 y p=0,02), y combinada (p=0,002). No se encontraron diferencias significativas entre metilación y los otros parámetros clínicos analizados. Los pacientes con LMA presentan hipermetilación de la región promotora en algunos genes supresores de tumores, afectando negativamente la supervivencia. Esto pudiese eventualmente contribuir al establecimiento de un patrón de metilación determinado con utilidad clínica.

There is growing evidence than acute myeloid leukemia presents a specific methylation profile. The Methylation of CpG islands within gene promoters is a major epigenetic transcriptional control mechanism and plays a critical role in the transcriptional silencing of tumor suppressor genes. This provides new insights into the biology of the disease and it may offer novel therapeutic opportunities. To identify the promoter methylation profile of tumor suppressor genes (p15, p16, ESR1, IGSF4, SOCS1, RARB y DAPK), and to relate the percentage of methylation with clinicopathological features, as age, gender, white cell count, disease classification and survival rates. Bone marrow and peripheral blood samples were collected at diagnosis from 33 patients with acute myeloid leukemia, infants and adult, between 1997 and 2008 from Hernán Henríquez Aravena Hospital, Temuco, Chile. Methylation in the promoter areas of each tumor suppressor gene was analyzed using the mehylation specific polymerase chain reaction (MSP) technique using sodium bisulfite modification. The frequency of hypermethylation among the patient samples was 88 percent, 27 percent, 27 percent, 21 percent, 15 percent, 3 percent and 0 percent for ESR1, RARb, IGSF4, p15, SOCS1, DAPK, and P16 for each one. Methylation was significantly associated with an inferior overall survival (p=0.03 and p=0.02). When both genes are used, inferior survival is even more significant (p=0.002). There is no significant correlation between methylation and clinicopathological features.Patients with AML have hipermetilation at the promoter region of some tumor supressor genes, with a negative effect in the overall survival. This could eventually become part of establishing a characteristical methilation pattern with clinical utility.