Foraging density for squirrel monkey Saimiri sciureus in two forests in Puerto Lopez - Colombia / Densidad de forrajeo para el tití Saimiri sciureus en dos bosques de Puerto López - Colombia

Objective. Forest remnants were analyzed to determine the density of squirrel monkeys (Saimiri sciureus) and the degree of alteration of the forest, by selecting areas for the conservation and maintenance of the species in natural environments. Materials and methods. Linear transects were conducted on two wooden fragments, "La Reforma" and "Campo Hermoso" farms (Puerto Lopez, Meta, Colombia), recording sightings of squirrel monkeys and identifying the tree species used by the primates. Results. The fragments studied correspond to trails at the edge of water bodies with low connectivity. Highest density values were observed on the second transect of La Reforma, a possible consequence of an overcrowding phenomenon due to the high degree of isolation of the fragment. The species preferentially used as refuge and food source were: Bellucia grossularioides, Eugenia jambos, Inga alba, Mauritia flexuosa, Pseudolmedia laevis and Rollinia edulis. Conclusions. The phenology of the plant species allows for a dynamic food supply, considering the constant availability of food for the primates. Therefore, despite the evident ecological problem of these forests, it is possible to use active restoration programs to strengthen the existing dynamics and balance the biogeochemical dynamics of the ecosystem, so that socioeconomic human activities are not in conflict with conservation efforts and vice versa.

Objetivo. Fueron analizados remanentes boscosos para determinar la densidad del Tití (Saimiri sciureus) y el grado de alteración del bosque, pretendiendo seleccionar áreas para conservación y mantenimiento de la especie en ambientes naturales. Materiales y métodos. Se realizaron transectos lineales en dos fragmentos boscosos, Hacienda La Reforma y Campo Hermoso (Puerto López, Meta-Colombia), registrando avistamientos del Tití e identificando las especies de árboles utilizadas por los primates. Resultados. Los fragmentos estudiados son senderos a la vera de cuerpos de agua con baja conectividad. Se observaron mayores valores de densidad en el segundo transecto de La Reforma; posiblemente como consecuencia de un fenómeno de sobrepoblación, debido al alto grado de aislamiento del fragmento. Las especies utilizadas preferencialmente como refugio y fuente alimenticia son: Bellucia grossularioides, Eugenia jambos, Inga alba, Mauritia flexuosa, Pseudolmedia laevis y Rollinia edulis. Conclusiones. La fenología de las especies de plantas permite un abastecimiento de alimento dinámico, considerando la disponibilidad constante de alimento para los primates, permitiendo afirmar que a pesar del evidente problema ecológico de estos bosques es posible utilizar programas de restauración activa para fortalecer la dinámica existente y equilibrar la dinámica biogeoquímica del ecosistema, para que las actividades antrópicas socio-económicas no estén en contraposición a la conservación y viceversa.

Obtención y evaluación del semen de capibara Hydrochoerus hydrochaeris / Collection and evaluation of semen from the Capybara Hydrochoerus hydrochaeris

Objetivo. Determinar las características del semen y la morfometría de los espermatozoides del Capibara (Hydrochoerus hydrochaeris). Materiales y métodos. Se utilizaron 10 machos con peso entre 21-45 kg, los cuales fueron restringidos y anestesiados. El semen se obtuvo mediante electroeyaculación y se determinó el color, volumen, pH, motilidad en masa, motilidad individual, viabilidad, concentración y morfología. Se realizaron además mediciones de la cabeza y la cola de los espermatozoides. Resultados. Se obtuvo semen en el 100% (10/10) de los animales. El mayor número de eyaculaciones (80%; 8/10), se obtuvo con un voltaje máximo de 6V. El color fue blanco, de aspecto lechoso, los valores promedio fueron volumen 135.5±93.56 µl, pH 8.14±0.38, motilidad masal 32.60±13.46%, motilidad individual 34±19.81%, viabilidad 51.3±19.42%, concentración espermática 127±59.01x106 espermatozoides/mL y morfología 51.3±19.42 espermatozoides normales. La longitud de la cabeza fue 5.41±0.7 µm, el ancho de la cabeza 3.77±0.5 µm y área de la cabeza 75.66±20.6 µm². La longitud de la cola fue 27.9±11.3 µm. Conclusiones. La obtención del semen fue satisfactoria mediante electroeyaculación, sin presentar notables diferencias en las características del semen y morfología de los espermatozoides con otros roedores silvestres de menor tamaño, aunque se observó una alta variabilidad de estas características entre los animales muestreados posiblemente por la heterogeneidad de los animales experimentales.

Objective. Determine the characteristics of semen and morphometry of the Capybara (Hydrochoerus hydrochaeris) spermatozoid. Materials and methods. 10 males, weighing between 21-45 kg, which were restrained and anesthetized, were used in the study. The semen sample was obtained by electroejaculation and the color, volume, pH, mass motility, individual motility, viability, concentration and morphology were determined. Measurements of the head and tail of spermatozoids were also conducted. Results. Semen was obtained from 100% (10/10) of the animals. The highest number of ejaculations (80%; 8/10) was obtained with a maximum voltage of 6V. The color was white, of a milky appearance, average values were volume 135.5 ± 93.56 µl, pH 8.14 ± 0.38, mass motility 32.60 ± 13.46%, individual motility 34 ± 19.81%, viability 19.42 ± 51.3%, sperm concentration 127 ± 59.01x106 spermatozoids / mL and morphology 51.3 ± 19.42 normal spermatozoids. The head length was 5.41 ± 0.7µm, the width of head 3.77 ± 0.5 and head area 75.66 ± 20.6 µm². The tail length was of 27.9 ± 11.3 µm. Conclusions. Semen collection by electro ejaculation was successful, without presenting significant differences in semen characteristics and spermatozoid morphology with other smaller wild rodents, although there was a high variability of these characteristics observed between the animals sampled, possibly due to the heterogeneity of the experimental animals.

Prevención de osteoporosis / Osteoporosis prevention

Un alto número de personas, especialmente mujeres, presenta osteoporosis densitomética, la cual es un importante factor de riesgo para fracturas. La osteoporosis se diagnostica y cuantifica por medio de la densitometría de doble fotón. No todos los pacientes tienen indicación de hacerse una densitometría, sino aquéllos con factores de riesgo o por edad.Para prevenir la osteoporosis es preciso asegurar una buena ingesta de calcio y vitamina D, modificar el estilo de vida y aumentar el ejercicio físico. La terapia farmacológica tiene su principal indicación en el tratamiento de la osteoporosis, aunque puede usarse también preventivamente en pacientes seleccionados por factores de riesgo

A large number of people, especially women, have densitometric osteoporosis, an important risk factor for fractures. Osteoporosis can be diagnosed and measured by double photon densitometry. Not all patients need a bone densitometry, but those with risk factors for osteoporosis or advanced age do. To prevent osteoporosis it is necessary to ensure an adequate calcium and vitamin D intake, to modify lifestyles, and to increase physical exercise. Pharmacologic therapy is mainly prescribed to treat osteoporosis, but it can also be used to prevent it in selected patients with increased risk factors

Linfoma renal bilateral; diagnóstico diferencial de riñón poliquístico: reporte de caso / Bilateral renal lymphoma a differential diagnosis of policyst renal disease: case report

Se reporta el caso de un paciente que consulta por dolor abdominal en ambos flancos, diaforesis y fiebre de 3 meses de evolución. Se le realizaron estudios de imágenes diagnósticas, los cuales concluyeron que se trataba de un caso de riñones poliquísticos. El paciente consultó a otra institución, en la cual se enfocó el caso de manera diferente, y se decidió realizar biopsia renal, con la que se confirmó la presencia de linfoma. El caso tiene importancia, por la forma como se realizó el diagnóstico y la importancia de tener en cuenta los diagnósticos diferenciales.

A case report of a patient with abdominal pain, diaphoresis and fever of three months durationImagingstudies were interpreted as polycystic kidneys. The patient went to another institution, where a different approach led to a kidney biopsy that confirmed renal lymphoma.The case is interesting, by the way it is diagnosedand it is important to note the differential diagnosis.

Cálculos biliares caídos después de una colecistectomía: reporte de un caso / Fallen gallstones after laparoscopic cholecystectomy: a case report

En este artículo se reporta el caso de una mujer quien consultó por dolor abdominal en el hipocondrio derecho y antecedente de colecistectomía laparoscópica seis semanas atrás. Se le realizó una ecografía que mostró imágenes nodulares en las regiones subfrénica y perihepática, interpretadas como cálculos biliares y confirmadas con escanografía. Algunos de estos nódulos presentaban realce periférico y sugerían la presencia de abscesos. La paciente fue llevada a cirugía y se confirmaron los hallazgos. El caso es muy importante por el papel de los estudios radiológicos en el diagnóstico de una complicación quirúrgica, que varía en su presentación clínica: desde ausencia de síntomas hasta una septicemia que puede comprometer la vida del paciente.

We report a case of a woman who consulted for right upper quadrant abdominal pain with history of cholecystectomy six weeks ago. The ultrasound showed subphrenic and perihepatic nodular images, interpreted as biliary stones, confirmed with CT. Some of these nodules showedperipheral enhancement and suggested the presence of abscesses. The patient underwent surgery confirming the imaging findings. The case is very important for the role of imaging studies in the diagnostic approach of a surgical complication which has various clinical presentations that range from the absence of symptoms to a septic life-threatening disease.

Fracturas vertebrales, osteoporosis y vitamina D en la posmenopausia: Estudio en 555 mujeres en Chile / Vertebral fractures, osteoporosis and vitamin D levels in Chilean postmenopausal women

Background: Approximately one-third of vertebral fractures can be clinically diagnosed. Aim: To study the frequency of vertebral fractures in postmenopausal women. Patients and methods: We recruited 555 postmenopausal women from Santiago, Chile, aged 55-84 years, who manifested interest in their bone health. All were healthy by self-declaration and by general clinical and laboratory tests and had not taken any bone-active therapy. They all underwent a spine and femoral neck (FN) densitometry and a digital lateral spine X-ray from T4 to L4 was obtained. PTH, calcidiol, and other parameters of calcium metabolism were also measured. Results: Overall, 142 of 478 patients with a complete study (29.7 percent) had at least one vertebral fracture. The proportion of women with fractures increased with age. A T score below -2.5 in the spine and hip was found in 32 percent and 14 percent of women, respectively. The proportion of women with spinal opeoporosis doubled between ages 55-70 and remained constant afterwards. In contrast, at the femoral neck, this proportion increased progressively reaching 53.3 percent at age 80-85. However, 56 percent of patients with vertebral fractures did not have densitometric osteoporosis in any location. Calcidiol levels were 16.8±6.8 ng/mL. With a cutoff point of 17 ng/mL, 47.5 percent of the patients had hypovitaminosis D. There was no association between calcidiol levels and vertebral fractures or bone density at the spine or femoral neck. Patients with fractures differed from those without fractures in that they had significantly lower bone density at the spine and hip and were older (p <0.001). However they did not differ in weight, body mass index, or calcidiol levels. Conclusions: Thirty percent of postmenopausal women in this series had a vertebral fractures. Osteoporosis and vitamin D deficiency were also common. Most vertebral fractures were observed in women without osteoporosis by densitometric criteria.

Profesionalismo médico: aspectos históricos y religiosos / Medical professionalism: Historical and religious aspects

The essence of the medical profession resides in the medical act, whereupon a sick human being meets another with the power to heal him or her. The source of this power has evolved from the divinity itself through magic to science or acquired knowledge. This power implies acknowledgement of values that are inherent to the profession as well as responsibility toward one's own conscience and toward society, elements considered constitutive of what we now call professionalism. From antiquity these principles have evolved into behavioral codes containing variable components according to the different ages and cultures, but also permenent core values such as respect for life, altruism, and honesty, among others. Scientific and technological advances have magnified medical power but at the same time they have required that the philosophical and ethical principles that ought to inform professional practice be made explicit. This happens at a time when certitudes are questioned or abandoned, relativism and secularism pervade culture, and traditional medical values are challenged. Therefore, consensus attainment appears for some as the only legitimation of the ethics of professional medical acts, while for others the ancestral principles and values of medicine have permanent validity as objective goods based on the dignity of the human person.

Características de presentación del microcarcinoma papilar del tiroides. Experiencia retrospectiva de los últimos 12 años / Pathological characteristics of thyroid microcarcinoma. A review of 402 biopsies

Background: Thyroid microcarcinoma is a tumor of 10 mm or less, that should have a low risk of mortality. However, a subgroup of these carcinomas is as aggressive as bigger tumors. Aim: To describe the pathological presentation of these tumors, and compare them with larger tumors. Material and methods: All pathological samples of thyroid carcinoma that were obtained between 1992 and 2003, were studied. In all biopsies, the pathological type, tumor size, the focal or multifocal character, the presence of lymph node involvement and the presence of lymphocytic thyroiditis or thyroid hyperplasia, were recorded. Results: One hundred eighteen microcarcinomas and 284 larger tumors were studied. The mean age of patients with microcarcinoma and larger tumors was 42.7±14 and 49.3±16 years respectively (p <0,001) and 83% were female, without gender differences between tumor types. Mean size of microcarcinomas was 8.6 mm and 116 (98%) were papillary carcinomas. Of these, 109 (94%) were well differentiated and seven (6%) were moderately differentiated. Thirty six (31%) were multifocal and in 10 (8,6%), there was lymph node involvement. The mean size of larger tumors was 23.8 mm and 241 (85%) were papillary carcinomas. Of these, 200 (83%) were well differentiated, and 41 (17%) were moderately differentiated. Eighty five (35%) were multifocal and in 44 (18%) there was lymph node involvement. The prevalence of thyroiditis and hyperplasia was significantly higher among microcarcinomas than in larger tumors (15 and 2.5%, respectively, p <0.001, for the former; 32.4 and 1.7%, respectively, p <0.001, for the latter). Conclusions: In this series, one third of microcarcinomas were multifocal and 10% had lymph node involvement. Therefore, the aggressiveness of these tumors is higher than what is reported in the literature and they should be treated with total thyroidectomy.

Ingesta de calcio y densidad ósea mineral en la menopausia: datos de una muestra de mujeres chilenas seguidas durante cinco años con suplementación cálcica / Relationship between calcium intake and bone mineral density in menopausal women followed for five years with calcium supplementation

Background: A low calcium intake is considered a risk factor for osteoporosis. Aim: To measure calcium intake and its relationship to bone mineral density in postmenopausal women and to assess the long term changes in bone mineral density after calcium supplementation. Patients and methods: in 80 postmenopausal women older than 41 years of age, calcium intake was assessed using dietary inquires and bone mineral density was measured using a double beam radiological densitometer. Twenty-four ramdomly selected women received a daily calcium supplementation of 500 mg during five years and their bone mineral density was measured at 1,3 and 5 years. Results: Initial calcium intake was 745±37mg/day, and it did not change in the 5 years follow up. There was no relationship between bone mineral density and calcium intake. In supplemented women, bone density did not change significantly at year one. At year three, a significant reduction was observed in the spine (-4.2 percent), Wards triangle (-4 percent) and whole body mineral content(-1.14 percent). At year five, there was a significant increase in bone density at the spine femoral neck and Wards triangle as compared with year three, but not with baseline measurements. No significant differences after supplementation were observed between women with initial calcium intake of less than 500 mg/day or over this value. Conclusions: Calcium intake in urban Chilean postmenopausal women is below recommendations and stable over time. Calcium intake and bone mineral density after the meinopause are not correlated. A 500 mg/day calcium supplementation during 5 years is associated with a late reversal of the postmenopausal bone-losing trend

Síndrome de ovario poliquístico como expresión de déficit de la enzima 3ß hidroxiesteroide deshidrogenasa / Polycystic ovary syndrome as expression of 3-beta-hydroxysteroid dehydrogenase deficit

Los defectos enzimáticos de expresión tardía de la esteroidogénesis suprarrenal están entre las causas más comunes de hirsutismo. Esta forma de hiperandrogenismo puede asumir las características clínicas de un síndrome de ovario poliquístico, lo que viene a confirmar la multicausalidad de esta última condición. Se comunica el caso de una mujer de 18 años con amenorrea secundaria e hirsutismo, cuya concentración sérica de testosterona y de DHEA-S eran 175 ng/dl y 7,3 *g/ml respectivamente y la relación LH/FSH de 5,9. La administración de dexametasona produjo una marcada reducción en la concentración de testosterona y DHEA-S, en tanto que el estímulo con ACTH se asoció a un aumento de 17 hidroxipregnenolona y de la relación 17 hidroxipregnenolona/17 hidroxiprogesterona en el rango descrito para el déficit de 3ß hidroxiesteroide deshidrogenasa

Síndrome de Cushing: problemas de diagnóstico y tratamiento en 27 casos / Cushing syndrome: diagnosis and treatment in 27 patients

Problems of diagnosis and treatment were analyzed in 27 patients with Cushing syndrome (25 confirmed by anatomic findings) followed for a mean fo 50 months. The etiology was Cushing disease in 14 (52%), suprarenal tumor in 9 (33%) and ectopic secretion of ACTH in 4(15%). Determination of plasma cortisol levels at 4PM or 11 PM was a highly sensitive test for the presence of this syndrome (100%). High resolution computed tomography was considerably more effective than conventional X ray studies of the sella in patients with Cushing disease (42 vs 20%. Treatment has been totally effective in all patients with bening suprarenal lesions. Cure was obtrained in 64% of patients with pituitary lesions and 0% of patients with Cushing syndrome associated to malignancy