Spine Fractures of Patients with Ankylosing Spondylitis and Diffuse Idiopathic Skeletal Hyperostosis: Fracture Severity and Injury-Related Mortality at a Level I Trauma Center

Methods@#Patients presenting with a spine fracture were diagnosed with AS or DISH at a single tertiary care center between 2010 and 2019. We excluded those who lacked cross-sectional imaging or fractures occurring at spinal segments affected by ankylosis, as well as polytraumatized patients. Patient demographics, injury mechanism, fracture level, neurologic status, treatment, and 1-year mortality were recorded. Computed tomography imaging was reviewed by two independent readers and graded according to the indicated AO Spine Injury Classification System. Differences in fracture severity, treatment method, and mortality were examined using Student t -tests, chi-square tests, and two-proportion Z-tests with significance set to p <0.05. @*Results@#We identified 167 patients with spine fracture diagnosed with AS or DISH. Patients with AS had more severe fractures and more commonly had surgery than patients with DISH (p <0.001). Despite these differences, 1-year mortality did not significantly differ between AS and DISH patients (p =0.14). @*Conclusions@#Although patients with AS suffered more severe fractures compared to DISH and more frequently underwent surgery for these injuries, outcomes and 1-year mortality did not differ significantly between the two groups. For patients with ASDs and fractures, outcomes appear similar regardless of treatment modality. Consequently, there may be an opportunity for critical reappraisal of operative indications in ASD and a larger role for nonoperative management in these challenging patients.

Migration of liquid silicone, an emerging contraindication of neuraxial anesthesia / Migración de silicona líquida, una contraindicación emergente de la anestesia neuroaxial

Abstract The illegal use of liquid silicone products or biopolymers in gluteal augmentation procedures is giving rise to multiple complications, with a significant negative health impact, both in the short and long-term. The migration of polymers to the sacral and lumbar region represents a major limitation to conducting neuraxial anesthesia procedures. This silicon migration is unpredictable through the superficial tissue as is widely described in the literature. Caudal, spinal and epidural anesthesia may cross the silicone in the fascia and contaminate the neural axis with substances that are highly capable of causing inflammation, edema and tissue necrosis. In order to improve the safety of neuraxial anesthetic procedures and avoid the potential risk of dissemination and contamination of the neural axis, this complication must be ruled out, or be considered an emerging contraindication for these anesthetic procedures.

Resumen La aplicación ilegal de productos como silicona líquida o biopolímeros en procedimientos de aumento de glúteos está generando múltiples complicaciones con gran impacto negativo para la salud tanto a corto como a largo plazo. La migración de polímeros a la región sacra y lumbar representa una importante limitación para la realización de procedimientos de anestesia neuroaxial. Esta migración de silicona es impredecible a través del tejido superficial, la cual está ampliamente descrita en la literatura. Los procedimientos anestésicos caudal, espinal y epidural podrían atravesar los silicomas en la fascia del tejido y contaminar el neuroeje con sustancias con alta capacidad de generar inflamación, edema y necrosis de tejidos. Con el fin de aumentar la seguridad de los procedimientos anestésicos neuroaxiales y evitar el riesgo potencial de dispersión y contaminación del neuroeje, es necesario descartar esta complicación o considerar una contraindicación emergente en estos procedimientos anestésicos.

Anomalía de Ebstein y aneurisma del seno coronario / Ebstein’s anomaly and coronary sinus aneurysm

Resumen La anomalía de Ebstein es una cardiopatía congénita poco común que se asocia a la presencia de vías de conducción anómalas y episodios de taquicardia supraventricular frecuentes, algunos inestables. La asociación con alteraciones anatómicas del seno coronario es rara y no ha sido reportada. Se presenta el caso de una paciente de 58 años con enfermedad coronaria, anomalía de Ebstein, episodios de taquicardia ortodrómica y aneurisma del seno coronario, a quien se realizó ablación.

Abstract Ebstein’s disease is a congenital cardiomyopathy, with a low prevalence in the general population. This abnormality has been associated with abnormal cardiac conduction problems, one of the most important being the accessory pathways. In the presence of an accessory pathway, frequent supraventricular tachycardias may occur, some of which are poorly tolerated. The association with the anomalies of the coronary sinus is not currently reported. The case of a 58-year-old woman with Ebstein’s disease, episodes of supraventricular tachycardia, and coronary sinus aneurysm undergoing ablation therapy is presented.

Efeitos dos Controles por Seleção e por Rejeição sobre os Movimentos do Olhos / Effects of Select and Reject Controls on Eye Movements

Resumo O presente estudo avaliou o efeito dos controles por seleção e por rejeição sobre a observação de S+ e S- em treinos de emparelhamento com o modelo. Quatro adultos foram expostos a treinos de discriminação condicional e testes de equivalência. Na condição de Linha de Base (LB), nenhuma relação de controle modelo/comparação específica foi favorecida; nas condições de Controle por Rejeição e Controle por Seleção, as relações modelo/S- e modelo/S+ foram favorecidas, respectivamente. Na condição LB, foi verificada uma maior observação do S+ em comparação ao S-. O estabelecimento do controle por rejeição tendeu a ser acompanhado por uma maior observação do S- e por escolhas baseadas na observação exclusiva do S-; no caso do controle por seleção, padrões similares foram verificados, porém para o S+. Foi concluído que o estabelecimento dos controles por seleção e por rejeição são acompanhados de mudanças na observação dos estímulos de comparação.

Abstract The present study investigated the effects of select and reject controls upon S+ and S- observations during a matching-to-sample training. Four adults were exposed to discriminative trainings and equivalence tests. In Baseline (BL), no specific sample-comparison control was biased; in the Reject Control and Select Control conditions, sample/S+ and sample/S- relations were biased, respectively. In BL, participants observed more the S+ than the S-. The establishment of reject control tended to be followed by an increase in the observation of the S- and by choices based on the exclusive observation of the S-; in the case of select control, similar patterns were found, however, for the S+. Thus, the establishment of select and reject controls are followed by changes in the observation of comparison stimuli.

Proteomic analysis of the venom of the social wasp Apoica pallens (Hymenoptera: Vespidae)

ABSTRACT Wasps are a diverse group of insects that possess a sting apparatus associated with a venom gland, which is used for predation and colony defense. The biochemistry of Hymenoptera venom has been evaluated in relation to allergy and immunology, and proteomics has been shown to be a powerful tool for the identification of compounds with pharmacological potential. Data on wasps venom the of genus Apoica are scarce, so the objective of the present work was to identify the venom proteins of the eusocial wasp Apoica pallens, as a first step towards further investigation of applied uses of the venom and its protein constituents. The venom proteins were separated by two-dimensional gel electrophoresis, followed by MALDI-TOF/TOF mass spectrometry. A total of 259 spots were detected, with molecular weights from 4.9 to 141 kDa. Thirty of these proteins were identified and classified into eight functional categories: allergen, enzyme, metabolism, structural, environmental response, proteoglycan, active in DNA and RNA, and unknown function. Due to the few available proteomic data for wasp venom, many proteins could not be identified, which makes studies with proteomic analysis of Hymenoptera venom even more important.

Episiotomía estado del arte. Una muestra conductual en los partos del Hospital Universitario Hernando Moncaleano Perdomo / Episiotomy state of the art. A sample in the deliveries of the Hernando Moncaleano Perdomo Hospital Universitario

Resumen La episiotomía es una intervención común usada en las salas de partos. Se define como la realización un tipo de intervención quirúrgica en el periné́ que pretende facilitar la expulsión del producto ampliando el canal blando del parto. Este tiene unas indicaciones para su realización. El objetivo de nuestro estudio fue evaluar las razones para la realización de episiotomía en el HUHMP, analizar si esta se realiza según las indicaciones maternas-fetales, evaluar cuanto la implementación de una episiotomía selectiva puede proteger contra las laceraciones perineales y realizar una revisión de la literatura relevante y actual en este tema. El total de pacientes fue 214 en el periodo de Agosto, Septiembre y Octubre DEL 2016. De las cuales 103 (48.13%) fueron primigestantes, y las no primigestantes fueron 111(51.86%). En cuanto a la presencia de desgarros en las primigestantes se encontró desgarro grado 1 (17.51%), desgarro grado 2 ( 21.63%) desgarro grado 3 (0%) y desgarro grado 4 ( 1.03%), sin desgarro (39.14%),a este grupo de pacientes se les realizo episiotomía a (25.75%). En las no primigestantes fue desgarro grado 1 (32.19%), desgarro grado 2 ( 14.43%) desgarro grado 3 (0%) y desgarro grado 4 ( 0%), sin desgarro (68.82%),a este grupo de pacientes se les realizo episiotomía a (7.77%) Cuando se realizaron episiotomías se tuvieron como indicación periné corto y poca distensibilidad con un 19.3%, acortamiento del periodo expulsivo 16%, prevención de desgarro y acortamiento de trabajo de parto 6.4%, primigestante 3.2% Y en el 58% de las pacientes en quienes se realizó episiotomía no tenían indicación descrita.

Abstract Episiotomy is a common intervention used in maternity ward. It is defined as a type of surgery in the perineum intended to facilitate the expulsion of the product extending the birth canal. This has some indications for its realization. The objetive of our study was to evaluate the episiotomy reasons in HUHMP, analyze whether this is done by maternal-fetal indications, the assess the implementation of a selective episiotomy may protect against lacerations and a review of the relevant and current literature on this subject. The total was of 214 patients in the period of August, September and October 2016. Of which 103 (48.13%) were primigravidae, and non primigravidae were 111 (51.86%). In the primigravidae group the tearing grade 1 (17.51%), tearing grade 2 (21.63%) tearing Grade 3 (0%) and tear Grade 4 (1.03%), without tearing (39.14%); this group of Patients underwent episiotomy (25.75%). In non primigravidae I was tear grade 1 (32.19%), tear grade 2 (14.43%) tearing Grade 3 (0%) and tear Grade 4 (0%), without tearing (68.82%), this group of Patients Were episiotomy Performed (7.77%) When episiotomies were performed were taken as indication Short perineum and poorly compliant con un 19,3%, shortening the period expulsive 16%, prevention tear and shortening of Labor 6.4%, 3.2% primiparousAnd in 58% of Patients Who episiotomy was performed in they had no indication described

Is high fluid intake good for the kidney?

No abstract available.

Semáforo nutricional de alimentos procesados: estudio cualitativo sobre conocimientos, comprensión, actitudes y prácticas en el Ecuador / Nutritional traffic light system for processed foods: qualitative study of awareness, understanding, attitudes, and practices in Ecuador

RESUMEN Objetivos. Analizar los conocimientos, comprensión, actitudes y prácticas relacionadas al semáforo nutricional (SN) en envases de alimentos procesados en el Ecuador. Materiales y métodos. Se realizaron 21 discusiones de grupos focales, en poblaciones de diverso tamaño de las regiones de costa, sierra y oriente. Se condujeron nueve entrevistas a informantes claves (IC) con representantes de empresas grandes, medianas y pequeñas que producían o comercializaban productos procesados. Resultados. Fueron 171 participantes de GF; en su mayoría reconocían y comprendían el SN. Hubo cierta disociación entre los conocimientos del SN y la actitud de compra, pues también se consideraba otros factores como el sabor, la marca o la accesibilidad. Las actitudes fueron diferentes entre grupos etarios: mientras que el grupo de 5 a 9 años conocía poco sobre el SN y prefería alimentos caseros, el grupo de 15 a 19 años era indiferente a la información del SN y daba más valor a otras características como el gusto. Las prácticas relacionadas a la compra y el consumo de alimentos procesados revelaron, siete estrategias diferentes que iban del reemplazo del producto a ignorar la información del SN. Los IC no concordaban con la política, pero reconocían haber modificado el contenido de algunos productos para reducir las concentraciones de grasa, azúcar y sal. Conclusiones. El SN ha tenido un efecto positivo en el conocimiento y comprensión del contenido de los productos procesados. Las prácticas relacionadas a la compra y consumo de alimentos procesados mejorarían a través de la promoción de la política del etiquetado nutricional, control de la comercialización, y el monitoreo y la vigilancia de su implementación.

ABSTRACT Objectives. To analyze awareness, understanding, attitudes, and practices related to the nutritional traffic light system (NTLS) on processed food packaging in Ecuador. Materials and methods. 21 discussions were held in focus groups (FG) in populations of various sizes in the coastal, mountainous, and eastern regions. Nine interviews were conducted with key informants (KI) representing large, medium, and small enterprises producing or selling processed foods. Results. There were 171 FG participants, the majority of whom recognized and understood the NTLS. There was a certain amount of discussion around awareness of the NTLS and purchasing attitudes, and other factors such as taste, brand, or accessibility were considered. Attitudes were different between age groups: while the group of five- to nine-year-olds knew little about the NTLS and preferred homemade foods, the group of 15- to 19-year-olds was indifferent to the NTLS information and placed more value on other features, such as taste. Practices related to the purchase and consumption of processed foods highlighted seven different strategies that ranged from replacing the product to ignoring the NTLS information. The KIs did not agree with the policy, but they acknowledged having amended the content of some products to reduce fat, sugar, and salt. Conclusions. The NTLS has had a positive effect on awareness and understanding of the content of processed products. Practices related to purchasing and consuming processed foods would be improved by promotion of the nutritional labeling policy, trade control, and the monitoring and surveillance of its implementation.

Transesophageal echo diagnosis of perioperative unusual transient left ventricular apical ballooning syndrome.

Stress cardiomyopathy, or Takotsubo syndrome, is a widely recognized cardiac pathology with a clinical presentation similar to acute coronary syndrome and related to physical or emotional stress. Perioperatively, it is challenging to identify it given the variety of forms and scenarios in which it can present. We describe a 22‑year‑old patient with an atypical presentation of Takotsubo syndrome during anesthesia induction, which highlights the usefulness of transesophageal echocardiography for the initial diagnosis.

Does Pre-Treatment with High Dose Atorvastatin Prevent Microvascular Dysfunction after Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome?

BACKGROUND AND OBJECTIVES: There is controversy surrounding whether or not high dose statin administration before percutaneous coronary intervention (PCI) decreases peri-procedural microvascular injury. We performed a prospective randomized study to investigate the mechanisms and effects of pre-treatment high dose atorvastatin on myocardial damage in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) undergoing PCI. SUBJECTS AND METHODS: Seventy seven patients with NSTE-ACS were randomly assigned to either the high dose group (atorvastatin 80 mg loading 12 to 24 h before PCI with a further 40 mg loading 2 h before PCI, n=39) or low dose group (atorvastatin 10 mg administration 12 to 24 h before PCI, n=38). Index of microcirculatory resistance (IMR) was measured after stent implantation. Creatine kinase-myocardial band (CK-MB) and high sensitivity C-reactive protein (CRP) levels were measured before and after PCI. RESULTS: The baseline characteristics were not different between the two patient groups. Compared to the low dose group, the high dose group had lower post PCI IMR (14.1±5.0 vs. 19.2±9.3 U, p=0.003). Post PCI CK-MB was also lower in the high dose group (median: 1.40 ng/mL (interquartile range [IQR: 0.75 to 3.45] vs. 4.00 [IQR: 1.70 to 7.37], p=0.002) as was the post-PCI CRP level (0.09 mg/dL [IQR: 0.04 to 0.16] vs. 0.22 [IQR: 0.08 to 0.60], p=0.001). CONCLUSION: Pre-treatment with high dose atorvastatin reduces peri-PCI microvascular dysfunction verified by post-PCI IMR and exerts an immediate anti-inflammatory effect in patients with NSTE-ACS.

Does Pre-Treatment with High Dose Atorvastatin Prevent Microvascular Dysfunction after Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome?

BACKGROUND AND OBJECTIVES: There is controversy surrounding whether or not high dose statin administration before percutaneous coronary intervention (PCI) decreases peri-procedural microvascular injury. We performed a prospective randomized study to investigate the mechanisms and effects of pre-treatment high dose atorvastatin on myocardial damage in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) undergoing PCI. SUBJECTS AND METHODS: Seventy seven patients with NSTE-ACS were randomly assigned to either the high dose group (atorvastatin 80 mg loading 12 to 24 h before PCI with a further 40 mg loading 2 h before PCI, n=39) or low dose group (atorvastatin 10 mg administration 12 to 24 h before PCI, n=38). Index of microcirculatory resistance (IMR) was measured after stent implantation. Creatine kinase-myocardial band (CK-MB) and high sensitivity C-reactive protein (CRP) levels were measured before and after PCI. RESULTS: The baseline characteristics were not different between the two patient groups. Compared to the low dose group, the high dose group had lower post PCI IMR (14.1±5.0 vs. 19.2±9.3 U, p=0.003). Post PCI CK-MB was also lower in the high dose group (median: 1.40 ng/mL (interquartile range [IQR: 0.75 to 3.45] vs. 4.00 [IQR: 1.70 to 7.37], p=0.002) as was the post-PCI CRP level (0.09 mg/dL [IQR: 0.04 to 0.16] vs. 0.22 [IQR: 0.08 to 0.60], p=0.001). CONCLUSION: Pre-treatment with high dose atorvastatin reduces peri-PCI microvascular dysfunction verified by post-PCI IMR and exerts an immediate anti-inflammatory effect in patients with NSTE-ACS.

Canalización venosa yugular interna: que tanta seguridad podemos llegar a ofrecer? / Internal jugular vein cannulation: How much safety can we offer?

Introduction: Central venous catheterization, performed by the anatomical landmark technique, has a mechanical complication rate between 5% and 19%. This technique has been modified and new approaches have been implemented aiming to improve patient safety. With the introduction of ultrasonography in the clinical practice, and recently in central venous catheter insertion, the rate of complications has dropped over time. Objective: To measure the clinical application of the algorithm "Successful ultrasound-guided internal jugular vein cannulation". Methods: A descriptive, prospective, case series study. Patients over 18 years of age were selected, and the informed consent documentation was filled out appropriately. Patients with masses, anatomical abnormalities, insertion site infections and coagulopathy (International Normalized Ratio [INR] ≥ 2.0, platelet count ≤50.000) were excluded. Central venous cannulation was performed under ultrasound guidance in accordance with safety of the Fundación Santa Fe de Bogotá University Hospital (HUFSFB). Adjustment and validation of the algorithm was done according to an expert consensus in our department. A descriptive univariate analysis was conducted, and efficacy was determined on the basis of the number of attempts to achieve successful venous cannulation, and the incidence of complications. Results: This series included 38 patients with a mean age of 62 years. In 97.4% of the cases, successful venous cannulation was achieved on the first attempt. Guidewire displacement was observed in one case, requiring a second attempt. The posterior jugular vein wall was punctured in two patients (5.2%), with no associated arterial vascular injury or pneumoth-orax. Conclusions: This algorithm resulted in a high rate of successful first attempts and the prevention of potential complications, improving operational standards and healthcare quality for the patients.

Introducción: La canulación venosa central por técnica de reparos anatómicos presenta complicaciones mecánicas entre 5-19%, por tal motivo se han modificado e implementado técnicas buscando disminuir los riesgos para el paciente. La introducción de la ultrasonografía en la práctica clínica y más recientemente en la colocación de catéteres venosos centrales, ha disminuido la incidencia de complicaciones. Objetivo: Evaluar la aplicación clínica del algoritmo "Adecuada inserción de catéteres venosos yugulares internos guiados por ultrasonografía". Metodología: Estudio descriptivo prospectivo de serie de casos. Se seleccionaron pacientes mayores de 18 anos de edad, con el consentimiento informado completamente diligenciado. Los criterios de exclusión fueron pacientes con masas, alteraciones anatómicas o infecciones en el sitio de punción, trastornos de coagulación (Índice Normalizado Internacional INR ≥ 2,0 y conteo plaquetario ≤50.000). La canulación venosa central fue realizada con técnica ultrasonofigura considerando las recomendaciones de seguridad que se tienen en el departamento de anestesia del Hospital Universitario Fundación Santa Fe de Bogotá (HUFSFB), los ajustes y validación del algoritmo guía se realizaron según el consenso de expertos en procedimientos invasivos y ultrasonografía. Se realizó análisis descriptivo uni-variado y la eficacia fue determinada por el número de punciones necesarias para una adecuada canulación vascular y la incidencia de complicaciones. Resultados: La serie de casos fue de 38 pacientes con una edad promedio de 62 años. En el 97,4% de los casos el paso fue realizado en el primer intento. En un paciente se evidenció desplazamiento inadecuado de la guía por lo que fue necesario repetir la punción. En 2 pacientes (5,2%) se presentó punción de la pared posterior del vaso sin que esto se hubiese correlacionado con presencia de lesión vascular arterial o neumotórax. Conclusiones: La implementación del algoritmo guía, permitió una alta tasa de éxito en el primer intento y la prevención de complicaciones potenciales, mejorando los estándares operacionales, brindando una mayor calidad en el cuidado y atención de los pacientes.

Análisis de cocaína en diferentes muestras por cromatografía de gases con detector de ionización de llama (CG-FID) / Analysis of cocaine in different samples by gas chromatography flame ionization detector (GC-FID) / Análise de cocaína em diferentes amostras por cromatografia gasosa com detector de ionização de chama (GC-FID)

En este estudio se realizó la validación de los métodos establecidos por la UNODC para la cuantificación y extracción de benzometilecgonina (cocaína) presente en las hojas de Erythhroxylum coca, en té de coca y en clorhidrato de cocaína. El primer método de extracción, recomendado por la UNODC, es una extracción solido-líquido (ESL), sin embargo, los resultados obtenidos indican que esta no es lo suficientemente eficiente para lograr una señal de analito distinguible de la relación señal a ruido (S/N) para las muestras de hojas de Erythhroxylum coca y té de coca. El segundo método propuesto es la extracción soxhlet, los resultados indican que esta resulta más eficiente para aislar y cuantificar el analito de interés por cromatografía de gases acoplada a un detector de ionización por llama (CG-FID). Después de someter las muestras al proceso de extracción soxhlet y cuantificación por CG-FID se encontró que la hoja de té posee 7,66×10² mg de cocaína/kg de muestra, las hojas de coca 17,15 mg de cocaína/kg de muestra y el clorhidrato de cocaína 7,15×10(5) mg de cocaína/kg de muestra. El método de análisis escogido se caracteriza por arrojar bajos límites de detección (0,169 mg/L) y por poseer parámetros estadísticos y cromatográficos ideales.

In this study validate the methods established by the UNODC for quantification and extraction benzometilecgonina (cocaine) in the leaves of Erythhroxylum coca, coca tea and cocaine hydrochloride. The first extraction method recommended by the UNODC is a solid-liquid extraction (ESL), however, the results indicate that this is not efficient enough to achieve analyte signal distinguishable from the signal to noise ratio (S/N) for samples Erythhroxylum coca leaves and coca tea. The second proposed method is soxhlet extraction, the results indicate that this is more efficient to isolate and quantify the analyte of interest by gas chromatography coupled to a flame ionization detector (GC-FID). After submitting the samples to the soxhlet extraction process and quantification by GC-FID it found that tea leaf has 7.66×10² mg of cocaine/kg sample, coca leaves 17.15 mg of cocaine/kg sample and cocaine hydrochloride concentration corresponded to 7.15×10(5) mg of cocaine/kg sample. The chosen analysis method is characterized by low detection limits shed (1.69 mg/L) and possessing ideal chromatographic and statistical parameters.

Neste estudo validaram-se os métodos estabelecidos pelo UNODC para a quantificação e extração de benzometilecgonina (cocaína) nas folhas de Erythhroxylum coca; em chá de coca e cloridrato de cocaína. O primeiro método de extração recomendado por UNODC é uma extração sólido-líquido (ESL), no entanto, os resultados indicam que esta não é suficientemente eficaz para atingir um sinal de analito distinguível da relação sinal-ruído (S/N) para amostras de folhas Erythhroxylum coca e chá de coca. O segundo método proposto é uma extração soxhlet, os resultados indicam que este é mais eficiente para isolar e quantificar o analito de interesse por cromatografia gasosa acoplada a um detector de ionização de chama (GC-FID). Depois de enviar as amostras para o processo de extração soxhlet e quantificação por GC-FID descobriu-se que as folhas de chá têm 7,66×10² mg de cocaína/kg de amostra, as folhas de coca 17,15 mg de cocaína/kg de amostra e o cloridrato de cocaína 7,15×10(5) mg de cocaína/kg de amostra. O método de análise escolhido é caracterizado por ter baixos limites de detecção (1,69 mg/L) e possuir parâmetros estatísticos e cromatográficos ideais.

Foraging strategies of the ant Ectatomma vizottoi (Hymenoptera, Formicidae)

Foraging strategies of the ant Ectatomma vizottoi (Hymenoptera, Formicidae). Foraging activity may be limited by temperature, humidity, radiation, wind, and other abiotic factors, all of which can affect energy costs during foraging. Ectatomma vizottoi's biology has only recently been studied, and no detailed information is available on its foraging patterns or diet in the field. For this reason, and because foraging activity is an important part of the ecological success of social insects, the present study aimed to investigate E. vizottoi's foraging strategies and dietary habits. First, we determined how abiotic factors constrained E. vizottoi's foraging patterns in the field by monitoring the foraging activity of 16 colonies on eight different days across two seasons. Second, we characterized E. vizottoi's diet by monitoring another set of 26 colonies during peak foraging activity. Our results show that E. vizottoi has foraging strategies that are similar to those of congeneric species. In spite of having a low efficiency index, colonies adopted strategies that allowed them to successfully obtain food resources while avoiding adverse conditions. These strategies included preying on other ant species, a foraging tactic that could arise if a wide variety of food items are not available in the environment or if E. vizottoi simply prefers, regardless of resource availability, to prey on other invertebrates and especially on other ant species.

Epidemiología de la Leptospirosis en Tolima, Colombia, 2009 - 2011 / Epidemiology of leptospirosis in Tolima - Colombia, 2009 - 2011

OBJETIVOS: describir el comportamiento epidemiológico de pacientes con diagnóstico presuntivo de leptospirosis en el departamento del Tolima (Colombia), entre 2009 y 2011. METODOLOGIA: estudio descriptivo transversal. Se analizaron variables epidemiológicas, clínicas y de laboratorio de 243 pacientes con diagnóstico presuntivo de leptospiroris, utilizando los criterios de FAINE modificado. RESULTADOS : se encontraron 48 casos con diagnóstico presuntivo positivo (19,8%), 87 casos negativos (35,8%) y 108 casos no concluyentes (44%). El icterohemorrágico fue el serovar más frecuente entre los presuntamente positivos, con una edad promedio de aparición de la enfermedad de 37 años, se presentó principalmente en hombres (87%), residentes de zona urbana, con deficiencia de servicios públicos (80,9%). El tratamiento hospitalario fue necesario para el 87,6% de los pacientes, se encontraron casos en forma aguda (91%),conalteración hepática (65,9%); la mortalidad fue del 19%. CONCLUSIONES la leptospirosis es una patología con diferentes características demográficas y clínicas, con un diagnóstico difícil y en ocasiones tardío; si se tuviera un registro adecuado de algunas características en las fichas podría hacerse un diagnóstico presuntivo a priori.Se presentó asociación entre el diagnóstico presuntivo de leptospiroris y laborar en ambiente abierto, residir en condiciones sanitarias deficientes, presentar dolor en las pantorrillas y presentar fiebre.

OBJECTIVE:: To describe the epidemiological behavior of patients with presumptive diagnosis of leptospirosis in department of Tolima (Colombia), between 2009 and 2011. METHODOLOGY A cross sectional study was carried out. Epidemiological, clinical and laboratory findings of 243 patients with presumptive leptospiroris, utilizing modified FAINE criteria were analyzed. RESULTS : There were 48 cases with presumptive diagnosisof leptospirosis (19.8%), 87 negative cases (35.8%) and 108 inconclusive cases (44%). The icterohaemorrhagiaewas the serovarmost common among presumptive positive, most patients were male (87%), with the mean age of 37years, residents of urban areas, with deficient public services (80.9%). Hospital treatment was required in 87.6% of patients;there were acute cases of the disease (91%), hepatic impairment (65.9%), 19% of the patients died. CONCLUSIONS : Leptospirosis is a disease with different demographic and clinical characteristics, with difficult and sometimes late diagnosis. Presumptive diagnosis of leptospiroris was associated with working in open environment, living in unsanitary conditions, having calf pain and fever.

Physiologic approach for coronary intervention

When invasively assessing coronary artery disease, the primary goal should be to determine whether the disease is causing a patient's symptoms and whether it is likely to cause future cardiac events. The presence of myocardial ischemia is our best gauge of whether a lesion is responsible for symptoms and likely to result in a future cardiac event. In the catheterization laboratory, fractional flow reserve (FFR) measured with a coronary pressure wire is the reference standard for identifying ischemia-producing lesions. Its spatial resolution is unsurpassed with it not only being vessel-specific, but also lesion-specific. There is now a wealth of data supporting the accuracy of measuring FFR to identify ischemia-producing lesions. FFR-guided percutaneous coronary intervention of these lesions results in improved outcomes and saves resources. Non-hemodynamically significant lesions can be safely managed medically with a low rate of subsequent cardiac events.

First report of interspecific facultative social parasitism in the paper wasp genus Mischocyttarus Saussure (Hymenoptera, Vespidae) / Primeiro registro de parasitismo social facultativo interespecífico em vespas do gênero Mischocyttarus Saussure (Hymenoptera, Vespidae)

First report of interspecific facultative social parasitism in the paper wasp genus Mischocyttarus Saussure (Hymenoptera, Vespidae). Parasitism of colonies of the social wasp Mischocyttarus cerberus Ducke, 1918 by females of Mischocyttarus consimilis Zikán, 1949 was observed in a rural area of Dourados, state of Mato Grosso do Sul, Brazil. In all monitored cases, the invasion occurred in the pre-emergence colony stage, generally by a single female of M. consimilis. The period of establishment of the foreign female in the host colony was marked by antagonistic behaviors between the host female and the invasive. In general, the architecture of the parasitized nest was modified from the typical architecture of the host species nest.

Primeiro registro de parasitismo social facultativo interespecífico em vespas do gênero Mischocyttarus Saussure (Hymenoptera, Vespidae). Parasitismo de colônias da vespa social Mischocyttarus cerberus Ducke, 1918 por fêmeas de Mischocyttarus consimilis Zikán, 1949 foram registrados em uma área rural no município de Dourados estado de Mato Grosso do Sul no Brasil. Em todos os casos monitorados a invasão ocorreu na fase colonial de pré-emergência, e em geral foi executado por uma única fêmea de M. consimilis. O período de estabelecimento da fêmea estrangeira na colônia hospedeira foi marcado por comportamentos antagônicos entre as fêmeas interespecíficas. Em geral, a arquitetura do ninho parasitado foi modificada em relação à arquitetura típica do ninho da espécie hospedeira.