Prevalencia de infección por COVID-19 por serología positiva (IgG/IgM) en personal médico de la cátedra y servicio de otorrinolaringología del Hospital de Clínicas / Prevalence of COVID-19 infection by positive serology (IgG/IgM) in medical personnel of the chair and service of otorhinolaryngology of the Hospital de Clínicas

Resumen Introducción: El personal de otorrinolaringología presenta una elevada exposición al virus SARS-CoV-2, debido a los procedimientos que lleva a cabo. Es fundamental tomar las medidas de protección adecuadas. Determinar la seroprevalencia nos dará un mejor panorama sobre la exposición, contagios y efectividad de medidas de protección adoptadas. Objetivo: Determinar la prevalencia de resultados serológicos positivos en personal médico que presta servicio en la Cátedra de Otorrinolaringología de marzo del 2020 a marzo de 2021. Material y Método: Estudio observacional, descriptivo, corte transversal, retrospectivo con asociación cruzada. Muestreo no probabilístico de casos consecutivos. La población total fue de 38 médicos del Servicio de Otorrinolaringología del Hospital de Clínicas. Resultados: La media de edades fue 37,4 años, 63,5% refirió haber atendido a paciente conocido portador de COVID-19. Un 42% refirió no haber cumplido con todas las medidas de protección personal, mientras que un 23,7% de los sujetos de estudio dio positivo para IgG, interpretándose como infección previa por COVID-19. Conclusión: Más de las dos terceras partes de los médicos refirió dar consulta a paciente COVID-19 positivo. Casi la cuarta parte de los médicos resultó ser positivo para COVID-19 según la prueba de serología anti-N. No se halló asociación entre consulta ni cirugía a pacientes portadores de COVID-19 y el contagio al personal médico.

Abstract Introduction: Otolaryngology personnel have a high exposure to SARS-CoV-2 virus due to the procedures they perform. It is essential to take appropriate protective measures. Determining seroprevalence will give us a better picture of exposure, contagion and effectiveness of protective measures adopted. Aim: To determine the prevalence of positive serological results in medical staff serving in the otolaryngology department from March 2020 to March 2021. Material and Method: Observational, descriptive, cross-sectional, retrospective, retrospective study with cross-association. Non-probability sampling of consecutive cases. The total population was 38 physicians of the Otolaryngology Service of the Hospital de Clinicas. Results: The mean age was 37.4. 63.5% reported having seen a patient known to be a COVID-19 carrier, while 42% reported not having complied with all personal protection measures. A 23.68% of the study subjects tested positive for IgG, interpreting previous COVID-19 infection. Conclusion: More than two-thirds of the physicians referred to giving consultation to COVID-19 positive patients. Almost a quarter of the physicians were positive for COVID-19 according to the Anti-N serology test. No association was found between consultation or surgery of patients with COVID-19 and infection of medical personnel.

Ex-vivo evaluation of the three-column concept in canine thoracolumbar fractures / [Avaliação em ex-vivo do conceito dos três compartimentos em fraturas toracolombares da coluna]

Traumatic events such as a motor vehicle accident or falling from heights are very common in veterinary medicine and often lead to vertebral fracture-luxation with concomitant spinal cord injuries, mostly in the thoracolumbar spine. The purpose of this cadaveric biomechanical study was to determine the feasibility of the three-column concept in canine thoracolumbar segments with induced fractures. Eighteen Functional Spinal Units (FSU) of the thoracolumbar segments (T12-L2) were collected from 18 medium-sized adult dog cadavers and were subjected to flexion-extension and lateral bending tests so that range of motion (ROM) was recorded with a goniometer. Fractures were induced by compressive loads applied by a universal testing machine (EMIC®). After this, specimens were screened using computed tomography (CT) and the fractures were graded as affecting one, two or three columns, and divided into groups A, B, and C, respectively. Post-fracture range of motion (ROM) was compared with the previous results. Groups B and C (with fractures in two or three columns) had instability in the two axes evaluated (P<0.05). The outcomes of this study support the applicability of the three-column theory to thoracolumbar spines of dogs, as the FSUs that suffered fractures in two or more columns showed axial instability.(AU)

Eventos traumáticos, como acidentes automobilísticos ou quedas, são muito comuns na medicina veterinária e, frequentemente, levam a fraturas ou luxações vertebrais, associadas a lesões medulares concomitantes, mais frequentemente na coluna toracolombar. O propósito deste estudo biomecânico em cadáveres foi determinar a viabilidade da teoria dos três compartimentos em fraturas induzidas em segmentos toracolombares de cães. Dezoito unidades espinhais funcionais (UEF) de segmentos toracolombares (T12-L2) foram coletadas de 18 cadáveres de cães adultos de médio porte e submetidas a testes de flexão-extensão e curvamento lateral, de modo que a amplitude de movimento (ADM) foi registrada com um goniômetro. Fraturas foram induzidas por meio de cargas compressivas aplicadas por uma máquina universal de ensaios (EMIC®). As amostras foram submetidas à tomografia computadorizada (TC), e as fraturas foram classificadas como afetando um, dois ou três compartimentos e divididas nos grupos A, B e C, respectivamente. A ADM pós-fratura foi comparada com os resultados prévios. Os grupos B e C (com fraturas em dois ou três compartimentos) apresentaram instabilidade nos dois eixos avaliados (P<0,05). Os resultados deste estudo corroboram a aplicabilidade da teoria dos três compartimentos para segmentos de coluna toracolombar em cães, uma vez que as UEF que sofreram as fraturas em dois ou mais compartimentos apresentaram instabilidade axial.(AU)

Efectos de dos protocolos de entrenamiento sobre el lactato sanguíneo en caballos de paso fino / Effects of two training protocols on blood lactate in paso fino horses

RESUMEN Objetivo: comparar los efectos de un protocolo de entrenamiento de resistencia (ER) con un protocolo tradicional (ET) sobre la concentración sanguínea de lactato (L) y la creatin kinasa (CK). Materiales y Métodos: se aplicaron dos protocolos de entrenamiento durante 6 meses divididos en tres etapas. Se realizaron pruebas de esfuerzo antes de comenzar los protocolos de entrenamiento y al finalizar cada una de las etapas. En cada prueba se tomaron muestras de sangre venosa en reposo, durante el ejercicio y en recuperación para medir el lactato (L) y al inicio y al final para medir la creatin kinasa (CK) e inferir las adaptaciones metabólicas y musculares. Se calculó la diferencia de medianas del lactato basal por medio de la U Mann Whitney y se comparó la diferencia de medias del porcentaje de aclaramiento entre los grupos a través de la T de Students. Resultados: se encontró una diferencia significativa en el porcentaje de depuración de lactato entre ER y ET. También hubo un aumento significativo de los valores de CK intra-grupos, antes y después de las pruebas, pero manteniéndose dentro de los rangos de referencia. Discusión: el ER aumentó la capacidad de metabolizar el lactato pos-ejercicio en potros con entrenamiento de resistencia, aunque no hubo diferencias entre la máxima producción de L entre el grupo ER y ET. El comportamiento de la CK dentro de los rangos de referencia indica que no hubo daño muscular en los potros de ambos grupos.

ABSTRACT Objective: To compare the effects of a resistance training protocol (ER) with a traditional protocol (ET) on blood lactate concentration and CK. Materials and methods: Two training protocols were applied for 6 months divided into three stages. Effort tests were performed before beginning the training protocols and at the end of each stage. In each test, samples of venous blood were taken at rest, during exercise and in recovery to measure lactate (L), and at the beginning and at the end to measure creatine kinase (CK) and infer metabolic and muscular adaptations. The difference in baseline lactate medians was calculated using Mann Whitney U and the mean difference in the percentage of clearance between the groups was compared through the Students' T test. Results: A significant difference in the percentage of lactate clearance between ER and ET was found. There was also a significant increase in intra-group CK values, before and after the tests, but remaining within the reference ranges. Discussion: ER increased the ability to metabolize post-exercise lactate in foals with resistance training, although there was no difference between the maximum production of L between the ER group and ET. The behavior of CK within the reference ranges indicates that there was no muscle damage in the foals of both groups of foals.

Manejo clínico y programático de la tuberculosis con resistencia a fármacos / Clinical and programatic management of multidrug resistant tuberculosis

Resumen Se presenta parte de la información entregada durante un curso de capacitación en tuberculosis con resistencia a fármacos para referentes clínicos del PROCET de Chile, con la colaboración del Dr. José Antonio Caminero Luna. Se enfatizó el uso de métodos de diagnóstico rápidos de resistencia a fármacos basados en la biología molecular, técnicas más sensibles y específicas, con el análisis de algunos algoritmos de diagnóstico factibles de implementar en nuestro país. Se detallaron las nuevas propuestas de terapia de tuberculosis con resistencia a fármacos, especialmente TBC-MDR (multidrogo resistente), y las ventajas de nuevos esquemas terapéuticos de mayor eficacia como los que son recomendados actualmente por la Organización Mundial de la Salud (OMS).

This publication summarizes part of the information provided during a training in multidrug resistant tuberculosis (MDR-TB) for clinical specialists in all health services of Chile with the collaboration of Dr. Jose Antonio Caminero Luna and the Chilean Program of Control and Eradication of Tuberculosis (PROCET). Emphasis was placed on early, sensitive and specific diagnostic methods of resistance to drugs based on molecular biology, showing some diagnostic algorithms feasible to implement in our country. Some proposals were made for changes in the treatment of tuberculosis with resistance to drugs, especially MDR-TB, with more effective therapeutic regimens recommended by the World Health Organization (WHO).

Consequences of intraoperative spinal cord manipulation in dogs with thoracolumbar intervertebral disc extrusion / Consequências da manipulação medular intraoperatória em cães com extrusão intervertebral de disco toracolombar

The objective of the present study was to evaluate if extradural contact during hemilaminectomy would cause neurological deterioration in the early and/or late postoperative period in dogs with intervertebral disc extrusion. Nineteen dogs with thoracolumbar intervertebral disc extrusion underwent hemilaminectomy for spinal cord decompression and removal of extruded disc material. Meningeal contacts during surgery were quantified. Paraplegia (with nociception) and paraparesis were observed in 11/19 and 8/19 of dogs, respectively, before surgery. At the end of our study, only two (2/19) had paraplegia and one (1/19), paraparesis. There were more extradural contacts when extruded intervertebral disc material was at a ventrolateral position. Extradural contacts during surgery had no influence on neurological progression nor on time to recovery of motor function. Immediately (24 and 48 hours) after surgery, 13/19 dogs had the same neurological stage before surgery. At 7 and 90 days, 13/19 and 17/19 dogs, respectively, showed neurological improvement, compared with their preoperative stage. There was no influence of the number of extradural contacts on neurological recovery. These findings indicate that a careful inspection of the vertebral canal for removal of as much extruded disc material as possible does not cause neurologic deterioration.(AU)

O presente trabalho teve como objetivo avaliar se contatos extradurais durante hemilaminectomia em cães com extrusão de disco intervertebral causariam piora neurológica no pós-operatório imadiato e/ou tardio. Dezenove cães com extrusão toracolombar de disco intervertebral foram submetidos à hemilaminectomia para descompressão medular e remoção do material extruso. Durante o procedimento cirúrgico, os contatos meningomedulares foram quantificados. Antes da cirurgia, 11/19 cães apresentavam paraplegia (com nocicepção) e 8/19 cães, paraparesia. Ao fim do estudo, apenas dois cães (2/19) mostravam paraplegia com dor profunda e um (1/19), paraparesia. Observou-se maior quantidade de contatos extradurais quando o material discal extruso encontrava-se em posição ventrolateral. Os contatos extradurais não mostraram influência estatística na evolução neurológica dos animais, bem como no tempo de recuperação das funções motora. Vinte e quatro e 48 horas após a cirurgia, 13/19 cães apresentavam o mesmo grau neurológico de antes da cirurgia. Após sete e 90 dias de pós-operatório, 13/19 e 17/19 demonstraram melhora neurológica em comparação com o pré-operatório, respectivamente. A quantidade de contatos extradurais não influenciou na recuperação neurológica dos cães. Esses achados indicam que uma inspeção minuciosa do canal vertebral pode ser recomendada, a fim de remover o máximo de material discal extruso, evitando-se piora neurológica por compressão medular.(AU)

Nuevos métodos para el diagnóstico de la tuberculosis / New methods for the diagnosis of tuberculosis

Until 2007, the diagnosis of tuberculosis was only based on smear and culture. Since then multiple diagnostic tests based on molecular technologies have emerged, with the objective of get faster and more sensitive diagnoses, and also to measure the resistance profile of the patients. The World Health Organization has recommended some of these tests for programmatic use. This article describes the methods currently implemented in the Institute of Public Health of Chile and those that are being evaluated and recently recommended by the World Health Organization.

Hasta antes de 2007, el diagnóstico de la tuberculosis se basaba en la baciloscopía y el cultivo. Desde entonces, y ante la necesidad de contar con diagnósticos más rápidos y más sensibles y que permitan conocer el perfil de resistencia de los enfermos, han surgido múltiples test diagnósticos basados en pruebas moleculares que ya están siendo recomendados para su uso programático por la Organización Mundial de la Salud. En este artículo se describen los métodos actualmente implementados en el Instituto de Salud Pública y aquellos que están siendo evaluados y recomendados recientemente por la Organización Mundial de la Salud.

GASES SANGUÍNEOS, ELECTROLITOS Y VARIABLES METABÓLICAS DETERMINANTES DEL ESTADO ÁCIDO-BASE EN CABALLOS CRIOLLOS COLOMBIANOS / COMPARISON OF BLOOD GASES, ELECTROLYTES, AND METABOLIC DETERMINANTS OF ACID-BASE STATUS IN COLOMBIAN CRIOLLO HORSES

Se determinaron y compararon los valores de los gases sanguíneos, electrolitos, lactato, hematocrito y estado ácido-base en sangre venosa y arterial de 17 equinos criollos del Centro de Veterinaria y Zootecnia de la Universidad CES, para lo cual se utilizó el sistema Epoc Blood Analysis®, analizador portátil de sangre que permite obtener resultados de gases, iones y metabolitos. Los resultados arrojados muestran que hay diferencia estadística significativa (p < 0,05) en la glucosa arterial con respecto a la edad y en el lactato venoso con respecto al sexo; además, al comparar la sangre venosa contra la sangre arterial, se hallaron diferencias estadísticas significativas en la presión parcial de oxígeno (pO2), la presión parcial de CO2 (PCO2), la saturación de oxígeno (cSO2) sodio, calcio ionizado, glucosa, bicarbonato, base exceso sanguínea (BEb), base exceso extracelular (BE(ecf)), PCO2 y PO2 corregidas por temperatura. Se concluye que se deben tomar muestras arteriales para realizar valoraciones precisas de los pacientes y que variables, como la pO2, la pCO2 y la cTCO2, dependen en gran medida de la temperatura ambiental, la temperatura del paciente y la altitud, condiciones que modifican las presiones parciales de los gases.

We determined and compared the values of blood gases, electrolytes, lactate, hematocrit and acid-base status for both arterial and venous blood in seventeen horses from the Veterinary and Zootechnical Center at CES University. We used the Epoc Blood Analysis® portable system, which allows analyzing and obtaining information about gases, ions and metabolites. Our results show that there is a statistically significant difference (p < 0,05) in the values of arterial glucose according to the age and in the concentration of venous lactate according to the sex. Likewise, when we compared the values obtained from arterial blood with the values obtained from venous blood, we found statistically significant differences in the oxygen partial pressure (pO2), carbon dioxide partial pressure (pCO2), oxygen saturation level (cSO2), sodium, ionized calcium, glucose, bicarbonate, blood base excess (BEb), extracellular base excess (BE(ecf)), temperature-corrected PO2 and pCO2. Based on these results, we can conclude that we should take arterial blood samples in order to assess accurately the status of the patients and that variables such as oxygen partial pressure, carbon dioxide partial pressure and the oxygen saturation level are largely dependent on the environmental temperature, patient's temperature and altitude; as these conditions modify the gas partial pressures.

A cross-sectional study of cryptorchidism in children: testicular volume and hormonal function at 18 years of age

Purpose To evaluate the relationship between unilateral or bilateral criptorchidism, patient age, primary location of the gonad and modality of treatment with testicular volume and hormonal status at 18 years in patients diagnosed and treated for cryptorchidism during childhood. Materials and Methods Testicular volume, LH, FSH, and testosterone were evaluated in 143 young men at 18 years treated in childhood for unilateral (n=103) or bilateral (n=40) cryptorchidism. Results Unilateral cryptorchidism: Location of testis was prescrotal in 36 patients, inguinal in 52 and non-palpable in 15. The mean volume was 9.7 mL compared to 16.2 mL. for the spontaneously descended testicle in unilateral cryptorchidism. However, 22 patients who received HCG had a significantly bigger testis (11.8 mL.) than those treated with primary surgery (9.2 mL). The results showed a significant positive correlation between testicular volume and patient age at treatment. Bilateral cryptorchidism Location of testis was prescrotal in 34 cases, inguinal in 40 and 6 patients with non-palpable testicles. Mean volume at 18 years was 12.9 mL, greater than unilateral cryptorchid testis (9.7 mL) but smaller than healthy contralateral in unilateral cases (16.2 mL). There were significant differences in the testicular growth for bilateral patients with testicular descent after being treated with HCG (14.4 mL) in respect with those untreated (11.1 mL) or those who underwent primary surgery (11.4 mL). There was a significant positive correlation between the testicular volume and palpable (12.4 mL) or non-palpable testis (10.4 mL). There was a correlation between unilateral or bilateral cryptorchidism and levels of FSH. Conclusions Testicular volume and hormonal function at 18 years for patients diagnosed and treated for cryptorchidism during childhood are strongly influenced by whether the undescended testis was unilateral or bilateral. Location of the testes at diagnosis or ...

Hallazgos endosóópicos de las vías respiratoria altas en equinos de la policíaa metropolitana de medellín, Colombia / Endoscopic fndinngs of the upper respiratorytract in equines of the metropoolitan police from medellín, Colombia

El objetivo del presente estudio fue identificar las lesiones sub-clínicas de las vías respiratorias altas en un grupo de la población equina de la Policía Metropolitana de la ciudad de Medellín, Colombia. Se revisaron las historias clínicas, se descartaron los caballos que presentaron afecciones respiratorias durante los últimos seis meses y, entre los aparentemente sanos, se seleccionaron 30 animales. Para ello se realizaron evaluaciones endoscópicas del tracto respiratorio anterior con un video-endoscopio Pentax™ EPM-3300, previa sedación con xilacina al 10% y maleato de acepromacina, ambos medicamentos a una dosis de 0,5 mg/kg de peso, a fin de examinar la cavidad nasal, la nasofaringe y las bolsas guturales. Cuando se encontraron alteraciones, se guardaron imágenes para luego describir las lesiones encontradas macroscópicamente. Siete animales presentaron lesiones o afecciones respiratorias sub-clínicas en las vías respiratorias altas:tres caballos presentaron abundante moco transparente en las vías respiratorias (10%),un caballo presentó moco blanquecino en las bolsas guturales (3,33%),un caballo presentó lesión vesicular en el piso de la bolsa gutural derecha en ambos compartimentos (3,33%),un caballo (3,33%) presentó tumefacción en la entrada de ambas bolsas guturales,dos caballos (0,66%) presentaron pólipos en la glotis y un caballo (3,33%) presentó hiperplasia nodular linfoide (linfademomegalia) grado 2 acompañada de colapso traqueal grado 4 (3,33%).Se recomienda realizar exploración endoscópica de las vías respiratorias al menos una vez al año en esta población equina para prevenir o disminuir la incidencia de enfermedades respiratorias de las vías altas de mayor gravedad.

The aim of the present study was to identify sub-clinical lesions ofdifferent originof the upper respiratory airwaysin a group of the Metropolitan Police equine population of Medellin city, Colombia. Medical records were inspected, horses that had respiratory problems during the last 6 months were discarded, and among healthy horses, 30 were selected. Endoscopic evaluations of upper respiratory tract were performed previous sedation with 10% xylazine and acepromazine maleate, at a dose of 0.5 mg/kg. It was examined the nasal cavity, nasopharynx and guttural pouches. When injury or sequelae were found, pictures were taken to describe macroscopically the found lesions. It was found that 7 animals showed injuries or subclinical respiratory conditions: 3 horses showed abundant clear mucus in the respiratory tract (10%), 1 horse presented whitish mucus in guttural pouches (3.33%), 1 horse (3.33%) presented canker sore on the floor of right guttural pouch in both compartments, 1 horse (3.33%) presented swelling at the entrance of both guttural pouches, 2 horses (6.66%) showed polyps y 1 horse (3.33%) had nodular lymphoid hyperplasia grade 2 accompanied by tracheal collapse grade 4 (3,33%). It was recommended to do endoscopic exploration of respiratory tract at least once a year in this equine population to prevent or reduce the incidence of upper respiratory diseases of greater gravity.

Schistosomus rellexus en un canino: reporte caso / Schistosomus rellexus in a canine: case report

Durante la realización de una cesárea en el Centro de Medicina Veterinaria y Zootecnia de la Universidad CES se encontró un neonato de la raza Bull Terrier con signos de Schistosomus reflexus, una alteración congénita en la formación de la pared abdominal con exposición de las vísceras. El cachorro del presente reporte nació con vida y se realizó la corrección quirúrgica de la agenesia de la pared abdominal, procedimiento que le permitió su supervivencia por una semana más. El artículo describe el caso clínico de este neonato que según lo reporta la literatura, es el segundo caso de Schistosomus reflexus en un canino.

During the execution of a caesarean section in the 'Centro de Medicina Veterinaria y Zootecnia de la Universidad CES' a Bull terrier neonate with signs of Schistosomus reflexus, a congenital abnormality in the formation of the abdominal wall with exposure of the viscera, was found. The puppy of this report was born alive and the surgical correction of the abdominal agenesis was performed, which allowed its survival for a week. This article describes the clinic case of this puppy which, according to available literature, is the second Schistosomus reflexum case observed in a dog.

Stem cells and androgen receptor in human periapical periodontitis / Células madre y receptor de andrógenos en periodontitis periapical humana

Activation of macrophages in periapical granulomas occurs through the presence of cytokines, endotoxin and other genetic and epigenetic factors, allowing the initiation of inflammation and bone resorption. The present study aims to analyze the presence of CD133 protein (marker of stem cells) and the AR (androgen receptor) protein in biopsies of human odontogenic periapical granuloma. Biopsies from 14 adult male patients with diagnosis of periapical granuloma included in paraffin blocks were processed histologically to obtain 5-um thick sections. Protein presence was detected and analyzed by immunohistochemistry of CD133 and AR. The quantification considered the number of positive cells in 0.17 mm2 random areas under the microscope using a 1000X objective. Both CD133 and AR proteins are expressed abundantly in cells in pathological periapical granulomas tissue. The number of cells expressing CD133 and AR shows a wide variation coefficient, so its variation is a particular feature for each individual. We concluded that in human odontogenic periapical granuloma there are abundant stem cells and cells expressing AR that may be important for the pathogenic inflammatory process.

La activación de los macrófagos en los granulomas periapicales humanos se producen a través de la presencia de citoquinas, endotoxinas y otros factores genéticos y epigenéticos que permiten la iniciación de la inflamación y la reabsorción ósea. El presente estudio pretende analizar la presencia de proteína CD133 (marcador de células madre) y de la proteína RA (receptor de andrógenos) en las biopsias de granulomas periapicales odontogénicos humanos. Las biopsias de 14 pacientes varones adultos con diagnóstico de granuloma periapical fueron incluidos en bloques de parafina y se procesaron histológicamente para obtener secciones de 5 micras de espesor. La presencia de CD133 y RA fueron detectadas y analizadas por inmunohistoquímica. La cuantificación se realizó considerando el número de células positivas en áreas al azar de 0,17mm2, utilizando microscopio con objetivo de 1000X. Ambas proteínas, CD133 y RA se expresan en abundancia en las células del tejido patológico con granuloma periapical. El número de células que expresan CD133 y RA presentan un amplio coeficiente de variación, por lo que su variación es una característica particular de cada individuo. Se concluye que en granuloma periapical odontogénico humano se expresan abundantes células madre y proteínas receptoras de andrógenos, antecedentes que pueden sermuy importantes en la expresión y diagnosis de los procesos patológicos inflamatorios.

Histological description of the interaction between muscle fibers and connective tissue of the fascia of the human trapezius muscle / Descripción histológica de la interacción entre las fibras musculares y tejido conectivo de la fascia del músculo trapecio humano

The skeletal muscle fascia corresponds to a condensation of connective tissue. Fascias are highly innervated and sensitive, and can cover non-expandable structures as well as musculature. It is suggested that fascias have a pivotal role in functions such as postural regulation, peripheral motor coordination and proprioception. Also, the presence of inflammation and microcalcification in fascia of patients with localized muscle pain has been described, suggesting a pathogenic role in pain. The aim was to describe the histological structure of the external deep fascia of the trapezius muscle, with emphasis on the content and arrangement of muscle fibers, type I collagen, and adipose tissue. Sample material was obtained from a male cadaver (60-70 years old), by dissection of the posterior cervical region of the superficial fascia of the trapezius muscle and fixed in buffered formalin. Samples were processed by routine histological techniques and embedded in paraffin, obtaining 5 µm-thick sections that were stained according to the van Gieson technique. The trapezius fascia is composed of type I collagen, organized into high-density collagen bundles and oriented in different directions, and by adipocytes disposed in longitudinal groups on the main axis of the fascia. Muscle fibers are organized into bundles that are inserted laterally on the thickness of the fascia. It is possible that lateral transmission of tensional forces between the fibers might be present.

La fascia del músculo esquelético corresponde a una condensación de tejido conectivo. Las fascias están inervadas y son sensibles y pueden cubrir estructuras no distensibles, así como las fibras musculares esqueléticas. Tienen un rol importante en la regulación de la postura, la coordinación motora periférica y la propiocepción. Además, se ha descrito la presencia de inflamación y microcalcificaciones en la fascia de los pacientes con dolor muscular localizado, lo que sugiere un rol patogénico en el dolor. El objetivo del trabajo fue describir la estructura histológica de la fascia externa profunda del músculo trapecio, con énfasis en el contenido y la disposición de las fibras musculares, colágeno tipo I y el tejido adiposo. Material y métodos: El material de la muestra fue obtenido de un cadáver de sexo masculino (60-70 años), por la disección de la región cervical posterior de la fascia superficial del músculo trapecio e inmediatamente fijado en formalina tamponada (pH 7,2) durante 48 horas. La muestra fue procesada por técnicas histológicas e impregnada en parafina (punto de fusión 56-58 C). Secciones de 5 µm de espesor fueron montadas en láminas silanizada para el desarrollo del protocolo de la técnica de van Gieson. Resultados y discusión: Se observa que la fascia del trapecio está compuesta por tejido conectivo denso irregular con abundante colágeno tipo I, organizado en paquetes grandes como verdaderos haces de colágeno de alta densidad orientada en diferentes direcciones; y por adipocitos dispuestos en grupos longitudinales en el eje principal de la fascia. Las fibras musculares estriadas están organizadas en paquetes que se insertan lateralmente en el espesor de la fascia. Es posible que la transmisión lateral de la tensión entre las fibras esté presente.

Avances en inmunidad gestacional / Advances in gestational immunity

El inicio y establecimiento de la gestación en los mamíferos dependen de la adaptación del sistema inmunológico de la madre para tolerar un feto semi-alogénico. La gestación en sí misma constituye un acontecimiento de equilibrio inmunológico, ya que mientras el sistema inmune mantiene la competencia para la defensa contra antígenos foráneos, mecanismos de tolerancia local y periférica previenen una respuesta inapropiada contra alo-antígenos fetales de origen paterno lo que pudiera provocar el rechazo del feto. La interacción materno-fetal es extremadamente compleja y es difícil determinar todos los componentes del sistema inmune involucrados. Hasta ahora se ha demostrado la participación activa de las células T y sus productos, las citoquinas y también se ha involucrado a las moléculas del complejo mayor de histocompatibilidad, los antígenos paternos y algunos inmunomoduladores como progesterona, indoleamina 2,3-dioxigeneasa y glicodelina, entre otros. Todos estos elementos parecen confluir para producir un gran cambio sistémico en el sistema inmune materno, promoviendo por una parte la tolerancia materno-fetal, crucial para finalmente permitir una gestación exitosa y, por otro lado, manteniendo una activa vigilancia inmune contra las infecciones que pondrían en riesgo la gestación y sobrevivencia de diversas especies. Se revisó la literatura más reciente acerca de los diferentes componentes del sistema inmune que han demostrado ser clave en el inicio y mantención de la gestación en mamíferos.

The initiation and establishment of pregnancy in mammals depends on the adaptation from maternal immune system to tolerate a semi-allogeneic fetus. Pregnancy itself constitutes an event of immune balance because, while the immune system maintains the capacity for defense against foreign antigens, mechanisms of local and peripheral tolerance may prevent an inappropriate response against fetal alloantigens of paternal origin which could lead to rejection of the fetus. The maternal-fetal immune interaction is extremely complex and it has therefore been difficult to identify all the immune components involved. So far, it is known that the active participation of T cells and their products, cytokines, and has also involved molecules from the major histocompatibility complex, other paternal antigens and some immunomodulators molecules such as progesterone, glycodelin and indoleamine 2,3-dioxigenase among others. All these elements seem to converge to produce a major systemic change in the maternal immune system, promoting on one hand the maternal-fetal tolerance, crucial to allow a successful pregnancy and on the other hand, maintaining an active immune surveillance against infections that might endanger pregnancy and survival of diverses species. A review of recent literature about the different components of the immune system that have proven key in the beginning and maintenance of pregnancy in mammals.

Intoxicación por monóxido de carbono: análisis de tres casos clínicos / Carbon monoxide poisoning: analysis of three cases

Se presentan tres casos clínicos de intoxicación accidental por monóxido de carbono y se destacan las dificultades para el diagnóstico y manejo terapéutico. El diagnóstico se realizó frente a la exposición, presencia de síntomas en más de un miembro de la familia y la mejoría al retirarse de la fuente. La dosificación de la carboxihemoglobina (COHb) no fue realizada de forma temprana lo que puede explicar sus valores normales o levemente elevados. Se dosificó CPK y CKMB siendo esta última elevada en los tres casos. Se realizó TAC de cráneo en las intoxicaciones graves. El tratamiento se basó en la administración de oxígeno. La pérdida de conocimiento y la severidad de la intoxicación de otros miembros de la familia determinaron la administración de oxigeno hiperbárico en dos de los casos.

Three clinical cases of accidental intoxication by carbon monoxide are presented, highlighting the difficulties for diagnosis and therapeutic managment. The diagnosis was done based on exposition, more than one family member with symptoms and the good response after retiring from the source. Carboxyhemoglobin (COHb) dosification was not held immediately which can explain the normal or slightly high values found. CK and CKMB were measured, being the last one high in the three cases. Cranial CT scan was performed when intoxication was severe. Treatment was based on oxigen administration. Two cases, one with loss of consciousness and one where other family members had sever intoxication, required the use of hyperbaric oxigen.

Preditores espaço-temporais do andar para testes de capacidade funcional em pacientes com doença de Parkinson / Gait spatial and temporal predictors for functional capacity tests in Parkinson's disease patients

OBJETIVOS: Determinar quais parâmetros espaço-temporais são preditores do andar de indivíduos com doença de Parkinson idiopática para os testes de resistência aeróbia e agilidade, propostos pela bateria de testes da American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD). MATERIAIS E MÉTODOS: Foram selecionados seis homens e seis mulheres com comprometimento e estágio da doença em níveis leve e moderado, que realizaram os testes de agilidade e resistência aeróbia, conforme o protocolo da AAHPERD, e andaram 8m sobre uma passarela. Uma câmera digital registrou uma passada central. Marcadores foram fixados no quinto metatarso e na face lateral do calcâneo do membro inferior direito e no primeiro metatarso e na face medial do calcâneo do membro inferior esquerdo. As variáveis dependentes selecionadas foram: tempo nos testes de agilidade e resistência e as variáveis cinemáticas (comprimento da passada - CP, cadência - CAD, duração da passada - DP, duração da fase de duplo suporte - DDS, duração do suporte simples - SS, duração da fase de balanço - DB e velocidade da passada - VP). RESULTADOS: Para agilidade, o teste de Pearson apontou correlação estatisticamente significativa entre as variáveis CP (r=-0,70; p<0,05), CAD (r=-0,72; p<0,01), VP (r=-0,83; p<0,01), DP (r=0,71; p<0,01) e DDS (r=0,90; p<0,01). Para resistência, houve correlação com as variáveis CP (r=-0,67; p<0,05), CAD (r=-0,72; p<0,01), VP (r=-0,82; p<0,01), DP (r=0,71; p<0,01) e DDS (r=0,90; p<0,01). A análise de regressão múltipla revelou que a DDS foi a única variável preditora dos testes de agilidade (R²=0,82; p<0,01) e resistência (R²=0,81; p<0,01). CONCLUSÕES: Observou-se o uso potencial da DDS como parâmetro espaço-temporal do andar preditor do desempenho dos testes de resistência aeróbia e agilidade em pacientes com doença de Parkinson idiopática.

OBJECTIVE: To determine which spatial and temporal parameters are predictors of the gait pattern of individuals with idiopathic Parkinson's disease, for the aerobic endurance and agility tests included in the battery of tests of the AAHPERD protocol. METHODS: Six men and six women with mild and moderate impairment and disease stage were selected. They performed agility and aerobic endurance test in accordance with the AAHPERD protocol, and walked 8 m on a walkway. A digital video camera recorded one central stride. Markers were attached to the fifth metatarsal and lateral face of the calcaneus of the right leg and to the first metatarsal and medial face of the calcaneus of the left leg. The dependent variables selected were the time taken in the agility and endurance tests and the kinematic variables: stride length (SL), cadence (CAD), stride time (ST), double support time (DS), single support time (SS), swing time (SW) and stride velocity (SV). RESULTS: For agility, Pearson's test showed statistically significant correlations with SL (r=-0.70; p<0.05), CAD (r=-0.72; p<0.01), SV (r=-0.83; p<0.01), ST (r=0.71; p<0.01) and DS (r=0.90; p<0.01). For endurance, there were correlations with SL (r=-0.67; p<0.05), CAD (r=-0.72; p<0.01), SV (r=-0.82; p<0.01), ST (r=0.71; p<0.01), and DS (r=0.90; p<0.01). Multiple regression analysis revealed that DS was the only variable that predicted performance in both the agility (R²=0.82; p<0.01) and the endurance (R²=0.81; p<0.01) tests. CONCLUSIONS: It was observed that DS measure has a potential use as a kinematic parameter of gait that predicts the performance in agility and aerobic endurance tests in patients with idiopathic Parkinson's disease.

Relevance of herniography for accurate diagnosis of patent processus vaginalis in cryptorchidism

OBJECTIVE: To clarify the role of peritoneography in assessing the patency of processus vaginalis (PV) in pediatric patients diagnosed with cryptorchidism. MATERIALS AND METHODS: We designed a prospective clinical trial to evaluate the patency of PV in boys presenting cryptorchidism. Herniography was performed in 310 prepubertal boys. Data about the morphology of PV was compared with operative findings in those surgically treated patients. Retractile and ectopic testes were excluded from the study. RESULTS: Of the 376 undescended testes (310 patients), 281 cases were associated with an obliterated PV. Herniography revealed 95 cases of open PV in cryptorchid boys. The 244 normally descended testes had associated patent processus vaginalis in only 31 cases. CONCLUSIONS: Herniography is the most relevant procedure for accurate diagnosis of persistent PV. The persistence of PV was significantly more frequent when the position of the testes is more cranial. The incidence of an open PV decreases with age.

Avaliação dos resultados clínicos após cirurgia descompressiva em cães com doença de disco intervertebral

Clinical results after decompressive surgery were evaluated in 45 dogs with cervical or thoracolumbar intervertebral disk disease. After surgery, 35 dogs recovered totally, eight (17.8%) partially, and two (4.4%) did not present any change in clinical findings. Eight dogs with paraplegy and loss of deep pain perception showed improvement, with total recovering in 62.5% of cases. Surgery was effective in four dogs with tetraparesy. Decompressive surgery (cervical slot or hemilaminectomy), with removal of disk material from inside the vertebral canal, was an effective form to produce functional improvement in dogs with this disease.

Avaliaram-se os resultados clínicos após realização de cirurgia descompressiva em 45 cães com doença do disco intervertebral cervical ou toracolombar. Após a cirurgia, 35 cães (77,8%) recuperaram-se totalmente, oito (17,8%) parcialmente e dois (4,4%) não apresentaram alteração do quadro inicial. Em oito cães com paraplegia e perda da sensibilidade dolorosa profunda houve completa melhora do quadro clínico, com recuperação total em 62,5% dos casos. Em quatro cães com tetraparesia, a cirurgia foi eficaz. A cirurgia descompressiva (slot cervical e hemilaminectomia toracolombar), com a retirada do material do disco do interior do canal vertebral, foi uma forma efetiva de gerar melhora do quadro funcional.

Avaliação dos resultados clínicos após cirurgia descompressiva em cães com doença de disco intervertebral / Evaluation of clinical results of decompressive surgery in dogs with degenerative disk disease

Avaliaram-se os resultados clínicos após realização de cirurgia descompressiva em 45 cães com doença do disco intervertebral cervical ou toracolombar. Após a cirurgia, 35 cães (77,8 por cento) recuperaram-se totalmente, oito (17,8 por cento) parcialmente e dois (4,4 por cento) não apresentaram alteração do quadro inicial. Em oito cães com paraplegia e perda da sensibilidade dolorosa profunda houve completa melhora do quadro clínico, com recuperação total em 62,5 por cento dos casos. Em quatro cães com tetraparesia, a cirurgia foi eficaz. A cirurgia descompressiva (slot cervical e hemilaminectomia toracolombar), com a retirada do material do disco do interior do canal vertebral, foi uma forma efetiva de gerar melhora do quadro funcional

Clinical results after decompressive surgery were evaluated in 45 dogs with cervical or thoracolumbar intervertebral disk disease. After surgery, 35 dogs recovered totally, eight (17.8 percent) partially, and two (4.4 percent) did not present any change in clinical findings. Eight dogs with paraplegy and loss of deep pain perception showed improvement, with total recovering in 62.5 percent of cases. Surgery was effective in four dogs with tetraparesy. Decompressive surgery (cervical slot or hemilaminectomy), with removal of disk material from inside the vertebral canal, was an effective form to produce functional improvement in dogs with this disease

Evaluación del efecto del cultivo probiótico Lactobacillus rhamnosus adicionado a yogurt natural y con probi6ticos comerciales sobre poblaciones de Staphylococcus aureus, Escherichia coli O157: H7, Listeria monocytogenes y Salmonella enteritidis / Evaluation of the effect of Lactobacillus rhamnosus probiotic culture added to yogurt over Staphylococcus aureus, Escherichia coli O157: H7, Listeria monocytogenes and Salmonella enteritidis populations

Se evaluó el efecto de diferentes tipos de cultivos probióticos en yogurt sobre poblaciones conocidas de Staphylococcus aureus, Escherichia coli O157:H7, Listeria monocytogenes y Salmonella enteritidis. Los tres tipos diferentes de yogurt comercial utilizados fueron: sin probióticos adicionados, con probióticos CHR HANSEN® (Lactobacillus casei CRL_431 y L. acidophilus CRL_730) y otro con los mismos probióticos mencionados anteriormente, adicionado con cultivo de Lactobacillus rhamnosus (LR-35). Se inoculó aproximadamente 109 UFC/mL de cada bacteria potencialmente patógena en los diferentes tipos de yogurt, se mantuvo en refrigeración a 4ºC durante la vida útil de cada uno de estos alimentos (aproximadamente 30 días) y se realizó un recuento bacteriano cada cuatro días incluyendo el mismo día de la inoculación. Los resultados obtenidos demuestran que, existe diferencia en cuanto a inhibición entre los yogures sin probióticos y el yogurt comercial con probióticos, observándose un efecto inhibitorio evidente, por parte del segundo sobre las poblaciones de S. aureus, E. coli O157:H7 y L. monocytogenes. Con respecto a los yogures comerciales con probióticos más L. rhamnosus, no se observó alguna diferencia con respecto al efecto inhibitorio que poseen los yogures con probióticos L. casei y L. acidophilus . En los yogures en que se evaluó S. enteritidis se obtuvo la muerte de ésta al cabo de cuatro días. El presente estudio confirma el efecto antagónico que poseen los cultivos probióticos sobre bacterias potencialmente patógenas para el ser humano y animales que pueden estar contenidas en los alimentos.No obstante, el uso del probiótico Lactobacillus rhamnosus no ejerce un efecto inhibitorio adicional.

The effect of different types of probiotics present in yogurt over known populations of Staphylococcus aureus, Escherichia coli O157:H7, Listeria monocytogenes and Salmonella enteritidis was evaluated. The three types of yogurt used were: without added probiotics, with added probiotics (Lactobacillus casei CRL_431 and L. acidophilus CRL_730 CHR HANSEN®) and another one with the same probiotics mentioned above and Lactobacillus rhamnosus (LR-35) culture. About 109 CFU/ mL of each potentially pathogenic bacteria was added to each type of yogurt tested, and kept in refrigeration at 4ºC during its shelf life, about 30 days. Bacterial count was done the initial day and every four days. Results obtained show that there is a difference in the inhibition between yogurts without added probiotics and the commercial yogurt with added probiotics; there is a clear inhibitory effect of the last one over S. aureus, E coli O157:H7 and Listeria monocytogenes. The yogurt with added probiotics and L. rhamnosus did not show any additional inhibitory effect over the bacteria tested when compared with the yogurt with added probiotics. S. enteritidis could not be evaluated because it was not detectable in any yogurt samples evaluated four days after its inoculation. This study confirms the antagonic effect of probiotic cultures over potentially pathogenic bacteria for human beings and animals that may be present in food. Nevertheless, the use of L. rhamnosus did not produce any additional inhibitory effect.

Antinocicepción opioide del extracto metanólico del Chuchuhuasi (Maytenus krukovii) en un modelo de dolor visceral en rat¢n / Antinociceptive opioid of chuchuhuasi Maytenus krukoviimethanolic extract in a model of visceral pain in mice

Evaluamos la acción antinociceptiva del extracto metanólico del Chuchuhuasi (Maytenus krukovii), al 20%, administrado por vía oral, en ratones albinos, machos, raza Webster Suizo obtenidos del Centro Nacional de Produccón de Biológicos del Ministerio de Salud del Peru, utilizando un modelo de dolor visceral, mediante la administración de  ácido acático al 2%, vía intraperitoneal, a la dosis de 0,05 ml/10g de peso. Observamos una disminución del 50% del número de contorsiones abdominales, en relación al grupo control, sin prolongación del período de latencia de las mismas. El efecto analgésico observado, fue bloqueado por la naloxona, lo que sugeriría la participación de receptores opioides, o de opioides endógenos en el mecanismo de la acción analgésica. Los resultados fueron analizados estadísticamente mediante el programa estadístico SPSS versión 11.5.

We evaluated the antinociceptive action of a 20% Chuchuhuasi (Maytenus krukovii) methanolic extract administered by oral route, on male albino Swiss Webster mice, from the Peruvian Health Institute, using a model of visceral pain. Intraperitoneal injections of 2% acetic acid at a concentration of 0,05 ml/10g were administered. We found a decrease of 50% in the average number of abdominal cramps, related to the control group, without increase of the latency period of abdominal contortions. The analgesic action was blocked by naloxone and could imply the participation of opioid receptors or endogenous opioids as the mechanism of action. Data were analyzed statistically with the SPSS program version 11.5.