Social determinants and sexual risk behaviors within Immunodeficiency Virus cases in Solidaridad, Quintana Roo, México / Determinantes sociales y conductas sexuales de riesgo en casos de Virus de la Inmunodeficiencia en Solidaridad, Quintana Roo, México

Abstract Objective: To determine the prevalence of HIV in individuals by analyzing the influence of social determinants and sexual risk behaviors, in order to estimate the crude and adjusted risks of being HIV positive in the municipality of Solidaridad, state of Quintana Roo, Mexico. Method and Materials: A cross-sectional study was conducted in the municipality of Solidaridad, Quintana Roo, Mexico. Third and fourth generation HIV rapid tests were performed. Descriptive statistics, measures of association (OR and 95 % CI) and p value were calculated for each stratum. Logistic regression models were performed to determine the risk factors associated with being HIV positive in the tests. Results: The sample consisted of 4,800 people, of whom 3,030 were men (63.12%); the mean age was 32.6 years (SD 14.96). The variables included in the multivariate model for being HIV positive are: men who have sex with men with OR=61.20, age 30-39 years OR=1.72, having anal sex OR=2.21, and as a protective factor having health service OR =0.42. Conclusions: This study confirms already known social determinants such as being male and being in economically active age and sexual practices such as: having anal sex and men with men. Being entitled to health services was shown to be the only protective factor.

Resumen Objetivo: Determinar la prevalencia de VIH en personas analizando la influencia de los determinantes sociales y las conductas sexuales de riesgo, para estimar los riesgos crudos y ajustados para ser VIH positivo en el municipio Solidaridad, estado de Quintana Roo, México. Método y Materiales: Se realizó un estudio transversal en el municipio de Solidaridad, Quintana Roo, México. Se realizaron pruebas rápidas de VIH de tercera y cuarta generación. Se calcularon las estadísticas descriptivas, las medidas de asociación (OR e IC del 95 %) y el valor de p para cada estrato. Se realizaron modelos de regresión logística para determinar los factores de riesgo asociados con ser VIH positivo en las pruebas. Resultados: La muestra estuvo compuesta por 4,800 personas de las cuales; 3,030 hombres (63.12%); la edad promedio fue de 32.6 años (D.E. 14.96). Las variables incluidas en el modelo multivariado para ser VIH positivo son: hombres que tienen sexo con hombres con OR=61.20, edad 30-39 años OR=1.72, tener sexo anal OR=2.21, y como factor protector contar con servicio de salud OR =0.42. Conclusiones: Este estudio confirma determinantes sociales ya conocidos como el ser hombre y estar en edad económicamente activa y prácticas sexuales como: el tener sexo anal y hombres con hombres. Contar con derechohabiencia se muestra como único factor protector.

Analysis of micro-costing through the Time-Driven Activity-Based Costing (TDABC) method in viscosupplementation procedures in different application regimens / Análise do microcusteio por meio de método Time-Driven Activity-Based Costing (TDABC) nos procedimentos de viscossuplementação do joelho em diferentes regimes de aplicação

Objective: To evaluate the micro-costing of viscosupplementation procedures compared to different infiltration regimens. Methods: This study compared, through the Time-Driven ActivityBased Costing method, the micro-costing of these different application regimens using national cost averages as a basis for calculation in a medium-sized outpatient service. Results: The results demonstrated that the difference in costs with the single application is 31.47% less for three and 119.13% for five applications. Conclusions: No study showed a superiority of the five-application regimen over the three-application regimen, which leads one to believe that there is no justification for this procedure from an economic or quality-of-life point of view.

Objective: Avaliar o microcusteio dos procedimentos de viscossuplementação do joelho em diferentes regimes de aplicação. Métodos: Este estudo comparou, por meio do método Time-Driven Activity-Based Costing, o microcusteio desses diferentes regimes de aplicação, usando com base de cálculo médias nacionais de custo em um serviço ambulatorial de porte médio. Resultados: Os resultados encontrados demonstraram que a diferença nos custos com a aplicação única é 31,47% menor para três aplicações e 119,13% para cinco aplicações. Conclusão: Em nenhum estudo houve superioridade do regime de cinco aplicações ao regime de três, fato que leva a acreditar que não há nenhuma justificativa para esse procedimento do ponto de vista econômico ou de qualidade de vida do paciente.

O uso da cirurgia robótica em artroplastias totais de joelho ­ Uma nova tecnologia chega ao Brasil / The use of robotic surgery in total knee arthroplasties ­ A new technology arrives in Brazil

Com a chegada da cirurgia robótica na cirurgia do joelho no Brasil em 2021, novos questionamentos são feitos para que possamos compreender como essa nova tecnologia pode ser assimilada no contexto da saúde e da realidade do país. As novas tendências no financiamento da saúde relacionadas ao setor privado fazem questionar de que maneira novos procedimentos podem ser incorporados, buscando o equilíbrio entre o avanço tecnológico e a acessibilidade baseada em custos e desfechos relacionados à qualidade de vida dos pacientes.

With the arrival of robotic surgery in knee surgery in Brazil in 2021, new questions are asked so that we can understand how this new technology can be assimilated in the context of health and the reality of the country. The new trends in health financing related to the private sector raises the question of how new procedures can be incorporated seeking a balance between technological advancement and accessibility based on costs and outcomes related to the quality of life of patients.

Toxocariasis en edad pediátrica. Presentación de un caso / Toxocariasis in pediatric age. A case presentation

RESUMEN La toxocariasis humana es una importante zoonosis parasitaria causada por formas larvarias del toxocara, un parásito nematodo de perros y gatos. La migración de la larva por los diferentes tejidos blandos en el ser humano genera una serie de entidades clínicas, tales como: toxocariasis encubierta, el síndrome de larva migrans visceral, la toxocariasis ocular y la neurotoxocariasis. Se presenta un caso clínico de un paciente de seis años de edad, hospitalizado a consecuencia de un síndrome febril agudo asociado a dolor abdominal; cuyo examen físico, reveló signos meníngeos, fotofobia, alteraciones en el fondo de ojo y eosinofilia moderada. Teniendo en cuenta la epidemiología, el cuadro clínico y los resultados de estudios serológicos, se concluyó el diagnóstico de larva migrans ocular, para lo cual se utilizó tratamiento específico con una evolución satisfactoria. Esta entidad nosológica requiere de una adecuada valoración socio-epidemiológica de los pacientes, así como de un minucioso examen físico que, unido a las pruebas específicas permitirán el diagnóstico precoz y el tratamiento oportuno.

ABSTRACT Human toxocariasis is an important parasitic zoonosis caused by larval forms of toxocara, a nematode parasite of dogs and cats. The migration of the larva through the different soft tissues in humans generates a series of clinical entities, such as: covert toxocariasis, visceral larva migrans syndrome, ocular toxocariasis and neurotoxocariasis. The clinical case of a six-year-old patient is presented, hospitalized as a result of an acute febrile syndrome associated with abdominal pain; whose physical examination revealed meningeal signs, photophobia, fundus alterations and moderate eosinophilia. Taking into account the epidemiology, the clinical picture and the results of serological studies, the diagnosis of ocular larva migrans was concluded, for which specific treatment was used with a satisfactory evolution. This nosological entity requires an adequate socio-epidemiological assessment of the patients, as well as a thorough physical examination that, together with the specific tests, will allow early diagnosis and timely treatment.

Prevalencia de β -lactamasas de espectro extendido en enterobacterias causantes de sepsis neonatal y factores asociados / Prevalence of extended-spectrum beta-lactamases in enterobacteria of neonatal sepsis and associated factors

Resumen Introducción: Las infecciones causadas por enterobacterias productoras de β-talactamasas de espectro extendido (EP-BLEE) tienen implicaciones sobre la morbilidad y mortalidad neonatal. Objetivo: Describir la prevalencia de EP-BLEE en sepsis neonatal y los factores asociados. Métodos: Estudio de cohorte prospectivo, desde agosto del 2016 a agosto del 2017. Se incluyeron recién nacidos (RNs) ingresados en el Hospital Civil de Guadalajara "Dr. Juan I. Menchaca". Mediante prueba de difusión de doble disco se indagó la presencia de EP-BLEE y su asociación con características clínicas y demográficas de los RNs. Resultados: Se estudiaron 1.501 RNs hospitalizados, con edad gestacional promedio de 36,3 semanas. Se diagnosticaron 196 eventos de sepsis neonatal, la etiología más frecuente fueron enterobacterias (45,5%); 88,8% demostraron resistencia a ampicilina y más de 42% a cefalosporinas de amplio espectro. El 22,9% presentó fenotipo BLEE positivo. Tener Apgar ≤ 7 a los cinco minutos de vida (OR 4,6; IC 95% 1,47-14,6) y edad gestacional < 37 semanas (OR 5,4; IC 95%1,04-27,7) incrementaron el riesgo. Conclusión: En las enterobacterias causantes de sepsis neonatal, 22,9% son EP-BLEE; la infección es más probable en pacientes con Apgar ≤ 7 a los cinco minutos de vida y en prematuros.

Background: Infections caused by extended-spectrum beta-lactamases enterobacteria (ESBL-EP) have implications for neonatal morbidity and mortality. Aim: To describe the prevalence of ESBL-EP in neonatal sepsis and associated factors. Methods: A prospective cohort study was conducted from August 2016 to August 2017; newborn babies (NB) hospitalized in the Hospital Civil de Guadalajara "Dr. Juan I. Menchaca" were included. The ESBL-EP were investigated by double-disk synergy test and its association with clinical and demographic characteristics of the NB. Results. A total of 1,501 hospitalized NB were studied, with an average gestational age of 36.3 weeks. They were diagnosed 196 neonatal sepsis events, the most frequent etiologies were enterobacteria (45.5%). Resistance to ampicilin was found in 88.8% and to broad spectrum cephalosporins in more than 42% of the strains; 22.9% of them were ESBL phenotype. Apgar ≤ 7 at five minutes of life (OR 4.6; 95% CI 1.47-14.6) and gestational age < 37 weeks (OR 5.4; 95% CI 1.04-27.) increase the risk. Conclusion: In enterobacteria that cause neonatal sepsis, 22.9% were EP-ESBL; infection was more likely in patients with Apgar ≤ 7 at five minutes of age and in preterm infants.

Mortalidad neonatal y factores asociados en recién nacidos internados en una Unidad de Cuidados Neonatales / Neonatal mortality and associated factors in newborn infants admitted to a Neonatal Care Unit

Introducción. La mayor supervivencia de pacientes prematuros ha modificado la epidemiología de las enfermedades del recién nacido, pero la mortalidad neonatal aún es el principal componente de la mortalidad infantil. El objetivo del estudio fue cuantificar la mortalidad neonatal y los factores asociados en recién nacidos internados en una Unidad de Cuidados Neonatales. Material y métodos. Estudio de cohorte prospectivo realizado de enero de 2016 a enero de 2017 en el Hospital Civil de Guadalajara "Dr. Juan I. Menchaca". Se cuantificó la incidencia de muertes y las condiciones asociadas mediante un análisis multivariado con regresión logística. Resultados. Se registraron 9366 nacidos vivos; fueron internados en la Unidad de Cuidados Neonatales el 15% (n: 1410). La mortalidad fue de 125,5 por 1000 recién nacidos internados (IC 95%: 109-144); las principales causas fueron malformaciones o enfermedades genéticas (28,2%), infecciones (24,9%) y síndrome de dificultad respiratoria (20,9%). Las condiciones asociadas a muerte fueron edad gestacional < 37 semanas (OR 2,41; IC 95%: 1,49-3,93), peso al nacer < 1500 gramos (OR 6,30; IC 95%: 4,159,55), dificultad respiratoria moderada/grave a los 10 minutos de vida (OR 1,89; IC 95%: 1,242,86), Apgar < 7 a los 5 minutos de vida (OR 9,40; IC 95%: 5,76-15,31), malformaciones congénitas (OR 5,52; IC 95%: 3,12-9,78) y menos de cinco consultas de control prenatal (OR 1,51; IC 95%: 1,09-2,08). Conclusiones. El nacimiento prematuro, bajo peso al nacer, dificultad respiratoria, Apgar < 7, malformaciones congénitas y antecedente de < 5 consultas de control prenatal se asociaron con mayor riesgo de muerte.

Introduction. The increasing survival rate of preterm infants has altered the epidemiology of neonatal diseases; however, neonatal mortality is still the main component of child mortality. The objective of this study was to evaluate neonatal mortality and associated factors in newborn infants admitted to a neonatal care unit. Material and methods. Prospective cohort study conducted between January 2016 and January 2017 at Hospital Civil de Guadalajara "Dr. Juan I. Menchaca." The incidence of deaths and associated conditions was evaluated using a multivariate logistic regression analysis. Results. A total of 9366 live births were registered; 15% (n: 1410) of these were admitted to the neonatal care unit. The mortality rate was 125.5 per 1000 hospitalized newborn infants (95% confidence interval --#91;CI--#93;: 109-144); the main reasons for admission were congenital malformations or genetic disorders (28.2%), infections (24.9%), and respiratory distress (20.9%). The conditions associated with death were gestational age < 37 weeks (OR: 2.41, 95% CI: 1.49-3.93), birth weight < 1500 grams (OR: 6.30, 95% CI: 4.15-9.55), moderate/severe respiratory distress at 10 minutes (OR: 1.89, 95% CI: 1.24-2.86), Apgar score < 7 at 5 minutes (OR: 9.40, 95% CI: 5.76-15.31), congenital malformations (OR: 5.52, 95% CI: 3.12-9.78), and less than 5 antenatal care visits (OR: 1.51, 95% CI: 1.09-2.08). Conclusions. Preterm birth, low birth weight, respiratory distress, Apgar score < 7, congenital malformations, and a history of < 5 antenatal care visits were associated with a higher risk for death.

Exogenous enzyme complex prevents intestinal soybean meal-induced enteritis in Mugil liza (Valenciennes, 1836) juvenile

ABSTRACT Four soybean meal-based diets containing increasing levels of an enzyme complex (E50, E100, E150 and E200 at 50, 100, 150 and 200 g ton-1, respectively) and one soybean meal-based diet without the enzyme complex (E0) were fed in triplicate to M. liza juveniles in a semi-static flow system with 20 fish per tank for 75 days. There were no differences between the treatments for animal performance parameters, but fish fed the enzyme complex treatment exhibited significantly (P<0.05) higher values of calcium bone retention compared with control fish. Although there was no relationship between bacterial counts in different sections of the gastrointestinal tract or enzyme levels, filamentous bacteria were increased in E50 compared with E150. All of the treatments resulted in higher bacterial counts in the stomach than in intestinal segments. Histological screening showed serious to moderate infiltration of inflammatory cells, modification in villus morphology and necrosis in some cases in fish fed the E0 diet. In addition, fish from the E0 treatment exhibited significantly (P<0.05) lower lipid deposition in the peritoneal cavity. Therefore, the use of low levels of exogenous enzyme is recommended in diets for M. liza when soybean meal is used as the main source of protein.

Posterior cruciate ligament reconstruction by means of tibial tunnel: anatomical study on cadavers for tunnel positioning / Reconstrução transtúnel tibial do ligamento cruzado posterior: estudo anatômico em cadáveres para a feitura do túnel tibial

Objective: To determine the reference points for the exit of the tibial guidewire in relation to the posterior cortical bone of the tibia. Methods: Sixteen knees from fresh cadavers were used for this study. Using a viewing device and a guide marked out in millimeters, three guidewires were passed through the tibia at 0, 10 and 15 mm distally in relation to the posterior crest of the tibia. Dissections were performed and the region of the center of the tibial insertion of the posterior cruciate ligament (PCL) was determined in each knee. The distances between the center of the tibial insertion of the PCL and the posterior tibial border (CB) and between the center of the tibial insertion of the PCL and wires 1, 2 and 3 (CW1, CW2 and CW3) were measured. Results: In the dissected knees, we found the center of the tibial insertion of the PCL at 1.09 ± 0.06 cm from the posterior tibial border. The distances between the wires 1, 2 and 3 and the center of the tibial insertion of the PCL were respectively 1.01 ± 0.08, 0.09 ± 0.05 and 0.5 ± 0.05 cm. Conclusion: The guidewire exit point 10 mm distal in relation to the posterior crest of the tibia was the best position for attempting to reproduce the anatomical center of the PCL...

Objetivo: Determinar os pontos de referência para a saída do fio-guia tibial em relação à cortical posterior da tíbia. Métodos: Foram usados para este estudo 16 joelhos de cadáveres frescos. Através de uma escopia e com um guia milimetrado, foi feita a passagem de três fios-guias a 0, 10 e 15 mm distalmente em relação à crista posterior da tíbia. Foram feitas dissecções e foi determinada a região do centro da inserção tibial do ligamento cruzado posterior (LCP) em cada joelho. Foram medidas as distâncias entre o centro da inserção tibial do LCP e a borda tibial posterior (CB) e entre o centro da inserção tibial do LCP e os fios 1-2 e 3 (CF1-CF2-CF3). Resultados: Nos joelhos dissecados, encontramos o centro da inserção tibial do LCP a 1,09 cm ± 0,06 da borda tibial posterior. As distâncias entre os fios 1,2 e 3 e o centro da inserção tibial do LCP foram respectivamente 1,01 ± 0,08; 0,09 ± 0,05 e 0,5 ± 0,05. Conclusão: A saída do fio- guia a 10 mm distalmente em relação à crista posterior da tíbia representa a melhor posição para tentar reproduzir o centro anatômico do LCP...

Lipossarcoma de joelho em um atleta de tênis: relato de caso / Lipossarcoma of the knee in a tennis player: case report

O lipossarcoma é uma neoplasia rara, originária de células mesenquimais primitivas e, entre os sarcomas, é o tipo histológico mais frequente. Os autores relatam o caso de um lipossarcoma localizado em região de joelho e coxa posterior distal direita de um paciente de 40 anos, jogador de tênis.

Lipossarcoma is an uncommon malignant tumor. It originates in the mesenchymal cells, and is the most common of the soft tissue sarcomas. The authors report a case of a 40 year-old male tennis player with lipossarcoma in the posterior right knee and distal thigh region.

Avaliação da altura patelar em atletas com tendinopatia crônica do aparelho extensor do joelho / Evaluation of the patellar height in athletes with diagnosed with chronic tendinopathy of the knee extensor mechanism

OBJETIVO: Avaliar radiograficamente a altura patelar de atletas com diagnóstico de tendinopatia crônica do aparelho extensor do joelho (TCAE). MÉTODOS: Na amostra foram avaliados radiograficamente 65 pacientes (110 joelhos) com idade entre 15 e 40 anos e de diferentes modalidades esportivas com e sem diagnóstico de tendinopatia crônica do aparelho extensor do joelho (jumper's knee). Os atletas foram divididos em dois grupos: aqueles com diagnóstico de TCAE (grupo 1: 38 atletas - 56 joelhos) e um grupo que denominamos de controle (grupo 2: 27 atletas - 54 joelhos). RESULTADOS: No grupo 1 tivemos 18 atletas que apresentavam a doença bilateralmente na ocasião dos exames. Para a medida da altura patelar utilizamos os índices radiográficos de Insall e Salvati e Blackburne e Peel. CONCLUSÃO: A presença de patela alta no grupo de atletas com tendinopatia crônica do aparelho extensor do joelho foi significante maior do que a observada no grupo controle.

OBJECTIVES: To carry out a radiographic evaluation of patellar height in athletes diagnosed with chronic tendinopathy of the knee extensor mechanism; METHODS: Radiographic assessments were carried out on 65 patients (110 knees) aged between 15 and 40 years, who practiced different kinds of sports, some with of chronic tendinopathy of the knee extensor mechanism (jumper's knee) and others without. The athletes were divided into two groups: those with diagnosed "jumper's knee" (group 1:38 athletes - 56 knees) and a control group (group 2:27 athletes - 54 knees). In group 1, 18 of the athletes presented the condition in both knees on examination. The height of the patella was measured using the Insall-Salvati and Blackburne-Peel x-ray methods. CONCLUSION: The presence of a high patella in the group of athletes with chronic tendinopathy of the knee extensor mechanism was significantly higher than in the control group.

Síndrome compartimental em perna após reconstrução de ligamento cruzado anterior: relato de caso / Leg's compartment syndrome after reconstruction of the anterior cruciate ligament: case report

Os autores apresentam o relato de caso de um paciente que foi submetido à cirurgia de reconstrução de ligamento cruzado anterior e reparo de ligamento colateral medial de joelho esquerdo e que evoluiu com síndrome de compartimento de perna.

The authors report a case of a patient that was submitted to a surgery of reconstruction of anterior cruciate ligament and collateral medial ligament repair of the left knee that complicated to a compartment syndrome.

Prevalence of pain on palpation of the inferior pole of the patella among patients with complaints of knee pain

CONTEXT AND OBJECTIVE: Patellar tendinopathy is a common condition in sports. It may occur at any location of the patellar tendon, but the most commonly affected area is the inferior pole of the patella. Among various diagnostic tests, the one most used is palpation of the inferior pole of the patella. The aim of this study was to investigate the prevalence of pain complaints among individuals with pathological knee conditions and to evaluate palpation of the inferior pole of the patella as a diagnostic test for patellar tendinopathy. METHODS: Palpation of the patellar tendon was performed on 318 individuals who presented with knee-related complaints. Palpation was performed with the individual in the supine position and the knee extended. The age, gender, physical activity and labor activity of each individual were recorded at the time the symptoms appeared; the diagnosis was also recorded. RESULTS: Of the total number of individuals evaluated, 124 (39 percent) felt pain on palpation of the inferior pole of the patella. Of these, only 40 (32.3 percent) received a diagnosis of patellar tendinopathy. We did not observe any difference with respect to gender and age distribution. When evaluating daily physical activity levels, however, we observed that individuals with pain on palpation of the inferior pole of the patella experienced more intense physical activity. CONCLUSIONS: Palpation of the inferior pole of the patella is a diagnostic procedure with high sensitivity and moderate specificity for diagnosing patellar tendinopathy, especially among individuals who perform activities with high functional demands.

Carrapatos do gênero amblyomma (acari: ixodidae) e suas relações com os hospedeiros em área endêmica para febre maculosa no Estado de São Paulo / Ticks of genus Amblyomma (Acari: Ixodidae) and their relationship with hosts in endemic area for spotted fever in the state of São Paulo

Seven species of mammals and 36 of birds were investigated to determine the tick prevalence and intensity of infestation. The study was conducted at the Esalq/USP in Piracicaba municipality, State of São Paulo. It was collected 52 mammals and 158 birds parasitized by 12,418 ticks. Adult ticks (N= 7,343) were found on capybaras, while the immature were mainly collected on small mammals and birds. The main hosts for immatures in descending order were opossums (69.1 percent), capybara (24.4 percent) and black vultures (3.7 percent). Among the avifauna, the black vulture (Cathartidae) had the heaviest infestation (69.9 percent) followed by species of the Thamnophilidae and Turdidae families. Adult ticks collected on capybaras were A. cajennense (80.8 percent) and A. dubitatum (19.2 percent). Both tick species were also found on opossums corresponding to 72.4 percent and 27.6 percent, respectively. Due to easy capture and attractiveness for ticks, opossums could be used as bioindicators in Brazilian zoonotic areas with spotted fever. Considering the prevalence and also abundance of ticks, host attractiveness, proliferation and susceptibly for R. rickettsi infection, capybaras and opossums are the main amplifying hosts for this microorganism at the ESALQ/Campus, while horses, black vultures and stray cats act as secondary hosts.

Foram avaliadas 7 espécies da mastofauna e 36 da avifauna quanto à prevalência e intensidade de infestação por carrapatos na ESALQ/USP, no Município de Piracicaba, SP. Analisaram-se 52 indivíduos da mastofauna e 158 da avifauna, parasitados por 12418 carrapatos. Os exemplares adultos (N= 7343) foram encontrados em parasitismo nas capivaras enquanto que os imaturos foram, na maioria, coletados de pequenos mamíferos e aves. Os principais hospedeiros para as formas imaturas, em ordem decrescente, foram gambás (69,1 por cento), capivaras (24,4 por cento) e urubus (3,7 por cento). Entre a avifauna, o urubu apresentou o maior número de carrapatos com 69,9 por cento, seguido por indivíduos das famílias Thamnophilidae e Turdidae. Os carrapatos adultos encontrados em capivaras foram A. cajennense (80,8 por cento) e A. dubitatum (19,2 por cento). Ambas as espécies foram também coletadas em gambás, correspondendo a 72,4 por cento e 27,6 por cento, respectivamente. Pela facilidade de captura e atratividade de Amblyomma spp. o gambá pode ser usado como bioindicador de infestação em locais endêmicos para febre maculosa. Considerando os índices de parasitismo e prevalência bem como de abundância de carrapatos, susceptibilidade dos hospedeiros, proliferação e susceptibilidade para infecção por R. rickettsi, capivaras e gambás são potenciais hospedeiros amplificadores desse microrganismo no Campus da ESALQ, enquanto eqüídeos, urubus e gatos atuam como hospedeiros secundários.

Reflujo enterogástrico: modelo experimental en ratas / Enterogastric reflux: experimental model in rats

Se crea un modelo de reflujo enterogástrico en ratas y se realizan procedimientos antireflujo. Se estudian las alteraciones producidas por el reflujo enterogástrico sobre la mucosa gástrica. Se emplean 5 series de 10 animales. Se obtiene gastritis crónica superficial de diferentes grados. Se miden el pH gastrico (Serie 1,3,4 y 5) y duodenal (Serie 2), mediante aspiración por sonda de gastrostomía y duodenostomia transgástrica, pre y postingesta. El medio gástrico y duodenal se acidifica en el postprandio. PH gástrico preingesta X=1,83; DS=0,38 y postingesta X=1; DS=O,OO. PH duodenal preingesta X=6,45; DS=0,63 y postingesta X=5,45; DS=0,63. En la serie 1 y 2 no hubo pérdida de peso. La confección de una píloroplastia de Heinecke-Mikulicz (Serie 3), logra la alcalinización del medio gástrico pre y postprandial. PH preingesta X=2,89; DS=0,56 y postingesta X=3,8S; DS=0,57. La pérdida de peso por animal es 1 por ciento. En la Serie 4 se realizó una piloroplastia de Heinecke-Mikulicz y Switch duodenal de asa corta. Se logró una mayor alcalinización del medio gastrico en estado de vacuidad y postprandial. PH preingesta X=5,61; DS=1,10 y PH postingesta X=4, S3; DS=1,09. La pérdida de peso por animal es 14 por ciento. En la Serie 5 se realiza una piloroplastia de Heinecke-Mikulicz y Switch duodenal de asa larga. Se logran valores de PH gástrico similares a los normales. PH preingesta X=2,18; DS=0,63 y postingesta X=1,28; DS=0,44. La pérdida de peso por animal 3 por ciento. La mortalidad global fue de 10 animales en 50 intervenidos. En todas las series, segun Test de Wilcoxon P=0,0001. Los autores concluyen que el Switch duodenal de asa corta lleva a la pérdida de peso significativa y a lesiones mucosas gastricas relevantes. No impide la alcalinizacion del medio gástrico. Switch de asa larga es un buen procedimiento antireflujo enterogastroesofágico en ratas. Asegura la acidificación del medio gástrico, la nutrición y la ausencia de lesiones mucosas gastricas