Uso y resultados del astegolimab en el manejo del asma severa: ¿qué se conoce?

El asma es una enfermedad inflamatoria crónica de las vías respiratorias que acarrea elevados costos en salud, afecta sustancialmente la calidad de vida y, dependiendo de ciertos factores de riesgo asociados, disminuye la capacidad funcional de quien lo padece. Para el 2019, el asma afectó a 262 millones de personas (4,3 % de la población mundial) y causó 461 000 muertes. Se estima que habrá 100 millones de personas adicionales con asma para el año 2025. El asma severa es un fenotipo resistente a corticoides que ocasiona mayor número de exacerbaciones, afecta sustancialmente la calidad de vida y capacidad funcional del afectado. Su manejo inicialmente se encamina a suprimir los síntomas, y este ha ido evolucionando hasta la comprensión, aún no completa, de los sistemas intrínsecos de su generación, con lo cual se han estudiado nuevas formas de incidir en su manejo, mediante la modulación de la respuesta inmune y la cascada inflamatoria, con la generación de medicamentos biológicos. A raíz del estudio e identificación de endotipos y fenotipos variados, se han diseñado este tipo de medicamentos, con distintos mecanismos de acción, que han demostrado una utilidad sólida en los últimos años. No obstante, existe evidencia de que se ha encontrado resistencia incluso a estos medicamentos, por lo que ha sido necesario seguir investigando nuevas dianas terapéuticas. El astegolimab es un novedoso anticuerpo monoclonal Ig G2 humano que bloquea la señalización de IL-33 al dirigirse a ST2, su receptor, por consiguiente, controla la respuesta inflamatoria en el asma severa. Actualmente, se encuentra en realización de ensayo clínico fase 2b, aunque experimentaciones previas han encontrado resultados positivos y significativos respecto a la inmunomodulación, función pulmonar, sintomatología y calidad de vida. En la actualidad, casi no existe literatura que haya analizado el potencial del astegolimab en el asma grave, y están disponibles prácticamente solo los ensayos que lo han evaluado y algunas revisiones que han compartido su farmacocinética y farmacodinamia. Sobre la base de lo anterior, el objetivo de esta revisión consiste en sintetizar evidencia relacionada con los resultados del uso del astegolimab en asma severa, discutiendo aspectos epidemiológicos y fisiopatológicos que resalten la necesidad del desarrollo de un fármaco seguro, eficaz y eficiente.

Asthma is a chronic inflammatory disease of the respiratory tract which causes high health costs, substantially affects the quality of life and, depending on certain associated risk factors, reduces the functional capacity of the sufferer. By 2019, asthma affected 262 million people (4.3 % of the world's population) and caused 461,000 deaths. It is estimated that there will be an additional 100 million people with asthma by 2025. Severe asthma is a phenotype resistant to corticosteroids which causes a greater number of exacerbations and substantially affects the quality of life and functional capacity of the affected person. Its management was initially aimed at suppressing the symptoms and then evolved to understand, although not completely, the intrinsic systems of its generation. Thus, new ways of influencing its management have been studied by modulating the immune response and the inflammatory cascade with the generation of biological drugs. As a result of the study and identification of various endotypes and phenotypes, drugs with different mechanisms of action have been designed and have demonstrated to be considerably useful in recent years. However, there is evidence that resistance even to these drugs has occurred, being necessary to continue researching new therapeutic targets. Astegolimab is a novel human IgG2 monoclonal antibody that blocks IL-33 signaling by targeting ST2, its receptor, thus controlling the inflammatory response in severe asthma. A phase 2b clinical trial is currently undergoing, although previous results have found positive and significant results regarding immunomodulation, pulmonary function, symptomatology and quality of life. At present, there is almost no literature that has analyzed the potential of astegolimab in severe asthma, and practically only trials that have evaluated it and some reviews that have shared its pharmacokinetics and pharmacodynamics are available. Based on the above, the aim of this review is to synthesize evidence related to the results of the use of astegolimab in severe asthma and discuss epidemiological and pathophysiological aspects that highlight the need for the development of a safe, effective and efficient drug.

Use of Ionized Monocalcium phosphate and enameline derivatives to reduce dentin hypersensitivity after periondontal therapy / Uso de Fostato Monocálcio y derivados en Enamelina para reducir la hipersensibilidad dentaria después de terapia periodontal

Abstract This study aimed to evaluate the effectiveness of using an ionized monocalcium phosphate and enamelin derivatives (IMP+ED) based mouthwash for the treatment of dentin hypersensitivity (DH) after scaling and root planing (SRP). 47 patients who reported DH after SRP treatment were included in this prospective cohort study. The Schiff Cold Air Sensitivity Scale (SCASS) was applied to classify their degree of pain in mild, moderate or intense at two times: after SRP (T0), and after one month of using a IMP+ED-based mouthwash (T1). The McNemar-Bowker test was used to compare the correlated proportions between both times (p<0.05). After the SRP therapy (T0), all the sample members reported pain distributed in the following manner: 12.8% were mild, 27.6% moderate, and 59.6% intense. At one month since treatment and with the use of the IMP+ED-based mouthwash (T1), the distribution of pain levels changed to 83% mild, 12.8% moderate, and 4.3% intense, this change was statistically significant (p<0.001). IMP+ED-based mouthwash produces a positive effect in reducing painful responses caused by exposure of the dentin tubules to the oral environment after SRP therapy.

Resumen El objetivo de este estudio fue evaluar la efectividad de un enjuague bucal a base de fosfato monocálcico ionizado y derivados de enamelina (FCI+DE) para el tratamiento de hipersensibilidad dentinaria (HD) posterior al tratamiento de raspado y alisado radicular (RAR). 47 pacientes que reportaron tener HD posterior al tratamiento de RAR fueron incluidos en este estudio prospectivo de cohorte. Con el fin de clasificar la HD de los pacientes en leve, moderada o intensa se utilizó la Escala de Sensiblidad al Aire Frío de Schiff (ESAFS). Los pacientes fueron evaluados después del tratamiento de RAR (T0) y posterior al uso de un enjuague bucal basado en FCI+DE (T1). Para comparar las proporciones correlacionadas se utilizó la prueba de McNemar-Bowker (p<0.05). La distribución del dolor de los pacientes posterior al tratamiento de RAR (T0) fue la siguiente: 12.8% fueron leves, 27.6% moderado, and 59.6% intenso. Un mes después del uso del enjuague buccal basado en FCI+DE (T1) la distribución en los niveles de dolor cambio a 83% leve, 12.8% moderado, and 4.3% intenso, este cambio fue estadísticamente significativo (p<0.001). El uso del enjuague bucal basado en FCI+DE produce una reducción significativa a la respuesta de dolor causada por la exposición de la dentina al ambiente oral como consecuencia del tratamiento de RAR.

Aplicaciones e implicaciones de la pausa al final de la inspiración en ventilación mecánica / Applications and implications of end-inspiratory pause in mechanical ventilation / Aplicações e implicações da pausa ao final da inspiração na ventilação mecânica

Resumen: El uso de la pausa al final de la inspiración (PFI) en ventilación mecánica data de hace más de 50 años y con mayor impulso en la década de los 70, se le atribuye una mejoría en la presión parcial de oxígeno arterial (PaO2) al incrementar la presión media de la vía aérea (Pma), mayor aclaramiento de la presión parcial de dióxido de carbono arterial (PaCO2) y permite la monitorización de la presión meseta (Pmeseta) en la mecánica ventilatoria; sin embargo, los estudios clínicos sobre su uso son escasos y controversiales. En este artículo se abordan los mecanismos fisiológicos, fisiopatológicos y la evidencia sobre el uso de la PFI en ventilación mecánica (VM).

Abstract: The use of the end inspiratory pause (EIP) in mechanical ventilation has been going on for more than 50 years and with greater momentum in the 1970s, an improvement in the partial pressure of arterial oxygen (PaO2) is attributed to the increase mean airway pressure, greater clearance of partial pressure of arterial carbon dioxide and allows monitoring of plateau pressure in ventilatory mechanics; However, the Clinical studies on its use are few and controversial. This article addresses the physiological and pathophysiological mechanisms and the evidence on the use of EIP in mechanical ventilation.

Resumo: A utilização da pausa ao final da inspiração (PFI) na ventilação mecânica remonta a mais de 50 anos e com maior impulso na década de 70, atribui-se uma melhora na pressão parcial de oxigênio arterial (PaO2) pelo aumento da pressão média das vias aéreas (Pma), uma maior depuração da pressão parcial de dióxido de carbono arterial (PaCO2) e permite a monitorização da pressão de platô (Pplateau) na mecânica ventilatória, porém estudos Os dados clínicos sobre seu uso são escassos e controversos. Este artigo aborda os mecanismos fisiológicos e fisiopatológicos e as evidências sobre o uso do PFI na ventilação mecânica (VM).

Percepción de los residentes sobre el impacto de la pandemia COVID 19 en la formación en profesionalismo / Residents ́perspective of the impact of the COVID 19 pandemic on professional competency training

Introducción: el profesionalismo es clave para construir la identidad de los profesionales sanitarios. El objetivo de este trabajo ha sido conocer en un colectivo de residentes, la influencia de la primera ola de la pandemia por SARS-CoV2 en sus competencias del profesionalismo. Materiales y métodos: estudio descriptivo transversal mediante cuestionario electrónico, remitido a 167 residentes, para medir su percepción sobre el impacto de la pandemia COVID-19 en el profesionalismo, con una escala verbal de cuatro niveles: excelente, por encima de lo esperado, lo esperado, por debajo de lo esperado. Se realizó, además, una pregunta abierta de "reflexión personal" analizada cualitativamente mediante un proceso de triangulación. La encuesta se hizo en el Hospital Universitario Fundación Alcorcón en los dos meses siguientes a la primera ola pandémica. Resultados: respondieron 59 residentes (35,3%) de 21 especialidades. Sus lugares de trabajo fueron muy variados. Los atributos del profesionalismo valorados por encima de esperado o excelente fueron: trabajo en equipo (74,6%), empatía (71,2%) y responder a las necesidades del paciente por encima de las propias (69,5%). Se encontró por debajo de lo esperado la gestión de las emociones (22%). Discusión: la pandemia COVID-19 ha contribuido a reforzar la identidad profesional de los residentes, manifestándose a través de muchas dimensiones del profesionalismo. La gestión de las emociones fue la que obtuvo menor valoración.

Introduction: Professionalism is essential to build the identity of health professionals. The aim in this study was to determine, in a group of residents, the influence of the first wave of SARS-CoV2 pandemic on their professionalism competencies. Methods: Cross-sectional descriptive study with an electronic survey sent to 167 residents of Hospital Universitario Fundación Alcorcón to assess their perception of the impact of COVID-19 pandemic on professionalism, with a four-level verbal scale: excellent, above expected, expected, below expected. In addition, an open-ended "personal reflection" question was qualitatively analyzed through a triangulation process. The survey was completed immediately after the first pandemic wave. Results: The questionnaire was answered by 59 residents (35.3%) of 21 specialties from different workplaces. The attributes of professionalism rated above expected or excellent were: teamwork (74.6%), empathy (71.2%) and responding to patient's needs above their own (69.5%). Management of emotions (21%) was found to be below expectations. Discussion: COVID-19 pandemic has contributed to reinforce the professional identity of the residents, expressing itself through many dimensions of professionalism. Emotional management was the lowest rated.

Evaluation of diagnostic agreement among cephalometric measurements for determining incisor position and inclination / Evaluación de la concordancia diagnóstica entre mediciones cefalométricas para la determinación de la posición e inclinación de los incisivos

SUMMARY: The incisors are a key factor in dental occlusion and dentofacial aesthetics; therefore, the sagittal position and inclination of the incisors is a key parameter in diagnosis and orthodontic treatment planning. In some cases, the orthodontist will use more than one cephalometric analysis, and thus different results can be obtained. The aim of this study was to establish the diagnostic agreement among the different cephalometric measurements used to determine the anteroposterior position and the inclination of the incisors. Lateral cephalometric radiograms of patients between 18 and 59 years old were measured (n=260). Digital cephalometric measurements were made with Dolphin Imaging software, by a single calibrated operator. Here, a specific cephalometric analysis was designed in the software analysis editor. The results for each variable and each measurement were registered and compared. Fleiss's Kappa statistical tests, Cohen's Kappa, and Kendall's coefficient were used to determine the strength of agreement using the Minitab software. The results showed diagnostic strength agreement between slight and moderate among measurements of the same variable. This indicates that same diagnosis might not be obtained when using different approaches to measure the anteroposterior position and inclination of the incisors. It was concluded that there is a difference in the diagnosis between one measurement and another because the results showed slight or moderate strength of agreement. However, in some cases, better agreement was found when the measurements were compared as a function of the diagnostic response.

RESUMEN: Los incisivos son un factor clave en la oclusión dental y la estética dentofacial; por lo tanto, la posición sagital y la inclinación de los incisivos es un parámetro clave en el diagnóstico y la planificación del tratamiento de ortodoncia. En algunos casos, el ortodoncista utilizará más de un análisis cefalométrico y, por lo tanto, se pueden obtener resultados diferentes. El objetivo de este estudio fue establecer el acuerdo de diagnóstico entre las diferentes mediciones cefalométricas utilizadas para determinar la posición anteroposterior y la inclinación de los incisivos. Se midieron radiografías cefalométricas laterales de pacientes entre 18 y 59 años (n = 260). Las mediciones cefalométricas digitales se realizaron con el software Dolphin Imaging, por un solo operador calibrado. Aquí, se diseñó un análisis cefalométrico específico en el editor de análisis de software. Los resultados para cada variable y cada medición se registraron y compararon. Las pruebas estadísticas Kappa de Fleiss, Kappa de Cohen y el coeficiente de Kendall se usaron para determinar la fuerza del acuerdo utilizando el software Minitab. Los resultados mostraron un acuerdo de fuerza diagnóstica entre leve y moderado entre las mediciones de la misma variable. Esto indica que no se puede obtener el mismo diagnóstico cuando se utilizan diferentes enfoques para medir la posición anteroposterior y la inclinación de los incisivos. Se concluyó que existe una diferencia en el diagnóstico entre una medición y otra porque los resultados mostraron una fuerza de acuerdo leve o moderada. Sin embargo, en algunos casos, se encontró un mejor acuerdo cuando se compararon las mediciones en función de la respuesta de diagnóstico.

Crecimiento de cuyes (Cavia porcellus) con alimento para conejos y suplementación de vitamina C / Growth of Guinea pigs (Cavia porcellus) with feed for rabbits and supplementation of vitamin C

RESUMEN Objetivo. Evaluar el consumo, la digestibilidad y el crecimiento de cuyes alimentados con dos alimentos (A y K) formulados para esta especie y un alimento para conejos en crecimiento con suplementación de vitamina C (AC+VC). Materiales y métodos. Dieciocho cuyes (Cavia porcellus) de 248±38 g de peso vivo inicial se distribuyeron en un diseño completamente al azar con un arreglo factorial 3 × 2 (tipo de alimento y género). La ingesta de alimento, fibra detergente neutro, el aumento de peso, la conversión alimenticia, y los cambios en las variables morfométricas se midieron diariamente, mientras que la digestibilidad de la MS y FDN se determinaron al final del periodo. Resultados. No hubo diferencias en el consumo de MS (p=0.88); sin embargo, la digestibilidad de la MS fue mayor (p<0.01) en los alimentos para cuyes e inferior en AC+VC. El consumo y digestibilidad de FDN fueron mayores en AC+VC (p<0.01). La ganancia diaria fue similar entre los tratamientos (p>0.05). No hubo diferencias (p>0.01) en las variables morfométricas entre los alimentos, pero los machos fueron más grandes que las hembras (p<0.01). Conclusiones. Los cuyes pueden ser alimentados con alimento de conejo suplementado con vitamina C.

ABSTRACT Objective. An experiment was conducted to evaluate the feed intake, digestibility and growth of pigs fed with two feeds (A and K) specially formulated for this species and a commercial feed for growing rabbits with supplementation of vitamin C (RF+VC). Materials and methods. Eighteen Guinea pigs of 248±38 g initial body weight were distributed in a completely randomized design with factorial arrangement 3×2 (dietary treatments and sex). Feed and neutral detergent fiber intake, weight gain, feed/gain, and morphometric variables were measured individually for 30 days. Dry matter and neutral detergent fiber digestibility were measured during the last seven days of the experiment. Results. There were no differences on feed intake (p=0.88); however, the dry matter digestibility was higher (p<0.01) in feeds formulated for Guinea pigs (A and K) and lower in the rabbit feed plus vitamin C. The intake and digestibility of NDF were higher in the RF+VC and lower in feeds for Guinea pigs (p< 0.01). The average daily gain was similar among the treatments (p>0.05). There were no differences (p>0.01) in the morphometric variables among dietary treatments, but there were sex differences as the males were bigger than the females (p<0.01). Conclusions. The results indicate that Guinea pigs can be fed with rabbit feed supplemented with vitamin C.

Hemolytic, anticancer and antigiardial activity of Palythoa caribaeorum venom

Background Cnidarian venoms and extracts have shown a broad variety of biological activities including cytotoxic, antibacterial and antitumoral effects. Most of these studied extracts were obtained from sea anemones or jellyfish. The present study aimed to determine the toxic activity and assess the antitumor and antiparasitic potential of Palythoa caribaeorum venom by evaluating its in vitro toxicity on several models including human tumor cell lines and against the parasite Giardia intestinalis. Methods The presence of cytolysins and vasoconstrictor activity of P. caribaeorum venom were determined by hemolysis, PLA2 and isolated rat aortic ring assays, respectively. The cytotoxic effect was tested on HCT-15 (human colorectal adenocarcinoma), MCF-7 (human mammary adenocarcinoma), K562 (human chronic myelogenous leukemia), U251 (human glyoblastoma), PC-3 (human prostatic adenocarcinoma) and SKLU-1 (human lung adenocarcinoma). An in vivo toxicity assay was performed with crickets and the antiparasitic assay was performed against G. intestinalis at 24 h of incubation. Results P. caribaeorum venom produced hemolytic and PLA2 activity and showed specific cytotoxicity against U251 and SKLU-1 cell lines, with approximately 50% growing inhibition. The venom was toxic to insects and showed activity against G. intestinalis in a dose-dependent manner by possibly altering its membrane osmotic equilibrium. Conclusion These results suggest that P. caribaeorum venom contains compounds with potential therapeutic value against microorganisms and cancer.

Neumonías de la comunidad en la infancia / Pneumonia of the community in childhood

Los virus son los responsables más frecuentes de neumonías en menores de 1 año. Entre las bacterias, Streptococcus pneumoniae y Haemophilus tipo bson las más frecuentemente aisladas. En el recién nacido (menor de 1 mes) se deberá tener en cuenta la posibilidad de Streptococcus grupo B, enterobacterias y Staphylococcus aureus. A partir de los 3 años de edad el Mycoplasma pneumoniae comienza a aumentar su prevalencia. A pesar de que los virus son los agentes etiológicos más frecuentes, cuando no se pueda descartar la infección bacteriana, sola o asociada, los cuadros serán tratados como presumiblemente bacterianos. Tos, taquipnea, tiraje y fiebre son los indicadores más fieles de neumonía, por lo que se debe remarcar la importancia de su presencia

Hemolytic, anticancer and antigiardial activity of Palythoa caribaeorum venom

Cnidarian venoms and extracts have shown a broad variety of biological activities including cytotoxic, antibacterial and antitumoral effects. Most of these studied extracts were obtained from sea anemones or jellyfish. The present study aimed to determine the toxic activity and assess the antitumor and antiparasitic potential of Palythoa caribaeorum venom by evaluating its in vitro toxicity on several models including human tumor cell lines and against the parasite Giardia intestinalis. Methods: The presence of cytolysins and vasoconstrictor activity of P. caribaeorum venom were determined by hemolysis, PLA2 and isolated rat aortic ring assays, respectively. The cytotoxic effect was tested on HCT-15 (human colorectal adenocarcinoma), MCF-7 (human mammary adenocarcinoma), K562 (human chronic myelogenous leukemia), U251 (human glyoblastoma), PC-3 (human prostatic adenocarcinoma) and SKLU-1 (human lung adenocarcinoma). An in vivo toxicity assay was performed with crickets and the antiparasitic assay was performed against G. intestinalis at 24 h of incubation. Results: P. caribaeorum venom produced hemolytic and PLA2 activity and showed specific cytotoxicity against U251 and SKLU-1 cell lines, with approximately 50% growing inhibition. The venom was toxic to insects and showed activity against G. intestinalis in a dose-dependent manner by possibly altering its membrane osmotic equilibrium. Conclusion: These results suggest that P. caribaeorum venom contains compounds with potential therapeutic value against microorganisms and cancer.(AU)

Composition and biological activities of the aqueous extracts of three scleractinian corals from the Mexican Caribbean: Pseudodiploria strigosa, Porites astreoides and Siderastrea siderea

Background: Scleractinian corals (stony corals) are the most abundant reef-forming cnidarians found in coral reefs throughout the world. Despite their abundance and ecological importance, information about the diversity of their toxins and their biological activities is very scarce. In this study, the chemical composition and the biological activities of the aqueous extracts of Pseudodiploria strigosa, Porites astreoides and Siderastrea siderea, three scleractinian corals from the Mexican Caribbean, have been assessed for the first time. Methods: Toxicity of the extracts was assessed in crickets; the presence of cytolysins was detected by the hemolysis assay; the vasoconstrictor activity was determined by the isolated rat aortic ring assay; the nociceptive activity was evaluated by the formalin test. The presence of phospholipases A2 (PLA2), serine proteases, and hyaluronidases was determined by enzymatic methods. Low-molecular-weight fractions were obtained by gel filtration chromatography and ultrafiltration. Results: Extracts from the three species were toxic to crickets, induced hemolysis in human and rat erythrocytes, produced vasoconstriction on isolated rat aortic rings, and presented phospholipase A2 and serine-protease activity. Despite the fact that these corals are not considered to be harmless to humans, the extracts generated significant nociceptive responses. The matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry analysis of the low-molecular-weight fractions revealed the presence of peptides within a mass range of 3000 to 6000 Da. These fractions were toxic to crickets and two of them induced a transitory vasoconstrictor effect on isolated rat aortic rings. Conclusion: This study suggests that scleractinian corals produce low-molecular-weight peptides that are lethal to crickets and induce vasoconstriction.(AU)

Composition and biological activities of the aqueous extracts of three scleractinian corals from the Mexican Caribbean: Pseudodiploria strigosa, Porites astreoides and Siderastrea siderea

Scleractinian corals (stony corals) are the most abundant reef-forming cnidarians found in coral reefs throughout the world. Despite their abundance and ecological importance, information about the diversity of their toxins and their biological activities is very scarce. In this study, the chemical composition and the biological activities of the aqueous extracts of Pseudodiploria strigosa, Porites astreoides and Siderastrea siderea, three scleractinian corals from the Mexican Caribbean, have been assessed for the first time. Methods: Toxicity of the extracts was assessed in crickets; the presence of cytolysins was detected by the hemolysis assay; the vasoconstrictor activity was determined by the isolated rat aortic ring assay; the nociceptive activity was evaluated by the formalin test. The presence of phospholipases A2 (PLA2), serine proteases, and hyaluronidases was determined by enzymatic methods. Low-molecular-weight fractions were obtained by gel filtration chromatography and ultrafiltration. Results: Extracts from the three species were toxic to crickets, induced hemolysis in human and rat erythrocytes, produced vasoconstriction on isolated rat aortic rings, and presented phospholipase A2 and serine-protease activity. Despite the fact that these corals are not considered to be harmless to humans, the extracts generated significant nociceptive responses. The matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry analysis of the low-molecular-weight fractions revealed the presence of peptides within a mass range of 3000 to 6000 Da. These fractions were toxic to crickets and two of them induced a transitory vasoconstrictor effect on isolated rat aortic rings. Conclusion: This study suggests that scleractinian corals produce low-molecular-weight peptides that are lethal to crickets and induce vasoconstriction.

Demodicosis: revisión de la literatura / Demodicosis: review of the literature

La demodicosis es una patología cutánea crónica caracterizada por lesiones eritemato-maculares pruriginosas, cuyo agente causal son ácaros foliculares del género Demodex. Presenta un abanico amplio y polimorfo de manifestaciones clínicas, donde la sospecha clínica se presentará frente a una erupción facial crónica persistente o recurrente, resistente a terapia convencional y de distribución asimétrica. El diagnóstico definitivo es difícil, y requiere un cuadro clínico compatible y la presencia de alta densidad de Demodex. El siguiente documento hace una revisión de conceptos con respecto a la patogenia, clínica, diagnóstico y tratamiento de esta entidad.

Demodicosis is a chronic skin condition characterized by itchy erythematous macular lesions whose causal agents are gender follicular Demodex mites. This entity presents a wide and polymorphous range of clinical manifestations, in which clinical suspicion appears in case of persistent or recurrent chronic facial rash, resistant to conventional therapy and with an asymmetric distribution. The definitive diagnosis is hard to reach, and requires a compatible clinical picture and a high density of Demodex. The following document is a review of concepts regarding pathogenesis, symptoms, diagnosis and treatment of this disease.

Histomorphology of Liver, Testicle and Body Fat in Farm Rabbits Fed with an Obesogenic Diet During the Peripuberal Period / Histomorfología del Hígado, Testículo y Grasa Corporal en Conejos de Granja Alimentados con una Dieta Obesogénica Durante el Período Peripuberal

Two groups were formed in order to evaluate the effect of an obesogenic diet on body and liver weight, body fat accumulation and the histometric characteristics of liver and testicles of New Zealand rabbits during the peripuberal period. One group received a standard farm diet and the other received a standard farm diet with canola oil added. During the study, weight of both groups was recorded. At the end of the study, the rabbits were euthanized and liver, testicles, and visceral, scapular and scrotal fat were weighed. Tissue samples were obtained from liver and testicles to carry out histometric analysis. Body weight, body mass index, liver and visceral fat weight were significantly different (P<0.01) in the obesogenic diet when compared to the control group. Notwithstanding, there were no significant differences between both groups in testicular weight, and scapular and scrotal fat (P>0.01). Histometry of the liver of the obesogenic diet group showed the greater total area and greater nucleus area of hepatocytes in the square lobe, right lobe and left lobe medial segment (P<0.01). Histometry of both testicles of individuals from the obesogenic diet group had a greater germinal epithelial thickness and intertubular intersticium (P<0.01). It is concluded that New Zealand male rabbits that received an obesogenic diet during 12 weeks had a higher liver and body weight, as well as, an important increased visceral fat. Furthermore, said diet caused histometric changes in liver and testicles. This set confirms that the domestic rabbit is a good model for the study of the body fat accumulation process associated to the consumption of an obesogenic diet and its effects on liver and testicles.

Con el propósito de evaluar el efecto de una dieta obesogénica sobre el peso corporal, hepático, acumulo de grasa corporal y las características histométricas del hígado y testículo de conejos Nueva Zelanda durante el período peripuberal, se formaron dos grupos; a uno se le proporcionó una dieta estándar de granja y el otro recibió una dieta estándar de granja adicionada con aceite de canola. Durante el estudio se registró el peso corporal de ambos grupos. Al final del estudio los conejos fueron eutanasiados y se pesó el hígado, testículos, la grasa visceral, escapular y escrotal. Se obtuvieron muestras de tejido hepático y testicular para realizar el análisis histométrico. El grupo con dieta obesogénica presentó diferencias significativas con respecto al grupo testigo, en las variables: peso corporal, índice de masa corporal, peso del hígado y de la grasa visceral (P<0,01). Por otra parte, no hubo diferencias significativas entre ambos grupos para las variables: peso de testículos, grasa escapular y escrotal (P>0,01). En la histometría del hígado el grupo con la dieta obesogénica presentó mayor área total y mayor área del núcleo de los hepatocitos en el lóbulo cuadrado, lóbulo derecho y lóbulo izquierdo segmento medial (P<0,01). En la histometría de ambos testículos del grupo con la dieta obesogénica se encontró mayor grosor del epitelio germinal y perímetro del intersticio intertubular (P<0,01). Se concluye que los conejos Nueva Zelanda machos que recibieron una dieta obesogénica durante 12 semanas presentaron mayor peso corporal, hepático y aumento de la grasa visceral. Además, presentaron cambios histométricos en hígado y testículo. Estos resultados en conjunto confirman que el conejo doméstico es un buen modelo para el estudio del proceso de acumulo de grasa corporal asociado al consumo de una dieta obesogénica y de sus efectos en el hígado y testículos.

Decisión multicriterio para la evaluación y selección de proyectos de ciencia e innovación / Multicriteria decision for the evaluation and selection of science and innovation projects

Los resultados obtenidos dentro del Sistema de Ciencia e Innovación cubano, desde el año 1995, requieren de tecnologías que contribuyan al proceso de toma de decisiones en la selección de los proyectos a ejecutar. Con este objetivo se diseñó un procedimiento para la evaluación y selección de proyectos de ciencia e innovación, ajustable a cualquier organización en el país. Se usaron herramientas de análisis cualitativo y cuantitativo de información y aplicaciones informáticas, para el diseño de indicadores, la determinación de sus pesos y la evaluación, y se estableció una prioridad para la decisión de seleccionar unos proyectos entre otros. Se garantiza además, un mecanismo de retroalimentación para la mejora del procedimiento. Se concluye que la visión integradora del procedimiento propuesto debe mejorar la efectividad de la gestión de proyectos dentro de las organizaciones y de la toma de decisiones sobre qué proyectos seleccionar para su financiamiento

The results obtained by the Cuban Science and Innovation System since 1995 require technologies supporting decision making in the selection of the projects to be executed. To this end, a procedure was designed for the evaluation and selection of science and innovation projects, adjustable to any organization in the country. Qualitative and quantitative information analysis tools and information applications were used to design indicators and to determine their weight and evaluation. Priorities were set for the decision to select certain projects and not others. A feedback mechanism to improve the procedure is also ensured. It is concluded that an integrated outlook on the procedure proposed should improve the effectiveness of project management in organizations, as well as the process of decision making on which projects to select for funding

Manejo anestésico de un paciente con síndrome de Rett y fractura distal de húmero: reporte de un caso y revisión de la literatura / Anesthetic management of a patient with Rett Syndrome and distal humerus fracture: A case report and literature review

El síndrome de Rett (SR) es un trastorno neurológico que afecta principalmente a las mujeres. Se caracteriza por un retraso mental severo después de un periodo de desarrollo aparentemente normal en la infancia temprana. Las principales características incluyen autismo, espasticidad, microcefalia, escoliosis, estereotipias, control anormal de la respiración y convulsiones. Se ha notificado que son muy sensibles a sedantes y tienen una lenta recuperación luego de una anestesia. Nosotros describimos y discutimos el manejo anestésico de una mujer de 26 años con SR y fractura distal del húmero, tratada con reducción y fijación con agujas de Kirschner bajo anestesia regional y sedación; quien tuvo depresión respiratoria luego de administrar 1 mg de midazolam i.v. intraoperatorio. Nuestra experiencia con este caso nos hace concluir y sugerir que no se deben usar benzodiacepinas en SR, y si no existe contraindicación, la anestesia regional es la técnica de elección.

Rett Syndrome (RS) is a neurological disorder that almost exclusively affects females. RS is characterized by severe mental retardation following a period of apparent normal development in early childhood. The main clinical features include autism, spasticity, microcephaly, scoliosis, stereotyping, abnormal respiratory control and seizures. Patients with RS have been reported to be extremely sensitive to sedatives and exhibit a slow recovery from anesthesia. We describe and discuss the anesthetic management of a 26-year-old woman with RS and distal fracture of the humerus that underwent reduction and fixation with Kirschner'swires under regional anesthesia and sedation. Intraoperatively, the patient experienced respiratory depression following the administration of 1 mg of I.V. midazolam. Our experience in this case led us to conclude and suggest that benzodiazepines should not be used in RS and in the absence of contraindications the technique of choice should be regional anesthesia.

Citología y análisis morfométrico de las células del epitelio vaginal durante el ciclo estral en ovejas de pelo (Ovis aries) / Citology and morphometric analysis of epithelial cells from the vagina of hair sheep ewes (Ovis aries) during their estrous cycle

La citología vaginal puede usarse para caracterizar estados del ciclo reproductivo de la hembra. Sin embargo, no ha sido validada en ovinos de pelo, y ofrece resultados inexactos debido a interpretaciones subjetivas. El objetivo del presente trabajo es tipificar las características morfológicas y morfométricas de las células epiteliales de la vagina durante el ciclo estral en ovinos de pelo. Cinco borregas Santa Cruz se sincronizaron con esponjas intravaginales. Desde el día del 1er celo posterior al retiro de la esponja y hasta el siguiente celo, se obtuvieron muestras diarias del epitelio vaginal de cada oveja, y se cuantificó el número de células parabasales, intermedias y superficiales, y se midió la longitud, perímetro y área de citoplasma y núcleo de cada una. Los resultados muestran que las células superficiales incrementan (P<0,05) durante el estro en comparación con el diestro. En contraste, el número de células parabasales e intermedias es mayor (P<0,05) durante el diestro que en el estro. Las células más grandes (36,11+/-0,38 µm) y núcleos más pequeños (8,46+/-0,12 µm) se encontraron durante el estro, independientemente del tipo de célula, mientras que citoplasmas más pequeños (26,72+/-0,11 µm) y núcleos más grandes (10,48+/-0,02 µm) se observaron durante el diestro. Se concluye que la morfología de las células epiteliales de la vagina de la oveja de pelo coincide con las variaciones encontradas en otras hembras, y que el tamaño de citoplasmas y núcleos presenta un patrón cíclico que puede utilizarse para determinar de manera objetiva la etapa del ciclo estral de la oveja.

Vaginal cytology can be used to characterize stages of the reproductive cycle of the female. However, it has not been validated in hair sheep, and generates inaccurate results due to subjective interpretations. Thus, the purpose of the present work is to typify morphologic and morphometric characteristics of the epithelial cells from the vagina during the estrous cycle of hair sheep. Five Saint Croix ewes were synchronized with intravaginal sponges. Day zero of the cycle was considered the day of first estrus after sponge withdrawal. From this day until next estrus, samples from the vaginal epithelium were obtained daily from each ewe. The number of basal, intermediate and superficial cells was quantified, and length, perimeter, and area from cytoplasm and nucleus were obtained. The results show that the number of superficial cells increase (P<0.05) during estrus and decrease during the rest of the cycle. In contrast, the number of basal and intermediate cells showed an inverse pattern. The largest cells (36.11+/-0.38 µm) and smallest nucleuses (8.46+/-0.12 µm) were present during estrus, regardless of the cell type, while the smallest cells (26.72+/-0.11 µm) and larger nucleuses (10.48+/-0.02 µm) were observed during diestrus. It was concluded that citology of the epithelial cells from the vagina of hair ewes is in accord with changes found in other female spices, and that cytoplasm and nucleus sizes display a cyclic pattern that might be used to objectively determine the specific estrous cycle phase of the ewes.

Macroscopic morphometric analysis of genital organs of rabbit does with differing parturitions at 24 hours post-weaning / Análisis morfométrico macroscópico de órganos genitales de conejas con diferentes partos a las 24 horas post-destete

The purpose of this study was to analyze the macroscopic morphometry of the ovaries, uterus and vagina in rabbit does in the first, second and third parturition at 24 hours post-weaning in order to determine if there are differences between parturitions. Weaning of the litter was performed at 30 days post-partum and 24 hours later the does were euthanized. Right and left ovaries, uterine horns-cervix and vagina were removed, and the length of each one was measured. Significant differences were found in the average of the right ovary length between the first group with respect to second and third parturition group (P 0.05 and P 0.01). Also, left ovary length was different between the first and second with respect to third parturition group (P <0.001). Average total ovary length increased significantly as the number of parturitions increased in second and third parturition groups (P 0.01 and P0.001). The weight of the left and right ovaries was higher in does in their second and third parturition when compared to those in their first (P 0.5; P 0.01). The average total ovary weight increased significantly as the number of parturitions in second and third parturition groups (P0.001). The length of the left and right uterine horn-cervix of the rabbits after second and third parturition decreased when compared to that of females in their first parturition (P 0.05; P0.001). The average total uterine horns-cervix length decreased significantly as the number of parturitions in second and third parturition groups (P0.001). Furthermore, vagina length in females in their third parturition was greater than that of first and second parturition (P 0.01).The color of the vulva of the majority of females in their first parturition (3/4) was pale pink while. In contrast, the majority of females in their second parturition (3/4) had their vulva intensely red. All of the females (4/4) in the third parturition group had their vulva intensely red...

El propósito de este estudio fue analizar la morfometría macroscópica de los ovarios, útero y vagina en conejas de primero, segundo y tercer parto a las 24 horas post-destete con el propósito de determinar si existen diferencias entre los partos. El destete de la camada se realizó a los 30 días después del parto y 24 horas después fueron eutanasiadas. De cada animal se removieron los ovarios derecho e izquierdo, cuernos-cuello uterinos derecho e izquierdo y la vagina y se midió la longitud de cada uno de los órganos genitales. Se encontraron diferencias significativas en la longitud del ovario derecho entre el grupo de primer parto con respecto al de segundo y tercer parto (P 0,05 y P 0,01). Además, la longitud media de ovario izquierdo fue significativamente diferente entre el grupo de primero y segundo parto con respecto al de tercer parto (P <0,001). La longitud total de los ovarios aumentó con el número de partos y fue mayor en los grupos de segundo y tercer parto (P 0,01 y P 0,001). El peso de los ovarios derecho e izquierdo fue mayor en el grupo de segundo y tercer parto al compararlo con el de primero parto (P 0,5; P 0,01). Por otra parte, el peso total de los ovarios aumentó en los grupos de segundo y tercer parto (P 0,001). La longitud del cuerno-cuello uterino izquierdo y derecho de los grupos de segundo y tercer parto disminuyó al compararlo con el de las hembras de primer parto (P 0,05; P 0,001). La longitud total del cuerno-cuello uterino izquierdo y derecho disminuyó significativamente en las hembras de segundo y tercer parto (P 0,001). La longitud de la vagina de hembras de tercer parto fue mayor que la de primero y segundo parto (P 0,01). El color de la vulva de la mayoría de las hembras de primer parto (3/4) fue rosa pálido. En contraste, la mayoría de las hembras en su segundo parto (3/4) presentaron vulva de color rojo intenso. Todas las hembras del grupo de tercer parto (4/4) presentaron vulva de color rojo intenso...