Acute and Chronic Ecotoxicity of Daphnia magna Exposed to Ash Leachate from the Cotopaxi Volcano, Ecuador.

Ecuador's wetlands and aquatic ecosystems are chronically exposed to ash contamination due to the frequent volcanoes' eruptions in the country. Still, the short and long-term effects of ash contamination on the aquatic biota are not well understood. We used ashes released by the Cotopaxi volcano in 2016 to investigate their acute and chronic effects in Daphna magna. We calculated the half maximal effective concentration (EC50) after 2 and 21 days of exposure, the non-observed effect concentration (NOEC), and the lowest observed effect concentration (LOEC) on offspring production. We also analyzed the metal concentration present in the ashes. The EC50 values at 2 and 21 days were found at 80% and 5% ash leachate concentrations, respectively. After 21 days of exposure, high mortality and low neonatal production were observed in all leachate concentrations (NOEC was at 15%, and LOEC was at 20% leachate concentration). Our results suggest that the ashes from the Cotopaxi volcano can cause acute and chronic toxicity to aquatic life and should be classified as hazardous waste, depending on the dose. There is an urgent need for further studies that assess toxicity caused by the intense volcanic activity in Ecuador.

Taxonomic revision and additional comments of some bats (Mammalia, Chiroptera) reported from Bolivia, with an updated checklist based on voucher material with verified identities

We review the taxonomic identities of museum specimens of three bat species previously reported from Bolivia. We comment on some erroneously reported taxa, or taxa either not represented by voucher materials or based on insufficient data (including acoustic detections) to verify their taxonomic affinities. As result of this review, the list of bat species known to occur in Bolivia is updated to eight families and 133 species, unlike the nine families and 146 species of previous lists. Some recommendations for future research and a brief historical revision of bat inventories in the country are included.

[Clinical characteristics of SARS-CoV-2 disease (COVID-19) in middle-aged patients]. / Características clínicas de la enfermedad por SARS-CoV-2 (COVID-19) en pacientes de mediana edad.

Coronavirus disease 2019 (COVID-19) meant an unprecedented global crisis, which involved the reorganization of health systems and the rationalization of available diagnostic and therapeutic resources. The objective of this observational and retrospective study was to analyze the clinical characteristics and evolution of patients admitted to general ward, intensive care unit and emergency department of a high complexity hospital in Buenos Aires city, during the first seven months of viral circulation. A total of 1005 patients with laboratory-confirmed COVID-19 were included. The median age was 45 years, and 73.7% were men. Half of the patients had at least one comorbidity. Among the laboratory findings, the median of total leukocytes was 6300 cells/mm3 and that of lymphocytes 818 cells/mm3; 82.3% of the patients presented alterations in the chest tomography, and the most frequently observed radiological pattern was ground-glass opacity (33%); 82.4% of them received empirical antibiotic therapy directed to the respiratory focus and, in addition, 18.7% were treated with dexamethasone. Regarding severity, 14.7% of the patients presented uncomplicated disease, 55.2% mild pneumonia, 20.8% moderate pneumonia, and 9.2% severe pneumonia. Likewise, 8.7% of them were transferred to intensive care. In-hospital mortality was 2.3%, and 20.5% among critically ill patients. A statistically significant association was found between mortality and age, with an age difference of 9.6 years, being greater among the deceased (p = 0.0004; 95% CI 4-14). However, there was no association between the presence of comorbidities and sex vs. mortality and severity of the disease.

La pandemia por COVID-19 significó una crisis mundial sin precedentes, que implicó la reorganización de los sistemas de salud y la racionalización de los recursos diagnósticos y terapéuticos disponibles. El objetivo de este estudio observacional y retrospectivo fue analizar características clínicas y evolución de los pacientes internados en guardia, sala general y terapia intensiva en un hospital privado de alta complejidad de la Ciudad de Buenos Aires, durante los primeros siete meses de circulación viral. Se incluyeron 1005 pacientes con COVID-19 confirmado por laboratorio. La mediana de edad fue de 45 años; 73.7% eran varones. La mitad de los pacientes presentaba al menos una comorbilidad. La mediana de leucocitos totales fue 6300 células/mm3 y de linfocitos 818 células/mm3. El 82.3% presentó alteraciones en la tomografía de tórax; y el patrón radiológico observado con mayor frecuencia fue opacidad tipo vidrio esmerilado (33%). El 82.4% recibió antibioticoterapia empírica dirigida a foco respiratorio y, además, el 18.7% fu e tratado con dexametasona. Respecto de la gravedad, el 14.7% presentó enfermedad no complicada, el 55.2% neumonía leve, el 20.8% neumonía moderada y el 9.2% neumonía grave. Asimismo, el 8.7% fue transferido a terapia intensiva. Se registró una mortalidad hospitalaria del 2.3% y del 20.5% en terapia intensiva. Se encontró asociación estadísticamente significativa entre mortalidad y edad, con una diferencia de edad de 9.6 años, siendo mayor entre los fallecidos (p = 0.0004; IC 95% 4-14). Sin embargo, no hubo asociación entre presencia de comorbilidades y sexo vs. mortalidad y gravedad de la enfermedad.

Características clínicas de la enfermedad por SARS-COV-2 (COVID-19) en pacientes de mediana edad / Clinical characteristics of SARS-CoV-2 disease (COVID-19) in middle-aged patients

Resumen La pandemia por COVID-19 significó una crisis mundial sin precedentes, que implicó la reorganización de los sistemas de salud y la racionalización de los recursos diagnósticos y terapéuticos disponibles. El objetivo de este estudio observacional y retrospectivo fue analizar características clínicas y evo lución de los pacientes internados en guardia, sala general y terapia intensiva en un hospital privado de alta complejidad de la Ciudad de Buenos Aires, durante los primeros siete meses de circulación viral. Se incluyeron 1005 pacientes con COVID-19 confirmado por laboratorio. La mediana de edad fue de 45 años; 73.7% eran varones. La mitad de los pacientes presentaba al menos una comorbilidad. La mediana de leucocitos totales fue 6300 células/mm3 y de linfocitos 818 células/mm3. El 82.3% presentó alteraciones en la tomografía de tórax; y el patrón radiológico observado con mayor frecuencia fue opacidad tipo vidrio esmerilado (33%). El 82.4% recibió antibioticoterapia empírica dirigida a foco respiratorio y, además, el 18.7% fu e tratado con dexametasona. Respecto de la gravedad, el 14.7% presentó enfermedad no complicada, el 55.2% neumonía leve, el 20.8% neumonía moderada y el 9.2% neumonía grave. Asimismo, el 8.7% fue transferido a terapia intensiva. Se registró una mortalidad hospitalaria del 2.3% y del 20.5% en terapia intensiva. Se encontró asociación estadísticamente significativa entre mortalidad y edad, con una diferencia de edad de 9.6 años, siendo mayor entre los fallecidos (p = 0.0004; IC 95% 4-14). Sin embargo, no hubo asociación entre presencia de comorbilidades y sexo vs. mortalidad y gravedad de la enfermedad.

Abstract Coronavirus disease 2019 (COVID-19) meant an unprecedented global crisis, which involved the reorganization of health systems and the rationalization of available diagnostic and therapeutic resources. The objective of this observational and retrospective study was to analyze the clinical characteristics and evolution of patients admitted to general ward, intensive care unit and emergency department of a high complexity hospital in Buenos Aires city, during the first seven months of viral circulation. A total of 1005 patients with laboratory-confirmed COVID-19 were included. The median age was 45 years, and 73.7% were men. Half of the patients had at least one comorbidity. Among the laboratory findings, the median of total leukocytes was 6300 cells/mm3 and that of lymphocytes 818 cells/mm3; 82.3% of the patients presented alterations in the chest tomography, and the most frequently observed radiological pattern was ground-glass opacity (33%); 82.4% of them received empirical antibiotic therapy directed to the respiratory focus and, in addition, 18.7% were treated with dexamethasone. Regarding severity, 14.7% of the patients presented uncomplicated disease, 55.2% mild pneumonia, 20.8% moderate pneumonia, and 9.2% severe pneumonia. Likewise, 8.7% of them were transferred to intensive care. In-hospital mortality was 2.3%, and 20.5% among critically ill patients. A statistically significant association was found between mortality and age, with an age difference of 9.6 years, being greater among the deceased (p = 0.0004; 95% CI 4-14). However, there was no association between the presence of comorbidities and sex vs. mortality and severity of the disease.

Mixoma auricular izquierdo como causa de accidente cerebral isquémico transitorio e infarto agudo de miocardio con elevación del ST / Left atrial myxoma as a cause of a transient ischaemic stroke and acute myocardial infarction with ST elevation

Resumen Los mixomas son los tumores cardíacos primarios más comunes. La mayoría tiene curso benigno y pueden tratarse de hallazgos incidentales o ser casi asintomáticos. Los síntomas dependen de su ubicación, en cuyo caso la más frecuente es la aurícula izquierda, de ahí que el riesgo embólico sea elevado. El principal lugar de embolia es el sistema nervioso central; sin embargo, en ocasiones puede afectar los sistemas respiratorio, periférico o coronario(1). Se expone el caso de una paciente con mixoma auricular izquierdo, el cual se manifiesta con accidente cerebral isquémico transitorio, seguido de infarto agudo de miocardio con elevación del segmento ST en la pared ínfero-posterior.

Abstract The myxomas are the most common primary cardiac tumours. The majority of them are benign and can be an incidental finding or be almost asymptomatic. The symptoms depend on their location, with the most common being the left atrium, which carries an increased risk of clots. The main effects of the clots are on the central nervous system, but occasionally they can involve the respiratory, peripheral, or coronary system. The case is presented of a patient with left atrial myxoma, as well as a transient ischaemic stroke and acute myocardial infarction with ST elevation in the inferior-posterior wall.

Enfermedad aneurismática coronaria / Coronary aneurysm disease

Resumen La enfermedad aneurismática coronaria se define como la dilatación de un segmento arterial coronario más 1,5 veces el diámetro de las arterias adyacentes de tamaño normal. Puede ser difusa, y afectar todo el trayecto de la arteria, o localizada y afectar sólo un segmento arterial específico. Puede encontrarse entre un 3 a un 8% de los estudios angiográficos y entre un 0,22% a un 1,4% de las necropsias clínicas. Se presenta 3 reportes de casos, donde la presentación clínica, los hallazgos angiográficos y el manejo farmacológico es diverso como corresponde a esta entidad.

Abstract Coronary aneurysm disease is defined as the dilation of a coronary artery segment more than 1.5 times the diameter of the adjacent arteries of normal size. It may be diffuse, and affect the whole trajectory of the artery, or localised and only affect a specific arterial segment. It can be found in between 3% and 8% of angiograph studies, with between 0.22% and 1.4% in clinical post-mortems. Three case reports are presented in which the clinical presentation, the angiographic findings, and the pharmacological management are shown to be as diverse as this condition itself.

Consideraciones bucales en el tratamiento de pacientes con esclerodermia: reporte de dos casos / Bucal considerations in the treatment of patients with scleroderma: Report of two cases

La esclerodermia pertenece a un grupo de enfermedades autoinmunes del tejido conectivo, que produce: inflamación, disfunción vascular y fibrosis excesiva del tejido conectivo de soporte de la piel y los órganos viscerales. A nivel bucal se evidencian afecciones como xerostomía, microstomía, caries y enfermedad periodontal. El tratamiento odontológico requiere un manejo integral por parte de los profesionales, que comprenda las patologías orales presentes y los síntomas permanentes característicos de la enfermedad sistémica de base. El objetivo de este artículo es presentar dos casos de esclerodermia resaltando sus manifestaciones orales presentes.

Scleroderma belongs to a group of autoimmune connective tissue diseases that causes inflammation, vascular dysfunction and excessive fibrosis of the connective tissue supporting the skin and visceral organs. A level oral conditions such as xerostomia, microstomia, caries and periodontal disease are evident. Dental treatment requires a comprehensive management by professionals who understand oral pathologies and permanent characteristic symptoms of systemic disease. The aim of this paper is to present two cases of scleroderma highlighting present oral manifestations.

Secreción de prolactina en hombres nativos de las grandes alturas / Prolactin secretion in high altitude natives

Objetivos: Determinar el efecto de la hipoxia crónica sobre la secreción de prolactina. Diseño: Estudio comparativo. Institución: Servicio de Endocrinología, Hospital Nacional Arzobispo Loayza, Lima, Perú. Participantes: Hombres jóvenes nativos de Lima y Cerro de Pasco. Intervenciones: Se estudió en forma dinámica tres grupos de hombres jóvenes normales de edad (X24a) y estado nutricional comparable, nativos de diferentes altitudes: 150 m.s.n.m. (Lima, N=10), 3 000 m.s.n.m. (Tarma, N= 10), 4 200 m.s.n.m. (Cerro de Pasco, n=11); y tres pacientes con mal de montaña crónico (MMC) nativos de Cerro de Pasco; todos clínicamente eutiroideos y sin bocio. En cada sujeto se determinó por RIA los niveles séricos basales de PRL y su respuesta. Principales medidas de resultados: Diferencia de niveles séricos de prolactina y su respuesta máxima a la hormona liberadora de tirotropina en sujetos a nivel del mar y en la altura. Resultados: Los niveles séricos basales de prolactina (PRL) y su respuesta máxima a la hormona liberadora de tirotropina (TRH) fueron significativamente menores en los nativos de altura en comparación con los del nivel del mar. La causa subyacente sería la hipoxia crónica, pudiendo estar implicados un incremento de la actividad dopaminérgica del sistema túbero û infundibular o una alteración a nivel del receptor o posreceptor del lactotrofo en los nativos de altura. Este hecho puede ser un mecanismo de adaptación para la conservación de la fertilidad en los hombres nativos de las grandes alturas. El escaso número de pacientes con mal de montaña crónico no permitió obtener resultados concluyentes, pero se observó persistencia de la menor secreción de prolactina, con una respuesta más tardía a la TRH. Se requiere más investigaciones en pacientes con MMC, para definir estas observaciones. Conclusiones: Los niveles séricos basales de prolactina y su respuesta máxima a la hormona liberadora de tirotropina fueron significativamente menores en los nativos de altura en comparación con los del nivel del mar.

Objectives: To determine the effect of chronic hypoxia on prolactin (PRL) secretion. Design: Comparative study. Setting: Endocrinology service, Hospital Nacional Arzobispo Loayza, Lima, Peru. Participants: Native young men from Lima and Cerro de Pasco. Interventions: Three groups of normal young men age (X24a) with comparable nutritional status, natives from different altitudes: 150 m.a.s.l. (Lima, N=10), 3 000 m.a.s.l. (Tarma, N= 10), 4 200 m.a.s.l. (Cerro de Pasco, n=11); and three patients with chronic mountain disease (CMD) natives from Cerro de Pasco were studied. All subjects were euthyroid and without goiter. RIA determinations of PRL basal serum levels and PRL response to thyrotrophin releasing hormone (TRH) 200 µg I.V. were carried out on each subject. Main outcome measures: Difference of serum prolactin levels and highest response to thyrotrophin releasing hormone in subjects at sea level and at high altitude. Results: Prolactin basal serum levels and the highest response to TRH were significatively less (P<0.05) in high altitude natives when compared to those at sea level. Underlying cause would be chronic hypoxia including either tubero-infundibular dopaminergic system activity increase or lactotrophsÆ receptor or post-receptor alteration in high altitude natives. This may be an adaptation mechanism for fertility preservation in high altitude natives. The few patients with chronic mountain disease studied did not allow concluding results, but persistence of less prolactin secretion was observed with late response to TRH. Further investigations in patients with MMD are required to define these observations. Conclusions: Prolactin basal serum levels and highest response to thyrotropin releasing hormone were significatively less in high altitude natives compared with those at sea level.

Nonendodontic periapical lesions: a retrospective study in Chile.

AIM: To determine the frequency with which the histopathological diagnosis of periapical lesions contributes to a change in the clinical diagnosis. METHODOLOGY: Cases having a clinical diagnosis of disease resulting from dental pulp necrosis were selected from the database of the Oral Pathology Reference Institute between 1975 and 2005. Cases with different histopathological diagnoses were determined and information about age and gender of the patient, location of associated tooth, pulp status and the histopathological diagnosis were recorded. The percentage of nonendodontic periapical lesions was then determined. RESULTS: In the 30-year period, 32,423 [corrected] biopsy specimens were received. Overall 4006 (9.13%) had a clinical diagnosis of pulpal necrosis with associated pathosis in the periradicular area. Within this group, 26 cases (0.65%) had a histopathological diagnosis of nonendodontic pathology. Keratocystic odontogenic tumour was the most frequent nonendodontic lesion (11 cases) in the periradicular region followed by central giant cell granuloma (three cases), chronic sinusitis (three cases) and one case each of the following lesions: nasopalatine duct cyst, lateral periodontal cyst, calcifying cystic odontogenic tumour, ameloblastic fibroma, squamous odontogenic tumour, cemental dysplasia, haemangioma, foreign body cell granuloma and amalgam tattoo. CONCLUSIONS: The histopathological study of periapical pathosis can occasionally reveal nonendodontic lesions. Odontogenic tumours made up the largest group.

Analgesic properties of Capraria biflora leaves aqueous extract.

The analgesic properties of dried leaves of Capraria biflora were investigated. The aqueous extract (50-200 mg kg(-1)) produced moderate inhibition of acetic acid-induced writhing in mice. At the same doses, a better analgesic effect was observed on the hot plate test.

Fisiología del vómito, emesis causada por citostático y antieméticos como tratamiento concomitante a la quimioterapia

En el presente trabajo se revisan los aspectos más relevantes de la fisiología del vómito. Se enfatiza en los niveles relacionados con la emesis inducida por citostático y las nuevas teorías sobre la génesis y desarrollo de dicho proceso. El arsenal terapéutico de que se dispone para tratar estos desagradables efectos adversos, es amplio. Se señalan los principales antieméticos y adyuvantes utilizados para tratar las náuseas y vómitos causados por quimioterapia, así como sus mecanismos de acción y eficacia clínica. Asimismo, se destaca el papel de los antagonistas de los receptores 5-HT3, como los antieméticos más selectivos y de mayor potencia para este tipo de terapia

[The assessment of the nutritional status of patients with epidemic neuropathy in the year of its evolution. The biochemical indicators]. / Evaluación del estado nutricional de enfermos con neuropatía epidémica al año de evolución. Indicadores bioquímicos.

The nutritional status of a group of patients with epidemic neuropathy (EN) was reevaluated after a one-year follow-up to observe the changes occurred and to assess their relationship with the individual clinical evolution. 71 patients (40 men and 31 women) were examined. 28 had optic epidemic neuropathy and 43 mixed epidemic neuropathy. Vitamins thiamine, niacin, A and E were determined and the values were compared with those of risk 21 days later. There was an improvement of these indicators after 21 days as a response to the treatment, and an increase one year later of the percentage of individuals deficient in or situated at the margin of thiamine and niacin, which reflects a nutritional unbalance without an apparent association with the clinical evolution that showed a trend towards the recovery of the patients. This disassociation between the clinics and the nutritional and vitamin status suggest that the pathogeny of the EN may be connected with non-nutritional factors. The deficiency found in the nutritional vitamin state could anticipate a worsening of the clinical picture and/or the appearance of clinical manifestations corresponding to deficiency diseases.

[Bladder drainage in patients undergoing the Pereyra surgical procedure]. / Drenaje vesical en pacientes sometidas a operación Pereyra.

Postoperative acute urinary retention was evaluated in the patients who underwent Pereyra procedure. Comparison of suprapubic and urethral catheterization. Between January 1994 and July 1995, fifty two patients with urinary stress incontinence underwent Pereyra procedure, 31 female patient with suprapubic drainage (cistofix Ch 15) and 17 urethral catherization with a latex foley catheter. Sponatneous micturition and urinary retention was evaluated until the catheter was removed. Mean age was 43.8 years (32 a 66), the duration of suprapubic vesical drainage with suprapubic catheter were 3 days in 58.6% of the patients, and more than 3 days in 41.29%. Recatheterizacion in the patients with urethral drainage was more frequent. Urinary retention after 7 days was present in 23.99% with suprapubic vesical drainage and 28.5% with urethral catheter. Recatheterization is more frequent in patients with urethral catheter.

Prevalencia de el antígeno de la hepatitis B (HbSAg) en mujeres embarazadas que acuden al Hospital Dr. Simón Striddels de Azua / Prevalence of hepatitis B (HbSAg) antigen in gravid women that attend to Dr. Simon Striddels Hospital in Azua

Antecedentes: Tenemos pocas estadísticas acerca de la prevalencia de el antígeno de superficie la Hepatitis B (HbSAg) en mujeres embarazadas en nuestro país. Materiales y métodos: Realizamos un estudio prospectivo, donde se estudiaron 50 embarazadas en trabajo de parto en el Hospital Dr. Simon Striddels en Azua, R.D., durante los meses de julio y agosto 1995. Resultados: Encontramos 4 casos de pacientes portadoras del antígeno de la Hepatitis B para un 8// y un recién nacido afectado (2//). Una de las portadoras tenía antecedentes personales de padecer clinicamente hepatitis. Tres de ellas vivían en la zona rural y habían tenido de 1 a 3 hijos. Comentario: el objetivo en la detención de la Hepatitis B, en mujeres embarazadas, es asegurar que estas lleven a cabo un control prenatal riguroso. Esta determinación tiene un gran valor en la prevención de trastornos que puedan perjudicar la salud de la madre y del niño

[Recurrent abdominal pregnancy. A case report]. / Embarazo abdominal recurrente. Presentación de un caso.

It's a report fo a case of recurrent abdominal pregnancy attended at the Instituto Nacional de Perinatologia of México City, the clinical manifestations, diagnosis, and management are described. A review of the literature is presented.

[Uterine leiomyoma: pathology and epidemiology]. / Leiomioma uterino: patología y epidemiología.

Two hundred biopsy reports with uterine myoma histopathological diagnosis were studied 67% of the cases were between 41-50 years of age. Premenopausic patients showed an average number of myomas almost three times higher than the postmenopausic women. The most frequent myoma were those within the walls with a size less than 2 cm. Chronic inespecific cervixitis was the most frequent finding in the cervix pathology, with in 1.5% of the cases. In 2 cases (1%) endometrial adenocarcinoma was found. In 60.5% of the cases one or both tubes and ovaries were removed neither case had malignant alterations. In 51 cases (25.2%) the myoma presented some type of degeneration, the most frequent being the cellular type, 16 out of 200, which represented 8% of the cases; it was considered as presarcomatose type. Presurgical clinical behavior is discussed considering the analysis of these figures and the perspectives of the conservative treatment with the use of new no ablative technique.