Impacto en la salud mental en residentes de tres programas de especialización médica de la Universidad de Valparaíso durante la pandemia por COVID-19 / Impact of the COVID-19 pandemic on the mental health of residents of three specialty medical programs

BACKGROUND: COVID-19 pandemic disturbed mental health of healthcare personnel. Residents of the specialization programs could be at risk, since they were reassigned in their functions. Aim: To describe the impact of COVID-19 pandemic on symptoms of depression, stress, anxiety and resilient coping in residents of Anesthesiology, Internal Medicine and Emergency Medicine MATERIAL AND METHODS: Residents were invited to answer an online survey containing the DASS-21 scale for anxiety, stress and depression symptoms and the Brief Resilient Coping Scale (BRCS) for resilience skills. RESULTS: Fifty four out of 90 residents answered the survey. Eighteen to 24% of respondents had symptoms of depression, anxiety and stress at severe and extremely severe levels. Those with severe and extremely severe symptoms had also the lowest score on the BRCS resilience scale. We did not find an association between severity of symptoms and gender. Discussion: A proportion of respondent residents had severe psychological symptoms and lower resilience scores during the COVID-19 pandemic.

The Effect in Renal Function and Vascular Decongestion in Type 1 Cardiorenal Syndrome Treated with Two Strategies of Diuretics, a Pilot Randomized Trial.

AIM: The main treatment strategy in type 1 cardiorenal syndrome (CRS1) is vascular decongestion. It is probable that sequential blockage of the renal tubule with combined diuretics (CD) will obtain similar benefits compared with stepped-dose furosemide (SF). METHODS: In a pilot double-blind randomized controlled trial of CRS1 patients were allocated in a 1:1 fashion to SF or CD. The SF group received a continuous infusion of furosemide 100 mg during the first day, with daily incremental doses to 200 mg, 300 mg and 400 mg. The CD group received a combination of diuretics, including 4 consecutive days of oral chlorthalidone 50 mg, spironolactone 50 mg and infusion of furosemide 100 mg. The objectives were to assess renal function recovery and variables associated with vascular decongestion. RESULTS: From July 2017 to February 2020, 80 patients were randomized, 40 to the SF and 40 to the CD group. Groups were similar at baseline and had several very high-risk features. Their mean age was 59 ± 14.5 years, there were 37 men (46.2%). The primary endpoint occurred in 20% of the SF group and 15.2% of the DC group (p = 0.49). All secondary and exploratory endpoints were similar between groups. Adverse events occurred frequently (85%) with no differences between groups (p = 0.53). CONCLUSION: In patients with CRS1 and a high risk of resistance to diuretics, the use of CD compared to SF offers the same results in renal recovery, diuresis, vascular decongestion and adverse events, and it can be considered an alternative treatment. ClinicalTrials.gov with number NCT04393493 on 19/05/2020 retrospectively registered.

[Impact of the COVID-19 pandemic on the mental health of residents of three specialty medical programs]. / Impacto en la salud mental en residentes de tres programas de especialización médica de la Universidad de Valparaíso durante la pandemia por COVID-19.

BACKGROUND: COVID-19 pandemic disturbed mental health of healthcare personnel. Residents of the specialization programs could be at risk, since they were reassigned in their functions. AIM: To describe the impact of COVID-19 pandemic on symptoms of depression, stress, anxiety and resilient coping in residents of Anesthesiology, Internal Medicine and Emergency Medicine Material and Methods: Residents were invited to answer an online survey containing the DASS-21 scale for anxiety, stress and depression symptoms and the Brief Resilient Coping Scale (BRCS) for resilience skills. RESULTS: Fifty four out of 90 residents answered the survey. Eighteen to 24% of respondents had symptoms of depression, anxiety and stress at severe and extremely severe levels. Those with severe and extremely severe symptoms had also the lowest score on the BRCS resilience scale. We did not find an association between severity of symptoms and gender. DISCUSSION: A proportion of respondent residents had severe psychological symptoms and lower resilience scores during the COVID-19 pandemic.

Retinitis pigmentosa as a clinical presentation of LCHAD deficiency: A clinical case and review of the literature.

Long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency is a rare metabolic disease caused by a specific mutation in the HADHA gene, which leads to an alteration in the metabolic pathway of fatty acids. Its most frequent form of presentation at the ophthalmological level is retinitis pigmentosa, and in some cases the ophthalmologist could be the first one to alert the other paediatric specialties to carry out a multidisciplinary approach to the case. The case is presented of a patient with long-chain 3-hydroxyacyl-CoA dehydrogenase deficit detected in neonatal screening, and which clinically debuted as pigmentary retinosis with no alteration in visual acuity as observed in the fundus images and optical coherence tomography of the retina provided. Finally, a review of the literature of this potentially lethal pathology is presented, and the main pathological and clinical features are highlighted.

Retinosis pigmentaria como clínica de presentación del déficit de LCHAD: caso clínico y revisión de la literatura / Retinitis pigmentosa as a clinical presentation of LCHAD deficiency: A clinical case and review of the literature

El déficit de 3-hidroxiacil CoA-deshidrogenasa de cadena larga es una enfermedad metabólica poco frecuente debido a una mutación específica en el gen HADHA, lo que provoca una alteración en la vía metabólica de los ácidos grasos. Su forma de presentación más frecuente a nivel oftalmológico es la retinosis pigmentaria, y en algunos casos el oftalmólogo podría ser quien alerte a las demás especialidades pediátricas para llevar a cabo un abordaje multidisciplinar del caso. Presentamos el caso de una paciente con déficit de 3-hidroxiacil CoA-deshidrogenasa de cadena larga detectado en el cribado neonatal que inició clínicamente como retinosis pigmentaria sin alteración de la agudeza visual y del que se aportan imágenes de fondo de ojo y de tomografía de coherencia óptica de la retina. Por último, se expone una revisión de la literatura de esta enfermedad potencialmente letal y se destacan las principales características anatomopatológicas y clínicas (AU)

Long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency is a rare metabolic disease caused by a specific mutation in the HADHA gene, which leads to an alteration in the metabolic pathway of fatty acids. Its most frequent form of presentation at the ophthalmological level is retinitis pigmentosa, and in some cases the ophthalmologist could be the first one to alert the other paediatric specialties to carry out a multidisciplinary approach to the case. The case is presented of a patient with long-chain 3-hydroxyacyl-CoA dehydrogenase deficit detected in neonatal screening, and which clinically debuted as pigmentary retinosis with no alteration in visual acuity as observed in the fundus images and optical coherence tomography of the retina provided. Finally, a review of the literature of this potentially lethal pathology is presented, and the main pathological and clinical features are highlighted (AU)

Resiliencia y adherencia al tratamiento en personas que viven con VIH/SIDA / Resilience and adherence to treatment in people living with HIV/AIDS

Objetivo: Analizar la relación entre la resiliencia y la adherencia al tratamiento de personas que viven con VIH/SIDA. Material y métodos: El estudio fue cuantitativo, no experimental y de cohorte transversal, con un alcance corre-lacional. La muestra fue de 380 participantes. Se utilizó la escala de Resiliencia de Connor-Davidson (CD-RISC) y la escala de Morisky Medication Adherence Scale (MMAS-4). Los datos se analizaron por medio del programa Análisis Estadístico en las Ciencias Sociales (SPSS) v25, a través de la prueba de correlación r de Pearson y un análisis regresión logística binaria. Resultados: Se identificó una relación estadísticamente significativa entre (<0’05) la resiliencia y la adherencia al tratamiento en los participantes, de la misma forma, la adaptabilidad-redes de apoyo predice en un 43’3% la resiliencia. Conclusiones: La resiliencia y las redes de apoyo son factores de relevancia en la atención del VIH/SIDA que deben seguir estudiándose en futuras investigacione (AU)

Objective: To analyze the relationship between resilience and treatment adherence of people living with HIV / AIDS. Material and methods: The study was quantitative, non-experimental and cross-sectional, with a correlational scope. The sample was 380 participants. The Connor-Davidson Resilience Scale (CD-RISC) and the Morisky Medication Adherence Scale (MMAS-4) were used. The data were analyzed uning the software Statistical Package for the Social Sciences (SPSS) v25, through the Pearson’s r correlation test and a binary logistic regression analysis. Results: A statistically significant relationship was identified (<.05) between resilience and treatment adherence in the participants, in the same way, adaptability-support networks predicted resilience by 43.3%. Conclusions: Resilience and support networks are relevant factors in HIV / AIDS care that should continue to be studied in future research (AU)

Acute kidney injury in renal trauma patients.

BACKGROUND: The kidney is the most commonly injured organ of the genitourinary system during trauma. We describe the associated risk factors for the development of acute kidney injury (AKI) in patients with renal trauma (RT). MATERIALS AND METHODS: We prospectively analyzed data from 65 patients who suffered RT from 2015 to 2019 at the Hospital Civil de Guadalajara. Demographic variables, clinical characteristics, and AKI risk factors were described. We assessed the risk factors related to AKI development. RESULTS: In our study cohort, 60 (92.3%) patients were men, mean age 25 (20 - 30) years; the most common cause of RT was firearm injury in 26 (40%) of patients and 46 (70%) required surgery. AKI associated with RT developed in 39 (60%) patients. There were no differences between patients with or without AKI requiring nephrectomy (35.9 vs. 19.2%, p = 0.15). RT was classified as high-grade in 37 (56.9%) cases; high-grade RT increased four-fold the probability of AKI (adjusted OR 3.95, p = 0.05). A model for AKI prediction during RT was built with the most relevant variables: firearm injury, shock, emergency surgery, high-grade RT, and liver injury, all predicting AKI (ROC-AUC of 0.74 p = 0.02). CONCLUSION: AKI occurred in 60% of cases with RT, and it was significantly associated with high-grade RT. Further studies will be required to confirm this association in other populations, which could lead to an earlier and proactive management of AKI in this setting.

Traumatismo craneal abusivo (síndrome del niño zarandeado) / Abusive head trauma (shaken baby syndrome)

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Cuidado y autocuidado en el personal de salud: enfrentando la pandemia COVID-19 / Facing the pandemic COVID-19: Care and self-care in health personnel

The great global and regional changes, both political, social and health, have created a situation of uncertainty for all people. In particular, health personnel have been very stressed in this coronavirus pandemic. We present this review with the aim of collaborating in the understanding and containment of our colleagues in health personnel.

Los grandes cambios mundiales y regionales, tanto políticos, sociales y sanitarios, han generado una situación de incertidumbre en todas las personas. Particularmente el personal de salud se ha visto muy estresado, en esta pandemia del coronavirus. Presentamos esta revisión con el objetivo de colaborar en la comprensión y contención de nuestros colegas del personal de salud.

[Long-term effects of a mindfulness and self-compassion program with Primary Healthcare professionals]. / Persistencia a largo plazo de los efectos de un programa de mindfulness y autocompasión en profesionales sanitarios de Atención Primaria.

BACKGROUND: The effectiveness of mindfulness and self-compassion-based interventions (MSCI) on emotional fatigue and stress in Primary Healthcare (PHC) professionals has been demonstrated in the short term. The aims of this work were to assess whether these effects persist after two years, and if the observed results differ between those who practiced mindfulness regularly during the follow-up (meditators) and those who did not. METHODS: Prospective study - pre-post and two years after performing an MSCI that was offered to all PHC professionals in Navarra, with group sessions of 2.5 hours / week for 8 weeks. Attending at least 75% of the sessions and practicing at home for 45 minutes a day were mandatory. At the three moments of the study, questionnaires were distributed to measure levels of mindfulness (FFMQ), self-compassion (SCS), perceived stress (PSQ) and burnout (MBI). At the end of the follow-up period, participants were asked if they were meditators and the time they dedicated to this weekly. RESULTS: Forty-eight professionals were enrolled and 41 (83% women) met the inclusion criteria, without loss to follow-up. Mean scores in mindfulness, self-compassion and perceived stress significantly improved after the intervention and in the long term (p <0.001), without observing differences in the level of burnout. The group of meditators achieved a greater long-term improvement in self-compassion (3.6 points vs. 1.6). CONCLUSIONS: The effectiveness of an MSCI persists two years later regardless of meditator status, although there is a significant improvement in self-compassion in the meditators.

Persistencia a largo plazo de los efectos de un programa de mindfulness y autocompasión en profesionales sanitarios de Atención Primaria / Long-term effects of a mindfulness and self-compassion program with Primary Healthcare professionals

INTRODUCCIÓN: La efectividad de las intervenciones basadas en mindfulness (IBM) y autocompasión sobre el cansancio emocional y el estrés en profesionales sanitarios de Atención Primaria (AP) ha sido demostrada a corto plazo. Los objetivos de este trabajo fueron valorar si esos efectos persisten a los dos años, y si los resultados encontrados difieren entre quienes practicaron mindfulness habitualmente durante ese tiempo (meditadores) y los que no. MATERIAL Y MÉTODOS: Estudio prospectivo antes-después y a los dos años de realizar una IBM ofertado a todos los profesionales sanitarios de AP de Navarra, con sesiones grupales de 2,5 horas/semana durante 8 semanas. Se requería asistir al menos al 75% de las sesiones y practicar en casa 45 minutos diarios. En los tres momentos se pasaron cuestionarios para medir los niveles de mind-fulness (FFMQ), autocompasión (SCS), estrés percibido (PSQ) y burnout (MBI). A los dos años tras la intervención se les preguntó si practicaban habitualmente mind-fulness y el tiempo semanal dedicado a ello. RESULTADOS: Aceptaron 48 profesionales y 41 (83% mujeres) cumplieron los criterios de inclusión, sin pérdidas en el seguimiento. Las puntuaciones medias en mind-fulness, autocompasión y estrés percibido mejoraron significativamente tras la intervención y a largo plazo (p < 0,001), sin obtenerse diferencias en el nivel de burnout. La mejoría a largo plazo en autocompasión fue mayor en el grupo que meditó regularmente (3,6 puntos vs 1,6). CONCLUSIONES: La efectividad de una IBM persiste a los dos años de la intervención independientemente de si se practicó meditación o no, aunque la autocompasión mejoró significativamente más en los meditadores

BACKGROUND: The effectiveness of mindfulness and self-compassion-based interventions (MSCI) on emotional fatigue and stress in Primary Healthcare (PHC) professionals has been demonstrated in the short term. The aims of this work were to assess whether these effects persist after two years, and if the observed results differ between those who practiced mindfulness regularly during the follow-up (meditators) and those who did not. METHODS: Prospective study - pre-post and two years after performing an MSCI that was offered to all PHC professionals in Navarra, with group sessions of 2.5 hours / week for 8 weeks. Attending at least 75% of the sessions and practicing at home for 45 minutes a day were mandatory. At the three moments of the study, questionnaires were distributed to measure levels of mindfulness (FFMQ), self-compassion (SCS), perceived stress (PSQ) and burnout (MBI). At the end of the follow-up period, participants were asked if they were meditators and the time they dedicated to this weekly. RESULTS: Forty-eight professionals were enrolled and 41 (83% women) met the inclusion criteria, without loss to follow-up. Mean scores in mindfulness, self-compassion and perceived stress significantly improved after the intervention and in the long term (p <0.001), without observing differences in the level of burnout. The group of meditators achieved a greater long-term improvement in self-compassion (3.6 points vs. 1.6). CONCLUSIONS: The effectiveness of an MSCI persists two years later regardless of meditator status, although there is a significant improvement in self-compassion in the meditators

The mushroom body D1 dopamine receptor controls innate courtship drive.

Mating is critical for species survival and is profoundly regulated by neuromodulators and neurohormones to accommodate internal states and external factors. To identify the underlying neuromodulatory mechanisms, we investigated the roles of dopamine receptors in various aspects of courtship behavior in Drosophila. Here, we report that the D1 dopamine receptor dDA1 regulates courtship drive in naïve males. The wild-type naïve males actively courted females regardless their appearance or mating status. On the contrary, the dDA1 mutant (dumb) males exhibited substantially reduced courtship toward less appealing females including decapitated, leg-less and mated females. The dumb male's reduced courtship activity was due to delay in courtship initiation and prolonged intervals between courtship bouts. The dampened courtship drive of dumb males was rescued by reinstated dDA1 expression in the mushroom body α/ß and γ neurons but not α/ß or γ neurons alone, which is distinct from the previously characterized dDA1 functions in experience-dependent courtship or other learning and memory processes. We also found that the dopamine receptors dDA1, DAMB and dD2R are dispensable for associative memory formation and short-term memory of conditioned courtship, thus courtship motivation and associative courtship learning and memory are regulated by distinct neuromodulatory mechanisms. Taken together, our study narrows the gap in the knowledge of the mechanism that dopamine regulates male courtship behavior.

Accuracy of immunoassay and mass spectrometry urinary free cortisol in the diagnosis of Cushing's syndrome.

PURPOSE: Urinary free cortisol (UFC) determination by highly specific methods as mass spectrometry instead of commercially available antibody-based immunoassays is increasingly recommended. However, clinical comparisons of both analytical approaches in the screening of Cushing's syndrome (CS) are not available. The aim of this study was to evaluate the diagnostic value of mass spectrometry versus immunoassay measurements of 24 h-UFC in the screening of CS. METHODS: Cross-sectional study of 33 histologically confirmed CS patients: 25 Cushing's disease, 5 adrenal CS and 3 ectopic CS; 92 non-CS patients; and 35 healthy controls. UFC by immunoassay (UFCxIA) and mass spectrometry (UFCxMS), urinary free cortisone (UFCo) and UFC:UFCo ratio were measured, together with creatinine-corrected values. Sensitivity, specificity, AUC and Landis and Koch concordance index were determined. RESULTS: AUC for UFCxIA and UFCxMS were 0.77 (CI 0.68-0.87) and 0.77 (CI 0.67-0.87) respectively, with a kappa coefficient 0.60 and strong Landis and Koch concordance index. The best calculated cutoff values were 359 nmol/24 h for UFCxIA (78 % sensitivity, 62 % specificity) and 258.1 nmol/24 h for UCFxMS (53 % sensitivity, 86 % specificity). The upper limit of UFCxIA and UCFxMS reference ranges were 344.7 and 169.5 nmol/24 h respectively. Sensitivity and specificity for CS diagnosis at these cutpoints were 84 and 56 % for UFCxIA and 81 and 54 % for UFCxMS. CONCLUSIONS: According to our data, both methods present a very similar diagnostic value. However, results suggest that lower cutoff points for mass spectrometry may be necessary in order to improve clinical sensitivity.

[Resident of emergency attitude towards patients-physician relationship at the Hospital de Clínicas- Asunción, Paraguay]. / Actitud de residentes de urgencias hacia la relación médico-paciente en el Hospital de Clínicas- Asunción, Paraguay.

INTRODUCTION: The doctor-patient relationship is reaching great importance in recent times, is highlighted their importance in areas as varied as satisfaction, compliance, perception of professional competence, the frequency of legal issues relating to malpractice and even the prognosis of the disease or the general health of the patient. OBJECTIVE: To evaluate the doctor-patient relationship from the point of view of residents of emergency unit. METHODS: An observational, descriptive study. The sample consisted of 36 doctors from different areas of the Emergency Rooms of the Hospital de Clínicas- Asunción, Paraguay. The patient-physician relationship was evaluated using an instrument developed by RA Chavarria-Islas et al. with four indicators: Respect, Information, Consent and Dedication. RESULTS: 69.4% of residents have a regular patient-physician relationship; despite the 2.78% has a good relationship, 25% bad relationship and 2.78% a very bad relationship. CONCLUSION: Gaps in doctor-patient relationship were found in this study.. It is interesting to invest greater efforts to enhance the doctor-patient relationship as one of the edges to improve health care, which is vital in emergency care.

Se estudiaron retrospectivamente pacientes con diagnóstico de lupus eritematoso sistémico (LES) de acuerdo a criterios ACR 1982, con nefritis lúpica (NL) durante el período comprendido desde 2005 al 2012 y que fueran sometidos a una biopsia renal repetida. El número total de pacientes con NL atendidos fue de 120, de los cuales 18 (15%) pacientes fueron sometidos a biopsia renal repetida, 18 con 2 biopsias renales y 6 con 3 biopsias. 3 (16,7%) de los pacientes fueron fumadores; 1 (5,6%) poseía antecedentes de DBT previa, 2 (11,1%) poseían antecedentes de HTA; y 3 (16,7%) pacientes tenían obesidad previa. El tiempo de diagnóstico de LES al momento del estudio fue de 96 meses ± 15; el tiempo transcurrido entre la 1° y la 2° biopsia fue de 45 ± 11 meses y el tiempo entre la 2° y 3° biopsia fue de 56 ± 12 meses. Las indicaciones de la biopsia repetida fueron proteinuria en 10 biopsias (41,6%); proteinuria con alteración de la función renal en 2 biopsias (8,3%); proteinuria con sedimento patológico en 8 biopsias (33,3%); y proteinuria con sedimento patológico y alteración de la función renal en 4 biopsias (16,6%). Los cambios histológicos más frecuentes encontrados entre las primeras y las biopsias repetidas fueron: de clase IV a clase III: 2 (8,2%); clase IV a clase IV: 8 (33,3%), clase IV a clase III+V: 2 (8,2%); clase IV a clase IV+V: 3 (12,5%); clase IV a clase V: 2 (8,2%). Los cambios en las biopsias de NL proliferativas con índices de actividad y cronicidad (A/C) fueron: de A a A/C: 7 (29,1%), A/C a A/C: 7 (29,1%). La intensidad de la terapia inmunosupresora aumentó en 79,1%, se mantuvo el tratamiento inmunosupresor en 16.6%. Con respecto al cambio de medicación 7 (20%) pacientes recibieron Ciclofosfamida 1 gr cada 30 días, 9 (26%) Ciclofosfamida 500 mg cada 15 días, 8 (23%) tratamiento de reinducción con Micofenolato mofetil; Rituximab 8 (23%); y 3 (8%) Ciclosporina A. El tratamiento de mantenimiento se realizó con micofenolato mofetil en 23 casos (55%); con azatioprina en 11 (26%) casos; ciclosporina en 3 (7%) oportunidades y rituximab en 5 (12%). En todos los casos se utilizó hidroxicloroquina.

Long-term remission and recurrence rate in a cohort of Cushing's disease: the need for long-term follow-up.

OBJECTIVE: Transsphenoidal surgery is the procedure of choice in Cushing disease (CD), with immediate post-operative remission rates ranging between 59 and 94% and recurrence rates between 3 and 46%, both depending upon the definition criteria and the duration of the follow-up. Our aim was to assess the rate of remission, recurrence and persistence of the disease after the first treatment and to identify predictors of remission in the CD population of our center. METHODS: Retrospective cohort study of the patients diagnosed of CD and with follow-up in our center between 1974 and 2011. We analyzed 41 patients (35 women and 6 men) with a mean age at diagnosis of 34 ± 13 years. The mean follow-up was 14 ± 10 years (range 1-37 years) and the median of follow-up period was 6.68 years. RESULTS: Thirty-five (85.4%) patients underwent transsphenoidal surgery as first treatment option. Histopathological evidence of a pituitary adenoma was registered in 17 (48.5%) patients. Thirty-two (78%) patients achieved disease remission after the first treatment, 21 (65.6%) of them presented disease recurrence. Persistent disease was observed in 9 (22%) patients. Twelve (29.3%) subjects developed post-surgical adrenal insufficiency, 7 of which (70%) achieved stable remission. Two parameters were found to be significant predictors of remission after the first treatment: age at disease diagnosis and the development of adrenal insufficiency (cortisol <3 µg/dl) in the immediate post-operative state. CONCLUSIONS: We report a high recurrence rate, at least partially attributable to the long follow-up time. Early post-surgery adrenal insufficiency predicts remission. Hypopituitarism was also very prevalent, and strongly associated with radiotherapy. These results lead us to the conclusion that CD needs a life-long strict follow-up.

Cultivo de cepas de levaduras de suelo trumao en ®vinaza¼ / Cultivation of yeast strains of the trumao soil in ®vinasse¼

30 cepas de levaduras aisladas desde un suelo trumao (Hapludans) usado como pradera en rotación, se cultivaron individualmente (100 µl = a 102 ufc delevaduras/mL) en matraces con 50 mL de ®vinaza¼, estos fueron incubados en un agitador orbital a 150 rpm, 23 °C por 5 días, luego de la incubación el contenido de cada matraz se centrifugo a 3.500 rpm por 20 min., a los pellet obtenidos se les determino: el peso seco (PS); fosforo total (FT) por digestión ácida y posterior lectura a 400 nm; proteínas totales (PT) por colorimetría Biuret a 595 nm y lípidos totales (LT) mediante el método colorimétrico de la sulfo-fosfo vainillina a 520 nm. Las 30 cepas de levaduras crecieron en la vinaza. El mayor PS lo registro la cepa 25 (331 g de levadura L-1 de ®vinaza¼). FT lo registro la cepa 28 (4,8 mg g-1 de levadura seca). PT lo registro la cepa 24 (25,90 mg g-1 de levadura seca) y LT lo registro la cepa 18 (287,4 mg g-1 de levadura seca).

Thirty strains of yeast isolated from a volcanic ash soil (Hapludans), used as pasture rotation, were individually cultured (100 µl = 102 cfu of yeast cells mL-1) in flasks with 50 mL of ®vinasse¼, these were incubated at 23 °C for 5 day, after incubation the contents of each flask was centrifuged at 3500 rpm for 20 min, the pellet obtained was determined: dry weight (DW); total phosphorus (FT) by acid digestion and later reading at 400 nm; total protein (TP) by Biuret at 595 nm and total lipid (TL) by the colorimetric method of the sulfo-phospho-vanillin at 520 nm. The Thirty strains of yeast grown on vinasse. The best DW, was determined for strain 25 (331 g yeast L-1 ®vinasse¼). FT was determined for strain 28 (4,8 mg g-1 dry yeast). TP was determined for strain 24 (25, 90 mg g-1 dry yeast) and TL was determined for strain18 (287, 4 mg g-1 dry yeast).

Asociación de gastrosquisis y artrogriposis múltiple congénita / Gastroschisis and arthrogryposis: clinical case

Introducción: La gastrosquisis (GQ) es un defecto congénito de cierre de la pared abdominal, a la derecha de la inserción del cordón umbilical. Una cantidad variable del intestino, y en ocasiones, otros órganos abdominales, se hernian fuera de la pared abdominal, sin cobertura membranosa. La Artrogriposis Múltiple Congénita (AMC) comprende un grupo de trastornos reumáticos caracterizados por contracturas articulares múltiples en que se afectan los músculos dorsales y de las extremidades superiores e inferiores. Objetivo: Describir una rara asociación de estas dos malformaciones congénitas. Caso clínico: Recién nacido con GQ clásica Se realizó cierre primario del defecto de pared abdominal en las primeras horas de vida, con buena evolución postoperatoria. Al nacimiento, se apreció además Artrogriposis de articulaciones distales de ambos miembros superiores y atrofia muscular en ellos asociada a paresia severa de miembros superiores. Conclusiones: Recientemente se ha señalado que la asociación entre GQ y AMC pueda ser más frecuente de lo que clásicamente se ha descrito. Aunque la etiología de estas dos afecciones no está clara, el fenómeno que causa la disrupción o accidente vascular podría explicar la coexistencia de estas dos patologías.

Introduction: Gastroschisis is a congenital abdominal wall closure defect, usually to the right of the umbilical cord insertion. A variable amount of the intestine and occasionally other abdominal organs herniate outside of the abdominal wall without a covering membrane. Arthrogryposis Multiplex Congenital (AMC) consists of a group of rheumatic disorders characterized by multiple joint contractures that may affect back muscles and upper and lower extremities. Objective: To describe a rare association of these two birth defects. Case report: Newborn with classical Gastroschisis; primary closure of the abdominal wall defect was performed in the first hours of life, with good results. At birth, Arthrogryposis in distal joints of both upper limbs and muscle atrophy associated with severe upper limb paresis were observed. Conclusions: It has recently been suggested that the association between Gastroschisis and AMC may be more common than previously described. Although the etiology of these conditions is unclear, the phenomenon that causes the disruption or stroke could explain the coexistence of both pathologies.