Enhancing Selenium Accumulation in Rhodotorula mucilaginosa Strain 6S Using a Proteomic Approach for Aquafeed Development.

It is known that selenium (Se) is an essential trace element, important for the growth and other biological functions of fish. One of its most important functions is to contribute to the preservation of certain biological components, such as DNA, proteins, and lipids, providing protection against free radicals resulting from normal metabolism. The objective of this study was to evaluate and optimize selenium accumulation in the native yeast Rhodotorula mucilaginosa 6S. Sodium selenite was evaluated at different concentrations (5-10-15-20-30-40 mg/L). Similarly, the effects of different concentrations of nitrogen sources and pH on cell growth and selenium accumulation in the yeast were analyzed. Subsequently, the best cultivation conditions were scaled up to a 2 L reactor with constant aeration, and the proteome of the yeast cultured with and without sodium selenite was evaluated. The optimal conditions for biomass generation and selenium accumulation were found with ammonium chloride and pH 5.5. Incorporating sodium selenite (30 mg/L) during the exponential phase in the bioreactor after 72 h of cultivation resulted in 10 g/L of biomass, with 0.25 mg total Se/g biomass, composed of 25% proteins, 15% lipids, and 0.850 mg total carotenoids/g biomass. The analysis of the proteomes associated with yeast cultivation with and without selenium revealed a total of 1871 proteins. The results obtained showed that the dynamic changes in the proteome, in response to selenium in the experimental medium, are directly related to catalytic activity and oxidoreductase activity in the yeast. R. mucilaginosa 6S could be an alternative for the generation of selenium-rich biomass with a composition of other nutritional compounds also of interest in aquaculture, such as proteins, lipids, and pigments.

Selenized non-Saccharomyces yeasts and their potential use in fish feed.

Selenium (Se) is a vital trace element, essential for growth and other biological functions in fish. Its significance lies in its role as a fundamental component of selenoproteins, which are crucial for optimal functioning of the organism. The inclusion of Se in the diets of farmed animals, including fish, has proved invaluable in mitigating the challenges arising from elemental deficiencies experienced in captivity conditions due to limitations in the content of fishmeal. Supplementing diets with Se enhances physiological responses, particularly mitigates the effects of the continuous presence of environmental stress factors. Organic Se has been shown to have higher absorption rates and a greater impact on bioavailability and overall health than inorganic forms. A characteristic feature of yeasts is their rapid proliferation and growth, marked by efficient mineral assimilation. Most of the selenized yeasts currently available in the market, and used predominantly in animal production and aquaculture, are based on Saccharomyces cerevisiae, which contains selenomethionine (Se-Met). The object of this review is to highlight the importance of selenized yeasts. In addition, it presents metabolic and productive aspects of other yeast genera that are important potential sources of organic selenium. Some yeast strains discussed produce metabolites of interest such as lipids, pigments, and amino acids, which could have applications in aquaculture and further enrich their usefulness.

Achieving Cochlear Therapeutic Hypothermia through Irrigation of the Mastoid and Tympanic Cavities.

INTRODUCTION: Mild therapeutic hypothermia (MTH) is an exciting nonpharmaceutical otoprotection strategy. In this study, we applied simple irrigation of the tympanic and mastoid cavities to understand the timing of both achieving MTH and recovery back to euthermic temperatures for application in the clinical setting. METHODS: Three human temporal bones were used in this study in the temporal bone laboratory. A standard mastoidectomy was performed on each followed by the insertion of temperature probes into the basal turn of the cochlea via a middle cranial fossa approach. The temporal bones were warmed in heated bead baths to 37°C. The tympanic and mastoid cavities were then irrigated with room temperature water, and intracochlear temperature readings were recorded every minute. After 15 min, irrigation was stopped, and temperature readings were collected until temporal bones returned to euthermic levels. RESULTS: Intracochlear MTH was achieved within the first minute of irrigating the tympanic and mastoid cavities. Intracochlear temperatures plateaued after 5 min around 30°C. Discontinuation of irrigation resulted in the temperature rising logarithmically above the MTH levels after 9-10 min. CONCLUSION: Intracochlear MTH can be achieved via irrigation of the tympanic and mastoid cavities with room temperature irrigation within 60 s. After irrigation for 5 min, hypothermic temperatures will remain therapeutic for 10 min following cessation of irrigation.

Jackson Heart Study: Aggregate cardiovascular disease risk and auditory profiles.

Objectives: Evaluate the relationship between cardiovascular disease (CVD) risk factors and cochlear function in African Americans. Methods: Relationships between hearing loss, cochlear function, and CVD risk factors were assessed in a cross-sectional analysis of 1106 Jackson Heart Study participants. Hearing loss was defined as puretone average (PTA0.5,1,2,4) > 15 dB HL. Distortion product otoacoustic emissions (DPOAEs) were collected for f 2 = 1.0-8.0 kHz. Two amplitude averages were computed: DPOAElow (f 2 ≤ 4 kHz) and DPOAEhigh (f 2 ≥ 6 kHz). Based on major CVD risk factors (diabetes, current smoking, total cholesterol ≥240 mg/dL or treatment, and systolic blood pressure [BP]/diastolic BP ≥ 140/≥90 mmHg or treatment), four risk groups were created: 0, 1, 2, and ≥3 risk factors. Logistic regression estimated the odds of hearing loss and absent/reduced DPOAElow and DPOAEhigh by CVD risk status adjusting for age, sex, education, BMI, vertigo, and noise exposure. Results: With multivariable adjustment, diabetes was associated with hearing loss (OR = 1.48 [95% CI: 1.04-2.10]). However, there was not a statistically significant relationship between CVD risk factors (individually or for overall risk) and DPOAEs. Conclusion: Diabetes was associated with hearing loss. Neither individual CVD risk factors nor overall risk showed a relationship to cochlear dysfunction. Level of Evidence: 2b.

Achieving Mild Therapeutic Hypothermia in the Human Cochlea.

OBJECTIVE: To determine temperature and duration of cooling necessary for achieving cochlear mild therapeutic hypothermia (MTH) via ear canal cooling using cool water and earmold attached to a Peltier device. STUDY DESIGN AND SETTING: Human temporal bone lab study performed at the University of Mississippi Medical Center. INTERVENTIONS: Cochlear cooling via the ear canal using water irrigation and an earmold attached to a Peltier device. Temperature analysis through implanted thermal probes within the cochlea. MAIN OUTCOME MEASURES: Temperature changes in the cochlea. RESULTS: Irrigation of the ear canal with water resulted in achieving MTH in approximately 4 minutes using cool water (30°C) and in approximately 2 minutes using ice-chilled water. After 20 minutes, irrigation of the ear canal using cool water plateaued at a ∆2°C while cooling with ice-chilled water results in an average ∆4.5°C. We observed MTH using a medium-length earmold attached to a Peltier device after approximately 22 minutes of cooling and achieved a maximal average ∆ of 2.3°C after 60 minutes of cooling. Finally, we observed that a longer earmold (C2L) with greater proximity to the eardrum resulted in more efficient intracochlear temperature change, achieving MTH in approximately 16 minutes. CONCLUSIONS: MTH of the cochlea can be achieved with water-based ear canal irrigation and via a Peltier device connected to an aluminum earmold.

Rapidly Progressive Complicated Acute Bacterial Sinusitis in the Setting of Severe Pediatric SARS-CoV-2 Infection.

OBJECTIVE: This case report presents a case of a rapidly progressive complicated sinus infection in a child with the multisystem inflammatory syndrome in children. METHODS: Case report with literature review. RESULTS/CASE REPORT: We present a novel case of severe rapidly progressive complicated sinusitis in a 14-year-old African American male diagnosed with the multisystem inflammatory syndrome in children. Infection was caused by an aggressive pathogen, Streptococcus intermedius (anginosus), and within 48 hours progressed to orbital, subgaleal, and intracranial abscess, requiring multidisciplinary intervention by ophthalmology, neurosurgery, and otolaryngology. Following surgical intervention and a 4-week course of intravenous antibiotic therapy, the patient had resolution of the infection with no neurologic sequelae. CONCLUSION: Despite the low incidence of multisystem inflammatory syndrome in children, physicians should be aware that immunologic changes and the cytokine storm induced by severe acute respiratory syndrome coronavirus 2 can potentially predispose patients to severe bacterial or opportunistic infections. As more cases of MIS-C develop, associated complications can become evident. Similar cases of SARS-CoV-2 and severe bacterial sinusitis have been published in the literature, but it remains unclear if there is an association between SARS-CoV-2 disease and an increased risk of complicated sinusitis in children.

Sound-Evoked Responses in the Vestibulo-Ocular Reflex Pathways of Rats.

Vestibular evoked myogenic potentials (VEMP) have been used to assess otolith function in clinics worldwide. However, there are accumulating evidence suggesting that the clinically used sound stimuli activate not only the otolith afferents, but also the canal afferents, indicating canal contributions to the VEMPs. To better understand the neural mechanisms underlying the VEMPs and develop discriminative VEMP protocols, we further examined sound-evoked responses of the vestibular nucleus neurons and the abducens neurons, which have the interneurons and motoneurons of the vestibulo-ocular reflex (VOR) pathways. Air-conducted clicks (50-80 dB SL re ABR threshold, 0.1 ms duration) or tone bursts (60-80 dB SL, 125-4,000 Hz, 8 ms plateau, 1 ms rise/fall) were delivered to the ears of Sprague-Dawley or Long-Evans rats. Among 425 vestibular nucleus neurons recorded in anesthetized rats and 18 abducens neurons recorded in awake rats, sound activated 35.9% of the vestibular neurons that increased discharge rates for ipsilateral head rotation (Type I neuron), 15.7% of the vestibular neurons that increased discharge rates for contralateral head rotation (Type II neuron), 57.2% of the vestibular neurons that did not change discharge rates during head rotation (non-canal neuron), and 38.9% of the abducens neurons. Sound sensitive vestibular nucleus neurons and abducens neurons exhibited characteristic tuning curves that reflected convergence of canal and otolith inputs in the VOR pathways. Tone bursts also evoked well-defined eye movements that increased with tone intensity and duration and exhibited peak frequency of ∼1,500 Hz. For the left eye, tone bursts evoked upward/rightward eye movements for ipsilateral stimulation, and downward/leftward eye movements for contralateral stimulation. These results demonstrate that sound stimulation results in activation of the canal and otolith VOR pathways that can be measured by eye tracking devices to develop discriminative tests of vestibular function in animal models and in humans.

Phylogeography of high Andean killifishes Orestias (Teleostei: Cyprinodontidae) in Caquena and Lauca sub-basins of the Altiplano (Chile): mitochondrial and nuclear analysis of an endangered fish.

From the early Miocene, the uplift of the Andes Mountains, intense volcanic activity and the occurrence of successive periods of dryness and humidity would have differentially influenced the modification of Altiplano watersheds, and consequently the evolutionary history of the taxa that live there. We analyzed Orestias populations from the Caquena and Lauca Altiplanic sub-basins of northern Chile to determine their genetic differentiation and relationship to their geographical distribution using mitochondrial (D-loop) and nuclear (microsatellite) molecular markers and to reconstruct its biogeographic history on these sub-basins. The results allowed reconstructing and reevaluating the evolutionary history of the genus in the area; genic diversity and differentiation together with different founding genetic groups suggest that Orestias have been spread homogeneously in the study area and would have experienced local disturbances that promoted isolation and diversification in restricted zones of their distribution.

Otologic and Audiologic Considerations for COVID-19.

The COVID-19 pandemic has created a number of considerations for otolaryngology; anosmia and ageusia in particular have gained significant attention. Here we present considerations in regard to treatment with quinine-derived drugs and the influence of masks on communication.

Passive eye movements induced by electromagnetic force (EMF) in rats.

Accurate information on eye position in the orbit is available from visual feedback, efference copy of the oculomotor commands and proprioceptive signals from the extraocular muscles (EOM). Whereas visual feedback and oculomotor commands have been extensively studied, central processing of EOM proprioceptive signals remains to be elucidated. A challenge to the field is to develop an approach to induce passive eye movements without physically contacting the eyes. A novel method was developed to generate passive eye movements in rats. A small rare-earth magnet disk (0.7 mm diameter, 0.5 mm thickness) was attached to the surface of a rat's eyeball. A metal rod (5 mm diameter) wrapped with an electromagnetic (EM) coil was placed near the magnet (8-15 mm). By passing currents to the EM coil, electromagnetic force (EMF) was generated and acted upon the magnet and induced passive eye movements. The EMF induced well-defined passive eye movements, whose directions were dependent on current polarity and amplitudes and peak velocities were dependent on current intensity and duration. Peak velocities of the EMF-induced eye movements were linearly related to amplitudes, exhibiting main sequence relationships similar to that of saccades in awake rats and eye movements induced by electrical microstimulation of the abducens nucleus in anesthetized rats. Histological examination showed that repetitive EMF stimulations did not appear to result in damages in the EOM fibers. These results validated the EMF approach as a novel tool to investigate EOM proprioceptive signals and their roles in visual localization and gaze control.

Frailty as a Predictor of Postoperative Outcomes among Patients with Head and Neck Cancer.

OBJECTIVES: To understand measures of frailty among preoperative patients and explain how these can predict perioperative outcomes among patients with head and neck cancer. STUDY DESIGN: Retrospective cross-sectional case series with chart review. SETTING: Academic tertiary medical center. SUBJECTS AND METHODS: A retrospective review was performed of patients presenting to an academic hospital following a surgical procedure for a head and neck cancer diagnosis. Charts were queried for preoperative medical diagnoses to calculate 2 frailty scores: the American College of Surgeons National Surgical Quality Improvement Program modified frailty index and the Johns Hopkins Adjusted Clinical Groups frailty index. The American Society of Anesthesiologists classification system was also analyzed as a predictor. Primary outcomes were mortality, 30-day readmission, and length of stay. Perioperative complications and discharge disposition were also evaluated. RESULTS: A total of 410 charts were queried between January 2014 and December 2017. Mortality was 11%; mean ± SD length of stay was 7.4 ± 5.5 days; and the readmission rate was 17%. The modified frailty index score significantly increased the odds of mortality (odds ratio = 1.475, P = .012) and readmission (odds ratio = 1.472, P = .004), the length of stay (relative risk = 1.136, P = .001), and the number of perioperative complications. The American Society of Anesthesiologists classification was also significantly associated with poor outcomes, including readmission, length of stay, and perioperative complications. The Adjusted Clinical Groups index was not a significant predictor of outcomes in this study population. CONCLUSIONS: This study demonstrated a significant increase in poor perioperative outcomes and mortality among patients with head and neck cancer and increased frailty, as measured by the modified frailty index.

Autonomic responses to blast overpressure can be elicited by exclusively exposing the ear in rats.

Blast overpressure has become an increasing cause of brain injuries in both military and civilian populations. Though blast's direct effects on the cochlea and vestibular organs are active areas of study, little attention has been given to the ear's contribution to the overall spectrum of blast injury. Acute autonomic responses to blast exposure, including bradycardia and hypotension, can cause hypoxia and contribute to blast-induced neurotrauma. Existing literature suggests that these autonomic responses are elicited through blast impacting the thorax and lungs. We hypothesize that the unprotected ear also provides a vulnerable locus for blast to cause autonomic responses. We designed a blast generator that delivers controlled overpressure waves into the ear canal without impacting surrounding tissues in order to study the ear's specific contribution to blast injury. Anesthetized adult rats' left ears were exposed to a single blast wave ranging from 0 to 110 PSI (0-758 kPa). Blast exposed rats exhibited decreased heart rates and blood pressures with increased blast intensity, similar to results gathered using shock tubes and whole-body exposure in the literature. While rats exposed to blasts below 50 PSI (345 kPa) exhibited increased respiratory rate with increased blast intensity, some rats exposed to blasts higher than 50 PSI (345 kPa) stopped breathing immediately and ultimately died. These autonomic responses were significantly reduced in vagally denervated rats, again similar to whole-body exposure literature. These results support the hypothesis that the unprotected ear contributes to the autonomic responses to blast.

Iatrogenic pneumothorax during hypoglossal nerve stimulator implantation.

Hypoglossal nerve stimulation is a promising new treatment for patients with obstructive sleep apnea. In the initial Stimulation Therapy for Apnea Reduction Trial, the overall rate of serious adverse events was <2% and no cases of pneumothorax were reported. We present the case of an iatrogenic pneumothorax during placement of the chest sensor lead between the intercostal muscles. Following clinical and radiological evaluation, surgery was continued and the patient was treated expectantly. In the following review, we discuss pathophysiology, diagnosis, and expected outcomes. Surgeons placing hypoglossal nerve stimulators should be aware of complications and prepared to manage a pneumothorax.

The effect of continuous positive airway pressure therapy on nasal patency.

BACKGROUND: Nasal congestion and obstruction are reported in the majority of continuous positive airway pressure (CPAP) users and are frequently cited as reasons for noncompliance. To our knowledge, no study has demonstrated a change in objective or subjective nasal patency in patients with obstructive sleep apnea (OSA) after a therapeutic trial of CPAP therapy. METHODS: This prospective nonrandomized trial tested the hypothesis that CPAP therapy would result in both objective and subjective improvements in nasal patency in patients with OSA. Prior to initiation of CPAP, acoustic rhinometry (AR) was used to determine nasal volume and minimum cross-sectional area in the upright and reclined positions. Subjective nasal patency was assessed with the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire. Both assessments were repeated at follow-up visits. RESULTS: AR data demonstrated a statistically significant increase in total nasal volume (TV) in the reclined position (p = 0.002) and minimum cross-sectional area (MCA) in both the sitting and reclined positions (p = 0.006, p = 0.021) in OSA patients after >30 days of CPAP therapy and with >70% compliance. NOSE scores decreased significantly (p = 0.038) representing an improvement in nasal patency. CONCLUSION: Objective and subjective measurements of TV and MCA increased after initiation of CPAP therapy in this prospective study.

Linitis plástica gástrica: a propósito de un caso / Gastric-plastic letinitis. A case report

Fundamento: el cáncer gástrico es una de las principales causas de muerte. En Cuba la mayoría son diagnosticados en fases avanzadas ensombreciendo el pronóstico. La linitis plástica es una forma de crecimiento submucoso del adenocarcinoma. Objetivo: ofrecer lección a médicos sobre los signos endoscópicos de sospecha y complementarios a utilizar para diagnosticarlo rápidamente. Presentación de caso: paciente que refería epigastralgia, vómitos y pérdida de peso. La radiografía contrastada de estómago evidenció rigidez y defecto de lleno en curvatura mayor y menor. La esofagogastroduodenoscopía mostró ausencia de peristalsis y estenosis de la luz del estómago. En el examen laparoscópico se observó exteriorización del tumor. El diagnóstico definitivo se realizó por macrobiopsia después de la cirugía. Conclusiones: se ha de sospechar la entidad ante un paciente con la clínica sugestiva de tumor y hallazgos endoscópicos como la disminución de la peristalsis y la reducción de la luz del órgano(AU)

Background: gastric cancer is one of the main causes of death. In Cuba most of the cases are diagnosed in advanced stages clouding the outlook. The plastic linitis is a form of submucosal growth adenocarcinoma. Objective: to provide medical lesson on endoscopic signs of suspicion and complementary use to diagnose it quickly. Case Presentation: a patient referred epigastralgia, vomiting and weight loss. The stomach contrasted radiography showed stiffness and squarely defect in major and minor curvature. The esophagogastroduodenoscopy showed absence of peristalsis and stenosis of the light of the stomach. In the laparoscopic exam the tumor externalization was observed. The final diagnosis was carried out by macrobiopsy after surgery. Conclusions: doctors have to suspect the disease in a patient with clinical suggestive features of tumor and endoscopic findings as decreased peristalsis and reduced organ light(AU)

Linitis plástica gástrica. A propósito de un caso / Gastric-plastic letinitis. A case report

Fundamento: el cáncer gástrico es una de las principales causas de muerte. En Cuba la mayoría son diagnosticados en fases avanzadas ensombreciendo el pronóstico. La linitis plástica es una forma de crecimiento submucoso del adenocarcinoma. Objetivo: ofrecer lección a médicos sobre los signos endoscópicos de sospecha y complementarios a utilizar para diagnosticarlo rápidamente. Presentación de caso: paciente que refería epigastralgia, vómitos y pérdida de peso. La radiografía contrastada de estómago evidenció rigidez y defecto de lleno en curvatura mayor y menor. La esofagogastroduodenoscopía mostró ausencia de peristalsis y estenosis de la luz del estómago. En el examen laparoscópico se observó exteriorización del tumor. El diagnóstico definitivo se realizó por macrobiopsia después de la cirugía. Conclusiones: se ha de sospechar la entidad ante un paciente con la clínica sugestiva de tumor y hallazgos endoscópicos como la disminución de la peristalsis y la reducción de la luz del órgano.

Background: gastric cancer is one of the main causes of death. In Cuba most of the cases are diagnosed in advanced stages clouding the outlook. The plastic linitis is a form of submucosal growth adenocarcinoma. Objective: to provide medical lesson on endoscopic signs of suspicion and complementary use to diagnose it quickly. Case Presentation: a patient referred epigastralgia, vomiting and weight loss. The stomach contrasted radiography showed stiffness and squarely defect in major and minor curvature. The esophagogastroduodenoscopy showed absence of peristalsis and stenosis of the light of the stomach. In the laparoscopic exam the tumor externalization was observed. The final diagnosis was carried out by macrobiopsy after surgery. Conclusions: doctors have to suspect the disease in a patient with clinical suggestive features of tumor and endoscopic findings as decreased peristalsis and reduced organ light.

Miocardiopatia hipertrófica obstructiva y embarazo: presentación de un caso y revisión de la literatura / Obstructive hypertrophic miocardiopathy disease and pregnancy: presentation of the a case and review of the literature

La miocardiopatía hipertrófica obstructiva, se caracteriza por hipertrofia ventricular izquierda, asociada a un gradiente de presión dinámica. La clínica varía desde formas asintomáticas hasta insuficiencia cardíaca y muerte súbita. Existe poca experiencia publicada sobre esta patología y embarazo y frecuentes controversias entre cardiólogos y obstetras respecto a la vía del parto. Se presenta una paciente de 20 años de edad, primigesta, con embarazo de 30 semanas, quien ingresó al Hospital Universitario de Caracas por presentar disnea de esfuerzo progresiva y síncopes ocasionales, de seis meses de evolución. Se diagnosticó miocardiopatía hipertrófica obstructiva. El embarazo, trabajo de parto y parto evolucionaron sin complicaciones. Se realiza una revisión y análisis de la literatura sobre el tema.

Embarazo después de trasplante hepático: comunicación de un caso / Pregnancy after liver transplantion: case report

El trasplante hepático es una forma de tratamiento efectivo para pacientes con falla hepática en fase terminal y representa un incremento de la duración y calidad de vida. Presentamos el caso de una paciente de 21 años de edad quien logró embarazo posterior a trasplante hepático ortotópico. Tuvo amenaza de parto pretérmino y restricción de crecimiento intrauterino; no se observaron signos de rechazo ni difunción hepática. A las 38 semanas se realizó cesárea obteniendo recien nacido femenino vivo. No se presentaron complicaciones durante el puerperio. Se realiza una revisión y análisis del tema.

Sección de Bridas por via Endoscópica: nuestra experiencia

Se realizó en nuestro servicio de Gastroenterología del Hospital Provincial Docente "Camilo Cienfuegos" de Sancti Spíritus un estudio descriptivo a partir de la experiencia obtenida con los primeros 80 pacientes ingresados o ambulatorios, que fueron sometidos a sección laparoscópica de Bridas intrabdominales desde septiembre de 1987 a Junio de 1991, ambos inclusive. Al sexo femenino pertenecian 73 pacientes para un 91,66 por ciento. Los sintomas principales que aquejaban a los mismos fueron el dolor abdominal difuso o localizado y la constipación. En el 91,66 por ciento de los pacientes se les realizó sección de las bridas sin electrofulguración y en sólo 7 pacientes (8,34 por ciento) se usó electrofulguración; infiltrándose, ó sea , administrándose anestesia en la pared ó en la brida en 12 pacientes. No se reportaron complicaciones de importancia y la evolución en todos los casos ha sido satisfactoria hasta la fecha de este informe.(AU)

Sección de Bridas por via Endoscópica: nuestra experiencia

Se realizó en nuestro servicio de Gastroenterología del Hospital Provincial Docente "Camilo Cienfuegos" de Sancti Spíritus un estudio descriptivo a partir de la experiencia obtenida con los primeros 80 pacientes ingresados o ambulatorios, que fueron sometidos a sección laparoscópica de Bridas intrabdominales desde septiembre de 1987 a Junio de 1991, ambos inclusive. Al sexo femenino pertenecian 73 pacientes para un 91,66 por ciento. Los sintomas principales que aquejaban a los mismos fueron el dolor abdominal difuso o localizado y la constipación. En el 91,66 por ciento de los pacientes se les realizó sección de las bridas sin electrofulguración y en sólo 7 pacientes (8,34 por ciento) se usó electrofulguración; infiltrándose, ó sea , administrándose anestesia en la pared ó en la brida en 12 pacientes. No se reportaron complicaciones de importancia y la evolución en todos los casos ha sido satisfactoria hasta la fecha de este informe.(AU)