Eficacia y seguridad de la terapia de vacío endoscópica para el tratamiento de perforaciones y dehiscencias anastomóticas del tracto digestivo superior / Safety and efficacy of endoscopic vacuum therapy for the treatment of perforations and anastomotic leaks of the upper gastrointestinal tract

OBJETIVO: Evaluar la eficacia y seguridad de la terapia de vacío endoscópica (TVE) en perforaciones y dehiscencias del tracto digestivo superior. PACIENTES Y MÉTODOS: Estudio retrospectivo observacional donde se incluyeron todos los pacientes que presentaron algún defecto del tracto gastrointestinal superior y que fueron sometidos a TVE en el período comprendido entre abril de 2017 y febrero de 2019 en 3 centros españoles. Para ello se utilizó el único sistema de terapia de vacío aprobado para uso endoscópico hasta la fecha (Eso-SPONGEr; B. Braun Melsungen AG, Melsungen, Alemania). RESULTADOS: Un total de 11 pacientes fueron sometidos a TVE como tratamiento de una dehiscencia de sutura anastomótica tras esofaguectomía (n=7), gastrectomía (n=2), como tratamiento de una perforación esofágica tras septomiotomía endoscópica de Zenker (n=1) y tras una perforación esofágica espontánea o síndrome de Boerhaave (n=1). La mediana del tamaño de la cavidad fue de 8×3cm. De mediana, la TVE se inició a los 7días de la cirugía inicial. La mediana de duración de la TVE fue de 28días. La mediana de esponjas colocadas fue de 7 y el intervalo de recambio de las esponjas, de 3,7días. En 10 casos (91%) se consiguió el cierre del defecto y en 9 casos (82%) la resolución clínica del cuadro infeccioso asociado. Cinco pacientes presentaron algún evento adverso: 3 estenosis anastomóticas, un episodio de dolor retrofaríngeo y un caso de neumonía de nueva aparición. La mediana de estancia hospitalaria desde el inicio de la TVE fue de 45días. Un paciente falleció debido a complicaciones sépticas secundarias a la dehiscencia de sutura. CONCLUSIÓN: La TVE tiene una eficacia superior al 90% en las perforaciones y fugas anastomóticas del tracto digestivo superior. Adicionalmente es una terapia segura, siendo los eventos adversos leves

AIM: To evaluate the efficacy and safety of endoscopic vacuum therapy (EVT) in the management of perforations and anastomotic leaks of the upper gastrointestinal tract. PATIENTS AND METHODS: This is a retrospective observational study which included patients who underwent EVT due to any upper gastrointestinal defect between April 2017 and February 2019 in three Spanish Hospitals. To this end, we used the only medical device approved to date for endoscopic use (Eso-SPONGEr; B. Braun Melsungen AG, Melsungen, Germany). RESULTS: 11 patients were referred for EVT of an anastomotic leak after esophagectomy (n=7), gastrectomy (n=2), esophageal perforation secondary to endoscopic Zenker's septomiotomy (n=1) and Boerhaave syndrome (n=1). The median size of the cavity was 8×3cm. The median delay between surgery and EVT was 7 days. The median of EVT duration was 28 days. The median number of sponges used was 7 and the mean period replacement was 3.7 days. In 10 cases (91%), the defect was successfully closed. In 9 cases (82%) clinical resolution of the septic condition was achieved. 5 patients presented some adverse event: 3 anastomotic strictures, 1 retropharyngeal pain and 1 case of new-onset pneumonia. The median hospital stay from the start of EVT was 45 days. 1 patient died owing to septic complications secondary to the anastomotic leak. CONCLUSION: EVT was successful in over 90% of perforations and anastomotic leaks of the upper gastrointestinal tract. Moreover, this is a safe therapy with only mild adverse events associated

Safety and efficacy of endoscopic vacuum therapy for the treatment of perforations and anastomotic leaks of the upper gastrointestinal tract. / Eficacia y seguridad de la terapia de vacío endoscópica para el tratamiento de perforaciones y dehiscencias anastomóticas del tracto digestivo superior.

AIM: To evaluate the efficacy and safety of endoscopic vacuum therapy (EVT) in the management of perforations and anastomotic leaks of the upper gastrointestinal tract. PATIENTS AND METHODS: This is a retrospective observational study which included patients who underwent EVT due to any upper gastrointestinal defect between April 2017 and February 2019 in three Spanish Hospitals. To this end, we used the only medical device approved to date for endoscopic use (Eso-SPONGEr; B. Braun Melsungen AG, Melsungen, Germany). RESULTS: 11 patients were referred for EVT of an anastomotic leak after esophagectomy (n=7), gastrectomy (n=2), esophageal perforation secondary to endoscopic Zenker's septomiotomy (n=1) and Boerhaave syndrome (n=1). The median size of the cavity was 8×3cm. The median delay between surgery and EVT was 7 days. The median of EVT duration was 28 days. The median number of sponges used was 7 and the mean period replacement was 3.7 days. In 10 cases (91%), the defect was successfully closed. In 9 cases (82%) clinical resolution of the septic condition was achieved. 5 patients presented some adverse event: 3 anastomotic strictures, 1 retropharyngeal pain and 1 case of new-onset pneumonia. The median hospital stay from the start of EVT was 45 days. 1 patient died owing to septic complications secondary to the anastomotic leak. CONCLUSION: EVT was successful in over 90% of perforations and anastomotic leaks of the upper gastrointestinal tract. Moreover, this is a safe therapy with only mild adverse events associated.

Comportamento de vacas da raça Holandesa em ordenha robotizada / Behaviour of Holstein cows in robotic milking

O objetivo do trabalho foi avaliar o comportamento ingestivo de concentrado e de ordenha de vacas em lactação em sistema de ordenha robotizada (SOR) conforme a paridade. O experimento foi realizado de março a junho de 2014, em Castro, PR, com vacas da raça Holandesa, confinadas em free stall, ordenhadas automaticamente e classificadas de acordo com a ordem de parto (1, 2 e +3 partos). Os dados foram extraídos do software de gerenciamento, sendo consideradas as atividades de um dia por mês (24h), por quatro meses, no dia seguinte após a realização do controle leiteiro oficial. Os dados foram analisados por técnicas de análise multivariada (análise fatorial, canônica e de agrupamento), utilizando-se o pacote computacional SAS. O comportamento ingestivo de concentrado influenciou toda a atividade das vacas no SOR, sendo fundamental para o desempenho dos animais nesse sistema. A ordem de parto não influenciou o comportamento na ordenha, somente o comportamento ingestivo, devido à dominância social das vacas multíparas. As vacas mais produtivas apresentaram um comportamento ingestivo mais agressivo. Conclui-se que a ordem de parto influencia o comportamento ingestivo de concentrado, porém não interfere no comportamento de ordenha de vacas com maior paridade. No SOR, primíparas devem ser manejadas em grupo específico.(AU)

The aim of this study was to assess the ingestive behavior of concentrate and milking of dairy cows in automatic milking system (AMS) according to parity. The experiment was conducted from March to June 2014, in Castro, PR, with Holstein cows housed in a free stall, milked automatically, and classified according to the lactation order (1, 2 and +3 lactations). Data were extracted from the management software, considering the activities of one day a month (24 hours) for four months, the day after the official milk production control. The data were analyzed by multivariate analysis (factorial analysis, canonical and cluster), using the statistical package SAS. The ingestive behavior of concentrate influenced the entire activity of the cows in the AMS, being a fundamental factor in the performance of animals in this system. Parity did not influence the milking behavior, only the ingestive behavior, due to the social dominance of multiparous cows. High-yielding cows had a more aggressive ingestive behavior. It was concluded that parity influenced the ingestive behavior of concentrate, but does not interfere in milking behavior in cows with higher parity. In the AMS, primiparous should be managed in a specific group.(AU)

Temporal characterization of wooden breast myopathy ("woody breast") severity and correlation with growth rate and lymphocytic phlebitis in three commercial broiler strains and a random-bred broiler strain.

Wooden breast myopathy (WBM), or "woody breast" or "wooden breast" affects modern, rapidly growing, high breast-yield broiler chickens. Decreased meat quality due to undesirable organoleptic properties and condemnation of affected breast meat cause economic losses. The pathogenesis of WBM remains unknown. In this study, WBM lesion development was determined in three modern broiler strains and Athens Canadian Random Bred (ACRB) broilers, a 1950s unselected broiler chicken. Correlations between WBM severity and incubation temperature profile, sex, strain, body weight, and lymphocytic phlebitis were also determined. At 2, 4, 6, and 8 weeks of age, samples of breast muscle from 10 male and 10 female birds from each strain, incubated under optimal or low-early, high-late temperatures, were scored histologically for severity of WBM and lymphocytic phlebitis. WBM lesions, identified as early as 2 weeks, became progressively more severe with age and growth in the three commercial broiler strains. WBM severity was significantly correlated with lymphocytic phlebitis and body weight. Lymphocytic phlebitis and minimal WBM were present in the ACRB broilers at all samplings, but did not progress in severity over time. There were no significant differences in severity of WBM among the commercial broiler strains, between sexes, or between incubation temperature profiles. The positive correlation between WBM severity and lymphocytic phlebitis indicates vascular injury is likely an important factor in the pathogenesis. Mild muscle lesions in ACRB birds without overt clinical signs indicate subclinical muscle disease may have been present in broilers prior to the description of WBM.

Prevalence and severity of osteochondrosis of the free thoracic vertebra in three modern broiler strains and the Athens Canadian Random Bred control broiler.

Osteochondrosis (OCD) results from a disturbance of endochondral ossification in articular cartilage and is an important cause of lameness in several animal species, including chickens. OCD lesions in the free thoracic vertebra (FTV) of chickens are essential to the pathogenesis of pathogenic Enterococcus cecorum. The goal of this study was to determine the prevalence of OCD in the FTV among three modern broiler chicken crosses (strains A/A, A/B, and C/C) and Athens Canadian Random Bred (ACRB) chickens, which served as the control group. The effect of sex, age, strain, body weight, and incubation temperature profile on OCD severity for each group was determined. At 2, 4, 6, and 8 weeks of age, the FTV of 10 male and 10 female birds from each strain exposed to either optimal or low-early, high-late incubation temperature profiles were collected and scored histologically for OCD lesion severity. OCD spectrum lesions were detected in >70% of all strain/sex combinations, including the ACRB controls. No association was observed between mean OCD score and broiler strain, incubation temperature profile, sex, age, or body weight. These findings indicate that OCD of the FTV is common in broiler chickens with similar prevalence observed in broilers with modern genetics and the ACRB broilers which represent 1950s broiler genetics. As the parameters examined did not have a statistical correlation with OCD, additional work is needed to understand factors that contribute to development of OCD in chickens.

Prediabetes en estudiantes de 1er año del campus ciencias de la salud de una universidad Mexicana / Prediabetes in 1st year students of the health sciences campus from a Mexican university

Introducción. Dado el aumento dramático de diabetes en el mundo, el objetivo de esta investigación fue analizar los valores de la glucemia en una población universitaria de nuevo ingreso para sustentar estrategias de detección y manejo preventivo de prediabetes y diabetes. Métodos. Estudio observacional, analítico, transversal, no probabilístico. Se analizaron los valores de glucemia en ayunas de 367 estudiantes de nuevo ingreso en 2011, y 430 en 2016 al campus de Ciencias de la Salud de una universidad del sureste de México. Se aplicaron pruebas de tendencia central, comparaciones y proyecciones. Resultados. En la muestra de 2011 hubo prevalencia de 11 por ciento de mujeres y 12,4 por ciento de hombres con glucemia en valores de prediabetes. En la de 2016, hubo 30,3 por ciento de mujeres y 40 por ciento en prediabetes. Hubo diferencia de los promedios de glucemia entre ambas muestras de 5,4 mg/dL (0,3 mmol/L) en mujeres, t = - 4,582 (p = 0,0001) y 10,81 mg/dL (0,6 mmol/L) en hombres, t = - 6,428 (p = 0,0001). No se encontró correlación con masa corporal. Conclusiones. En la muestra de 2016 hubo incremento en la prevalencia de prediabetes y de adultos jóvenes en riesgo de desarrollar diabetes mellitus de tipo 2, por lo que es necesario desarrollar estrategias para mejorar el estilo de vida.(AU)

Introduction. Given the dramatic increase of diabetes in the world, the aim of this research was to analyze the values of blood glucose in a university population again income to support strategies for detection and preventive management of pre-diabetes and diabetes. Methods. Study observational, analytical, transverse, non-probability. The blood glucose values were analyzed in fasting of 367 freshmen students from move income in 2011 and 430 in 2016 to the campus of Health Sciences from a University in the Southeast of Mexico. Testing central tendency, comparisons and projections were applied. Results. In the sample of 2011 there was prevalence of 11 percent of women and 12.4 percent of men with blood glucose values of pre-diabetes. In the 2016 there were 30.3 percent of women and 40 percent in pre-diabetes. There was a difference of blood glucose averages among both samples of 5.4 mg/dL (0.3 mmol/L) in women, t = - 4.582 (p = 0.0001) and 10.81 mg/dL (0.6 mmol/L) in males, t = - 6.428 (p = 0.0001). Correlation with body mass was not found. C Conclusions. In the sample of 2016 there was increase in the prevalence of pre-diabetes and young adults at risk of developing type 2 diabetes mellitus by what is needed to develop strategies to improve lifestyle.(AU)

Influência da profundidade do úbere na limpeza dos tetos e na saúde da glândula mamária em ordenha robótica / Influence of udder depth on cleaning teats and health of the mammary gland in robotic milking

O objetivo deste trabalho foi avaliar a influência da profundidade do úbere sobre a limpeza de tetos e a saúde da glândula mamária. O experimento foi desenvolvido no período de março a junho de 2014, em Castro, PR. Foram utilizadas 20 vacas da raça Holandesa confinadas em free stall e ordenhadas em sistema de ordenha robotizada (SOR). As vacas foram divididas em quatro grupos com cinco animais cada (duas primíparas e três multíparas), com base na distância do piso do úbere em relação ao jarrete (úbere profundo, normal, pequeno e raso). Os dados, registrados eletronicamente, foram coletados mensalmente, por quatro meses, referentes à semana do controle leiteiro oficial. Para avaliar a efetividade da limpeza dos tetos, foram feitos swabs de dois tetos contralaterais (anterior direito e posterior esquerdo) antes e após a limpeza automática, bem como foram esfregadas toalhas umedecidas, uma vez, ao redor dos outros tetos. Uma amostra de leite foi coletada por vaca para determinar a contagem de células somáticas (CCS). Na análise multivariada, foi observada relação da profundidade do úbere com a limpeza de tetos avaliada por meio do escore de limpeza de tetos com toalhas umedecidas (ELTT). Os úberes levemente acima do jarrete (normal) apresentaram menor CCS e contagem bacteriana total (CBT) dos tetos. Os úberes rasos apresentaram maior diferença no ELTT. As vacas com úberes profundo e raso apresentaram menor efetividade na limpeza de tetos e na saúde da glândula mamária. Vacas com úbere normal apresentaram conformação e sanidade da glândula mamária e contaminação de tetos mais adequadas à ordenha robótica. Em fazendas que pretendem introduzir o SOR, é recomendado selecionar vacas com úbere com profundidade um pouco acima do jarrete. O impacto do SOR na CBT dos tetos está relacionado à condição de limpeza deles na pré-ordenha e das instalações. Portanto, a condição de ambiência das vacas é fundamental para a saúde da glândula mamária e a obtenção de um leite com alta qualidade.(AU)

The aim of this study was to assess the influence of the depth of the udder on cleaning of teats and health of the mammary gland. The experiment was developed in the period spanning from March to June 2014, in Castro, PR. Twenty Holstein cows confined in free stall and milked in an automatic milking system (AMS) were used. The cows were divided into 4 groups with five animals (2 primiparous and 3 multiparous) based on the depth of the udder (udder depth: normal, small, and shallow). The electronically recorded data were collected monthly for four months, referring to the week of the official production milk control. To evaluate the effectiveness of cleaning teats, two contralateral teats were swabbed (right front quarter and left rear) before and after the automatic cleaning and once moistened towels were scrubbed around the other teats. A sample of milk was collected per cow to determine the somatic cell count (SCC). In the multivariate analysis relation of the udder depth with the teat cleaning was observed and evaluated through the teat cleaning with moistened towels score (TCTS). Udders slightly above the hocks (normal) had lower SCC and total bacterial count (TBC) of the teats. Shallow udders showed greater difference in TCTS. Cows with deep and shallow udders show less effective teat cleaning and health of the mammary gland. Cows with normal udders presented mammary gland conformation and health and contamination of teats most appropriate for robotic milking. On farms intending to introduce AMS it is recommended to select cows with udder depth which is a little above the hock. The impact of AMS on the TBC of the teats is related to the condition of cleaning of the teats pre-milking and housing conditions. Therefore, the condition of ambience of the cows is fundamental for the health of the mammary gland and obtaining high quality milk.(AU)

Efficacy and safety of a combination of hyaluronic acid, chondroitin sulfate, and poloxamer 407 as a submucosal injection solution for endoscopic resection: pilot study on a swine model.

BACKGROUND AND AIMS: Endoscopic resection techniques require use of submucosal injection. The aim of this study was to assess a new solution that combines hyaluronic acid, chondroitin sulfate, and poloxamer 407 for submucosal injection. METHODS: A total of 48 gastric submucosal cushions were created in fresh porcine stomachs using gelafundin (n = 16) or the new solution diluted at 50 % (n = 16), or 80 % (n = 16). The duration of mucosal elevation was measured. In an in vivo model, 10 gastric submucosal cushions were created by injecting 2 mL of the new solution at 80 % and the animal was euthanized 30 minutes after the last injection. RESULTS: Submucosal cushions with the new solution at 80 % and 50 % concentration lasted longer than with gelafundin (23.13 ±â€Š15.57, 13.1 ±â€Š6.6, 3.94 ±â€Š1.53 minutes, respectively; P  = 0.000). In the in vivo study, no damage or necrosis was observed in the mucosa or muscularis propria. CONCLUSION: The combination of hyaluronic acid, chondroitin sulfate, and poloxamer 407 produces a long-lasting submucosal cushion and does not seem to induce acute damage in the tissue making it suitable for submucosal injection.

The role of a computed tomography-based image registered navigation system for natural orifice transluminal endoscopic surgery: a comparative study in a porcine model.

BACKGROUND AND STUDY AIMS: Most natural orifice transluminal endoscopic surgery (NOTES) procedures have been performed in animal models through the anterior stomach wall, but this approach does not provide efficient access to all anatomic areas of interest. Moreover, injury of the adjacent structures has been reported when using a blind access. The aim of the current study was to assess the utility of a CT-based (CT: computed tomography) image registered navigation system in identifying safe gastrointestinal access sites for NOTES and identifying intraperitoneal structures. METHODS: A total of 30 access procedures were performed in 30 pigs: anterior gastric wall (n = 10), posterior gastric wall (n = 10), and anterior rectal wall (n = 10). Of these, 15 procedures used image registered guidance (IR-NOTES) and 15 procedures used a blind access (NOTES only). Timed abdominal exploration was performed with identification of 11 organs. The location of the endoscopic tip was tracked using an electromagnetic tracking system and was recorded for each case. Necropsy was performed immediately after the procedure. The primary outcome was the rate of complications; secondary outcome variables were number of organs identified and kinematic measurements. RESULTS: A total of 30 animals weighting a mean (± SD) of 30.2 ± 6.8 kg were included in the study. The incision point was correctly placed in 11 out of 15 animals in each group (73.3 %). The mean peritoneoscopy time and the number of properly identified organs were equivalent in the two groups. There were eight minor complications (26.7 %), two (13.3 %) in the IR-NOTES group and six (40.0 %) in the NOTES only group ( P = n. s.). Characteristics of the endoscope tip path showed a statistically significant improvement in trajectory smoothness of motion for all organs in the IR-NOTES group. CONCLUSION: The image registered system appears to be feasible in NOTES procedures and results from this study suggest that image registered guidance might be useful for supporting navigation with an increased smoothness of motion.

[Unusual case: injury of the 4 heart valves in a patient with old heart injury caused by fire arm. Review of the literature]. / Un caso insólito: lesión de las 4 válvulas cardiacas en un paciente con lesión cardiaca antigua por proyectil de arma de fuego. Revisión de la literatura.

We review the literature on heart wounds. Along the history surgeons regarded heart wounds as forbidden place for therapeutic approach. We present a patient who sustained a bullet wound to the heart and two years later 3 knife' stabs in the same place injuring its 4 valves and inducing 2 fistulae: one from the aorta to the pulmonary artery, the other from left-ventricle and the pulmonary artery. Surgery was successful in repairing the damage without the need of valve replacement.

The presence of Helicobacter pylori in nonoperated duodenal ulcer patients compared to patients late after highly selective vagotomy.

There are many recent studies that clearly suggest that Helicobacter pylori (HP) is an etiological agent for duodenal ulcer disease (1-3). Randomized trials have shown that duodenal ulcers treated by omeprazole or H2 blockers heal faster if HP is eradicated concurrently (4-6). Besides, several studies have demonstrated that eradication of HP significantly reduces duodenal ulcer relapses (7-9). Patients followed up to 7 years after eradication of HP demonstrated that 92% remained HP negative, with only 3% recurrence (10). Highly selective vagotomy has been the treatment of choice for duodenal ulcer patients who are candidates for surgical therapy (11, 12). The late results have shown an approximately 10% recurrence rate 8 to 10 years after surgery (13, 14). We hypothesized that in these asymptomatic cases after HSV, HP probably will exist in a minor proportion of cases, similar to what happens after successful medical antiulcer therapy. Therefore the purpose of the present study was to determine the HP status at the antrum in a group of nonoperated duodenal ulcer patients compared to a group submitted to highly selective vagotomy many years prior to the actual study.

[Endoscopic location of squamous columnar mucosal changes in patients with different degrees of pathologic gastroesophageal reflux]. / Localización endoscópica del cambio de mucosa escamoso-columnar en pacientes con diferentes grados de reflujo gastroesofágico patológico.

BACKGROUND: There is little information about the precise location of the squamous columnar mucosal junction in the Chilean population. AIM: To study endoscopically, the location of the squamous columnar mucosal junction in patients with esophageal disease. PATIENTS AND METHODS: The location of the squamous columnar mucosal junction was prospectively studied by endoscopy in 347 subjects with normal upper gastrointestinal endoscopy, 117 patients with chronic gastroesophageal reflux without esophagitis, 117 patients with erosive esophagitis, 63 patients with short Barret's esophagus and 28 patients with an extensive Barret's esophagus. RESULTS: No differences in the mucosal junction location were observed between controls and patients with gastroesophageal reflux or erosive esophagitis. In patients with Barret's esophagus, the junction was more proximal. In women, the junction was three cm more proximal than in men, probably due to their shorter stature. CONCLUSIONS: Women have a more proximal squamous columnar mucosal junction than men.

Effect of high-protein diet on renal concentration capacity in rabbits.

In the present studies, we have found that New Zealand White rabbits kept on normal rabbit chow (16% protein, LP) are unable to raise fractional free water reabsorption [TCH2O divided by glomerular filtration rate (GFR)] as the fractional osmotic load (Cosm/GFR) is increased. Acute administration of urea (400 mosmol/l) or indomethacin (10 mg/kg iv bolus, followed by 0.25 mg/min infusion) corrects the defect. Moreover, rabbits kept for 2 wk on a 40% protein diet (HP) showed marked improvement in their renal concentration capacity. Balance studies showed that, in rabbits on HP, urine prostaglandin E2 (PGE2) excretion was lower while GFR, urine urea, and osmolar excretion were significantly higher than in rabbits in the LP group. Medullary tissue electrolytes in the HP vs. LP group were as follows: urea, 1,035 +/- 90 vs. 790 +/- 60 mmol.l-1 x g wet tissue wt-1; tissue Na+, 548 +/- 96 vs. 298 +/- 37 meq.l-1 x g wet wt-1; and K+, 201 +/- 43 vs. 99 +/- 16 meq.l-1 x g wet wt-1. Also, medullary slices from animals on HP had a lower PGE2 synthesis than those on LP when stimulated with angiotensin II (ANG II). Papillary plasma flow (PPF) measured by the accumulation of 125I-labeled albumin, after infusion of vasopressin, was 13.7 +/- 2.0 in the HP group and 22.7 +/- 3.4 ml.min-1 x 100 g-1 in the LP group. These findings suggest that lower PPF and higher urea and electrolyte content in the medullary interstitium of HP intake results from inability to produce medullary PGE2 even during ANG II or antidiuretic hormone (ADH) stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Cellular and molecular aspects of the renal effects of diuretic agents.

In the past few years, increased knowledge of the nature of transport proteins and their molecular regulation in the translocation of ions across kidney membranes has emerged. We are beginning to better understand the characteristics of the interaction of diuretics with these transport proteins. It is likely that this knowledge will permit further insight into nephron function regulation.

Chronic indomethacin increases rabbit cortical collecting tubule Na+-K+-ATPase activity.

To help determine whether prostaglandin-mediated inhibition of transport in the isolated rabbit cortical collecting tubule (CCT) is related to a suppression of sodium pump activity, adrenalectomized rabbits on replacement dexamethasone were treated for 3 days with vehicle or the prostaglandin inhibitor, indomethacin. On the day of death, rabbits treated with indomethacin had a significantly reduced urinary prostaglandin E2 (PGE2) excretion rate compared with vehicle-treated animals (107 +/- 7 vs. 415 +/- 129 ng.kg body wt-1.day-1, indomethacin vs. vehicle, P less than 0.05). In addition, CCTs obtained from indomethacin-treated rabbits had a significantly higher Na+-K+-ATPase activity than controls (2.66 +/- 0.33 vs. 1.17 +/- 0.33 mol Pi.kg dry wt-1.h-1, 37 degrees C, P less than 0.005); Mg-ATPase activity was invariant. Despite the elevated CCT Na+-K+-ATPase activity, there was no evidence of a sustained increase in Na reabsorption and/or K excretion by the kidney. Thus at death, the fractional excretions of Na and K, urinary Na/K ratios and plasma K values in rabbits given indomethacin were not significantly different from control values. There was also no evidence for a direct effect of either indomethacin or PGE2 on Na+-K+-ATPase activity when added directly to CCT broken-cell assays. Therefore in vivo chronic indomethacin administration leads to a rise in CCT Na+-K+-ATPase activity, which is coincident with a fall in urinary PGE2, suggesting that endogenous PGE2 may suppress the activity of this enzyme by a cell-mediated process.

Experimental reproduction of leprosy in seven-banded armadillos (Dasypus hybridus).

Four autochthonous seven-banded armadillos (Dasypus hybridus) from Argentina which developed disseminated leprosy are reported. The average time from inoculation to death was 14.6 months. Acid-fast bacilli (AFB) were found in the skin, nerves, spleen, lymph nodes, lungs, meninges, and striated muscle. Several tests were used to prove that the AFB found in the infected animals were Mycobacterium leprae: a) failure to grow in standard culture media for mycobacteria, b) extraction of acid-fastness with the pyridine test, c) patterns of growth in the mouse foot pad, and d) histopathologic features.

Ictiosis ligada al sexo. / Ichthyosis linked to sex

Se estudio un paciente con ILS efectuandose una revision bibliografica de la fisiopatologia, conjuntamente con la deficiencia de la enzima sulfatasa esteroidea y se estudiaron los mecanismos por los cuales se producen alteraciones en el trabajo de parto

Ictiosis ligada al sexo. / Ichthyosis linked to sex

Se estudio un paciente con ILS efectuandose una revision bibliografica de la fisiopatologia, conjuntamente con la deficiencia de la enzima sulfatasa esteroidea y se estudiaron los mecanismos por los cuales se producen alteraciones en el trabajo de parto