The 2024 French guidelines for scenario design in simulation-based education: manikin-based immersive simulation, simulated participant-based immersive simulation and procedural simulation.

BACKGROUND: Simulation-based education in healthcare encompasses a wide array of modalities aimed at providing realistic clinical experiences supported by meticulously designed scenarios. The French-speaking Society for Simulation in Healthcare (SoFraSimS) has developed guidelines to assist educators in the design of scenarios for manikin- or simulated participant- based immersive simulation and procedural simulation, the three mainly used modalities. METHODS: After establishing a French-speaking group of experts within the SoFraSimS network, we performed an extensive literature review with theory-informed practices and personal experiences. We used this approach identify the essential criteria for practice-based scenario design within the three simulation modalities. RESULTS: We present three comprehensive templates for creating innovative scenarios and simulation sessions, each tailored to the specific characteristics of a simulation modality. The SoFraSimS templates include five sections distributed between the three modalities. The first section contextualizes the scenario by describing the practicalities of the setting, the instructors and learners, and its connection to the educational program. The second section outlines the learning objectives. The third lists all the elements necessary during the preparation phase, describing the educational method used for procedural simulation (such as demonstration, discovery, mastery learning, and deliberate practice). The fourth section addresses the simulation phase, detailing the behaviors the instructor aims to analyze, the embedded triggers, and the anticipated impact on simulation proceedings (natural feedback). This ensures maximum control over the learning experience. Finally, the fifth section compiles elements for post-simulation modifications to enhance future iterations. CONCLUSION: We trust that these guidelines will prove valuable to educators seeking to implement simulation-based education and contribute to the standardization of scenarios for healthcare students and professionals. This standardization aims to facilitate communication, comparison of practices and collaboration across different learning and healthcare institutions.

'What this article adds'1. The SoFraSimS provides guidelines to facilitate the development of simulation-based activities.2. These guidelines are theory-informed as well as evidence and experience-based.3. A detailed approach to writing a complete activity or scenario for procedural and immersive simulation including manikins or simulated participants is provided (the 'SoFraSimS templates').4. This work aims at standardizing practices and exchanging scenarios between simulation centers.

Ex vivo comparison of pin placement with patient-specific drill guides or freehand technique in canine cadaveric spines.

OBJECTIVE: To compare vertebral implant placement in the canine thoracolumbar spine between 3D-printed patient-specific drill guides (3DPG) and the conventional freehand technique (FH). STUDY DESIGN: Ex vivo study. ANIMALS: Cadaveric canine spines (n = 24). METHODS: Implant trajectories were established for the left and right sides of the T10 through L6 vertebrae based on computed tomography (CT) imaging. Customized drill guides were created for each vertebra of interest. Each cadaver was randomly assigned to one of six veterinarians with varying levels of experience placing vertebral implants. Vertebrae were randomly assigned a surgical order and technique (3DPG or FH) for both sides. Postoperative CT images were acquired. A single, blinded observer assessed pin placement using a modified Zdichavsky classification. RESULTS: A total of 480 implants were placed in 240 vertebrae. Three sites were excluded from the analysis; therefore, a total of 238 implants were evaluated using the FH technique and 239 implants using 3DPG. When evaluating implant placement, 152/239 (63.6%) of 3DPG implants were considered to have an acceptable placement in comparison with 115/248 (48.32%) with FH. Overall, pin placement using 3DPG was more likely to provide acceptable pin placement (p < .001) in comparison with the FH technique for surgeons at all levels of experience. CONCLUSION: The use of 3DPG was shown to be better than the conventional freehand technique regarding acceptable placement of implants in the thoracolumbar spine of canine cadavers. CLINICAL SIGNIFICANCE: Utilizing 3DPG can be considered better than the traditional FH technique when placing implants in the canine thoracolumbar spine.

Characteristics Upon Presentation of Patients with Type 2 Macular Telangiectasia in Puerto Rico.

OBJECTIVE: To describe the systemic disease associations and clinical features upon initial presentation of a cohort of patients with type 2 macular telangiectasia who live in Puerto Rico. METHODS: A retrospective review of patients with macular telangiectasia was performed in 4 private retina practices in Puerto Rico. The demographic and clinical characteristics were recorded. RESULTS: Twenty-one patients who were diagnosed with macular telangiectasia were included in the analysis. The median age of presentation was 62 years; 86% were female, and all patients were Hispanics. The median visual acuity at presentation was 20/50. A prior medical diagnosis of type II diabetes mellitus was found in 15 (71.4%) patients, essential hypertension in 12 (57.1%), and dyslipidemia in 9 (42.9%). All patients had bilateral disease. The most common ocular findings were the presence of right-angle vessels in 32 (76.2%) eyes and angiographic hyperfluorescence temporal to the fovea, found in 22 (52.4%) of the affected eyes. One eye had evidence of choroidal neovascularization. CONCLUSION: Our cohort showed a higher prevalence of type 2 diabetes in patients with type 2 macular telangiectasia than in other cohorts. It also supports the findings of other studies showing that macular telangiectasia patients are more likely to have type 2 diabetes and hyperlipidemia. However, the increased prevalence of diabetes and hyperlipidemia may be due to selection bias, and further studies are needed to assess the significance of these findings.

Miopericarditis aguda por Mycoplasma pneumonae en un niño de 5 años / Acute myopericarditis caused by Mycoplasma pneumonae in a 5 years old child

RESUMEN Las infecciones causadas por Mycoplasma pneumonae han sido reconocidas a nivel mundial y es un patógeno común de las infecciones de las vías respiratorias altas y bajas. La pericarditis aguda está a menudo acompañada por un grado de miocarditis y en la práctica clínica la pericarditis y miocarditis coexisten por su etiología en común y en su mayoría por virus cardiotrópos. A continuación, presentamos el caso muy poco común reportado de miopericarditis causada por Mycoplasma pneumonae en un niño de 5 años, con una evolución clínica interesante.

ABSTRACT Infections caused by Mycoplasma pneumoniae are well recognized all over the world, and this microorganism is a common pathogen affecting the lower respiratory tract. Acute pericarditis is often accompanied by myocarditis, and both conditions coexist in clinical practice because they have common etiologic agents, mainly cardiotropic viruses. We present a very unusual case of myopericarditis caused by Mycoplasma pneumoniae affecting a 5 year-old child, who developed an interesting clinical outcome.

Vacuna hexavalente en el Perú. Hacia la cobertura segura y sostenida de la vacunación en la infancia. Consenso de expertos / Hexavalent vaccine in Peru. Towards safe and sustained coverage of childhood immunization. Expert consensus

Objetivo. La inmunización es una de las intervenciones más importantes para prevenir la morbimortalidad en la población mundial. No obstante, aún persisten brechas para alcanzar coberturas ideales de vacunación. Además, las múltiples dosis y vacunas dificultan alcanzar las metas mínimas establecidas. Por ello, se desarrollan vacunas combinadas y fraccionadas para reducir el número de inyecciones, errores programáticos, reactogenicidad y mejorar la adherencia. En tres días distintos, durante 9 horas, se reunieron 6 médicos pediatras expertos en vacunas en el Perú siguiendo el método RAND/UCLA, con el objeto de elaborar un consenso de opinión y actualización de la vacuna combinada hexavalente [DTaP+Haemophilus influenzae tipo b (Hib)+Hepatitis B (HVB)+antipolio inactivada (IPV)] y su eventual uso en el Programa ampliado de inmunizaciones (PAI). Las recomendaciones del consenso son: reemplazar las vacunas, antipolio oral (OPV) por IPV, pertussis de células enteras por vacunas acelulares y DTP de los 4 años por dTap entre los 4 y 6 años; usar la vacuna hexavalente para la serie primaria (2, 4 y 6 meses); usar 4 dosis de vacuna contra Hib (2, 4, 6 y 18 meses); incorporar la vacuna hexavalente en el PAI; no usar la IPV fraccionada (fIPV) y administrar solo 4 dosis de IPV.

Objetive. Immunization is one of the most important interventions to prevent morbidity and mortality in the world population. However, gaps persist to achieve ideal vaccination coverage. In addition, the multiple vaccines and necessary doses make it difficult to reach the minimum established goals. On this scenario, combined and fractionated vaccines are being developed with the aim of reducing the injections number, programmatic errors, reactogenicity and improving adherence. On three different days, for 9 hours, 6 pediatricians experts in vaccines in Peru met following the RAND/UCLA method in order to develop a consensus opinion and update of the combined hexavalent vaccine [DTaP+Haemophilus influenzae type b (Hib)+Hepatitis B (HVB)+Inactivated Polio Vaccine (IPV)] and its eventual use in the Extended Immunization Program (EPI). The consensus recommendation are: replace the vaccines, Oral Polio Vaccine (OPV) by IPV, pertussis of whole cells by acellular vaccines and DTP of 4 years old by dTap between 4 and 6 years old; use the hexavalent vaccine for the primary series (2, 4 and 6 months); use 4 doses of Hib vaccine (2, 4, 6 and 18 months); incorporate the hexavalent vaccine in the EPI; do not use fractionated IPV (fIPV) and only administer 4 doses of IPV.

Effects of variable durations of food availability on interval time-place learning with pigeons Columba Livia.

We assessed the effects of variable durations of food availability on an interval time-place learning task. 3 pigeons were exposed to a task in which food could be obtained for responses in one of four feeders according to an RI 25 s during 3 min, after which, food could be obtained on a different feeder according to the same schedule. The correct feeder changed following a fixed sequence that was repeated four times throughout the session. After 50 training sessions, an Open Hopper Test was conducted, after which, the second training condition ensued. This condition was like the first one with the exception that the availability period could be either 1,2,3, or 6 min long. A second test was conducted after 50 sessions of this training. Another group of 3 birds experienced these conditions in the reverse order. Data suggest that birds solved the task via interval timing under the fixed duration condition, and via ordinal timing when faced with variable durations. Birds learned the fixed sequence involved in the task under both conditions. Although the present data agree with previous research exploring variability in TPL tasks, they do not necessarily support previous claims for an asymmetrical role of spatial and temporal information in these tasks.

Crecimiento y mortalidad de Haemulon plumieri (Perciformes: Haemulidae) en el archipiélago Los Frailes, Venezuela

El corocoro margariteño Haemulon plumieri es muy abundante en la región nororiental de Venezuela, pero los aspectos biológicos y pesqueros han sido poco estudiados en este país. El objetivo de este estudio fue estimar el crecimiento y la mortalidad de este recurso. De enero a diciembre 2014 se realizaron muestreos mensuales y se obtuvieron 2 967 ejemplares, de los cuales se registró la longitud total (cm) y peso (g) de cada uno. Se encontró que no existe diferencia entre sexos con respecto a la longitud (ts = 0.093; P > 0.05), por lo que se estimó la relación longitud-peso para ambos sexos: P = 1.4x10-3 * L2.99, mostrando un crecimiento isométrico. Se utilizaron las rutinas del paquete FiSAT para estimar los parámetros del modelo de crecimiento individual de von Bertalanffy: L∞ = 30.95 cm, k = 0.67/año, P∞ = 418.17 g, t0 = -0.24 años. Se calculó una edad máxima de 4 años. El coeficiente de variación del índice de desempeño de crecimiento (Ø′) para el método directo (CV = 5.26 %) mostró una variabilidad en el patrón de crecimiento según la región. La tasa de mortalidad natural (M = 1.36/año) fue alta, posiblemente por causa de depredación y enfermedades, entre otros. Las tasas de mortalidad por pesca (F = 1.95/año) y mortalidad total (Z = 3.31/año) fueron altas. La tasa de explotación (E = 0.59/año) indica que es probable que H. plumieri esté sobreexplotado.

The white grunt Haemulon plumieri is abundant in northeastern Venezuela, but the biological and fishery aspects of this species have been little studied in the country. The objective of this study was to estimate the growth and mortality of this resource. We collected samples monthly from January to December 2014, obtaining 2 967 specimens. Total length (cm) and weight (g) were determined for each specimen. No sexual dimorphism was shown with respect to length (tS = 0.093; P > 0.05). Thus, one length-weight ratio was established for both sexes: W = 1.4×10-3* L2.99, which showed isometric growth. FiSAT package routines were used to estimate the growth parameters of the individual growth model of von Bertalanffy: L ∞ = 30.95 cm, k = 0.67/year, W ∞ = 418.17 g, t0 = -0.24 years. We estimated a max age of 4 years. The coefficient of variation of the growth performance index (Ø′) for the direct method (CV = 5.26 %) showed a variability in growth patterns according to region. The rate of natural mortality (M = 1.36/year) was high, possibly due to predation and disease, among others. Rates of fishing mortality (F = 1.95/year) and total mortality (Z = 3.31/year) were high. The exploitation rate (E = 0.59/year) indicates that H. plumieri is likely overexploited.

Evidence of non-circadian timing in a low response-cost daily Time-Place Learning task with pigeons Columba Livia.

Previous research has shown that rats require high response cost in order to display circadian timing in daily Time-Place Learning (TPL) tasks. For many possible reasons, no explicit effort to explore the effects of response cost on the performance of other species in these tasks has been made. Therefore, the present paper explores the effects of response cost on pigeon's performance on a daily TPL task. Head entry responses were reinforced according to a Random Interval schedule of reinforcement on one feeder during morning sessions and on another feeder during afternoon sessions. Feeders were located 8 cm apart for one group of birds (Group Near) and 56 cm apart for another group (Group Far). After 50 training sessions, testing began. Test sessions consisted of skipping either the morning or the afternoon session. Results show that most birds in the near group respond primarily on the opposite feeder during the first 20 s of the test sessions and then they switch to the correct feeder. On the other hand, most birds in Group Far respond at the same rate on both opposite and correct feeders during 20 s, and then they respond primarily on the correct feeder. The possibility of these data revealing non circadian timing for birds in a low response-cost daily TPL task is discussed along with the implications of such a finding for previous literature that claims that this type of performance could be unique to rats.

Crecimiento y mortalidad del pez Canthidermis sufflamen (Perciformes: Balistidae) de los archipiélagos Los Frailes y Los Testigos, Venezuela / Growth and mortality of the triggerfish Canthidermis sufflamen (Perciformes: Balistidae) from Los Frailes and Los Testigos Archipelagos, Venezuela

ResumenEn la comunidad pesquera de El Tirano, estado Nueva Esparta, Venezuela, la especie Canthidermis sufflamen se ha convertido en un recurso con una alta demanda para el consumo debido su bajo costo, por lo que su captura ha venido incrementándose en los últimos años. Debido a la escasa información existente sobre la dinámica poblacional de este recurso, y con la finalidad de aportar algunos parámetros biológico-pesqueros se planteó como objetivo general determinar el crecimiento y mortalidad de Canthidermis sufflamen en los archipiélagos Los Frailes y Los Testigos, Dependencias Federales de Venezuela, durante el período mayo 2012 y abril 2013, se obtuvo un total de 3 595 ejemplares capturados con nasa por la flota artesanal de El Tirano. A cada ejemplar se le tomó datos de longitud total (cm), peso total (g) y se determinó el sexo. Se comprobó que no existe diferencia sexual con respecto a longitud (ts = -0.96; p > 0.05), la relación longitud-peso para ambos sexos fue: P = 0.164*L2.26, lo que evidencia un crecimiento alométrico minorante. La estimación del crecimiento se basó en el análisis de la distribución de frecuencia de longitudes, con uso del software FiSAT. Los parámetros de crecimiento estimados (L∞ = 61.69 cm, P∞ = 1 868.402 g, k = 0.36 / año y to = -0.654 años) mostraron un crecimiento lento. La edad límite fue A0.95 = 8 años. El índice de crecimiento (Ø′) obtuvo un valor de 3.14. La tasa de explotación E = 0.72 / año calculada a través de la mortalidad total Z = 2.67 / año, natural M = 0.73 / año y por pesca F = 1.93 / año, indica que C. sufflamen está siendo sobre explotada por la pesca artesanal de El Tirano; por consiguiente se sugiere regular la pesquería, reduciendo la tasa de mortalidad por pesca.

AbstractCanthidermis sufflamen has become a low cost food resource in high demand in El Tirano fishing community, and captures have been increasing in recent years. Since there is a lack of information on this resource population dynamics in Venezuela, the goal of this research was to provide some biological-fishery parameters, and has as general objective to determine growth and mortality of the triggerfish of Los Frailes and Los Testigos Archipelagos, Federal Territories of Venezuela. For this, a total of 3 595 specimens were collected from El Tirano commercial fishing, every week, from May 2012 to April 2013. We determined total length (cm), total weight (g), and sex for each specimen. No sexual dimorphism was shown with respect to length (ts = -0.96; p > 0.05), so one length-weight ratio was established for both sexes: W = 0.164*L2.26; and they both exhibited minor allometric growth. Growth was estimated by analysis of the frequency distribution of lengths, using FiSAT software. Growth parameters, estimated by the von Bertalanffy model, were considered slow, being L∞ = 61.69 cm, W∞ = 1 868.402 g, k = 0.36 / year, and to = -0.654 years. The maximum age was A0.95 = 8 years. The growth index (Ø′), showed a value of 3.14. The exploitation rate E = 0.72 / year, using total mortality values Z = 2.67 / year, natural M = 0.73 / year and from fishing F = 1.93 / year, indicates that C. sufflamen is being over-exploited by the artisanal fishers of El Tirano. We recommend following some harvest guidelines that will reduce mortality rate due to fishing. Rev. Biol. Trop. 65 (3): 858-867. Epub 2017 September 01.

Triple Pelvic Osteotomy and Double Pelvic Osteotomy.

Triple and double pelvic osteotomy (TPO, DPO) are performed with the goal of increasing acetabular ventro-version, increasing femoral head coverage, and decreasing femoral head subluxation. Since the first descriptions of TPO, there have been modifications in technique, most notably omission of the ischial osteotomy for DPO, and improvements in the implants, including availability of locking TPO/DPO bone plates. Associated complication rates seem to have declined accordingly. The most salient questions regarding these procedures remain what selection criteria should be used to identify candidates and whether halting or preventing osteoarthritis is necessary to consider these surgeries clinically beneficial.

[Simulation for the announcement of health care-associated harm]. / La simulation pour l'annonce des dommages associés aux soins.

A participative pedagogical tool, simulation aids the transfer of competencies in relation to the complex situation of announcing health care-associated harm. The aim is to reinforce patient safety and to improve the quality of communication with patients and between health professionals.

[Growth and mortality parameters of Orthopristis ruber (Perciformes: Haemulidae) from Los Frailes Archipelaeo. Venezuela]. / Parametros de crecimiento y mortalidad de Orthopristis ruber (Perciformes: Haemulidae) en el archipielago Los Frailes, Venezuela.

Orthopristis ruber is a species in high demand in Eastern Venezuela, but production has been decreasing in recent years. For this reason, our objective was to estimate the growth and mortality parameters of this resource. Monthly samples were collected from June 2011 to May 2012, obtaining 2980 specimens in El Tirano and Puerto Abajo. Data on total length (cm), total weight (g), and sex were recorded for each specimen. No sexual dimorphism was shown with respect to length (t(S)=1.113, p>0.05), so one length-weight ratio was established for both sexes (Wt=0.0612*Lt(2.54)); and they both exhibited minor allometric growth. Growth was estimated by analysis of length frequency distributions using FiSAT software. The estimated growth parameters (L.=39.03cm, W.=679.60g, k=0.48/year and t(O) = -0.32 year) showed moderately rapid growth. Length frequency data were adjusted to the von Bertalaniffy model, and indicated an exponential tendency of accelerated growth during the first years of life, followed by slow growth until the fish reached its maximum length. The coefficient of variation of the growth index (theta) demonstrated no differences in growth pattern. The natural mortality rate (M=0.97/year), from fishing (F=1.57/year), and total mortality (Z=2.54/year), were high, as well as the exploitation rate (E=0.62/year). We concluded that O. ruber has been fully exploited by artisanal fishers, and suggest a continuous study on population dynamics, to recommend optimum management techniques for the fishery.

Surgical Site Infections Rates in More Than 13,000 Surgical Procedures in Three Cities in Peru: Findings of the International Nosocomial Infection Control Consortium.

BACKGROUND: Surgical site infections (SSIs) are a threat to patient safety. However, there are not available data on SSI rates stratified by surgical procedure (SP) in Peru. METHODS: From January 2005 to December 2010, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in four hospitals in three cities of Peru. Data were recorded from hospitalized patients using the U.S. Centers for Disease Control and Prevention-National Healthcare Safety Network (CDC-NHSN) methods and definitions for SSI. Surgical procedures (SPs) were classified into 4 types, according to ICD-9 criteria. RESULTS: We recorded 352 SSIs, associated to 13,904 SPs (2.5%; CI, 2.3-2.8) SSI rates per type of SP were the following for this study's Peruvian hospitals, compared with rates of the INICC and CDC-NHSN reports, respectively: 2.9% for appendix surgery (vs. 2.9% vs. 1.4%); 2.8% for gallbladder surgery (vs. 2.5% vs. 0.6%); 2.2% for cesarean section (vs. 0.7% vs. 1.8%); 2.8% for vaginal hysterectomy (vs. 2.0% vs. 0.9%). CONCLUSIONS: Our SSIs rates were higher in all of the four analyzed types of SPs compared with CDC-NHSN, whereas compared with INICC, most rates were similar. This study represents an important advance in the knowledge of SSI epidemiology in Peru that will allow us to introduce targeted interventions.

Biología y pesquería del pulpo Octopus vulgaris (Octopoda: Octopodidae) en las costas del estado Nueva Esparta, Venezuela / Octopus vulgaris (Octopoda: Octopodidae) biology and fishery on the shores of Nueva Esparta state, Venezuela

In the State of Nueva Esparta, Venezuela, the fishery of octopus Octopus vulgaris is considered an alternative activity by the artisanal fishers to diversify production and to increase their income. Nevertheless, the inter annual fluctuations that have been witnessed in recent years, suggest that this resource requires an urgent analysis of the species reproduction, growth, mortality and the fishery activity, in order to provide a scientific basis to develop sustainable management strategies. For this, weekly samples were collected during the June-December 2012 El Tirano fishing season. Mantle length (ML), total weight (TW), sex and stage of gonadal development were recorded for 1 268 males (9-25cm ML) and 818 females (9-22cm ML). The monthly sex ratio differed from one, except in June and August, with a high percentage of mature individuals in both sexes. Minimum and average sizes were: 11cm ML (428g) and 16cm ML (1 142g) in sexually mature males, and 12cm ML (476g) and 15.35cm ML (844g) in sexually mature females. The length-weight relationship of males (TW=0.7994*ML2.62) and females (TW=1.4552*ML2.33) showed minor allometric growth. Growth was estimated by analysis of the frequency distribution of lengths, using FiSAT software. Growth parameters, estimated by the von Bertalanffy model, were considered rapid, being L∞=26.26cm, W∞=3 769g, k=2.3/year, and t o=-0.015/year, in males; and L∞=24.28cm, W∞=2 287g, k=1.8/year, and t o=-0.09/year, in females. The maximum age in males was A0.95=1.3 years and A0.95=1.57 years in females. Octopus captures were directly significant with superficial water temperature, but negatively significant with wind velocity and precipitation, which corresponds to a study zone with seasonal hydrologic variability. The actual exploitation rate (E=0.61/year in males, E=0.60/year in females) was calculated by using the values of total mortality (Z=7.73/year in males, Z=6.63/year in females), for fishing (F=4.7/year in males, F=3.99/year in females), and natural (M=3.03/year in males, M=2.64/year in females), indicating that the octopus is over-exploited. Consequently, we recommend regulating the fishery by reducing the fishing mortality rate. Rev. Biol. Trop. 63 (2): 427-442. Epub 2015 June 01.

En el estado Nueva Esparta, Venezuela, la pesca del pulpo Octopus vulgaris es considerada por los pescadores artesanales como una actividad alternativa para diversificar la producción y aumentar los ingresos, pero en los últimos años han venido experimentando fluctuaciones interanuales considerables. La necesidad de gestionar el recurso de una forma racional y responsable, impuso analizar algunos aspectos de la reproducción, crecimiento, mortalidad y pesquería, de modo que sirvan de base científica para llevar a cabo estrategias de manejo. Con el fin de cumplir con los objetivos, las muestras se obtuvieron durante la temporada de pesca junio-diciembre 2012 con una periodicidad semanal. A cada uno de los especímenes se le registró la longitud del manto (Lm), peso total (Pt), sexo y estado de madurez gonádica. Se procesaron 1 268 machos de 9 a 25cm Lm y 818 hembras de 9 a 22cm Lm; la proporción de sexo mensual fue diferente a uno excepto junio y agosto, con un alto porcentaje de maduros en ambos sexos. Las tallas mínima y media de madurez sexual en machos fueron: 11cm (428g) y 16cm (1 142g); mientras que en hembras 12cm (476g) y 15.35cm (844g). La relación longitud-peso de machos: Pt=0.7994*Lm2.62 y hembras: Pt=1.4552*Lm2.33 expresaron un crecimiento alométrico minorante. La estimación del crecimiento se basó en el análisis de la distribución de frecuencia de longitudes, para ello se usó el software FiSAT. Los parámetros de crecimiento estimados del modelo de von Bertalanffy fueron en machos: L∞=26.26cm, P∞=3 769g, k=2.3/año, t o=-0.015/año y en hembras: L∞=24.28cm, P∞=2 287g, k=1.8/año, t o=-0.09/año, mostraron un crecimiento rápido. La edad límite en machos fue de 1.30 años y en hembras de 1.57 años. Se observó asociación significativa y positiva de la captura del pulpo con la temperatura superficial del mar y negativa con la velocidad del viento y precipitación, que corresponde con la variabilidad hidrológica estacional de la zona de estudio. Se calculó la tasa de explotación actual (E=0.61/año en machos; E=0.60/año en hembras) a través de los valores de mortalidad total (Z=7.73/año en machos; Z=6.63/año en hembras), por pesca (F=4.7/año en machos; F=3.99/año en hembras) y natural (M=3.03/año en machos; M=2.64/año en hembras), indicando que el pulpo se encuentra sobreexplotado; por consiguiente se recomienda regular la pesquería, reduciendo la tasa de mortalidad por pesca.

Parámetros de crecimiento y mortalidad de Orthopristis ruber (Perciformes: Haemulidae) en el archipiélago Los Frailes, Venezuela / Growth and mortality parameters of Orthopristis ruber (Perciformes: Haemulidae) from Los Frailes Archipelago, Venezuela

Orthopristis ruber is a species in high demand in Eastern Venezuela, but production has been decreasing in recent years. For this reason, our objective was to estimate the growth and mortality parameters of this resource. Monthly samples were collected from June 2011 to May 2012, obtaining 2 980 specimens in El Tirano and Puerto Abajo. Data on total length (cm), total weight (g), and sex were recorded for each specimen. No sexual dimorphism was shown with respect to length (t s=1.113, p>0.05), so one length-weight ratio was established for both sexes (Wt=0.0612*Lt2.54); and they both exhibited minor allometric growth. Growth was estimated by analysis of length frequency distributions using FiSAT software. The estimated growth parameters (L∞=39.03cm, W∞=679.60g, k=0.48/year and t o=-0.32year) showed moderately rapid growth. Length frequency data were adjusted to the von Bertalanffy model, and indicated an exponential tendency of accelerated growth during the first years of life, followed by slow growth until the fish reached its maximum length. The coefficient of variation of the growth index (Ø’) demonstrated no differences in growth pattern. The natural mortality rate (M=0.97/year), from fishing (F=1.57/year), and total mortality (Z=2.54/year), were high, as well as the exploitation rate (E=0.62/year). We concluded that O. ruber has been fully exploited by artisanal fishers, and suggest a continuous study on population dynamics, to recommend optimum management techniques for the fishery.

Orthopristis ruber es una especie de gran demanda en el oriente de Venezuela cuya producción se ha visto disminuida en los últimos años. Por esta razón, se planteó como objetivo estimar los parámetros de crecimiento y mortalidad del recurso. Se realizaron muestreos mensuales de junio 2011 a mayo 2012, para un total de 2 980 ejemplares recolectados en El Tirano y Puerto Abajo. A cada ejemplar se le tomó datos de longitud total (cm), peso total (g) y se determinó el sexo. Se comprobó que no existe diferencia sexual con respecto a longitud (t s=-1.113; p>0.05), la relación longitud-peso para ambos sexos fue: Pt=0.0612*Lt2.54, lo que evidencia un crecimiento alométrico minorante. La estimación del crecimiento se basó en el análisis de la distribución de frecuencia de longitudes, con uso del software FiSAT. Los parámetros de crecimiento estimados (L∞=39.03cm, P∞=679.60g, k=0.48/año y t o=-0.32año) mostraron un crecimiento moderadamente rápido. Los datos de frecuencias de longitudes fueron ajustados al modelo de von Bertalanffy, e indica una tendencia de tipo exponencial con crecimiento acelerado los primeros años de edad, que luego se hizo lento hasta que el pez alcanzó la longitud máxima. El coeficiente de variación del índice de crecimiento (Ø’) demostró que no hay diferencias en el patrón de crecimiento. La tasa de mortalidad natural (M=0.97/año), por pesca (F=1.57/año), y total (Z=2.54/año) fueron altas así como la tasa de explotación (E=0.62/año). Se concluye que O. ruber está plenamente explotado por la pesca artesanal; por lo que se sugiere continuar con los estudios de dinámica de poblaciones para evaluar la pesquería con fines de manejo.

Sensibilidad antibiótica de Streptococcus pneumoniae en portadores nasofaríngeos en niños sanos menores de un año en Lima, Perú / Antibiotic susceptibility of Streptococcus pneumoniae in nasopharyngeal carriers in healthy children younger than one year of age in Lima, Peru

Introducción: el neumococo es causa importante de morbi-mortalidad en niños en países en vías de desarrollo. En los últimos años han aparecido a nivel mundial cepas de neumococo resistentes a penicilina y a otros antibióticos utilizados frecuentemente en pediatría. A nivel local hay pocos estudios recientes que describen este problema. Objetivo: el objetivo principal del estudio fue determinar el porcentaje de resistencia antibiótica del neumococo en portadores nasofaríngeos en niños sanos entre dos meses y un año en los Consultorios de Crecimiento y Desarrollo y/o Vacunación de los hospitales Cayetano Heredia, Edgardo Rebagliati, San Bartolomé e Instituto Nacional de Salud del Niño en Lima, Perú. Materiales y métodos: se tomaron muestras de hisopado nasofaríngeoen 400 niños (noviembre 2007-junio 2008) para cultivo de neumococo y determinación de su sensibilidad a la penicilina y a otros antibióticos con la prueba de sensibilidad en disco. Resultados: se encontró 28 por ciento (111/400) de portadores nasofaríngeos de neumococo. De las 111 cepas aisladas, 60 (55 por ciento) fueron resistentes a cotrimoxazol, 52 (47 por ciento) a penicilina y 30 (35 por ciento) a azitromicina. No se encontró ninguna asociación entre los factores estudiados y la condición de portador y/o resistencia antibiótica. Conclusión: la resistencia del neumococo al cotrimoxazol y a la penicilina fue alta. Sin embargo, se necesita completar el estudio con la determinación de la concentración inhibitoria mínima para poder usar los nuevos puntos de corte para penicilina para cepas no-meníngeas. Con estos nuevos criterios es muy probable que la penicilina continúe siendo la droga de elección para infecciones no severas fuera del sistema nervioso central.

Introducction: Pneumococcus is a major cause of morbidity and mortality in children in developing countries. Over the last few years, pneumococcal strains resistant to penicillin and other antibiotics commonly used in pediatrics have emerged. There are few recent local studies that describe this problem. Objectives: The main purpose of the study was to determine the pneumococcal resistance rates in healthy nasopharyngeal carriers 2 to12 months of age, who attended the outpatient clinic for a routine well child and/or vaccination visit at Cayetano Heredia, Edgardo Rebagliati, San Bartolomé Hospitals and Instituto Nacional de Salud del Niño in Lima-Peru. Methods: Nasopharyngeal samples were obtained from 400 children (November 2007-June 2008) for S. pneumoniae culture and determination of the susceptibility to penicillin and other antibiotics by disk diffusion. Results: The pneumococcal carriage rate was 28 per cent (111/400). From the 111 strains isolated, 60 (55 per cent) were resistant to cotrimoxazole, 52 (47 per cent) to penicillin and 30 (35 per cent) to azythromycin. We did not find any association between the factors analyzed and the carrier state and/or antibiotic resistance. Conlusions: We found high resistance rates of pneumococcus to cotrimoxazole and penicillin. However, this study needs to be complemented with minimal inhibitory concentrations in order to use the new penicillin breakpoints for non-meningeal strains. With the new breakpoints, it is likely that penicillin will continue to be the drug of choice for non-severe infections outside the central nervous system.

Hepatoportal sclerosis: a cause of portal hypertension to bear in mind / Hepatoportal sclerosis: a cause of portal hypertension to bear in mind

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Uso reportado de metamizol intramuscular por pediatras de entidades públicas y privadas para el manejo de la fiebre en niños de 3 meses a 5 años de edad / Reported use of intramuscular metamizol among pediatricians in public and private health facilities for management of fever among children between 3 months and 5 years old

El tracto gastrointestinal es capaz de desarrollar como respuesta a una condición nociva síntomas como dolor abdominal, náuseas, vómitos y diarrea. Además edemas y malnutrición si hay malabsorción o pérdida de proteínas. Usualmente los responsables de estos síntomas gastrointestinales han sido los agentes infecciosos, alteraciones metabólicas e incluso defectos anatómicos. Recientemente las reacciones adversas a los alimentos: alergia o intolerancia en niños, están siendo cada vez más reconocidas como responsables de estos síntomas sobretodo en los países desarrollados, lo que ha generado abundante información y confusión. La presente revisión pretende actualizar a los pediatras sobre las definiciones, datos epidemiológicos, conceptos sobre la patogenia, cuadro clínico, pruebas diagnosticas, como se trata y se previenen las manifestaciones gastrointestinales de la alergia alimentaria.