[Renal involvement in monoclonal gammopathies]. / Compromiso renal en gammapatías monoclonales.

INTRODUCTION: The kidney is one of the organs most frequently affected by disease processes which produce monoclonal immunoglobins, therefore renal morphological and immunopathological alterations should be clearly recognized. OBJECTIVE: To describe the pathological features of renal involvement in monoclonal gammopathies. MATERIAL AND METHODS: A descriptive, retrospective and cross-sectional study of renal biopsies studied in a single center during a period of 14 years was carried out. RESULTS: 102 cases were included, of which 53% were male patients and the median age was 62.5 years (range 34 - 79). 97% of the biopsies were from native kidneys. The most frequent histopathological diagnosis (31.4%) was myeloma kidney, with kappa being the light chain most frequently deposited (65.6% of cases). AL amyloidosis was the second most common (29.4%) where the lambda chain predominated in 86.6%, followed by light chain deposition disease (20.6%) with the predominance of the kappa chain in 66.6%. CONCLUSIONS: The most frequent renal involvement due to monoclonal gammopathies was myeloma kidney with deposition of kappa light chains, followed by AL lambda amyloidosis; these diseases were found more frequently in patients over 50 years of age.

Compromiso renal en gammapatías monoclonales / Renal involvement in monoclonal gammopathies

Introducción: El riñón es uno de los órganos más comprometidos en enfermedades con producción de inmunoglobulinas monoclonales, por lo que es de gran importancia caracterizar muy bien las alteraciones morfológicas e inmunopatológicas en dicho compromiso. Objetivo: Describir las características del compromiso renal en gammapatías monoclonales desde una perspectiva anatomopatológica. Material y métodos: Se realizó un estudio descriptivo, retrospectivo y transversal, recolectándose biopsias renales estudiadas en un único centro durante un período de 14 años. Resultados: Se incluyeron 102 casos provenientes de 102 pacientes, el 53% de sexo masculino, la mediana de la edad fue 62,5 años (rango 34-79). El diagnóstico histopatológico más frecuente fue riñón de mieloma (31,4% de los casos), siendo kappa la cadena ligera más frecuentemente depositada (65,6% de casos), seguido de amiloidosis AL (29,4%), donde predominó la cadena lambda en un 86,6% y la enfermedad por depósitos de cadenas ligeras (20,6%) con predominio de la cadena kappa: 66,6%. El 97% de las biopsias fueron de riñón nativo. Conclusiones: El compromiso renal por gammapatías monoclonales más frecuente fue el riñón de mieloma con depósito de cadenas ligeras kappa, seguida de la amiloidosis AL lambda; estas enfermedades se encontraron con mayor frecuencia en pacientes mayores de 50 años de edad.(AU)

Introduction: The kidney is one of the organs most frequently affected by disease processes which produce monoclonal immunoglobins, therefore renal morphological and immunopathological alterations should be clearly recognized. Objective: To describe the pathological features of renal involvement in monoclonal gammopathies. Material and methods: A descriptive, retrospective and cross-sectional study of renal biopsies studied in a single center during a period of 14 years was carried out. Results: 102 cases were included, of which 53% were male patients and the median age was 62.5 years (range 34 - 79). 97% of the biopsies were from native kidneys. The most frequent histopathological diagnosis (31.4%) was myeloma kidney, with kappa being the light chain most frequently deposited (65.6% of cases). AL amyloidosis was the second most common (29.4%) where the lambda chain predominated in 86.6%, followed by light chain deposition disease (20.6%) with the predominance of the kappa chain in 66.6%. Conclusions: The most frequent renal involvement due to monoclonal gammopathies was myeloma kidney with deposition of kappa light chains, followed by AL lambda amyloidosis; these diseases were found more frequently in patients over 50 years of age.(AU)

Evaluación de tres especies de Brachiaria spp con pastoreo rotacional para ceba bovina / Evaluation of three species of Brachiaria spp with rotational grazing methods for bovine fattening / Avaliação de três espécies de Brachiaria spp com de pastejo rotativo para engorda bovina

Resume El Objetivo de este trabajo fue evaluar el desempeño de bovinos de carne con pastoreo rotacional en las gramíneas Brachiaria humidicola, B. brizantha cv. marandú y B. decumbens. El ensayo fue realizado en la finca Agua Claras, en el piedemonte del municipio de Tame - Arauca, a 430 msnm, con temperatura media de 28 °C, precipitación anual de 2.890 mm/año y distribución mono modal, brillo solar de 1.800 horas luz/año y humedad relativa de 83%. Fueron utilizados 75 bovinos de 22±2 meses de edad y 300±40 kg de peso, distribuidos en un diseño experimental totalmente al azar con tres tratamientos (métodos de pastoreo) y 25 repeticiones por tratamiento para un total de 75 unidades experimentales, los métodos de pastoreo experimentales fueron 1. método de pastoreo en B. humidicola alojados en 44 potreros de 0,5 ha. 2. método de pastoreo en B. brizantha cv. marandú, alojados en 15 potreros de 1,4 ha., y 3. El método de pastoreo en B. decumbens alojados en potreros de 1, 2 y 2,5 ha, los potreros contaban con acceso a agua a voluntad y suministro de sal mineralizada, los animales fueron pesados en ayuno al inicio y final del ensayo, las variables estudiadas incluían la disponibilidad de forraje, cantidad de materia seca, de proteína cruda, fibra detergente neutra, fibra detergente ácida, actividad ureásica, concentración de los minerales calcio, fosforo y magnesio, la fase experimental tuvo una duración de 80 días previo acostumbramiento de 60 días. En los resultados no hubo diferencia significativa en la ganancia diaria de peso. Los métodos de pastoreo influenciaron (p<0,05) el contenido de proteína cruda, fibra en detergente neutra y fibra en detergente acida, calcio, fósforo, magnesio y la actividad ureásica. En conclusión, el pastoreo rotacional en brachiaria spp no afecta el desempeño de bovinos en ceba.

Abstract This work was aimed at evaluating beef cattle performance regarding rotational grazing on Brachiaria humidicola, B. brizantha cv. Marandu and B. decumbens tropical forage grasses. The experiment was carried out on the Água Claras Farm in the piedmont municipality of Tame in Colombia's Arauca department; the area is 430 masl, has 8°C average temperature, 2,890 mm/year annual rainfall, 1,800 light hours/year monomodal distribution and 83% relative humidity. Seventy-five 22±2 month-old beef cattle, weighing 300±40 kg were used in this study; a completely randomised design was used involving three treatments (grazing methods) and 25 repetitions per treatment (i.e. giving 75 experimental units.) The experimental grazing methods involved cattle grazing on in forty-four 0.5 ha pastures, cattle grazing on d cv. Marandu on fiftee1.4 ha pastures and cattle grazing on B. decumbens in 1, 2 and 2.5 ha pastures. The pastures enabled cattle to have access to water at will and a mineralised salt supply was provided; the cattle were weighed while fasting at the beginning and the end of the trial. Forage availability, the amount of forage dry matter (FDM), crude protein (CP), neutral detergent fibre (NDF), acid-detergent fibre (ADF), urease activity (UA) and calcium, phosphorus and magnesium concentration/intake were the variables studied. The cattle had a 60-day adaptation period, followed by the 80-day experimental phase. The results revealedeefregarding daily weight gain. The grazing methods did influence (p<0.05) CP, NDF, ADF, calcium, phosphorus and magnesium content, as well as UA. Grazing on Brachiaria spp. thus does not affect fattening cattle's performance.

Resumo de corte em pastejo rotacionado em gramíneas Brachiaria humidicola, B. brizantha cv. marandú e B. decumbens. O experimento foi realizado na Fazenda Água Claras, no piedemonte do município de Tame - Arauca, a 430 metros de altitude, temperatura média de 28 ° C, precipitação anual de 2.890 mm / ano e distribuição monomodal , 1.800 horas-luz / ano e umidade relativa de 83%. Foram utilizados 75 bovinos de 22 ± 2 meses de idade e 300 ± 40 kg de peso, distribuídos em delineamento experimental totalmente casualizado com três tratamentos (métodos de pastejo) e 25 repetições por tratamento, totalizando 75 unidades experimentais. 1. método de pastejo em B. humidicola alojada em 44 piquetes de 0,5 ha. 2. método de pastejo em B. brizantha cv. marandú, alojado em 15 piquetes de 1,4 ha., e 3. O método de pastejo em B. decumbens alojado em piquetes de 1, 2 e 2,5 ha, os piquetes tinham acesso à água à vontade e fornecimento de sal mineralizado, os animais eram pesadas em jejum no início e no final do ensaio, as variáveis estudadas incluíram a disponibilidade de forragem, quantidade de matéria seca, proteína bruta, fibra em detergente neutro, fibra em detergente ácido, atividade da urease, concentração de minerais de cálcio, fósforo e magnésio, a fase experimental durou 80 dias após a adapatação de 60 dias. Nos resultados não houve diferença significativa no ganho de peso diário. Os métodos de pastejo influenciaram (p<0,05) o teor de proteína bruta, fibra em detergente neutro e fibra em detergente ácido, cálcio, fósforo, magnésio e atividade da urease. Em conclusão, o pastejo rotacionado em Brachiaria spp não afeta o desempenho de bovinos em engorda.

Síndrome larva migrans cutánea en pediatría / Cutaneous Larva Migrans Syndrome in Pediatrics

La dermatosis denominada larva migrans cutánea: (LMC) es una infección cutánea secundaria a infestación parasitaria por la migración de larvas de anquilostomas animales a la epidermis humana, frecuentemente por contacto directo con suelos contaminados, especialmente en zonas tropicales. Se caracteriza por la aparición de lesiones induradas, eritematosas con patrón irregular o serpiginoso acompañado de prurito. Describimos un caso de LMC en una niña, adquirido durante unas vacaciones en Colombia y tratado inicialmente como celulitis con antibióticos (AU)

Cutaneous larva migrans (CLM) is an infection secondary to parasitic infestation due to the migration of animal hookworm larvae into the human skin, frequently by direct contact with contaminated grounds, especially in the tropics. Clinically, it is characterized by the appearance of indurated, erythematous lesions with irregular or "creeping eruption" pattern and pruritus. This article describes a case of CLM infection in a pediatric patient, it was acquired during the holidays in Colombia, diagnosed as cellulitis and treated accordingly with antibiotics without success (AU)

Platinum ineligibility in squamous cell carcinoma of the head and neck: consensus from Central America and the Caribbean.

The high incidence of head and neck cancer in Central America and the Caribbean, together with limitations in the healthcare system for patients with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) in this region necessitate a consensus of opinion based on a review of the literature on therapy with cisplatin plus radiation. Such an approach will ensure appropriate selection of patients who can benefit from therapy and reduce the incidence of related adverse events. Therefore, we recorded the opinion of experts in the region in order to identify needs and challenges in the treatment of LA SCCHN.

The impact of incorporating toilet-training status in the pediatric Rome IV criteria for functional constipation in infant and toddlers.

BACKGROUND: The diagnosis of functional constipation (FC) is based on the Rome criteria. The last edition of the criteria (Rome IV) for infants and toddlers modified the criteria to differentiate toilet-trained (TT) and non-toilet-trained (NTT) children. These changes have not been validated. We aimed to understand the impact of adding toilet training to the diagnostic criteria and to assess the prevalence of FC. METHODS: Parents of infants and toddlers from six outpatient clinics (four public, two private) located in three geographically dispersed cities in Colombia completed validated questionnaires to diagnose functional gastrointestinal disorders according to Spanish version of Rome IV criteria (QPGS-IV). RESULTS: A total of 1334 children (24.4 months ±15.0) participated: 482 (36%) TT and 852 (64%) NTT. The prevalence of FC was 21.1%. The prevalence increased with age, 0-1 years 7.7%; 2 years 18.2%; 3 years 23.7%; and 4 years 37.2%. TT vs NTT for FC 41.9% vs 9.3%, respectively (OR 7.06, 95% CI 5.26-9.47, P < .0001). TT more likely to report ≥ 3 criteria (OR = 2.43, 95% CI 1.41-4.21, P = .0015). 18.3% of TT had episodes of fecal incontinence that met the frequency required by Rome for FC (≤1 episode/week). However, 87.1% had fecal incontinence less often. 7.4% of them characterized as large quantity. CONCLUSION: We found no changes in the prevalence of FC using the Rome IV criteria vs Rome III. TT children are more likely to have FC. Study suggests that changes in Rome IV criteria were potentially clinically relevant and to have adequate face validity. Future studies should confirm our findings.

Coexistencia de trastornos gastrointestinales funcionales en lactantes y preescolares latinoamericanos / Coexistence of functional gastrointestinal disorders in Latin American infants and preschoolers

Resumen Introducción: se ha descrito la coexistencia de trastornos gastrointestinales funcionales (c-TGF) en lactantes y preescolares (LactPre); sin embargo, hay poca literatura sobre los principales c-TGF y sus características. Objetivo: describir la prevalencia y posibles asociaciones de c-TGF en un mismo LactPre latinoamericano. Metodología: estudio de prevalencia en LactPre de Colombia, Ecuador, Nicaragua y Panamá de consulta externa y urgencias, a quienes, según los criterios de Roma III en español, se identificaron regurgitación, síndrome de rumiación, síndrome del vómito cíclico, cólico, diarrea funcional, estreñimiento funcional y disquecia. Se tuvieron en cuenta la edad, el sexo y el origen. La estadística incluyó t de Student, chi cuadrado, prueba exacta de Fisher, análisis uni y multivariados y el cálculo de los OR e IC 95%, siendo una p <0,05 significativa. Resultados: se analizaron 2417 niños (2,4±19,8 meses de edad, 51,3% masculinos, con diagnóstico de por lo menos algún TGF del 35,7%). Se presentó c-TGF en el 3,6%, siendo el principal el síndrome de rumiación del lactante (SRL) más estreñimiento funcional (EF). Hubo predomino del género masculino en los lactantes y ser colombiano. Conclusión: la principal c-TGF en este grupo de LactPre de Latinoamérica es el SRL más EF, presentándose principalmente en el sexo masculino y en lactantes menores de 24 meses.

Abstract Introduction: Coexistence of functional gastrointestinal disorders (FGID) in infants and preschool children has been described, but there is little literature on the main types of FGID coexistence or their characteristics. Objective: This study describes the prevalence and possible associations of FGID coexistence among Latin American infants and preschool children. Methodology: This is a prevalence study of infants and preschool children conducted in Colombia, Ecuador, Nicaragua and Panama. Children included were outpatients and emergency patients who were identified according to the Rome III Criteria in Spanish as suffering from regurgitation, rumination syndrome, cyclic vomiting syndrome, colic, functional diarrhea, functional constipation and/or dyspepsia. Age, sex and origin of patients were registered. Statistical analyses included Student's T test, chi squared test, Fisher's exact test, univariate analysis, multivariate analysis and calculation of odds ratios and 95% confidence intervals with p <0.05 set as significant. Results: Two thousand four hundred and seventeen children were included. Their age range was 2.4 months to 19.8 months of age, and 51.3% were male. The proportion of patients with a diagnosis of at least one FGID was 35.7%. FGID coexistence was found in 3.6% of the patients. The most frequent combination was rumination syndrome plus functional constipation. There were predominances of males, infants and Colombian children in the total sample. Conclusion: The most commonly coexisting FGIDs in this group of Latin America infants and preschool children were infant rumination syndrome and functional constipation which were found together most frequently among boys who were under 24 months old.

Evaluación de variables agronómicas, calidad del forraje y contenido de taninos condensados de la leguminosa Lotus corniculatus en respuesta a biofertilizante y fertilización química en condiciones agroecológicas de trópico alto andino colombiano

En la sabana de Bogotá, 2600 m.s.n.m., se analizaron variables agronómicas; altura de planta, número y longitud de ramas, producción de materia seca total ha-1, y variables de calidad del forraje, digestibilidad de materia seca, proteína cruda, extracto etéreo, fibra detergente ácido, fibra detergente neutra, calcio, así como el contenido de taninos condensados de la leguminosa Lotus corniculatus, mediante un diseño completo al azar de cuatro tratamientos aplicados al suelo Tl: sin fertilizante; T2: biofertilizante; T3: fertilización química, y T4: biofertilizante más fertilización química, con tres repeticiones por tratamiento. Se utilizó análisis de varianza (ANOVA) y prueba de comparación de medias de Tukey al 0,1%. Los resultados señalan que el cultivo de L corniculatus, responde muy bien a la biofertilización, ya que el T2 exhibió el mejor comportamiento para la mayoría de variables agronómicas y de calidad del forraje, mientras que T4 mostró los mejores resultados para número de ramas y menos contenido de taninos condensados. En digestibilidad de la materia seca T2 y T4 ostentaron un buen comportamiento con diferencias altamente significativas con respecto a TI y T3; en contenidos de grasa y calcio, el mejor comportamiento se presentó en el T3 y TI con diferencias altamente significativas. Se concluye que la biofertilización incide de manera favorable en las características edáficas, producción y calidad del forraje Lotus corniculatus, con mejores comportamientos en las principales variables evaluadas en el estudio.

In the savannah of Bogotá, 2600 m.s.n.m., were analyzed Agronomic variables; plant height, number and length of branches, total dry matter yield ha-1, and quality variables of forage, dry matter digestibility, raw protein, ethereal extract, Fiber Acid Detergent, Neutral Detergent Fiber calcium, as well as the condensed tannin content of the legume Lotus corniculatus, by means of a complete random design of four treatments applied to the soil Tl: no fertilizer; T2: biofertilizer; T3: chemical fertilization, and T4: biofertilizer with chemical fertilization, with three replicates per treatment. It was used analysis of variance (ANOVA) and comparison test ofTukey averages at 0.1%. The results indicate that the cultivation of L corniculatus responds very well to biofertilization because T2 exhibited the best performance for most changeful agronomic and forage quality while T4 showed the best results for number of branches and less content of condensed tannins. In dry matter digestibility T2 and T4 showed good behavior with highly significant differences with respect to Tl and T3; In fat and calcium contents, the best behavior was presented in T3 and Tl with highly significant differences. It is concluded that biofertilization favorably influences the edaphic characteristics, production and quality of the forage Lotus corniculatus, with better behaviors in the main variables evaluated in the study

Na planície de Bogotá, 2600 m.s.n.m., variáveis agronômicas analisadas; altura das plantas, número e comprimento das ramificações, a produção de matéria seca total ha-1, e digestibilidade qualidade da forragem variável de matéria seca, proteína bruta, extrato etéreo, fibra em detergente ácido, neutro fibra em detergente, de cálcio, e o taninos condensados conteúdo Lotus corniculatus leguminosa de, utilizando um desenho de blocos completos ao acaso, quatro tratamentos aplicados ao solo T1: não fertilizados; T2: biofertilizante; T3: adubação química, e T4: biofertilizantes fertilização mais química, com três réplicas por tratamento. análise de variância (ANOVA) e teste de Tukey comparação foi utilizada a 0,1%. Os resultados indicam que a cultura de L. corniculatus, responde muito bem ao Biofertilização como o T2 exibiu o melhor desempenho para a maioria das características agronômicas e qualidade da forragem, enquanto T4 apresentaram os melhores resultados para número de agências emenor teor de taninos condensados. Na seca T2 de digestibilidade e T4 que ostentava um bom desempenho com diferenças altamente significativas em relação ao T1 e T3; em gordura e teor de cálcio, o melhor desempenho foi apresentado nas diferenças altamente significativas T3 e T1. Conclui-se que Biofertilização favoravelmente impactos sobre as características do solo, produção e qualidade de forragem Lotus corniculatus, com melhores performances nas principais variáveis avaliadas no estudo.

A Population-Based Study on the Epidemiology of Functional Gastrointestinal Disorders in Young Children.

OBJECTIVE: To perform a population-based study with Rome III criteria to describe the prevalence of functional gastrointestinal disorders (FGIDs) in children in Colombia. STUDY DESIGN: We conducted a multicity cross-sectional study to investigate the epidemiology of FGIDs in children 0-48 months of age using the Rome III criteria in Colombia. Children with organic medical diseases were excluded. Parents provided demographic information and completed the Spanish version of the Questionnaire on Pediatric Gastrointestinal Symptoms for Infants & Toddlers. RESULTS: Parents of 1231 subjects completed the questionnaires; 48 children were excluded due to presence of organic diseases and being older than 48 months of age. Four hundred eighty children (40.5%) were diagnosed with at least 1 FGID according to the Rome III diagnostic criteria (49% female, median 12 months). Functional constipation was the most commonly diagnosed disorder in infants (up to 12 months of age) and children of ages 13-48 months (16.1% and 26.8%, respectively). Analysis revealed that the prevalence of FGID was significantly greater in children who were the only child in the family (P = .003), children who were first-born (P = .007), and children with divorced or separated parents. (P = .001). CONCLUSIONS: FGIDs are common in children younger than 4 years of age. Functional constipation and infant colic were the most common FGIDs in infants (up to 12 months of age), and functional constipation and rumination were the most common FGIDs in children 13-48 months of age.

Obesidad y embarazo

Con el diseño de un programa de computador se analizaron 1.860 historias clínicas y se seleccionaron las pacientes obesas. Estas de acuerdo al incremento de peso sobre lo ideal, se catalogaron como obesas y muy obesas. Determinamos morbilidad y mortalidad perinatal en ambos grupos, comparados con pacientes no obesas normales. Se encontró que el peso al nacer de los hijos de madres obesas y muy obesas tenían un promedio de peso de 319.8 y 487.7 gramos respectivamente, mayor que los controles y la incidencia de macrosomia fue de 7 y 15 veces mayor en los mismos grupos. No hubo diferencia entre mortalidad perinatal , prematurez e incidencia de césareas entre los tres grupos. Se compararon los resultados con la literatura universal

Tratamiento de las luxofracturas toracolumbares / Tratment of thoracolumbar fracture-dislocations

El trauma espinal es un problema que ha venido en creciente aumento como consecuencia del mundo moderno. Su tratamiento se inicia desde el sitio del accidente y se debe sospechar en todo paciente politraumatizado con TCE. Es urgente dar instruccion a todo nivel sobre la atencion primaria y multidisciplinaria de estos pacientes, para ofrecer un tratamiento eficiente. Este tiene como finalidad decomprimir los elementos neurales, realinear el canal, estabilizar la columna para facilitar la recuperacion neurologica, la movilizacion y la rehabilitacion temprana. Se estudiaron 80 pacientes con lesiones traumaticas de la columna toracolumbar durante el periodo de enero de 1977 a junio de 1983, en el Hospital Militar Central de Bogota. El agente causal mas frecuente fue el accidente automoviliario seguido de las caidas de lo alto. La mayor incidencia fue en la tercera decada de la vida. Se analizaron los pacientes de acuerdo a los criterios de estabilidad de la columna, el grado de compromiso neurologico, el tratamiento realizado y las complicaciones. Se encontraron 30 lesiones inestables, de las cuales 2 sin deficit neurologico, 15 con compromiso parcial y 13 total. 50 lesiones estables de las cuales 3 presentaron alteracion neurologica incompketa evolucionando posteriormente a la mejoria con el tratamiento instaurado. El tratamiento utilizado para las lesiones estables consistio en reposo en cama dura, inmovilizacion en corse de yeso en hiperextension por 3 - 4 meses y proteccion con ortesis por 2 meses. Se obtuvieron excelentes resultados en el 90 por ciento de los casos..