Effects of Prenatal Cannabinoids Exposure upon Placenta and Development of Respiratory Neural Circuits.

Cannabis use has risen dangerously during pregnancy in the face of incipient therapeutic use and a growing perception of safety. The main psychoactive compound of the Cannabis sativa plant is the phytocannabinoid delta-9-tetrahydrocannabinol (A-9 THC), and its status as a teratogen is controversial. THC and its endogenous analogues, anandamide (AEA) and 2-AG, exert their actions through specific receptors (eCBr) that activate intracellular signaling pathways. CB1r and CB2r, also called classic cannabinoid receptors, together with their endogenous ligands and the enzymes that synthesize and degrade them, constitute the endocannabinoid system. This system is distributed ubiquitously in various central and peripheral tissues. Although the endocannabinoid system's most studied role is controlling the release of neurotransmitters in the central nervous system, the study of long-term exposure to cannabinoids on fetal development is not well known and is vital for understanding environmental or pathological embryo-fetal or postnatal conditions. Prenatal exposure to cannabinoids in animal models has induced changes in placental and embryo-fetal organs. Particularly, cannabinoids could influence both neural and nonneural tissues and induce embryo-fetal pathological conditions in critical processes such as neural respiratory control. This review aims at the acute and chronic effects of prenatal exposure to cannabinoids on placental function and the embryo-fetal neurodevelopment of the respiratory pattern. The information provided here will serve as a theoretical framework to critically evaluate the teratogen effects of the consumption of cannabis during pregnancy.

Assessment of cadmium and lead contamination in rice farming soils and rice (Oryza sativa L.) from Guayas province in Ecuador.

Rice is the world's most consumed and in-demand grain. Ecuador is one of the main rice-consuming countries in Latin America, with an average per capita consumption of 53.2 kg per year. Rice cultivation takes place under flooding conditions, which favors the mobilization and subsequent accumulation of heavy metals in the plant. This study's principal objective was to evaluate the contamination of cadmium (Cd) and lead (Pb) in the rice cultivation system in the province of Guayas. To this end, extensive sampling of water, soil and rice grains was carried. Water samples were analyzed to determine physicochemical properties and concentrations of dissolved Cd and Pb. Physicochemical properties, total organic carbon (TOC), total content of nitrogen (N), iron (Fe), manganese (Mn), phosphorus (P), bioavailable phosphorus (P mehlich), Cd and Pb were determined in soil samples. In addition, to understand the dynamics of Cd and Pb mobility and bioavailability, an extraction of six randomly selected soil samples was carried out. The concentration values of the total Cd and Pb content in the rice cultivation system did not exceed the maximum recommended limit for soil, water and rice grains. However, 85% of the total Cd was in the soluble or exchangeable fraction of the soil, while the Pb was strongly bound to crystalline iron oxyhydroxides. It was established that the TOC, N, Fe, and P mehlich have a significant correlation (p < 0.05) with the overall concentration of Cd and Pb in the rice farming soil. The Cd and Pb present in rice do not represent a dietary health risk to the population of Ecuador.

Seno del segundo arco branquial en un paciente adulto / Bilateral second branchial cleft cysts in an adult patient

Resumen El seno del segundo arco branquial es una alteración secundaria a un desarrollo anormal de los arcos branquiales. Las anomalías de los arcos branquiales incluyen quistes, fístulas, senos y glándulas ectópicas. Deben ser consideradas en el diagnóstico diferencial de las masas en cuello de pacientes adultos o pediátricos. El seno del arco branquial supone alrededor del 30 % de las masas congénitas del cuello y suele ser diagnosticado en la segunda a tercera década de la vida, siendo más comunes las del segundo arco. Se presenta con síntomas inespecíficos. Los estudios de imágenes son esenciales para su diagnóstico, clasificación y manejo quirúrgico. Se presenta el caso de un paciente de 67 años con historia clínica y examen físico de seno del segundo arco branquial, quien requirió de fistulografía y tomografía computarizada para una adecuada caracterización. El paciente fue intervenido quirúrgicamente sin complicaciones posteriormente.

Abstract The sinus of the second branchial arch is a secondary alteration of an abnormal development of the branchial arches. The anomalies of the branchial arches include cysts, fistulas, sinuses and ectopic glands. They should be considered in the differential diagnosis of neck masses in adult or pediatric patients. The sinus of the branchial arch accounts for about 30 % of the congenital masses of the neck and is usually diagnosed in the second to third decade of life, with those of the second arch being more common. It presents with nonspecific symptoms. Imaging studies are essential for the diagnosis, classification and surgical management. We present the case of a 67-year-old patient with a clinical history and physical examination of second branchial arch sinus, who required fistulography and computed tomography for adequate characterization. The patient underwent surgery without complications.

Apendicitis aguda complicada en un paciente con malrotación intestinal. Reporte de caso / Left-sided complicated appendicitis associated with midgut malrotation. A case report

Se presentan los hallazgos clínicos y tomográficos en un hombre de 46 años admitido al Hospital Pablo Tobón Uribe, de Medellín, Colombia, con un cuadro atípico de abdomen agudo en quien una tomografía axial computarizada (TAC) evidenció malrotación intestinal con apendicitis perforada. Esta anomalía se debe a falla en la rotación del intestino fetal sobre los vasos mesentéricos superiores entre las semanas décima y duodécima de la gestación; su incidencia ha sido difícil de calcular porque la mayoría de los casos son asintomáticos o de presentación larvada durante la infancia.

We report the clinical and tomographic findings in a 46-year-old man admitted to the emergency service at Pablo Tobón Uribe Hospital, in Medellín, Colombia. He had a bizarre abdominal pain history. An abdominal computed tomography evidenced left-sided complicated appendicitis associated with midgut malrotation. The latter is a rare anomaly due to lack of or incomplete rotation of the fetal intestine around the superior mesenteric artery between the tenth and twelfth weeks of gestation. Its incidence has been difficult to estimate as most cases are asymptomatic or minimally symptomatic, usually during childhood.

Angiotomografía con multidetectores (TCMD): ¿Nueva prueba de oro para el diagnóstico de lesiones vasculares de las extremidades? / Multidetector CT (MDCT) angiography: new gold standard for the diagnosis of vascular injuries in the extremities?

El enfoque diagnóstico y terapéutico de los pacientes con sospecha de trauma vascular de las extremidades ha cambiado a lo largo del tiempo. La arteriografía de rutina desplazó al tratamiento quirúrgico obligado debido al alto número de exploraciones quirúrgicas no terapéuticas. Posteriormente se adoptó un enfoque selectivo y el análisis juicioso de los hallazgos del examen físico condujo a la disminución del número de arteriografías practicadas. En los últimos años se ha recurrido al uso de la tomografía helicoidal y, más recientemente, al de la angiotomografía con multidetectores (TCMD) para la evaluación de situaciones médicas y quirúrgicas de urgencia y su uso se ha extendido a los pacientes con trauma vascular. La experiencia acumulada en el Hospital Universitario San Vicente de Paúl de Medellín (Colombia) y en otros centros de trauma permite concluir que es un procedimiento seguro, confiable y que por su excelente desempeño se puede constituir en la prueba de oro para el diagnóstico del trauma vascular de las extremidades.

The diagnostic and therapeutic approaches to patients with suspected vascular injuries in the extremities haschanged throughout time. Routine arteriography replaced mandatory surgical treatment due to the high number of non-therapeutic explorations. Later on, a more selective approach was adopted, and thestrict analysis of physical examination findings led toa reduced number of arteriographies. In recent yearsthe use of Helical CT arteriography and then Multidetector CT angiography have become useful tools in the evaluation of some medical and surgicalconditions, which now include vascular trauma. With the accumulated experience at Hospital Universitario San Vicente de Paúl, in Medellín (Colombia) as well as in other trauma centers, it can be now stated that this procedure is safe, reliable and that, due to its excellent performance, it can be considered the Gold-Standard Test for the diagnosis of vascular traumain the extremities.

Resonancia magnética en neuralgia del trigémino: presentación de tres casos / MRI in trigeminal neuralgia: presentation of three cases

La neuralgia del trigémino se caracteriza por episodios de dolor facial lancinante. Puede ser causada por diversas patologías que afectan cualquiera de los segmentos del V par. La resonancia magnética es de elección cuando se requieren estudios de imagen. Se presentan tres casos evaluados por este método y comprobados por cirugía.