Biliary Complications Post Transjugular Intrahepatic Portosystemic Shunt in a Child With Portal Vein Cavernous Transformation.

The transjugular intrahepatic portosystemic shunt is a rising interventional procedure with multiple indications and high technical success but with risks of biliary injuries, an underreported scenario. We present an 11-year-old patient with biliary injury with a leak, biloma formation, and biliary obstruction caused by the percutaneous procedure. Interventional radiology drainages addressed these complications by resolving the leak and biloma. These biliary complications in percutaneous procedures and their management are rarely reported in the medical literature, making their management not standard. We highlight drainage management and the importance of sharing it to add experience to this clinical scenario and encourage sharing cases with similar diagnoses.

Interventional Therapy for Upper Extremity Phlegmasia Cerulea Dolens in a Patient With Heparin-Induced Thrombocytopenia: A Case Report.

This article presents a case of a multimorbid 63-year-old woman with chronic kidney disease and heparin-induced thrombocytopenia (HIT). Following the insertion of a central venous catheter, she developed phlegmasia cerulea dolens (PCD) in her left arm, a rare and severe complication of deep vein thrombosis (DVT). Given the severity of the case, adapting to anticoagulant contraindications or unavailability, management with catheter-directed thrombolysis and mechanical thrombectomy was made. It is concluded that catheter-directed thrombolysis and mechanical thrombectomy are valuable therapeutic alternatives in critical situations where treatment options are limited.

Endovascular Management of Acute Lower Limb Ischemia Linked to Cocaine Abuse: A Case Report.

Cocaine abuse is a public health concern with well-documented cardiovascular complications. However, acute limb ischemia remains a rare and underreported consequence. We present a case of a 36-year-old man with acute right lower limb ischemia following heavy cocaine use, successfully managed with systemic heparin and intra-arterial nitroglycerin. The case highlights considering cocaine as a potential cause of acute limb ischemia and the efficacy of endovascular therapy. Further case reports with this diagnosis and their management are crucial for establishing the best strategies and improving outcomes in these scenarios.

Endovascular Treatment of Acute Lower Limb Ischemia Associated with Cocaine Use: A Scoping Review.

The endovascular treatment of acute lower limb ischemia associated with cocaine use is an underexplored topic. This scoping review aims to map existing information and point out potential knowledge gaps for future research. We searched databases with a strategy of terms and keywords (Cocaine, Acute, Lower Limb, and Ischemia) for articles related to acute ischemia in the lower limbs and cocaine use. We established eligibility and exclusion criteria and searched without restrictions on language or date of publication. We obtained five case reports published between 2004 and 2015. Most of the patients were men with an average age of 38 years. Treatments were heterogeneous. Most patients showed improvement after surgical thrombectomy. The sample size and variety of interventions limit the generalizability of the results, so it is necessary to do more studies with robust methodologies to standardize treatments and improve the understanding of the condition.

Extending resolution within a single imaging frame.

The resolution of fluorescence microscopy images is limited by the physical properties of light. In the last decade, numerous super-resolution microscopy (SRM) approaches have been proposed to deal with such hindrance. Here we present Mean-Shift Super Resolution (MSSR), a new SRM algorithm based on the Mean Shift theory, which extends spatial resolution of single fluorescence images beyond the diffraction limit of light. MSSR works on low and high fluorophore densities, is not limited by the architecture of the optical setup and is applicable to single images as well as temporal series. The theoretical limit of spatial resolution, based on optimized real-world imaging conditions and analysis of temporal image stacks, has been measured to be 40 nm. Furthermore, MSSR has denoising capabilities that outperform other SRM approaches. Along with its wide accessibility, MSSR is a powerful, flexible, and generic tool for multidimensional and live cell imaging applications.

Preoperative Embolization of a Giant Solitary Fibrous Tumor of the Pleura: A Case Report.

Only 5% of pleural neoplasms are fibrous tumors of the pleura, which typically develop from sub-mesothelial mesenchymal tissue of the visceral pleura. These tumors often behave clinically benignly, and when they are larger than 15 cm or occupy more than 40% of the hemithorax, they are referred to as "giant" tumors. Surgical excision is the gold standard treatment, although intra-operative bleeding is one of the major complications. In this case report, we discuss a 39-year-old female patient with a large homogeneous enhancing mass of soft tissue density in the right lower hemithorax with systemic arterial supply from the right inferior phrenic artery. Angiography and embolization were valuable adjuncts in preoperative management. Via thoracotomy, the mass was successfully removed completely with minimal blood loss. Giant SFTP is a rare neoplasm of the pleura. Intraoperative bleeding is one of the main complications during surgical resection, which is the gold standard of its treatment. Angiography and embolization are valuable complements in the preoperative treatment of this type of tumors to reduce intraoperative blood loss and operative times.

Fishes of the Mitú Region: middle basin of the río Vaupés, Colombian Amazon / Peces de la región de Mitú: cuenca media del río Vaupés, Amazonia colombiana

Abstract: The Amazon River basin hosts the most diverse freshwater ichthyofauna in the world, and yet huge areas of the basin remain unexplored. This is the case for the upper tributaries of the rio Negro, especially those draining the Colombian territory. Here we present a list of 224 species derived from the examination of specimens collected in the Mitú region (Vaupés Department, Colombia), the middle basin of the río Vaupés. Of the species identified in our study, 10 species are recorded from Colombia for the first time, and 26 species are newly recorded from the Colombian Amazon. The number of species we present here comprise almost one-third of the known species diversity of the Colombian Amazon and nearly a tenth of the total number of those known across the entirety of the Amazon basin. The most diverse orders were Characiformes (120 species) and Siluriformes (65 species), and the remaining six orders comprised less than 20% of total species. The study area comprised blackwater systems, which are considered to be nutrient-poor environments. We discuss some ecological aspects that might explain how this highly diverse ichthyofauna originates and is maintain in less productive systems. The list presented here adds an important number of new records and complements the information derived from previous studies, carried out thus far with regards to the fish fauna of the Colombian Amazon.

Resumo: La cuenca del río Amazonas alberga la ictiofauna dulceacuícola más diversa del mundo, sin embargo, grandes áreas de la cuenca permanecen inexploradas. Este es el caso de los afluentes de la parte alta del río Negro, especialmente los sistemas que drenan el territorio colombiano. A continuación, presentamos un listado de 224 especies derivadas del análisis de especímenes recolectados en la región de Mitú, cuenca media del río Vaupés (Departamento de Vaupés, Colombia). De las especies identificadas, 10 especies se registran en Colombia por primera vez y 26 especies para la Amazonía colombiana. El número de especies que presentamos aquí comprende casi un tercio de las especies conocidas para la Amazonía colombiana y casi una décima parte del total de las conocidas para la gran cuenca del Amazonas. Los órdenes más diversos fueron Characiformes (120 especies) y Siluriformes (65 especies), y los seis órdenes restantes comprendieron menos del 20% del total de especies. El área de estudio comprende sistemas de aguas negras que se consideran ambientes poco productivos por sus bajos contenidos de nutrientes. Discutimos aquí algunos aspectos ecológicos que podrían explicar cómo esta ictiofauna tan diversa tiene su origen y es mantenida en estos sistemas poco productivos. La información derivada del presente estudio adiciona nuevos registros de especies de peces para Colombia, y complementa la información derivada de los estudios realizados a la fecha en la Amazonía colombiana.

Treatment of Post-biopsy Arteriovenous Fistula of a Renal Graft by Selective Embolization.

The development of an arteriovenous fistula (AVF) after renal graft biopsy is a rare complication, it is associated in most cases with spontaneous resolution. However, interventional therapies are required in some cases, to prevent graft loss. Selective embolization has been described as an alternative treatment. In the present study, we describes our experience on AVF after biopsy in kidney transplant patients, which was managed with selective embolization. From 2005 to 2015, a total of 452 kidney transplant biopsies were performed, 12 had an AVF requiring embolization. In 92% of cases, this was successful. Beforehand, mean serum creatinine levels were 2.45 mg/dL, after the procedure, that increased to 3.05, however, 3 months later, mean creatinine levels dropped to 1.85 mg/dL. Graft survival after 2 follow-up years was 72%. Our experience demonstrates that selective embolization of the AVF after kidney transplant biopsy is a safe procedure, and that transplant function can be maintained in patients with this complication.

Experiencia de embolización de la arteria renal previa a nefrectomía / Experience of Renal Artery Embolization Prior to Nephrectomy

Resumen Objetivo: Describir la evolución perioperatoria de pacientes sometidos a nefrectomía con y sin embolización de la arteria renal (EAR) prequirúrgica, en un hospital de alta complejidad de Medellín, Colombia. Materiales y Métodos: Observacional descriptivo retrospectivo; se incluyeron pacientes de 18-90 años con diagnóstico de tumor renal, sometidos a nefrectomía con y sin EAR prequirúrgica. Las variables cualitativas se expresaron por medio de frecuencias y proporciones, y las cuantitativas mediante medidas de tendencia central y dispersión. Resultados: Se incluyeron 71 pacientes con una media de edad de 58,1 (DE: 10,6) años, 41 eran mujeres y el 69% tenía diagnóstico de carcinoma de células claras. La media del volumen de sangrado intraoperatorio fue de 540,8 cc, y 19,7% requirió transfusión. El tiempo quirúrgico promedio fue de 2,6 horas y el 38% presentó alguna complicación, con una mortalidad total del 4,2%. Al observar comparativamente los pacientes con EAR (15 pacientes) versus aquellos sin ella (56 pacientes), se identificó un mayor volumen de sangrado intraoperatorio y la necesidad de transfusión en los primeros. Conclusión: Los pacientes sometidos a EAR presentaron un mayor volumen de sangrado, mayor frecuencia de transfusión y complicaciones postoperatorias, siendo necesario un consenso sobre su real pertinencia terapéutica.

Abstract Aim: To describe the perioperative outcomes of patients undergoing nephrectomy with and without preoperative Renal Artery Embolization (RAE) in a high-complexity hospital in Medellín, Colombia. Materials and Methods: Retrospective, descriptive and observational study; 18-90 years old patients with renal tumor diagnosis, submitted to nephrectomy with and without preoperative RAE were included. Qualitative variables were expressed by measures of frequencies and proportions, and quantitative variables were expressed by measures of central tendency and dispersion. Results: 71 patients with a media age of 58,1 (SD: 10,6) years were included, 41 were women and 69% were diagnosed with clear cell carcinoma. The blood loss volume media was 540.8 cc, and 19.7% required transfusion. The operative time media was 2.6 hours and 38% had any complication, with a total mortality of 4.2%. Comparatively observing patients with RAE (15 patients) versus patients without RAE (56 patients), a higher intraoperative blood loss and transfusion requirements were identified in the first ones. Conclusion: Patients submitted to RAE presented greater volume of bleeding, greater frequency of transfusion and post-operative complications, requiring a consensus on its real therapeutic relevance.

Heterologous calcium-dependent inactivation of Orai1 by neighboring TRPV1 channels modulates cell migration and wound healing.

Store-operated calcium entry (SOCE) is an essential calcium influx mechanism in animal cells. One of the most important auto regulatory control systems involves calcium-dependent inactivation (CDI) of the Orai channel, which prevents excessive calcium influx. In the present study we analyze the role of two channels in the induction of CDI on Orai1. Here we show that calcium entering through freely diffusing TRPV1 channels induce strong CDI on Orai1 while calcium entering through P2X4 channel does not. TRPV1 can induce CDI on Orai1 because both channels were found in close proximity in the cell membrane. This was not observed with P2X4 channels. To our knowledge, this is the first study demonstrating that calcium arising from different channels may contribute to the modulation of Orai1 through CDI in freely diffusing single channels of living cells. Our results highlight the role of TRPV1-mediated CDI on Orai1 in cell migration and wound healing.

Integrating social and ecological data to model metapopulation dynamics in coupled human and natural systems.

Understanding how metapopulations persist in dynamic working landscapes requires assessing the behaviors of key actors that change patches as well as intrinsic factors driving turnover. Coupled human and natural systems (CHANS) research uses a multidisciplinary approach to identify the key actors, processes, and feedbacks that drive metapopulation and landscape dynamics. We describe a framework for modeling metapopulations in CHANS that integrates ecological and social data by coupling stochastic patch occupancy models of metapopulation dynamics with agent-based models of land-use change. We then apply this framework to metapopulations of the threatened black rail (Laterallus jamaicensis) and widespread Virginia rail (Rallus limicola) that inhabit patchy, irrigation-fed wetlands in the rangelands of the California Sierra Nevada foothills. We collected data from five diverse sources (rail occupancy surveys, land-use change mapping, a survey of landowner decision making, climate and reservoir databases, and mosquito trapping and West Nile virus testing) and integrated them into an agent-based stochastic patch occupancy model. We used the model to (1) quantify the drivers of metapopulation dynamics, and the potential interactions and feedbacks among them; (2) test predictions of the behavior of metapopulations in dynamic working landscapes; and (3) evaluate the impact of three policy options on metapopulation persistence (irrigation district water cutbacks during drought, incentives for landowners to create wetlands, and incentives for landowners to protect wetlands). Complex metapopulation dynamics emerged when landscapes functioned as CHANS, highlighting the importance of integrating human activities and other ecological processes into metapopulation models. Rail metapopulations were strongly top-down regulated by precipitation, and the black rail's decade-long decline was caused by the combination of West Nile virus and drought. Theoretical predictions of the two metapopulations' responses to dynamic landscapes and incentive programs were complicated by heterogeneity in patch quality and CHANS couplings, respectively. Irrigation cutbacks during drought posed a serious extinction risk that neither incentive policy effectively ameliorated.

Minimally invasive circumferential arthrodesis of the fourth lumbar level for spondylolisthesis treatment / Artrodese circunferencial minimamente invasiva de 4º nível lombar para tratamento de espondilolistese / Artrodesis circunferencial minimamente invasiva del cuarto nivel lumbar para tratamiento de espondilolistesis

ABSTRACT Objective: To know the clinical and radiographic results of patients with L4-L5 degenerative spondylolisthesis grade I, II, and III surgically treated with minimally invasive 360-degree arthrodesis. To determine the clinical and radiographic results according to the Oswestry Index 6 months after surgery and the percentage of postsurgical reduction in these patients. Methods: The present study was developed in the Department of Spinal Surgery of the Unidad Médica de Alta Especialidad Lomas Verdes, from October 2016 to August 2017. It is a prospective, cross-sectional, comparative observational study. We evaluated the reduction of the listhesis using pre and post-operative radiographs, as well as the Oswestry Disability Index. Results: The sample was composed of 12 patients, eight females and four males, showing a statistical significance in the Student's t test, with p=0.05 for both variables. Conclusions: Degenerative spondylolisthesis of the 4th lumbar level is a very frequent pathology that affects groups of productive age and represents a burden not only for the patient, but also for the community. This surgical technique showed a high level of security and confidence for its resolution, showing results comparable to the literature. However, it requires certain technical resources and training to be performed. Evidence Level II; Prospective comparative study.

RESUMO Objetivo: Conhecer os resultados clínicos e radiográficos de pacientes com espondilolistese degenerativa L4-L5 de grau I, II e III, tratados cirurgicamente com artrodese minimamente invasiva de 360 graus. Determinar os resultados clínicos e radiográficos segundo o Indice de Oswestry seis meses após a cirurgia e a porcentagem de redução pós-operatória nesses pacientes. Métodos: Este estudo se desenvolve na Unidade Médica de Alta Especialidade "Lomas Verdes", Cirurgia de coluna, no período de outubro 2016 a agosto de 2017. É um estudo transversal prospectivo, observacional seccional. Avaliamos a lista de redução através de estudos radiográficos pré e pós-operatórios e escala de incapacidade Oswestry. Resultados: Observamos 12 pacientes, oito homens e quatro mulheres, mostrando significancia estatística pelo teste t de Student com p = 0,05, para ambas as variáveis. Conclusão: Espodilolistesis degenarativa de 4° nível lombar são muito frequentes, afetam grupos etários produtivos e afetam tanto o paciente quanto o seu ambiente social. Esta técnica cirúrgica mostra um alto nível de segurança e confiança para solução, mostrando resultados comparáveis com a literatura. No entanto, ele requer recursos técnicos e nível de formação para a sua execução. Nível de Evidência II; Estudo prospectivo comparativo.

RESUMEN Objetivo: Conocer los resultados clínicos y radiográficos en pacientes con espondilolistesis degenerativa L4-L5 grado I, II y III operados con artrodesis 360 minimamente invasivo. Determinar los resultados clínico y radiográficos de pacientes con espondilolistesis degenerativa L4-L5 grado I, II y III con la escala de Oswestry después de 6 meses de operados. Determinar el porcentaje de reducción postquirúrgico de pacientes con espondilolistesis degenerativa L4-L5 grado I, II y III operados con artrodesis 360 minimamente invasivo.. Métodos: El presente estudio se desarrolló en la Unidad Médica de Alta Especialidad Lomas Verdes, módulo de Cirugía de Columna en el periodo de Octubre de 2016 a Agosto del 2017. Es un estudio prospectivo, observacional transversal y comparativo. Evaluamos la reducción de la listesis mediante estudios radiográficos pre y posoperatorios, así como la escala de discapacidad Oswestry. Resultados: La muestra fue de 12 pacientes, ocho del sexo femenino y cuatro del masculino, mostrando una significancia estadística mediante la prueba T de Student con una p=0,05 para ambas variables. Conclusiones: La espondilolistesis degenerativa en el cuarto nivel lumbar es una entidad patológica muy frecuente, que afecta grupos en edad productiva y representa una carga no solo para el paciente, sino también para la sociedad. Esta técnica quirúrgica mostró un alto nivel de seguridad y confianza para su resolución, mostrando resultados equiparables a la literatura. Sin embargo, requiere ciertos recursos técnicos y nivel de adiestramiento para su ejecución. Nivel de Evidencia II; Estudio prospectivo comparativo.

Sagittal balance after posterior instrumentation in lumbar fractures / Equilíbrio sagital após a instrumentação posterior em fraturas lombares / Balance sagital después de la instrumentación posterior en fracturas lumbares

ABSTRACT Objective: When a lumbar fractures developes a significant deformity, the sagittal balance is altered which can lead to clinical consequences. The aim of this study was to measure and analyze the sagittal balance in patients with lumbar fractures operated with posterior instrumentation after three months and analyze their correlation with the different variables of the patient and the fracture. Methods: Sixty-three medical records of patients with lumbar fracture operated with posterior instrumentation were analyzed, excluding those with previous spinal pathology, or inability to stand upright. The parameters of pelvic incidence, sacral slope, pelvic tilt, lumbar lordosis, lumbar lordosis/pelvic incidence (LL/ PI) ratio, as well as the pre and postoperative status of segmental kyphosis and residual pain were measured. Results: Eighteen women, 44 men, with mean age of 42 years, with lumbar fractures: 29 in L1, 19 in L2, 10 in L3, 3 in L4 and 1 in L5. AOSpine Clasification: 2 type A1, 2 type A2, 37 type A3, 19 type A4, 2 type B. All patients were operated with a transpedicular polyaxial system. More than 80% of patients with spinopelvic balance within parameters considered normal. More than 70% with lumbar lordosis and LL/PI ratio within parameters. All with improvement of segmental kyphosis (average correction of 8.5°, p<.000). Final mean VAS of 1.85. Conclusions: The posterior instrumentation with a polyaxial system allows acceptable corrections of the segmental kyphosis of lumbar fractures. No statistically significant correlation was found between sagittal balance parameters, and characteristics of the patient and fracture. Level of Evidence IV; Case series.

RESUMO Objetivo: Quando uma fratura lombar evolui com deformidade significativa, o equilíbrio sagital é alterado, o que pode levar a consequências da manifestação clínica. O objetivo deste estudo foi mensurar e analisar o equilíbrio sagital em pacientes com fratura lombar operada com instrumentação, após três meses, analizando sua correlação com as diferentes variáveis do paciente e da fratura. Método: Foram analisados 63 casos de pacientes com fratura lombar, operados com instrumentação posterior, excluindo-se aqueles com patologia anterior da coluna vertebral ou incapacidade de se manter em pé, parâmetros de incidência pélvico, sacro inclinação, a inclinação da pelve, lordose lombar, relação lordose lombar/incidência pélvica (LL / IP) e a cifose segmentar pós-operatória e pré estado da dor residual mensuradas. Resultados: 18 mulheres, 44 homens, idade média dos pacientes: 42 anos, fraturas: 29 em L1, 19 em L2, 10 em L3, 3 em L4 e 1 em L5. AOSPINE: 2 tipo A1, 2 tipo A2, 37 tipo A3, 19 tipo A4, 2 tipo B. Todos operados com sistema poliaxial transpedicular. > 80% dos pacientes com balanço espinopélvico, dentro de parâmetros considerados normais. > 70% com lordose lombar e relação LL / IP dentro dos parâmetros. Todos com melhora da cifose segmentar (correção média de 8,5°, p <0,000). EVA final médio de 1,85. Conclusão: Instrumentação posterior com um sistema poliaxial permite correções aceitáveis da cifose segmentar das fraturas lombares. Não houve correlação estatisticamente significativa encontrada entre os parâmetros de equilíbrio sagital e as características do paciente e da fratura. Nível de Evidência IV; Série de casos.

RESUMEN Objetivo: Cuando una fractura lumbar evoluciona con una deformidad significativa, se ve alterado el balance sagital lo cual puede llevar a consecuencias clínicas. El objetivo de este estudio fue medir y analizar el balance sagital en pacientes con fracturas lumbares operados con instrumentación posterior después de tres meses y analizar su correlación con las diferentes variables del paciente y la fractura. Métodos: Se analizaron 63 expedientes de pacientes con fractura lumbar operados con instrumentación posterior excluyendo aquellos con patología previa de columna, o incapacidad para bipedestación. Se midieron los parámetros de incidencia pélvica, pendiente sacra, inclinación pélvica, lordosis lumbar, relación lordosis lumbar/incidencia pélvica (LL/IP), así como el estado pre y postoperatorio de la cifosis segmentaria y el dolor residual. Resultados: Dieciocho mujeres, 44 hombres, con edad promedio de 42 años con fracturas lumbares: 29 en L1, 19 en L2, 10 en L3, 3 en L4 y 1 en L5. Clasificación AOSPINE: 2 tipo A1, 2 tipo A2, 37 tipo A3, 19 tipo A4, 2 tipo B. Todos los pacientes fueron operados con sistema poliaxial transpedicular. Más del 80% de los pacientes con balance espinopélvico dentro de parámetros considerados normales. Más del 70% con lordosis lumbar y relación LL/IP dentro de los parámetros. Todos con mejoría de la cifosis segmentaria (corrección promedio de 8,5°, p < 0.000). EVA final promedio de 1,85. Conclusiones: La instrumentación posterior con un sistema poliaxial permite correcciones aceptables de la cifosis segmentaria de las fracturas lumbares. No se encontró correlación estadísticamente significativa entre los parámetros de balance sagital y las características del paciente y la fractura. Nivel de Evidencia IV; Serie de casos.

Checklist of the freshwater fishes of Colombia: a Darwin Core alternative to the updating problem.

The present work is part of a process to create a Catalogue of the Freshwater Fishes of Colombia and consisted in the depuration and updating of the taxonomic and geographic components of the checklist of the freshwater fishes of Colombia. An exhaustive revision of the 1435 species recorded in 2008 was necessary to: 1. Add new species described since 2009 and species originally described from Colombia but inadvertently omitted in 2008; 2. Add new records of already described species; 3. Delete species whose presence in Colombia was not supported by voucher specimens in ichthyological collections; and 4. Revise the geographic distribution of the species listed in 2008. This process resulted in the following numbers: 1. Total number of freshwater fish species in Colombia: 1494; 2. Number of species recorded by hydrographic region - Amazon: 706, Orinoco: 663, Caribbean: 223, Magdalena-Cauca: 220, Pacific: 130; and 3. Number of endemic species: 374 (76% from the trans-Andean region). Updating the current checklist is a fundamental requirement to ensure its incorporation in the decision-making process with regard to the conservation of Colombian aquatic species and ecosystems, which are facing transformation processes as a result of activities such as mining, construction of hydroelectric plants, expansion of the agricultural frontier and subsequent deforestation, industrial and domestic pollution, development of waterways, introduction of exotic species, and climate change.

ResumenEl presente trabajo es parte de un proceso para crear un Catálogo de Peces de Agua Dulce de Colombia y consistió en la depuración y actualización de los componentes taxonómico y geográfico del listado de peces de agua dulce de Colombia. Una revisión exhaustiva de las 1435 especies registradas en 2008 fue necesaria para: 1. Adicionar las especies nuevas descritas desde 2009 y especies descritas originalmente para Colombia pero omitidas inadvertidamente en 2008; 2. Adicionar nuevos registros de especies ya descritas; 3. Eliminar especies cuya presencia en Colombia no estaba soportada por especímenes en colecciones ictiológicas; y 4. Revisar la distribución geográfica de las especies listadas en 2008. Este proceso resultó en las siguientes cifras: 1. Número total de especies de peces de agua dulce en Colombia: 1494; 2. Número de especies registradas por región hidrográfica - Amazonas: 706, Orinoco: 663, Caribe: 223, Magdalena-Cauca: 220, Pacífico: 130; y 3. Número de especies endémicas 374 (76% distribuidas en la región transandina). La actualización del presente listado es un requerimiento fundamental para asegurar su incorporación en el proceso de toma de decisiones en lo concerniente a la conservación de las especies y ecosistemas acuáticos colombianos, los cuales están enfrentando procesos de transformación, como resultado de actividades como la minería, construcción de plantas hidroeléctricas, expansión de la frontera agropecuaria y subsecuente desforestación, polución industrial y doméstica, desarrollo de hidrovías, introducción de especies exóticas y cambio climático.

Open surgical vs. minimally invasive treatment of thoracolumbar ao fractures type a and b1 in a reference hospital / Tratamento cirúrgico aberto vs. minimamente invasivo de fraturas toracolombares ao tipo a e b1 em um hospital de referência / Tratamiento quirúrgico abierto vs. mínimamente invasivo de las fracturas toracolumbares ao tipo a y b1 en un hospital de referencia

ABSTRACT Objective: The thoracolumbar spine trauma represents 30% of spinal diseases. To compare the minimally invasive technique with the open technique in lumbar fractures. Method: A prospective, cross-sectional, comparative observational study, which evaluated the following variables: surgery time, length of hospital stay, transoperative bleeding, postoperative pain, analyzed by SPSS software using Student's t test with statistical significance of p ≥ 0.05, with 24 patients with single-level thoracolumbar fractures, randomly treated with percutaneous pedicle screws and by open technique with a transpedicular system. Results: The surgery time was 90 minutes for the minimally invasive technique and 60 minutes for the open technique, the bleeding was on average 50 cm3 vs. 400 cm3. The mean visual analogue scale for pain at 24 hours of surgery was 5 for the minimally invasive group vs. 8 for the open group. The number of fluoroscopic projections of pedicle screws was 220 in the minimally invasive technique vs. 100 in the traditional technique. Quantified bleeding was minimal for percutaneous access vs. 340 cm3 for the traditional system. The hospital discharge for the minimally invasive group was at 24 hours and at 72 hours for those treated with open surgery. Conclusions: It is a technique that requires longer surgical time, with reports of less bleeding, less postoperative pain and less time for hospital discharge, reasons why it is supposed to be a procedure that requires a learning curve, statistical significance with respect to bleeding, visual analogue scale for pain and showed no significant difference in the variables of surgical time.

RESUMO Objetivo: O trauma da coluna toracolombar representa 30% das doenças de coluna. Comparar a técnica minimamente invasiva com a técnica aberta em fraturas lombares. Método: Estudo prospectivo, transversal, comparativo e observacional, que avaliou as seguintes variáveis: tempo de cirurgia, tempo de internação, sangramento transoperatório, dor pós-cirúrgica, analisadas pelo software SPSS usando o teste t de Student com significância estatística de p ≥ 0,05, com 24 pacientes com fraturas toracolombares em um só nível, tratados randomicamente com parafusos pediculares por via percutânea e por técnica aberta com sistema transpedicular. Resultados: O tempo de cirurgia foi 90 minutos para a técnica minimamente invasiva e 60 minutos para a técnica aberta, o sangramento foi em média 50 cm3 vs. 400 cm3. A escala visual analógica média para dor às 24 horas da cirurgia foi de 5 para o grupo minimamente invasivo vs. 8 para o grupo aberto. O número de projeções fluoroscópicas de parafusos pediculares foi de 220 na técnica minimamente invasiva vs. 100 na técnica tradicional. O sangramento quantificado foi mínimo para o acesso percutâneo vs. 340 cm3 para o sistema tradicional. A alta hospitalar para o grupo minimamente invasivo foi às 24 horas e às 72 horas para os tratados com cirurgia aberta. Conclusões: É uma técnica que exige maior tempo cirúrgico, com relatos de menor sangramento, menos dor pós-operatória e tempo menor para alta hospitalar, motivos pelos quais se supõe que é um procedimento que requer uma curva de aprendizagem, significância estatística com relação ao sangramento, escala visual analógica para dor e não mostrou diferença significante nas variáveis de tempo cirúrgico.

RESUMEN Objetivo: El trauma de la columna toracolumbar representa un 30% de las enfermedades de la columna. Comparar la técnica mínimamente invasiva contra la técnica abierta en fracturas lumbares. Método: Estudio prospectivo, transversal, comparativo y observacional, que evaluó las siguientes variables: tiempo quirúrgico, tiempo de internación, sangrado transquirúrgico, dolor posquirúrgico, analizados por el software SPSS utilizando la prueba t de Student para significación estadística p ≥ 0,05, con 24 pacientes con fracturas toracolumbares de un nivel, tratados de forma aleatoria mediante tornillos pediculares por vía percutánea vs. técnica abierta con sistema transpedicular. Resultados: El tiempo quirúrgico fue de 90 minutos para la técnica mínimamente invasiva y de 60 para la técnica abierta; el sangrado fue en un promedio de 50 cm3 vs. 400 cm3. La escala visual analógica promedio del dolor a las 24 horas del tratamiento quirúrgico fue de 5 para el grupo mínimamente invasivo vs. 8 para el grupo abierto. El número de proyecciones fluoroscópicas de tornillos pediculares fue de 220 en la técnica mínimamente invasiva vs. 100 en la técnica tradicional. El sangrado cuantificado fue mínimo para el acceso percutáneo vs. 340 cm3 para el sistema tradicional. El egreso hospitalario para el grupo mínimamente invasivo fue a las 24 horas, y a las 72 horas para los tratados con cirugía abierta. Conclusiones: Es una técnica que requiere mayor tiempo quirúrgico, con reportes de menor sangrado, menor dolor postoperatorio y un tiempo de egreso hospitalario menor, por lo que se asume que es un procedimiento que requiere una curva de aprendizaje, significación estadística en cuanto al sangrado, escala visual analógica del dolor y no mostró diferencia significativa en las variables de tiempo quirúrgico.

An alternative mode of CD43 signal transduction activates pro-survival pathways of T lymphocytes.

CD43 is one of the most abundant co-stimulatory molecules on a T-cell surface; it transduces activation signals through its cytoplasmic domain, contributing to modulation of the outcome of T-cell responses. The aim of this study was to uncover new signalling pathways regulated by this sialomucin. Analysis of changes in protein abundance allowed us to identify pyruvate kinase isozyme M2 (PKM2), an enzyme of the glycolytic pathway, as an element potentially participating in the signalling cascade resulting from the engagement of CD43 and the T-cell receptor (TCR). We found that the glycolytic activity of this enzyme was not significantly increased in response to TCR+CD43 co-stimulation, but that PKM2 was tyrosine phosphorylated, suggesting that it was performing moonlight functions. We report that phosphorylation of both Y105 of PKM2 and of Y705 of signal transducer and activator of transcription 3 was induced in response to TCR+CD43 co-stimulation, resulting in activation of the mitogen-activated protein kinase kinase 5/extracellular signal-regulated kinase 5 (MEK5/ERK5) pathway. ERK5 and the cAMP response element binding protein (CREB) were activated, and c-Myc and nuclear factor-κB (p65) nuclear localization, as well as Bad phosphorylation, were augmented. Consistent with this, expression of human CD43 in a murine T-cell hybridoma favoured cell survival. Altogether, our data highlight novel signalling pathways for the CD43 molecule in T lymphocytes, and underscore a role for CD43 in promoting cell survival through non-glycolytic functions of metabolic enzymes.

Paracoccidioidomicosis: características clínicas de 94 casos

Paraguay es considerado una zona afectada por esta micosis endémica en gran parte de Sudamérica. No existe trabajo analítico en nuestro país que evalúe las formas de presentación y los desenlaces de la forma crónica de la paracoccidioidomicosis. Objetivo: Descripción de las características clínicas de casos de paracoccidioidomicosis con compromiso pulmonar. Material y métodos: Estudio observacional descriptivo de fichas clínicas de pacientes con diagnóstico de paracoccidioidomicosis internados en el INERAM durante el período de enero 1980-diciembre 2003. El análisis estadístico consistió en un análisis bivariado (X2 y ANOVA), considerando significativa una p < 0,05. Resultados: Se identificaron 94 casos diagnosticados durante el periodo de estudio. La edad de presentación fue de 49±11 años y un notorio bajo índice de masa corporal promedio (16,6) sumado a la alta prevalencia de tabaquismo (77%) caracterizaron a la serie. A pesar de la preponderancia de síntomas respiratorios, se consignaron además lesiones mucosas en 33% y adenopatías cervicales en 19% de los registros médicos. Se describen hallazgos en la analítica sanguínea y en los análisis radiográficos asentados. El análisis de las variables entre el grupo de los fallecidos y de los sobrevivientes mostró una diferencia significativa en la frecuencia respiratoria y en la distribución radiográfica de las lesiones al momento de la internación. Utilizando imidazólicos en 97% de los casos, la mejoría sintomática fue constatada a las 1.6 semanas en promedio, aunque se ha registrado una mortalidad intrahospitalaria del 11.7%. Los pacientes quedaban internados durante 63±58 días para poder recibir tratamiento, pero una vez en condiciones ambulatoriales, el 88% discontinuaba los fármacos. Conclusión: Pese a los síntomas inespecíficos, se debería considerar el diagnóstico de esta micosis en cuadros respiratorios subagudos o crónicos concomitantes a lesiones mucosas y/o adenopatías. Urgen medidas generales que puedan paliar la alta tasa de abandono terapéutico.(AU)

Paraguay is an endemic country for paracoccidiomycosis. There is no analytical work in our country evaluating the clinical presentation and the outcomes of the chronic form of paracoccidioidomycosis. Objective: To describe the clinical characteristics of paracoccidioidomycosis cases with pulmonary involvement. Material and Methods: Observational study of clinical records of patients admitted with a diagnosis of paracoccidioidomycosis during the period of January 1980 - December 2003 in INERAM, a reference medical center. Statistical analysis consisted of a bivariate analysis (X2 and ANOVA), considering significant a p < 0.05. Results: 94 cases diagnosed during the study period were identified. The mean age of presentation was 49 ± 11 years old. The patients had notorious low average body mass index (16.6) and a high prevalence of smoking habit (77%). Respiratory symptoms, mucosal lesions (33%) and cervical lymphadenopathy (19%) were noted. Blood testing and radiographic results are described. The analysis of the variables between the group who died and the survival group showed significant difference in the respiratory rate and the radiographic images at admission. Most patients (97%) were treated with imidazole antifungal drugs; clinical improvement was observed after on average 1.6 weeks of treatment. Lethality among hospitalized patients was 11.7%. Patients were hospitalized for 63 ± 58 days, in order to receive treatment but once at home, 88% discontinued the drugs . Conclusion: Despite the nonspecific symptoms, diagnosis should be suspected in patients with subacute or chronic respiratory symptoms which are concomitant with mucosal lesions and lymphadenopathy. General measures should be taken to decrease the high rate of treatment default at home.(AU)

Paracoccidioidomicosis: características clínicas de 94 casos / Paracoccidioidomycosis: Clinical Characteristics of 94 Cases

Paraguay es considerado una zona afectada por esta micosis endémica en gran parte de Sudamérica. No existe trabajo analítico en nuestro país que evalúe las formas de presentación y los desenlaces de la forma crónica de la paracoccidioidomicosis. Objetivo: Descripción de las características clínicas de casos de paracoccidioidomicosis con compromiso pulmonar. Material y métodos: Estudio observacional descriptivo de fichas clínicas de pacientes con diagnóstico de paracoccidioidomicosis internados en el INERAM durante el período de enero 1980-diciembre 2003. El análisis estadístico consistió en un análisis bivariado (X2 y ANOVA), considerando significativa una p < 0,05. Resultados: Se identificaron 94 casos diagnosticados durante el periodo de estudio. La edad de presentación fue de 49±11 años y un notorio bajo índice de masa corporal promedio (16,6) sumado a la alta prevalencia de tabaquismo (77%) caracterizaron a la serie. A pesar de la preponderancia de síntomas respiratorios, se consignaron además lesiones mucosas en 33% y adenopatías cervicales en 19% de los registros médicos. Se describen hallazgos en la analítica sanguínea y en los análisis radiográficos asentados. El análisis de las variables entre el grupo de los fallecidos y de los sobrevivientes mostró una diferencia significativa en la frecuencia respiratoria y en la distribución radiográfica de las lesiones al momento de la internación. Utilizando imidazólicos en 97% de los casos, la mejoría sintomática fue constatada a las 1.6 semanas en promedio, aunque se ha registrado una mortalidad intrahospitalaria del 11.7%. Los pacientes quedaban internados durante 63±58 días para poder recibir tratamiento, pero una vez en condiciones ambulatoriales, el 88% discontinuaba los fármacos. Conclusión: Pese a los síntomas inespecíficos, se debería considerar el diagnóstico de esta micosis en cuadros respiratorios subagudos o crónicos concomitantes a lesiones mucosas y/o adenopatías. Urgen medidas generales que puedan paliar la alta tasa de abandono terapéutico.

Paraguay is an endemic country for paracoccidiomycosis. There is no analytical work in our country evaluating the clinical presentation and the outcomes of the chronic form of paracoccidioidomycosis. Objective: To describe the clinical characteristics of paracoccidioidomycosis cases with pulmonary involvement. Material and Methods: Observational study of clinical records of patients admitted with a diagnosis of paracoccidioidomycosis during the period of January 1980 - December 2003 in INERAM, a reference medical center. Statistical analysis consisted of a bivariate analysis (X2 and ANOVA), considering significant a p < 0.05. Results: 94 cases diagnosed during the study period were identified. The mean age of presentation was 49 ± 11 years old. The patients had notorious low average body mass index (16.6) and a high prevalence of smoking habit (77%). Respiratory symptoms, mucosal lesions (33%) and cervical lymphadenopathy (19%) were noted. Blood testing and radiographic results are described. The analysis of the variables between the group who died and the survival group showed significant difference in the respiratory rate and the radiographic images at admission. Most patients (97%) were treated with imidazole antifungal drugs; clinical improvement was observed after on average 1.6 weeks of treatment. Lethality among hospitalized patients was 11.7%. Patients were hospitalized for 63 ± 58 days, in order to receive treatment but once at home, 88% discontinued the drugs . Conclusion: Despite the nonspecific symptoms, diagnosis should be suspected in patients with subacute or chronic respiratory symptoms which are concomitant with mucosal lesions and lymphadenopathy. General measures should be taken to decrease the high rate of treatment default at home.

The Murcia Twin Registry: a population-based registry of adult multiples in Spain.

The Murcia Twin Registry (MTR) was created in 2006, under the auspices of the University of Murcia and the regional Health Authority, aiming to develop a research resource in Spain intended to stimulate current research and new investigation on the analysis of genetic factors related to health and health-related behaviors. The MTR development strategy was designed as a step-by-step process. Initially, it was focused on women's health but nowadays it includes males and opposite-sex twins. The database comprises 2,281 participants born between 1940 and 1966 in the region of Murcia, in Spain. There have been three waves of data collection and today the MTR databases include questionnaire and anthropometric data as well as biological samples. The current main areas of research interest are health and health-related behaviors, including lifestyle, health promotion, and quality of life. Future short-term development points to the completion of the biobank and continuing the collection of longitudinal data.