Exploring the microbiome of two uterine sites in cows.

Bacterial communities in the mammalian reproductive system can be rich and diverse, differing in structure and quantity depending on location. In addition, its microbiome is associated with the state of health of this tract and reproductive success. This study evaluated the microbiome composition of the uterine body (UB) and uterine horn mucosa (UH) samples using 16S rRNA sequencing of samples extracted from cows in the Amazon region. It was observed that four main phyla were shared between the uterine sites: Actinobacteria, Bacteroidetes, Firmicutes, and Proteobacteria. Linear discriminant analysis effect size and heat tree analysis showed that members of Lachnospiraceae (NK3A20 group) and Oscillospiraceae were significantly more abundant in the UB than in UH. In addition, there are more unique genera in the UB than in the UH. A higher bacterial load in UB than in UH is expected because of the exposure to external factors of UB. However, comparing the site's communities through beta diversity did not generate well-defined clustering. Thus, it can be attributed to the closeness of the sites, which would make the niches similar ecologically and microbiologically. Therefore, this research provides knowledge to understand biomarkers in the prior reproduction period.

Maximizing diabetes education efforts in vulnerable populations - newer delivery concepts.

PURPOSE OF REVIEW: Patients from ethnic/minority backgrounds or low socioeconomic status face numerous barriers to achieving ideal diabetes care goals. The purpose of this review is to describe the burden of diabetes in vulnerable populations; discuss the etiologic factors leading to health disparities in diabetes; and present challenges and solutions to improving diabetes care through novel diabetes self-management education and support interventions. RECENT FINDINGS: Recent interventions to alleviate health disparities utilize a combination of community health workers, peer leaders and technology-based approaches to provide diabetes self-management education and support and overcome barriers to diabetes control such as low literacy, difficulty with transportation, and cultural beliefs. These interventions achieve clinically meaningful improvements in blood glucose control as measured by haemoglobin A1C and are effective in addressing psychosocial outcomes such as diabetes distress. Research is underway to address food insecurity through food delivery and use behavioural economics principles to provide financial incentives to diabetes control. SUMMARY: Combining human interaction through peer or community health worker led diabetes educational efforts and support with technology-based interventions shows promise in improving diabetes outcomes for vulnerable populations.

Milk Macrophage Function in Bovine Leukemia Virus-Infected Dairy Cows.

The implications of bovine leukemia virus (BLV) on innate and adaptive immune responses have been widely investigated; however, the effects of BLV on mammary gland immunity require further investigation. The present study investigated the viability, phagocytic capacity, and intracellular production of reactive oxygen and nitrogen species (RONS) by macrophages in milk samples from dairy cows naturally infected with BLV with or without persistent lymphocytosis (PL). No effect of BLV infection in the overall number of macrophages per milliliter and in the percentage of viable macrophages among overall milk viable cells was found. Furthermore, BLV-infected dairy cows had a higher frequency of viable milk macrophages, while healthy animals had a tendency toward a higher percentage of apoptotic milk macrophages. The percentage of milk macrophages that phagocytosed Staphylococcus aureus in seronegative animals was higher than that in BLV-infected dairy cows. No effect of BLV infection on the intracellular RONS production and the intensity of phagocytosis by milk macrophages was observed. Thus, this study provides new insights into the implications of BLV infections in the bovine mammary gland.

States' Performance in Reducing Uninsurance Among Black, Hispanic, and Low-Income Americans Following Implementation of the Affordable Care Act.

Purpose: To assess state-level variation in changes in uninsurance among Black, Hispanic, and low-income Americans after implementation of the Affordable Care Act (ACA). Methods: We analyzed data from the Behavioral Risk Factor Surveillance System from 2012 to 2016, excluding 2014. For Black, Hispanic, and low-income (<$35,000/year) adults 18-64 years of age, we estimated multivariable regression adjusted pre- (2012-2013) to post-ACA (2015-2016) percentage point changes in uninsurance for each U.S. state. We compared absolute and relative changes and the proportion remaining uninsured post-ACA across states. We also examined whether state-level variation in coverage gains was associated with changes in forgoing needed care due to cost. Results: The range in the percentage point reduction in uninsurance varied substantially across states: 19-fold for Black (0.9-17.4), 18-fold for Hispanic (1.2-21.5), and 23-fold for low-income (1.0-27.8) adults. State-level variation in changes in uninsurance relative to baseline uninsurance rates also varied substantially. In some states, more than one quarter of Black, one half of Hispanic, and approaching one half of low-income adults remained uninsured after full implementation of the ACA. Compared with states in the lowest quintile of change in coverage, states in the highest quintile experienced greater improvements in ability to see a physician. Conclusions: Performance on reducing uninsurance for Black, Hispanic, and low-income Americans under the ACA varied substantially among U.S. states with some making substantial progress and others making little. Post-ACA uninsurance rates remained high for these populations in many states.

Postoperative outcomes and functional results after Deloyer's procedure - a retrospective cohort study / Desfechos pós-operatórios e resultados funcionais após o procedimento de Deloyer ­ um estudo de coorte retrospectivo

ABSTRACT Introduction: The objective of our study was to describe surgical outcomes of Deloyers procedure in our referral center, and to compare the results of patients with and without protective ileostomy. Methods: Patients undergoing a Deloyers procedure from 2013 to 2016 were prospectively included. General characteristics, intraoperative variables, postoperative course, and functional outcomes were analyzed. Patients were compared into two groups: group (1) patients undergoing Deloyers procedure without ileostomy, and group (2) Deloyers procedure with protective ileostomy. Results: Sixteen patients undergoing isoperistaltic transposition of the right colon remnant were included, of which 9 (63%) were males with a median age of 47 (range 22-76) years. The main surgical indication was the restoration of bowel transit (62.5%). There was higher major morbidity rate in the Deloyers procedure with protective ileostomy group, but without statistical significance (20% vs. 9%, p = 0.92). No leaks or deaths were reported. The length of hospital stay was 7 days. The mean number of bowel movements per day was 4 at 18 months of follow up. Only four (25%) patients used irregularly loperamide. Conclusions: The Deloyers procedure has satisfactory results and is reproducible with low morbidity. The major and minor morbidity rates were similar between groups, suggesting that the costs and risks of a second procedure can be avoided by providing a safe primary anastomosis.

RESUMO Introdução: O objetivo de nosso estudo foi descrever os resultados cirúrgicos do procedimento de Deloyer em nosso centro de referência e comparar os resultados de pacientes com e sem ileostomia de proteção. Métodos: Pacientes submetidos ao procedimento de Deloyer de 2013 a 2016 foram incluídos prospectivamente. Foram analisadas as características gerais, as variáveis intraoperatórias, o curso pós-operatório e os desfechos funcionais. Os pacientes foram comparados em dois grupos: Grupo 1) pacientes submetidos ao procedimento de Deloyer (PD) sem ileostomia, e grupo 2) procedimento de Deloyer com ileostomia de proteção (IP). Resultados: Foram incluídos 16 pacientes submetidos à transposição isoperistáltica da porção remanescente do cólon direito, dos quais 9 (63%) eram do sexo masculino com idade média de 47 anos (variação de 22-76) anos. A principal indicação cirúrgica foi a restauração do trânsito intestinal (62,5%). Houve maior morbidade maior no grupo IP, mas sem significância estatística (20% vs. 9%, p = 0,92). Nenhum vazamento ou óbito foi relatado. A duração da hospitalização foi de 7 dias. O número médio de evacuações por dia foi 4, aos 18 meses de seguimento. Apenas quatro (25%) pacientes utilizaram irregularmente a loperamida. Conclusões: O procedimento de Deloyer tem resultados satisfatórios e é reprodutível com baixa morbidade. As taxas de morbidades maiores e menores foram semelhantes entre os grupos, sugerindo que os custos e riscos de um segundo procedimento podem ser evitados proporcionando-se uma anastomose primária segura.

Coverage and Access for Americans With Chronic Disease Under the Affordable Care Act: A Quasi-Experimental Study.

BACKGROUND: Half of Americans have at least 1 chronic disease. Many in this group, particularly racial/ethnic minorities, lacked insurance coverage and access to care before the Patient Protection and Affordable Care Act (ACA) was enacted. OBJECTIVE: To determine whether the ACA has had an effect on insurance coverage, access to care, and racial/ethnic disparities among adults with chronic disease. DESIGN: Quasi-experimental policy intervention. SETTING: Nationally representative, noninstitutionalized sample in the United States. PATIENTS: 606 277 adults aged 18 to 64 years with a chronic disease. INTERVENTION: Implementation of ACA provisions on 1 January 2014. MEASUREMENTS: Self-reported insurance coverage, having a checkup, having a personal physician, and not having to forgo a needed physician visit because of cost. RESULTS: After the ACA was implemented, insurance coverage increased by 4.9 percentage points (95% CI, 4.4 to 5.4), not having to forgo a physician visit increased by 2.4 percentage points (CI, 1.9 to 2.9), and having a checkup increased by 2.7 percentage points (CI, 2.2 to 3.4). Having a personal physician did not change (0.3 percentage points [CI, -0.2 to 0.8]). All outcomes varied considerably by state, and coverage increased more in states that expanded Medicaid. Although racial/ethnic minorities had greater improvements in some outcomes, approximately 1 in 5 black and 1 in 3 Hispanic persons with a chronic disease continued to lack coverage and access to care after ACA implementation. LIMITATION: The study examined data from only the first year of the ACA's major coverage expansion provisions. CONCLUSION: Although the ACA increased coverage and access for persons with chronic disease, substantial gaps remain, particularly for minorities and those in Medicaid nonexpansion states. PRIMARY FUNDING SOURCE: None.

Advantages of Minimally Invasive Surgery for the Treatment of Colovesical Fistula.

BACKGROUND: Colovesical fistulas in two-thirds of the cases are due to diverticular disease. In recent years, a minimally invasive approach has shown advantages over the traditional open approach. The goal of this study was to evaluate the surgical results and safety of the laparoscopic procedure in patients with colovesical fistula. MATERIAL AND METHODS: We retrospectively evaluated 24 patients who underwent surgery for colovesical fistula in a referral center from 2005 to 2011. Patients were divided into two groups: (i) laparoscopic approach, and (ii) open approach. RESULTS: The laparoscopic and open groups had similar characteristics with respect to age and gender distribution. There were a higher number of bladder repairs in the open approach group (83.3 vs. 16.6%; p = 0.01). The operative time (212 ± 74 min vs. 243 ± 69 min; p = 0.313) and intraoperative bleeding (268 ± 222 ml vs. 327 ± 169 ml; p = 0.465) were similar in both groups. The conversion rate of the laparoscopic approach to open surgery was 25%. There was no difference in morbidity (41.1 vs. 25%; p = 0.414), although the laparoscopic group had a shorter hospital stay (9 ± 4 days vs. 15 ± 11 days; p = 0.083) without statistical significance. CONCLUSIONS: The treatment of colovesical fistula by a laparoscopic approach is safe and is associated with less bladder repairs and a shorter hospital stay.

miRIAD-integrating microRNA inter- and intragenic data.

MicroRNAs (miRNAs) are a class of small (∼22 nucleotides) non-coding RNAs that post-transcriptionally regulate gene expression by interacting with target mRNAs. A majority of miRNAs is located within intronic or exonic regions of protein-coding genes (host genes), and increasing evidence suggests a functional relationship between these miRNAs and their host genes. Here, we introduce miRIAD, a web-service to facilitate the analysis of genomic and structural features of intragenic miRNAs and their host genes for five species (human, rhesus monkey, mouse, chicken and opossum). miRIAD contains the genomic classification of all miRNAs (inter- and intragenic), as well as classification of all protein-coding genes into host or non-host genes (depending on whether they contain an intragenic miRNA or not). We collected and processed public data from several sources to provide a clear visualization of relevant knowledge related to intragenic miRNAs, such as host gene function, genomic context, names of and references to intragenic miRNAs, miRNA binding sites, clusters of intragenic miRNAs, miRNA and host gene expression across different tissues and expression correlation for intragenic miRNAs and their host genes. Protein-protein interaction data are also presented for functional network analysis of host genes. In summary, miRIAD was designed to help the research community to explore, in a user-friendly environment, intragenic miRNAs, their host genes and functional annotations with minimal effort, facilitating hypothesis generation and in-silico validations. Database URL: http://www.miriad-database.org.

Src as a novel therapeutic target for endometriosis.

BACKGROUND: Endometriosis is a common condition that is associated with an increased risk of developing ovarian carcinoma. Improved in vitro models of this disease are needed to better understand how endometriosis, a benign disease, can undergo neoplastic transformation, and for the development of novel treatment strategies to prevent this progression. METHODS: We describe the generation and in vitro characterization of novel TERT immortalized ovarian endometriosis epithelial cell lines (EEC16-TERT). RESULTS: Expression of TERT alone was sufficient to immortalize endometriosis epithelial cells. TERT immortalization induces an epithelial-to-mesenchymal transition and perturbation in the expression of genes involved in the development of ovarian cancer. EEC16-TERT was non-tumorigenic when xenografted into immunocompromised mice but grew in anchorage-independent growth assays in an epidermal growth factor and hydrocortisone dependent manner. Colony formation in agar was abolished by inhibition of Src, and the Src pathway was found to be activated in human endometriosis lesions. CONCLUSIONS: This new in vitro model system mimics endometriosis and the early stages of neoplastic transformation in the development of endometriosis associated ovarian cancer. We demonstrate the potential clinical relevance of this model by identifying Src activation as a novel pathway in endometriosis that could be targeted therapeutically, perhaps as a novel strategy to manage endometriosis clinically, or to prevent the development of endometriosis-associated ovarian cancer.

Kinin B1 receptor gene ablation affects hypothalamic CART productionb.

A role for the kinin B1 receptor in energy-homeostatic processes was implicated in previous studies; notably, the studies where kinin B1 receptor knockout mice (B1-/-) were shown to have impaired adiposity, impaired leptin and insulin production, lower feed efficiency, protection from liver steatosis and diet-induced obesity when fed a high fat diet (HFD). In particular, in a model where the B1 receptor is expressed exclusively in the adipose tissue, it rescues the plasma insulin concentration and the weight gain seen in wild type mice. Taking into consideration that leptin participates in the formation of hypothalamic nuclei, which modulate energy expenditure, and feeding behavior, we hypothesized that these brain regions could also be altered in B1-/- mice. We observed for the first time a difference in the gene expression pattern of cocaine and amphetamine related transcript (CART) in the (lateral hypothalamic area (LHA) resulting from the deletion of the kinin B1 receptor gene. The correlation between CART expression in the LHA and the thwarting of diet-induced obesity corroborates independent correlations between CART and obesity. Furthermore, it seems to indicate that the mechanism underlying the 'lean' phenotype of B1-/- mice does not stem solely from changes in peripheral tissues but may also receive contributions from changes in the hypothalamic machinery involved in energy homeostasis processes.

Pneumonia quality measures not associated with antibiotics for congestive heart failure patients.

BACKGROUND: Pneumonia antibiotic timing performance measures can result in unnecessary antibiotic administration to patients in whom a diagnosis of pneumonia remains possible but has not been confirmed. OBJECTIVE: Our objective was to determine if unnecessary antibiotic administration to admissions with Emergency Department (ED) congestive heart failure (CHF) diagnoses increased as institutional attention to pneumonia antibiotic timing intensified. METHODS: We performed a cross-sectional study in an academic ED with 39,000 annual visits. Our subjects included adult admissions with ED CHF diagnoses between October and March of 2004-2005, 2005-2006, and 2006-2007. We excluded patients with any concomitant infectious diagnosis from primary analysis. We obtained patient age, sex, triage acuity, vital signs, ED diagnoses, and admitting service from electronic databases. Trained abstractors confirmed infectious diagnosis presence and noted if antibiotics were administered. Inter-observer agreement was assessed. Multivariate logistic regression determined association of time period with antibiotic administration. We assessed trends in concomitant infectious diagnoses. RESULTS: Of 778 CHF admissions, 125 had infectious diagnoses, leaving 653 for primary analysis. Inter-observer agreement was good to excellent (κ = 0.71-0.83). Demographic and presenting characteristics did not vary by period. Antibiotics were administered to 18.4% (95% confidence interval [CI] 12.7-23.3), 15.0% (95% CI 9.6-18.5), and 15.1% (95% CI 10.2-19.8), per period, respectively. Time period was not associated with antibiotics, odds ratios were 0.8 (95% CI 0.5-1.4) and 0.9 (95% CI 0.5-1.6) for periods 2 and 3, respectively. Concomitant infectious diagnoses did not increase significantly (from 15.5% to 19.4%). Pneumonia antibiotic timing compliance remained low (50-70%). CONCLUSIONS: Unnecessary antibiotic administration to ED CHF admissions did not increase as institutional scrutiny of pneumonia antibiotic timing intensified, although neither did compliance with pneumonia antibiotic timing.

Kinin B1 receptor in adipocytes regulates glucose tolerance and predisposition to obesity.

BACKGROUND: Kinins participate in the pathophysiology of obesity and type 2 diabetes by mechanisms which are not fully understood. Kinin B(1) receptor knockout mice (B(1) (-/-)) are leaner and exhibit improved insulin sensitivity. METHODOLOGY/PRINCIPAL FINDINGS: Here we show that kinin B(1) receptors in adipocytes play a role in controlling whole body insulin action and glucose homeostasis. Adipocytes isolated from mouse white adipose tissue (WAT) constitutively express kinin B(1) receptors. In these cells, treatment with the B(1) receptor agonist des-Arg(9)-bradykinin improved insulin signaling, GLUT4 translocation, and glucose uptake. Adipocytes from B(1) (-/-) mice showed reduced GLUT4 expression and impaired glucose uptake at both basal and insulin-stimulated states. To investigate the consequences of these phenomena to whole body metabolism, we generated mice where the expression of the kinin B(1) receptor was limited to cells of the adipose tissue (aP2-B(1)/B(1) (-/-)). Similarly to B(1) (-/-) mice, aP2-B(1)/B(1) (-/-) mice were leaner than wild type controls. However, exclusive expression of the kinin B(1) receptor in adipose tissue completely rescued the improved systemic insulin sensitivity phenotype of B(1) (-/-) mice. Adipose tissue gene expression analysis also revealed that genes involved in insulin signaling were significantly affected by the presence of the kinin B(1) receptor in adipose tissue. In agreement, GLUT4 expression and glucose uptake were increased in fat tissue of aP2-B(1)/B(1) (-/-) when compared to B(1) (-/-) mice. When subjected to high fat diet, aP2-B(1)/B(1) (-/-) mice gained more weight than B(1) (-/-) littermates, becoming as obese as the wild types. CONCLUSIONS/SIGNIFICANCE: Thus, kinin B(1) receptor participates in the modulation of insulin action in adipocytes, contributing to systemic insulin sensitivity and predisposition to obesity.

Personal stories: voices of Latino youth health advocates in a diabetes prevention initiative.

The YMCA-Silicon Valley Racial and Ethnic Approaches to Community Health (REACH) U.S. Proyecto Movimiento (PM) Action Community project is a community-based partnership that aims to reduce the prevalence of diabetes among Latinos in the Greater Gilroy, California, area by delivering a prevention campaign across generations. A critical component of PM has been the creation of a Youth Health Advocate (YHA) afterschool club at three public high schools in Gilroy. The YHAs, who are trained on health, nutrition, diabetes, basic leadership skills, and digital storytelling, are at the forefront of the campaign targeting Gilroy youth. In their own words, the YHAs describe why they decided to become a YHA, the positive health impact of YHA activities on themselves and their family, and the positive impact on burgeoning leadership skills. The voices of YHAs in this prevention campaigns have brought value to the PM evaluation, and this qualitative element bears further examination in other community-based prevention campaigns.

The role of kinin B1 and B2 receptors in the scratching behaviour induced by proteinase-activated receptor-2 agonists in mice.

BACKGROUND AND PURPOSE: Activation of the proteinase-activated receptor-2 (PAR-2) induces scratching behaviour in mice. Here, we have investigated the role of kinin B(1) and B(2) receptors in the pruritogenic response elicited by activators of PAR-2. EXPERIMENTAL APPROACH: Scratching was induced by an intradermal (i.d.) injection of trypsin or the selective PAR-2 activating peptide SLIGRL-NH(2) at the back of the mouse neck. The animals were observed for 40 min and their scratching response was quantified. KEY RESULTS: I.d. injection of trypsin or SLIGRL-NH(2) evoked a scratching behaviour, dependent on PAR-2 activation. Mice genetically deficient in kinin B(1) or B(2) receptors exhibited reduced scratching behaviour after i.d. injection of trypsin or SLIGRL-NH(2). Treatment (i.p.) with the non-peptide B(1) or B(2)receptor antagonists SSR240612 and FR173657, respectively, prevented the scratching behaviour caused by trypsin or SLIGRL-NH(2). Nonetheless, only treatment i.p. with the peptide B(2)receptor antagonist, Hoe 140, but not the B(1)receptor antagonist (DALBK), inhibited the pruritogenic response to trypsin. Hoe 140 was also effective against SLIGRL-NH(2)-induced scratching behaviour when injected by i.d. or intrathecal (i.t.) routes. Also, the response to SLIGRL-NH(2) was inhibited by i.t. (but not by i.d.) treatment with DALBK. Conversely, neither Hoe 140 nor DALBK were able to inhibit SLIGRL-NH(2)-induced scratching behaviour when given intracerebroventricularly (i.c.v.). CONCLUSIONS AND IMPLICATIONS: The present results demonstrated that kinins acting on both B(1) and B(2) receptors played a crucial role in controlling the pruriceptive signalling triggered by PAR-2 activation in mice.

Disparities in trauma center access despite increasing utilization: data from California, 1999 to 2006.

BACKGROUND: Although efforts have been made to address disparities in access to trauma care in the past decade, there is little evidence to show if utilization has changed. We use patient-level data to describe the changes in utilization of trauma centers (TCs) in an 8-year period in California. METHODS: We analyzed all statewide trauma admissions (n = 752,706) using the California Office of Statewide Health Planning and Discharge Patient Discharge Database from the period of 1999 to 2006, and determined the trends in admissions and place of care. RESULTS: The proportion of severe injuries admitted increased by 3.6% (p < 0.05), with a concomitant rise in the proportion of patients with trauma to TCs, from 39.3% (95% CI: 39.0%-39.7%) to 49.7% (49.4%-50.0%). Within the severely injured with injury severity scores (ISS) >15, 82.4% were treated in a TC if they resided in a county with a TC, compared with 30.8% of patients who did not live in a county with a TC. After adjustment, patients living greater than 50 miles away from a TC still had a likelihood ratio of 0.11 (p < 0.0001) of receiving care in a TC compared with those less than 10 miles away. Similarly, even severely injured patients not living in a county with a TC had a likelihood ratio of 0.35 (p < 0.0001) of being admitted to a TC compared with those residing in counties with TCs. CONCLUSION: Admissions to TCs for all categories of injury severity are increasing. There remains, however, a large disparity in TC care depending on geographical distance and availability of a TC within county.

Deletion of bradykinin B1 receptor reduces renal fibrosis.

The Kallikrein-kinin system works through activation of two receptors. One constitutive, named B2 receptor (B2R) and another inducible, denominated B1 receptor (B1R). In renal fibrosis, B2R receptor activation appears to be protective, however B1R participation is unveiled. The aim of this study was to analyze how the deletion of the B1R would modify tissue responses after unilateral ureteral obstruction (UUO). For that, B1R knockout (B1KO) and wild-type mice (B1B2WT) were subjected to UUO and sacrificed at days 1, 5 and 14. Renal dysfunction was assayed by urine proteinuria/creatinine ratio and percentage of tubulointerstitial fibrosis. Kidneys were harvested at day 5 to analyze anti and pro-inflammatory molecules expression by real-time PCR. We demonstrated that at all time points, B1KO mice presented lower proteinuria/creatinine ratio from bladder urine. B1KO protection was reinforced by its lower tubular interstitial fibrosis percentage at day 14 (B1B2WT: 12.16+/-1.53% vs. B1KO: 6.73+/-1.07%, p<0.02). UUO was able to induce B1R expression and its highest transcription was achieved at day 5. At this day, B1KO had significant lower expression of pro-inflammatory molecules such as TGF-beta, MCP-1, OPN and IL-6 and higher anti-inflammatory components, as IL-10 and HO-1. Herein, we observed that B1R deletion may be an important component in renal fibrosis prevention.

Linfosarcoma canino / Canine lymphosarcoma

Un canino criollo hembra de 5 años de edad fue llevado a la clínica veterinaria de la universidad de los llanos, con historia de anorexia y con una lesión en la región frontal de la cara. El análisis hematológico mostró anemia leve, neutropenia acompañada de linfocitosis marcada. En la necropsia se evidenció hepatomegalia y congestión hepática, esplenomegalia, congestión de vasosmesentéricos, la cápsula renal se desprendió con facilidad y la periferia renal presentaba zonas debajo relieve así como zonas pálidas en la corteza. Los resultados histopatológicos mostraron hallazgos compatibles con linfosarcoma que se clasificó como grado IV, con metástasis en hígado riñón y bazo. La distribución de la neoplasia encontrada es compatible con linfoma hepatoesplénico; en el cual se demostró la distribución de células neoplásicas que reflejaron un tropismo vascular y la lesión cutánea en la frente pudo ser resultado primario o secundario del linfosarcoma; la patología fue compatible con microabscesos de Pautrier

A 5 year-old female Creole canine was taken to the veterinary clinic of the Universidad de Los Llanos, with anorexy history and with a lesion in the front region of face. The hemathological analysis showed light anemia, neutropenia with marked lymphocytosis. In the necrosis was evidencedhepatomegaly and hepatic congestion, splenomegaly, congestion of mesenteric vessels, the renal capsule came off with easiness and the renal periphery presented areas of low relief as well as pale areas in peel. The histopathology results showed compatible discoveries with lymphosarcoma that was classified as grade IV, with metastasis in liver kidney and spleen. The neoplasia found is compatible with lymphoma hepatosplenic; in which distribution of neoplasia cells was demonstratedreflecting a vascular tropism and the cutaneous lesion in the forehead could be primary or secondary result of lymphosarcoma; pathology was compatible with Pautrier microabscess.

Alosetron: ischemic colitis and serious complications of constipation.

Drugs such as alosetron that modulate serotonin effects by stimulating or blocking its receptors may play an important role in the treatment of some patients with irritable bowel system. In the case of alosetron, a 5HT-3 antagonist, an analysis of data from randomized clinical trials and postmarketing experiences have demonstrated a causal relationship between this drug and ischemic colitis and serious complications of constipation. Because the mechanism(s) of drug-induced ischemic colitis and possibly other forms of intestinal ischemia associated with alosetron have not been elucidated, there is need to further assess risk with regard to patient susceptibility and other factors.

Pseudomixoma peritoneal: diagnóstico y tratamiento / Pseudomyxoma peritonei: diagnosis and treatment

Introducción: el pseudomixoma peritoneal (PMP) es una entidad clínica poco frecuente, caracterizada por múltiples implantes peritoneales, de un material mucinoso derivado generalmente de un tumor mucosecretor, que se localiza con mayor frecuencia en apéndice, ovario y páncreas. En un 10 de los casos no se puede determinar su origen.Caso Clínico: Varón, de 69 años, que consulta por distensión abdominal progresiva y pérdida de peso (16 Kg.) de un año de evolución exacerbada en los últimos 3 meses asociada a dolor abdominal difuso y estado nauseoso. Se realiza una laparotomía exploradora mediana supra-infraumbilical, la cual permitió drenar abundante cantidad de contenido mucinoso, constatándose el compromiso de varios órganos, especialmente el ciego. Ante la imposibilidad de llevar a cabo el procedimiento de Sugarbaker, por el grado de compromiso de las estructuras abdominales, se prcedió a instilar Mitomicina C (12,5/m2 de superficie corporal) intraoperatoria, hipertérmica (43º C) durante 90 minutos. El paciente evoluciona favorablemente, retirándose los drenajes, gracias al descenso gradual del débito.Discusión: Representa el primer caso en 95 años de labor asistencial en nuestra institución. Como factores que empeoran el pronóstico, se han descrito, la presencia de distensión abdominal, sexo masculino, historia de pérdida de peso, enfermedad difusa, afectación de órganos vecinos (todos presentes en nuestro paciente). La incidencia de esta patología es baja, según lo reportado por la literatura, no obstante esta es más frecuente en mujeres. Creemos que la cirugía es de suma utilidad, teniendo en cuenta que permite obtener un diagnóstico, la posibilidad de drenar el contenido mucinoso de la cavidad, y en los mejores casos realizar los procedimientos de Sugarbaker, Siendo paliativo el tratamiento realizado por nuestro equipo, el paciente experimentó una mejoría clínica importante, lo cual le permitió su reinserción familiar y laboral.