Identification of Cotylophoron cotylophorum (Fischoeder, 1901) in cattle on St. Kitts, West Indies and its relationship with African and Asian populations.

There is limited information about the species of rumen fluke (Family Paramphistomidae) in the Caribbean. However, knowledge of species distribution is needed to better understand disease risk and epidemiology. Morphological identification is challenging with more recent DNA sequencing enabling a better understanding of rumen fluke distribution. In this study, rumen fluke specimens, collected between 2015 and 2016 from cattle on the island of St. Kitts, West Indies, were analysed. The ribosomal internal transcribed spacer 2 (ITS-2) region of rDNA was amplified using generic trematode primers. Results from Sanger sequencing were compared to reference sequences in GenBank and indicated the species was Cotylophoron cotylophorum with 100% sequence identity and 91% query cover. The ITS2 sequences were then compared to previously published ITS2 sequences for the Cotylophoron genus. When all the St. Kitts C. cotylophorum ITS2 sequences were compared with all other Cotylophoron sequences from India, Kenya, and Zimbabwe, three variable nucleotide sites, resulting in five unique haplotypes, were identified. Nine ITS2 sequences shared haplotype 1, which included all those from St. Kitts and single representatives from India and Kenya, potentially indicating global movement of this species.

Qualitative investigation of the speech-language therapy experiences of individuals who covertly stutter.

PURPOSE: Individuals who covertly stutter have a unique experience of stuttering that involves concealing the core behaviors of stuttering (e.g., repetitions, prolongations, and blocks). From the listener's perspective, covert stuttering results in minimum typical, overt stuttering behaviors. However, from the speaker's perspective, covert stuttering often increases the cognitive and emotional impact of stuttering. This study explores the speech-language therapy experiences of individuals who covertly stutter in order to improve treatment recommendations and best practice. METHODS: This investigation is a qualitative analysis of individuals' speech-language therapy experiences as persons who covertly stutter. Real-time video interviews were conducted with the use of open-ended phenomenological interview questions. Interviews were transcribed and thematic analysis of interview transcripts was conducted to investigate the speech-language therapy experiences of the participants. RESULTS: The participants indicated that stuttering therapy was most impactful when it included explicit goals and activities, personalized selection of therapy techniques or strategies beyond fluency techniques, encouraged self-education, and educated those in the person's environment. CONCLUSION: The evidence suggests individualized therapy based on each client's unique manifestation of covert stuttering is beneficial; while, fluency-focused stuttering therapy is often incongruent with the needs of persons who covertly stutter. Therapeutic implications and recommendations for speech-language pathologists are discussed.

Covert Stuttering: Investigation of the Paradigm Shift From Covertly Stuttering to Overtly Stuttering.

Purpose: Covert stuttering is a type of stuttering experience that occurs when a person who stutters conceals his or her stutter from others, attempting to be perceived as a nonstuttering individual. A person who covertly stutters experiences the cognitive and emotional elements of stuttering with minimum overt behavioral symptoms. Individuals who covertly stutter are able to provide insight into their experiences in attempting to be perceived as nonstuttering individuals. Covert stuttering is a topic that continues to be in need of a formal definition. The current investigation is utilizing thematic analysis to provide a detail-rich investigation of the paradigm shift from covertly stuttering to overtly stuttering. Method: The current investigation is a qualitative analysis of individuals' transition process from covertly stuttering to overtly stuttering. Real-time video interviews were conducted with the use of open-ended phenomenological interview questions. Interviews were transcribed, and thematic analysis of interview transcripts was conducted to investigate the covertly to overtly stuttering process for participants. Results: The findings provide insight into a paradigm shift that occurs when individuals who covertly stutter begin to outwardly identify themselves and allow for overt stuttering. The primary theme was a paradigm shift in the 6 participants' mindset regarding stuttering; additional details are provided in the subthemes: attending speech therapy, meeting other people who stutter, and a psychological low point. The details of the covert-to-overt stuttering conversion are documented with the use of direct quotations. Conclusion: The evidence suggests the various intricacies of the experiences of persons who are covert. Clinical implications of these findings for assessing and treating individuals who covertly stutter are discussed.

Regional Overview of Specific Populations, Workforce Considerations, Training, and Diseases in Latin America.

Latin America has significant disparities that make the region vulnerable in the delivery of health care. There is a need to plan comprehensive health care strategies that result in a more robust trained health care workforce, while improving the quality and efficiencies of tertiary public hospitals. This article introduces a survey conducted among otorhinolaryngology leaders in the region that identified the need to strengthen postgraduate programs. Although all countries in Latin America have at least one residency program, more otorhinolaryngology-trained specialists are necessary to address the workforce shortages that are present in about 50% of Latin American countries.

Ránula, experiencia con técnica de marsupialización: servicio de otorrinolaringología Hospital J. M. de los Ríos / Ránula, experience with technique of marsupializatión: service of otolaryngology Hospital J. M. de los Ríos

Se presentan 9 casos de pacientes evaluados con diagnóstico de ránula sublingual, de los cuales predominó el grupo de los escolares (55 por ciento), y el sexo femenino (55 por ciento), todos de localización sublingual unilateral con predominio izquierdo (66 por ciento) (6 casos). El 100 por ciento de las lesiones eran mayor de 2cm, fluctuantes y deprimibles; el 55 por ciento de coloración translucida amarillenta y el 45 por ciento violácea. La dificultad para la masticación fue el síntoma predominante (77 por ciento), el dolor y los trastornos articulatorios del lenguaje en menor porcentaje. Todos los pacientes fueron intervenidos quirúrgicamente con abordaje intraoral por técnica de masurpialización con extirpación de la pared superior de la ránula y sutura de la membrana quística a la mucosa del suelo de la boca. El 100 por ciento sin evidencia de recidivas

Hipoacusia en recién nacidos con factores de riesgo perinatal / Hypoacusia in newborns with perinatal risk factors

Estimar la incidencia de hipoacusia en recién nacidos ingresados en la Unidad de Terapia Intensiva Neonatal del Hospital de Niños J.M de Los Ríos, con factores de riesgo perinatal, entre marzo a septiembre de 2005. Se diseño una investigación prospectiva, transversal, analítica, no experimental, no aleatoria. La medición de Potenciales Auditivos Evocados de Tronco Cerebral se realizó en 31 pacientes (62 oídos): 17 del sexo femenino y 14 del sexo masculino, con edad de 34.09 ± 18.39 días. Del total de los pacientes 87,10 por ciento presentaron algún grado de hipoacusia, de los cuales el 92,6 por ciento presentaron afección bilateral y el 7,4 por ciento unilateral, el 12,9 por ciento presento audición normal. Encontrándose entre los factores de riesgo más importantes para hipoacusia: exposición a medicamentos ototóxicos (Amikacina) 45,16 por ciento, sepsis neonatal y meningitis 25.80 por ciento cada uno, y otros 3,24 por ciento. En cuanto a la evaluación del umbral auditivo de los 62 oídos se encontró: 10 audición normal (16,12 por ciento), 22 hipoacusia leve (35.48 por ciento), 11 moderada (17.74 por ciento), 10 severa (16.12 por ciento), 9 profunda (14.51 por ciento). No se hallaron diferencias significativas relacionadas con el sexo o con el número de factores de riesgo. Todo paciente con antecedente de exposición a medicamentos ototóxicos, sepsis o meningitis tiene alta probabilidad de adquirir algún grado de hipoacusia.

To estimate the incidence of hypoacusia in newborns at the Neonatal Intensive Therapy Unit of the J.M de Los Ríos Children Hospital, with perinatal risk factors, between March and September 2005. A prospective, transversal, analytical, no experimental and no aleatory investigation was designed. A measurement of evoke auditive potential of cerebral torso was performed in 31 patients (62 ears): 17 females and 14 males, betwenn 34.09 ± 18.39 days old. The 87.10% patients presented some degree of hypoacusia. From them, 92.6% had bilateral affection, the 7,4% had unilateral affection and 12.9% had normal audition. The most important risk found for hypoacusia were: 45.16% was exposure to ear toxic medicines (Amikacin), 25.8% to neonatal sepsis and meningitis, and 3.24% for other factors . According to the auditive threshold evaluation of 62 ears: 10 had normal audition (16.12%), 22 had mild hypoacusia (35.48%), 11 had medium hypoacusia (17.74%), 10 had severe hypoacusia (16.12%) and 9 had very severe hypoacusia (14.51%). There were not significative differences related to gender or the number of risk factor.

Hipoacusia conductiva congénita: agenesia de yunque: a propósito de un caso / Congenital conductive hipocausia: incusagenesia: to purpose of a case

La hipoacusia conductiva es un problema común en niños, relacionado generalmente con otitis media aguda serosa o crónica. Las anormalidades congénitas de oído externo y medio están comúnmente asociadas como parte de procesos sindromáticos congénitos u otras malformaciones, frecuentemente hay antecedentes familiares de patologías relacionadas. Se presenta el caso de una escolar de 12 años con hipoacusia conductiva bilateral por alteración congénita de cadena osicular como anomalía única sin trastornos ni déficit de lenguaje y adecuado progreso escolar, se plantea su resolución quirúrgica lográndose la recuperación auditiva compatible a la normalidad

Fibrosis quística: estudio de 41 pacientes Hospital de Niños J. M. de los Ríos / Cystic fibrosis: study of 41 patients Hospital de Niños

La fibrosis quística (F.Q) es una enfermedad autosómica recesiva caracterizada por el espesamiento de las secreciones debido al transporte anormal de iones de las células epiteliales. Se diagnóstica por (a) electrolitos en sudor, mayor de 60 meglL y (b) estudio genético. En el Hospital de Niños "J.M de los Ríos" de Caracas, se estudiaron prospectivamente 41 pacientes con F.Q presentando el 70 por ciento (29) la mutación genética F508. De nuestros pacientes el 51 por ciento (21) eran pre escolares. La patología más frecuente fue Rinosinusitis (30 pacientes), de los cuales 9 manifestaron pólipos nasales en edad escolar. Otitis media serosa y otitis media crónica, se observó en 12 y 2 pacientes respectivamente. El 80 por ciento (33) se asoció con patología de tracto respiratorio inferior y gastrointestinal. La terapia se orientó hacia el balance funcional de las secreciones y tratamiento de las complicaciones

Estenosis subglótica adquirida: experiencia en 80 casos: Hospital Niños "J. M. de los Ríos" / Adquire subglotic stenosis: experience in cases: Hospital of Niños \"J. M.\" of the Rios

La Estenosis Subglótica Adquirida es una entidad que afecta a tejidos blandos y estructuras cartilaginosas del espacio subglótico. Desde enero de 1987 hasta agosto de 1995, ingresaron al servicio de ORL del Hospital de Niños "J.M de Los Ríos" 80 pacientes con esta patología. El 87 por ciento (70) ameritaron traqueotomía y el 13 por ciento (10) no necesito tratamiento alguno. De los 70 pacientes traqueotomisados el 77 por ciento (60), se les realizó dilatación más infiltración de esteroides. al 10 por ciento (8), se les practicó laringotraqueoplastia, 2 pacientes fallecieron. El 75 por ciento (45) de los traqueotomisados fueron decanulados y dados de alta. El 25 por ciento (15) de los pacientes se mantienen en tratamiento. Fueron decanulados el 75 por ciento (6) de los 8 pacientes a los cuales se les realizó laringotraqueoplastia; y el 25 por ciento (2) no han podido ser decanulados por regresión de la estenosis.