Evolución de artralgias posterior a cirugía bariátrica / Evolution of arthralgia subsequent to bariatric surgery

Resumen Objetivo: En este estudio, se propuso establecer la relación entre la pérdida de peso y la evolución de las artropatías en un grupo de pacientes obesos sometidos a cirugía bariátrica. Materiales y Método: Investigación correlacional y de corte longitudinal, retrospectivo, donde se revisaron 33 historias de pacientes obesos mórbidos con artralgia en cualquier articulación, sometidos a cirugía bariátrica. Se realizó el análisis descriptivo de las variables numéricas según la distribución de los datos. Como prueba de relación se utilizó la Prueba T de Student para comparación de proporciones, asumiendo un valor p < 0,05. Resultados: 63,3% fueron femeninas, siendo la rodilla la principal articulación afectada (51,5%), con reducción considerable de su índice de masa corporal poscirugía. Al compararse los promedios del IMC inicial, a los 3, 6 y 12 meses, se encontraron diferencias estadísticamente significativas (p < 0,01). La desaparición de la artralgia en la mayoría de los pacientes ocurrió durante los primeros 3 meses, principalmente pacientes con obesidad grado I y II, en contraste con aquellos pacientes con obesidad grado III y IV, quienes requirieron un mayor lapso, para lograr la desaparición total de la artralgia. Conclusiones: La disminución gradual del dolor articular estuvo en relación directa a la reducción de las cifras de peso del paciente ya operado, mejorando la calidad de vida de los pacientes de la muestra.

Aim: In this study it was proposed to establish the relationship between weight loss and the evolution of the joint diseases in a group of obese patients undergoing bariatric surgery. Materials and Method: Cutting longitudinal, retrospective, and correlational research where studied 33 morbidly obese patients histories and arthralgia, in any joint they was undergoing bariatric surgery. It was the descriptive analysis of the numerical variables according to the distribution of the data. As proof of relationship the Student T test was used for comparison of proportions, assuming a P-value < 0.05. Results: 63.3% were female, being the main affected joint (51.5%), with significant reduction in their rate of body mass post surgery knee. To compare the averages of initial IMC, 3, 6 and 12 months statistically significant differences were found (p < 0.01). The disappearance of arthralgia in patients most occurred during the first 3 months, mainly patients with obesity grade I and II, in contrast to those patients with obesity grade III and IV, who required a greater period, to achieve the total disappearance of arthralgia. Conclusion: The gradual decrease in the pain joint was in direct relation to the reduction of the numbers of weight of the patient already operated, improving the quality of life of the patients of the indicated.

GRANULOMATOSIS WITH POLYANGIITIS IN PUERTO RICO: CASE REPORTS.

Wegener's Granulomatosis or Granulomatosis with Polyangiitis (WG/GPA) is one of the antineutrophil cytoplasmic antibody associated vasculitis. Ocular manifestations the first presenting signs in patients with WG/GPA. We report on two patients diagnosed with WG/GPA and discuss their pertinent clinical findings. Our case report reviews the most common clinical manifestations and ophthalmic associations to compare them with the physical findings of two Hispanic patients. Further, to our knowledge this is the first report of ocular findings in patients with WG/GPA in two Puerto Rican patients.

Ventajas de la nutrición enteral temprana en pacientes con lesión del intestino delgado en el trauma abdominal penetrante / Benefits of early enteral nutrition in patients with injury of the small bowel in pene-trating abdominal trauma

Objetivo: En el trauma abdominal penetrante se observan frecuentemente lesiones de intestino delgado. Si bien el tratamiento inmediato y quirúrgico de estos pacientes es importante, el manejo postoperatorio, sobre todo la parte nutricional, lo es aún más. Determinar las ventajas que tiene la nutrición enteral temprana en este tipo de pacientes, nos permitirá un mejor manejo de ellos, en la Ciudad Hospitalaria Doctor Enrique Tejera del Estado Carabobo. Métodos: El estudio es una investigación descriptiva, transversal y retrospectiva, revisando 1500 historias clínicas desde enero de 2009 hasta septiembre de 2010, fueron seleccionados 267 pacientes con lesiones de intestino delgado por trauma abdominal penetrante, y solo 44 cumplieron con los criterios de inclusión previamente establecidos. Resultados: Los resultados determinaron que existe predominio del sexo masculino, con un grupo etáreo de mayor incidencia correspondiente a las edades comprendidas entre 21-25 años, con un porcentaje del 38,64 % y el mecanismo de lesión dominante fue el proyectil percutido por arma de fuego con un 38,63 %. El tiempo de hospitalización para los pacientes fue de 11.91 ± 12.38 días y el tiempo promedio de inicio de la dieta es de aproximadamente 3,97 + 2,02 días, observándose que de los pacientes que recibieron soporte nutricional con glutamina sólo el 28,58% presentaron pérdida de peso, 14,29% se desnutrió y 28,58% presentó complicaciones. Conclusión: En los pacientes en los que se inició la dieta de forma temprana, se disminuyó significativamente el tiempo de hospitalización, así como, la aparición de desnutrición y complicaciones(AU)

Objective: In penetrating abdominal trauma are frequently observed small bowel injuries. Although immediate surgical treatment of these patients is important, postoperative management, especially the nutrition, it is even more. Determine the advantages of early enteral nutrition in these patients, will allow better management of them, at Ciudad Hospitalaria Dr. Enrique Tejera, Valencia, Estado Carabobo. Methods: The study is a descriptive, cross-sectional and retrospective, reviewing 1500 medical records from January 2009 to September 2010, were selected 267 patients with small bowel injury penetrating abdominal trauma, and only 44 met the criteria previously established inclusion. Results: The results determined that there is predominance of male age group with a higher incidence for those aged between 21-25 years, with a rate of 38.64% and the dominant mechanism of injury was hammered by the projectile gun with 38.63%. The hospitalization time for patients was 11.91 ± 12.38 days and the median time to onset of the diet is about 3.97 + 2.02 days, showing that patients who received nutritional support with glutamine only 28.58 % had weight loss is 14.29% and 28.58% had malnutrition complications. Conclusion: Those patients who started early diet significantly decreased length of hospitalization and the occurrence of malnutrition and complications(AU)

A novel agent (Endozoicomonas elysicola) responsible for epitheliocystis in cobia Rachycentrum canadum larvae.

Aquaculture of cobia has gained popularity in the last decade, and this species is now farmed in several countries in Latin America and Asia. Despite recent improvement in production techniques that allowed the expansion of the industry, little is known about the diseases that affect cobia during the larviculture stage. In this article we investigated the cause of mass mortalities occurring 13-20 d post-hatching in 3 cycles of cobia larviculture. Wet mounts from diseased larvae gills revealed the presence of cyst-like basophilic inclusions. DNA from the cysts was extracted and PCR amplified using the 16S rRNA gene universal primers for prokaryotes. The amplified products were sequenced and analyzed using BLAST, finding a similarity of 99% with Endozoicomonas elysicola, a Gram-negative bacterium. Confirmation of E. elysicola was conducted by designing a specific probe for in situ hybridization. Specific primers were also designed for diagnostic purposes. This is the first report of epitheliocystis in cobia larvae and also the first report of E. elysicola as an epitheliocystis-causing agent.

Characterization of a new strain of Taura syndrome virus (TSV) from Colombian shrimp farms and the implication in the selection of TSV resistant lines.

Prior to 2004, Colombian shrimp farming benefited from a selection program in which Penaeus vannamei stocks were developed with resistance to Taura syndrome disease (TS). However since 2004, TS reappeared as a significant disease. In 2010, an apparently new strain of TSV (designated as CO 10) was collected in Colombia. Its genome was sequenced and compared with six other fully sequenced isolates. This analysis revealed that the TSV CO 10 is closely related to the isolates from Hawaii and Venezuela. Phylogenetic analysis based on capsid protein 2 (CP2) region from 59 TSV isolates shows that the recent Colombian isolates (2006-2010) form a new cluster and differ from the previous Colombia isolates (1994-1998) by 4% in nucleotide sequence. The virulence of this CO 10 isolate was similar to a Belize TSV determined through experimental infection in P. vannamei showing 100% mortalities and similar survival curves. By RT-qPCR for TSV, the viral loads were also close in the infected shrimp from both CO 10 and Belize at the order of 1×10(10) copies per µl RNA. To develop TSV-resistant lines, the candidate shrimp should be challenged with virus strains that have been isolated most recently from the regions where they will be cultured. This study suggests that the TSV present in Colombian shrimp farms during the last 5 years is a new TSV strain with high virulence.

Does hyperthermia increase apoptosis in white spot syndrome virus (WSSV)-infected Litopenaeus vannamei?

Apoptosis plays a critical role in development and maintenance of multicellular organisms. It has also been described as an anti-viral mechanism in both insects and vertebrates. In fact, to escape the immune system and to increase their spread, some viruses such as baculovirus produce anti-apoptotic molecules. Conversely, a recent report showing a positive correlation between the number of apoptotic cells and the severity of white spot syndrome virus (WSSV) infection in Penaeus monodon suggested that apoptosis might be the cause of death in viral-infected shrimp. Searching for the mechanisms involved in the beneficial effect of hyperthermia for WSSV-infected Litopenaeus vannamei (also called Penaeus vannamei) and considering that hyperthermia increases apoptosis in other experimental models, we investigated the presence of apoptosis by Tdt-mediated dUTP nick-end label (TUNEL), from 4 of 168 h in 3 groups of 50 L. vannamei juveniles. Group 1 consisted of experimentally infected shrimp (intramuscular injection of 3 x 10(7) viral copies) kept at 25 degrees C, Group 2 of similarly infected shrimp kept at 32 degrees C and Group 3 of uninjected shrimp kept at 32 degrees C. Apoptosis was found only in WSSV-infected individuals. Shrimp at 25 degrees C were positive for apoptotic cells in 48 (16%) of their examined tissues or organs, compared to 62 (21%) for those at 32 degrees C. Moreover, shrimp at 32 degrees C also had a significantly higher overall mean apoptotic index (AI) than shrimp at 25 degrees C (p < 0.05). Comparison of mean AI at 72, 96 and 120 h post-infection showed that individuals at 32 degrees C presented a significantly higher values than those at 25 degrees C. These results suggested that hyperthermia might facilitate apoptosis in WSSV-infected L. vannamei and might be one of the mechanisms responsible for increased survival of infected shrimp maintained at 32 degrees C.