Genetic relationships of the Yucatan black hairless pig with Iberian breeds using single nucleotide polymorfisms / Relações genéticas de porcos pretos calvos de Yucatán com raças ibéricas usando Polimorfismo de nucleotídeos isolados

To conduct ex-situ creole pig conservation programs, it is essential to determine which breeding animals will be used, preferentially those with a more significant Iberian genetic component to preserve their origin. This study used a Yucatan black hairless pigs (YBHP) subpopulation to estimate its genetic diversity and population structure. One hundred four adult pigs were selected for the absence of hair, black skin (without spots), black hoof, and straight snout. The porcine-GGP-50K chip was used for SNP genotyping in YBHP, and information on Iberian and Yucatán hairless pigs from the United States (USYU) was taken from databases. All analysis was performed using PLINK v1.9 and v2.1 software. Inbreeding and fixation index values were lower in YBHP, with high observed heterozygosity and allogamy index values, which agree with those obtained in the populations of Canarias and Chato Murciano. According to the clusters generated by the "Genome-Wide Identity by State" analysis, four groups were identified, one of which included pigs from Guadyerbas, USYU, and YBHP. Between populations, YBHP was closely related to the hairless pigs from Guadyerbas, USYU, and Canarias. Principal component analysis showed the same result. According to the results obtained from the runs of homozygosity investigation, aimed to get pools consensus of regions of overlapping, 119 SNPs associated with genes and biological processes were identified. The BMP7 and NSUN2 genes were associated with epithelial cell differentiation, morphogenesis, and epithelial development. For nutrient metabolism: energy, the HADHA, PPARA, ADD1/SREBF1, and FAT 1genes were identified.(AU)

Para realizar programas de conservação ex-situ de suínos crioulos, é importante determinar quais animais serão criados, preferencialmente aqueles com maior componente de genética ibérica, para preservar sua origem. Uma subpopulação de porco preto calvo de Yucatán (YBHP) foi usada para estimar sua diversidade genética e estrutura populacional. Um total de 104 suínos adultos foram selecionados levando-se em consideração características como ausência de pelos, pele preta (sem manchas), casco preto e focinho reto. O painel GGP-50K foi utilizado para a genotipagem dos SNPs em animais YBHP, e informações de porcos sem pelos ibéricos e de Yucatán dos Estados Unidos (USYU) foram retiradas de bancos de dados. Todas as análises foram realizadas com o software PLINK v1.9 e v2.1. Os valores dos índices de endogamia e fixação foram menores em YBHP, com altos valores de índice de heterozigosidade e alogamia observados, que concordam com os obtidos nas populações de Canárias e Chato Murciano. De acordo com os clusters gerados pela análise "Genoma-Wide Identity By State", quatro grupos foram identificados, um dos quais incluiu porcos de Guadyerbas, USYU e YBHP. Entre as populações, YBHP estava intimamente relacionado com os porcos sem pelo de Guadyerbas, USYU e Canárias. A análise de componentes principais mostrou o mesmo resultado. De acordo com os resultados obtidos nas corridas de investigação de homozigose, visando obter consenso de pools de regiões de sobreposição, foram identificados 119 SNPs associados a genes e processos biológicos. Os genes BMP7 e NSUN2 foram associados à diferenciação de células epiteliais, morfogênese e desenvolvimento epitelial. Para metabolismo de nutrientes: energia, os genes HADHA, PPARA, ADD1/SREBF1 e FAT1 foram identificados.(AU)

Actin Stress Fibers Response and Adaptation under Stretch.

One of the many effects of soft tissues under mechanical solicitation in the cellular damage produced by highly localized strain. Here, we study the response of peripheral stress fibers (SFs) to external stretch in mammalian cells, plated onto deformable micropatterned substrates. A local fluorescence analysis reveals that an adaptation response is observed at the vicinity of the focal adhesion sites (FAs) due to its mechanosensor function. The response depends on the type of mechanical stress, from a Maxwell-type material in compression to a complex scenario in extension, where a mechanotransduction and a self-healing process takes place in order to prevent the induced severing of the SF. A model is proposed to take into account the effect of the applied stretch on the mechanics of the SF, from which relevant parameters of the healing process are obtained. In contrast, the repair of the actin bundle occurs at the weak point of the SF and depends on the amount of applied strain. As a result, the SFs display strain-softening features due to the incorporation of new actin material into the bundle. In contrast, the response under compression shows a reorganization with a constant actin material suggesting a gliding process of the SFs by the myosin II motors.

The Roles of Microtubules and Membrane Tension in Axonal Beading, Retraction, and Atrophy.

Axonal beading, or the formation of a series of swellings along the axon, and retraction are commonly observed shape transformations that precede axonal atrophy in Alzheimer's disease, Parkinson's disease, and other neurodegenerative conditions. The mechanisms driving these morphological transformations are poorly understood. Here, we report controlled experiments that can induce either beading or retraction and follow the time evolution of these responses. By making quantitative analysis of the shape modes under different conditions, measurement of membrane tension, and using theoretical considerations, we argue that membrane tension is the main driving force that pushes cytosol out of the axon when microtubules are degraded, causing axonal thinning. Under pharmacological perturbation, atrophy is always retrograde, and this is set by a gradient in the microtubule stability. The nature of microtubule depolymerization dictates the type of shape transformation, vis-à-vis beading or retraction. Elucidating the mechanisms of these shape transformations may facilitate development of strategies to prevent or arrest axonal atrophy due to neurodegenerative conditions.

Lily Pollen Tubes Pulse According to a Simple Spatial Oscillator.

Polar growth is a fundamental mode of cell morphogenesis observed in nearly all major groups of organisms. Among polarly growing cells, the angiosperm pollen tubes have emerged as powerful experimental systems in large part because of their oscillatory growth, which provides a window into the network of interactions regulating morphogenesis. Empirical studies of oscillatory pollen tubes have sought to uncover the temporal sequence of cellular and molecular events that constitutes an oscillatory cycle. Here we show that in lily pollen tubes the distance or wavelength (λ = 6.3 ± 1.7 µm) over which an oscillatory cycle unfolds is more robust than the period of oscillation (τ = 39.1 ± 17.6 s) (n = 159 cells). Moreover, the oscillatory cycle is divided into slow and fast phases, with each phase unfolding over precisely one half of the wavelength. Using these observations, we show that a simple spatial bi-oscillator predicts the most common modes of oscillation observed in pollen tubes. These results call into question the traditional view of pollen tube morphogenesis as a temporal succession of cellular events. Space, not time, may be the most natural metric to inteprete the morphogenetic dynamics of these cells.

Non-invasive Neurite Mechanics in Differentiated PC12 Cells.

Thermal Fluctuations Spectroscopy (TFS) in combination with novel optical-based instrumentation was used to study mechanical properties of cell-cultured neurites with a spatial resolution limited only by the light diffraction. The analysis of thermal fluctuations together with a physical model of cellular elasticity allow us to determine relevant mechanical properties of neurite as axial tension σ, flexural rigidity B , plasma membrane tension γ, membrane bending rigidity K , and cytoskeleton to membrane-coupling ρ bk, whose values are consistent with previously reported values measured using invasive approaches. The value obtained for the membrane-coupling parameter was used to estimate the average number of coupling elements between the plasma membrane and the cytoskeleton that fell in the range of 30 elements per area of the laser spot used to record the fluctuations. Furthermore, to expand the TFS analysis, we investigate the correlation between F-actin linear density and the mechanical features of PC12 neurites. Using a hybrid instrument that combines TFS and a simple fluorescent technique, our results show that the fluctuations are related with the F-actin concentration. These measurements have an advantage of not requiring the application of an external force, allowing as to directly establish a correlation between changes in the mechanical parameters and cytoskeleton-protein concentrations. The sensibility of our method was also tested by the application of TFS technique to PC12 neurite under Paraformaldehyde and Latrunculin-A effect. These results show a dramatic modification in the fluctuations that are consistent with the reported effect of these drugs, confirming the high sensitivity of this technique. Finally, the thermal fluctuation approach was applied to DRG axons to show that its utility is not limited to studies of PC12 neurites, but it is suitable to measure the general characteristic of various neuron-like cells.

Complex Laparoscopic Myomectomy with Severe Adhesions Performed with Proper Preventive Measures and Power Morcellation Provides a Safe Choice in Certain Infertility Cases.

Laparoscopic myomectomy offers a real benefit to infertile patients with uterine fibroids and peritoneal adhesions. The procedure requires a skilled surgeon and laparoscopy technique to minimize adhesion formation and other proven benefits. Restrictions arise since this procedure requires power morcellation for fibroid tissue extraction. Two years ago, the Food and Drug Administration in the United States of America (FDA) issued the alert on power morcellation for uterine leiomyomas, addressing the risk of malignant cell spreading within the abdominal cavity (actual risk assessment from 1 in 360 to 1 in 7400 cases). We review a 30-year-old female, without previous gestations, hypermenorrhea, intermenstrual bleeding, and chronic pelvic pain. Transvaginal ultrasound reports multiple fibroids in the right portion of a bicornuate uterus. Relevant history includes open myomectomy 6 years before and a complicated appendectomy, developing peritonitis within a year. Laparoscopy revealed multiple adhesions blocking uterine access, a bicornuate uterus, and myomas in the expected site. Myomectomy was performed utilizing power morcellation with good results. FDA recommendations have diminished this procedure's selection, converting many to open variants. This particular case was technically challenging, requiring morcellation, and safety device deployment was impossible, yet the infertility issue was properly addressed. Patient evaluation, safety measures, and laparoscopy benefits may outweigh the risks in particular cases as this one.

Time-resolved neurite mechanics by thermal fluctuation assessments.

In the absence of simple noninvasive measurements, the knowledge of temporal and spatial variations of axons mechanics remains scarce. By extending thermal fluctuation spectroscopy (TFS) to long protrusions, we determine the transverse amplitude thermal fluctuation spectra that allow direct and simultaneous access to three key mechanics parameters: axial tension, bending flexural rigidity and plasma membrane tension. To test our model, we use PC12 cell protrusions-a well-know biophysical model of axons-in order to simplify the biological system under scope. For instance, axial and plasma membrane tension are found in the range of nano Newton and tens of pico Newtons per micron respectively. Furthermore, our results shows that the TFS technique is capable to distinguish quasi-identical protrusions. Another advantage of our approach is the time resolved nature of the measurements. Indeed, in the case of long term experiments on PC12 protrusions, TFS has revealed large temporal, correlated variations of the protrusion mechanics, displaying extraordinary feedback control over the axial tension in order to maintain a constant tension value.

Forceps, Actual Use, and Potential Cesarean Section Prevention: Study in a Selected Mexican Population.

OBJECTIVE: Assessment of the frequency of complications observed with various forceps and operative vaginal delivery (OVD) techniques performed at the ABC Medical Center (Mexico City) to evaluate their safety, bearing in mind the importance of decreasing our country's high cesarean section incidence. METHODS: We reviewed 5,375 deliveries performed between the years 2007 and 2012, only 146 were delivered by OVD. RESULTS: Only 1.0% of the cases had a serious, life-threatening situation (uterine rupture). The Simpson forceps was the most favored instrument (46%) due to its simplicity of use, effectiveness, and familiarity. Prophylactic use was the most common indication (30.8%) and significant complications observed were vaginal lacerations (p = 0.016), relative risk (RR) of 3.4 (95% confidence interval [CI]: 1.15-10.04), and fourth degree perineal tear (p = 0.016), RR of 3.4 (95% CI: 1.15-10.04). CONCLUSIONS: Forceps use and other OVD techniques are a safe alternative to be considered, diminishing C-section incidence and its complications.

Diverse population of a new bipartite begomovirus infecting tomato crops in Uruguay.

Several isolates of a novel begomovirus were characterized from tomato samples collected in northern Uruguay exhibiting disease symptoms associated with Bemisia tabaci infestations. Analysis of full-length sequences of DNA-A and DNA-B components revealed the presence of a new begomovirus with the typical genome organization of a New World begomovirus, for which the name tomato rugose yellow leaf curl virus (ToRYLCV) is proposed. A high degree of nucleotide sequence diversity was found for both components, suggesting the presence of a diverse virus population. Recombination analysis suggested relationships of ToRYLCV to begomoviruses reported from the New World. Although common regions from DNA-As and DNA-Bs were surprisingly divergent for a cognate pair, a DNA-A and DNA-B pair cloned from one sample were infectious in Nicotiana benthamiana and tomato and reproduced symptoms observed in field-infected tomato plants, suggesting that ToRYLCV is the causal agent of the disease observed. This is the first report of a begomovirus infecting tomato crops in Uruguay and of the presence of begomovirus in this country.

[A technique for total laparoscopic hysterectomy with vaginal morcellation on large uteri in order to maintain minimal invasion]. / Técnica para histerectomía laparoscópica de útero grande con morcelación vaginal para mantener la invasión mínima.

The advancement and increasing popularity of laparoscopic hysterectomy and the patient's foremost cosmetic concern has made the need for performing laparoscopic hysterectomy in a less morbile and time-consuming manner, we present a technique for large uteri using only three 5 mm entry ports, with tissue morcellation and removal vaginally using the Koh colpo-pneumo occluder.

[Latzko surgery in recidivant vesicovaginal fistulae. Two case reports and literature review]. / Operación de Latzko en fistula vesicovaginal recidivante. Reporte de dos casos y revisión del tema.

Recurrent vesicovaginal fistulae represent a clinical problem of the utmost importance due to the impact on the patients' quality of life. The current standard of treatment for this problem is surgical, with an abdominal approach, notwithstanding, may authors state that this repair should be done with the technique and approach that the surgeon feels most comfortable. We have successfully treated two patients with recurrent vesicovaginal fistulae using a vaginal approach, therefore we suggest it as a viable alternative in the treatment of this condition. We present two case reports an literature review, with the necessary modifications of the Latzko technique.

Flujo y capacidad amortiguadora salival en dos grupos de sujetos de 6 a 11 años de edad con bajo y alto índice de dientes cariados, perdidos y obturados / Salivary flow and buffer capacity in two 6-to-11-year-old groups of subjects with low and high decayed, missing and filled teeth index

Objetivo: comprobar la relación entre el flujo y la capacidad amortiguadora salival con la experiencia de caries, en niños con bajo y alto índice de dientes cariados, perdidos y obturados (CPOD). Método: Se realizó un estudio descriptivo transversal a un grupo de 60 niños de 6 a 11 años de edad, de ambos sexos, admitidos para consulta en la Clínica de Admisión de la Facultad de Odontología de la Universidad Autónoma de Baja California, sede Mexicali. Se establecieron dos grupos en función del CPOD: grupo 1 (puntuación 0-3) y grupo 2 (4 o más). Se elaboró una historia clínica que incluyó tanto los datos generales del niño como el registro de la experiencia de caries bajo los criterios de la Organización Mundial de la Salud. Asimismo, se midieron y registraron el volumen de saliva estimulada y la capacidad amortiguadorapara cada sujeto. Resultados: se observó una correlación negativa (r=–0,221) entre el flujo salival y el CPOD; sin embargo, esta tendencia no fue estadísticamente significativa (p>0,05). En cuanto a la capacidad amortiguadora, se hallaron diferencias estadísticamente significativas al relacionar una mayor capacidad amortiguadora y un CPOD bajo (p<0,05). Conclusión: la mayor capacidad amortiguadora de la saliva se relacionó con la menor experiencia de caries. Por su parte, el flujo salival estimulado mostró alguna asociación descriptivamente con el CPOD, pero dicha asociación no fue estadísticamente significativa.

Objective: Demonstrate the association between salivary flow and buffer capacity with caries experience in children with low and high Decayed, Missing and Filled Teeth Index (DMFT). Methods: A cross-sectional study was conducted with 60 6-to-11-year-old children of both sexes, who attended the Dental School of Universidad Autónoma de Baja California, Mexicali campus. The patients were assigned to two groups according to the DMFT score, group 1 (score 0-3) and group 2 (score 4 or more). A clinical record including patient’s general information and dental evaluation was filled out. Cavity experience evaluation was carried out following WHO parameters. Also, salivary flow and buffer capacity were measured in each individual. Results: A weak negative correlation between salivary flow and DMFT score was observed (r=–0.221); however, this trend was not statistically significant (p>0.05). Regarding the buffer capacity, statistically significant differences between this salivary property and DMFT were found (p<0.05). Conclusion: The buffer capacity of saliva was associated with lower caries experience. On the other side, stimulated salivary flow show was not found to be related with the DMFT score.

Drag force as a tool to test the active mechanical response of PC12 neurites.

We investigate the mechanical response of PC12 neurites subjected to a drag force imposed by a laminar flow perpendicular to the neurite axis. The curvature of the catenary shape acquired by an initially straight neurite under the action of the drag force provides information on both elongation and tension of the neurite. This method allows us to measure the rest tension and viscoelastic parameters of PC12 neurites and active behavior of neurites. Measurement of oscillations in the strain rate of neurites at constant flow rate provides insight on the response of molecular motors and additional support for the presence of a negative strain-rate sensitivity region in the global mechanical response of PC12 neurites.

[Fusion of the labia minora as a cause of urinary incontinence in a postmenopausal woman. A case report and literature review]. / Fusión de los labios menores como causa de incontinencia urinaria en una mujer posmenopáusica. Reporte de un caso y revisión bibliográfica.

Labial fusion is rarely presented in the postmenopausal age group, its predisposing factors are hipoestrogenism and a inflamation/repair process in the vaginal epithelium. Our case report involves a 73 years old woman that presents with urinary incontinence. On physical exploration, complete labial fusion was noted, a surgical approach was undertaken with liberation of the labia and fixation, postoperatory local estrogen ointment was indicated with complete recovery. The literature review confirmed that this was the ideal treatment and also confirms the role of local estrogen ointment as profilactic and therapeutic.

[Prevalence of burnout syndrome in nurses in 2 Mexican hospitals]. / Prevalencia del síndrome de burnout en el personal de enfermería de 2 hospitales mexicanos.

OBJECTIVE: To determine the prevalence of burnout syndrome in nursing staff in 2 different second level hospitals in the city of Mexicali, Baja California, Mexico. METHOD: A cross-sectional study was conducted in all nursing staff (n = 698) in 2 second level hospitals (the Gynecology, Pediatrics and Family Medicine Hospital No. 31 and the General Specialist Hospital No. 30 in Mexicali). A stratified random sample was obtained from the 698 nurses, with a sample size of 184 nurses from each hospital. The Maslach Burn-out Inventory and a general questionnaire on demographic factors were used. Statistical analysis consisted of descriptive statistics and analysis of proportions using the chi-squared test. RESULTS: A total of 368 nurses were studied, of whom 345 (93.75%) were women. The mean age was 41.21 SD (standard deviation) = 6.59 years. The mean length of service was 15.87 (SD = 6.12) years. In both hospitals, the prevalence of burnout syndrome was 6.79% (25). CONCLUSIONS: Previous publications on burn-out have included studies performed in Mexico and in nurses in the emergency department of a tertiary hospital in Barcelona, as well as in other health care professionals. In comparison with these studies, the prevalence of burn-out observed in the present study was significantly lower.

Prevalencia del síndrome de burnout en el personal de enfermería de 2 hospitales mexicanos / Prevalence of burnout syndrome in nurses in 2 Mexican hospitals

Objetivo. Determinar la prevalencia del síndrome de burnout en el personal de enfermería en 2 hospitales de segundo nivel en la ciudad de Mexicali, BC (México). Método. Diseño transversal, realizado en el profesionales de enfermería del Hospital de Gineco-Pediatría con Medicina Familiar n.º 31, y el Hospital General de Especialidades n.º 30, en Mexicali, BC. Se obtuvo una muestra probabilística estratificada para la población finita de los 698 profesionales de enfermería que trabajaban en dichos hospitales, y se seleccionaron aleatoriamente 184 sujetos de cada hospital. Se aplicó el cuestionario de Maslach para identificar el síndrome y el cuestionario general para factores sociodemográficos. Posteriormente se utilizaron estadísticas descriptivas e inferenciales mediante prueba para proporciones de x2. Resultados. Se estudiaron 368 sujetos, 345 (93,75%) mujeres, con una edad media de 41,21 años (desviación estándar [DE] = 6,59); la antigüedad laboral fue de 15,87 años (DE = 6,12). La prevalencia de burnout en los profesionales de enfermería de ambos hospitales fue del 6,79% (25). Conclusiones. La prevalencia obtenida fue menor a la reportada en otros estudios, tanto los realizados en México como otro realizado con profesionales de enfermería que trabajaban en la sala de urgencias de un hospital de tercer nivel de Barcelona, así como en los realizados con otros profesionales de la salud

Objective. To determine the prevalence of burnout syndrome in nursing staff in 2 different second level hospitals in the city of Mexicali, Baja California, Mexico. Method. A cross-sectional study was conducted in all nursing staff (n = 698) in 2 second level hospitals (the Gynecology, Pediatrics and Family Medicine Hospital No. 31 and the General Specialist Hospital No. 30 in Mexicali). A stratified random sample was obtained from the 698 nurses, with a sample size of 184 nurses from each hospital. The Maslach Burn-out Inventory and a general questionnaire on demographic factors were used. Statistical analysis consisted of descriptive statistics and analysis of proportions using the chi-squared test. Results. A total of 368 nurses were studied, of whom 345 (93.75%) were women. The mean age was 41.21 SD (standar deviation) = 6.59 years. The mean length of service was 15.87 (SD = 6.12) years. In both hospitals, the prevalence of burnout syndrome was 6.79% (25). Conclusions. Previous publications on burn-out have included studies performed in Mexico and in nurses in the emergency department of a tertiary hospital in Barcelona, as well as in other health care professionals. In comparison with these studies, the prevalence of burn-out observed in the present study was significantly lower

Mechanical properties of axons.

The mechanical response of PC12 neurites under tension is investigated using a microneedle technique. Elastic response, viscoelastic relaxation, and active contraction are observed. The mechanical model proposed by Dennerll et al. [J. Cell Biol. 109, 3073 (1989).10.1083/jcb.109.6.3073], which involves three mechanical devices--a stiff spring kappa coupled with a Voigt element that includes a less stiff spring k and a dashpot gamma--has been improved by adding a new element to describe the main features of the contraction of axons. This element, which represents the action of molecular motors, acts in parallel with viscous forces defining a global tension response of axons T against elongation rates delta(k). Under certain conditions, axons show a transition from a viscoelastic elongation to active contraction, suggesting the presence of a negative elongation rate sensitivity in the curve T vs delta(k).

[Endometrial ossification: a report of four cases and literature review]. / Osificación endometrial: comunicación de cuatro casos y revisión bibliográfica.

Endometrial ossification is a rare endometrial pathology. Its predisposing factors include history of uterine curettage to metabolic abnormalities. It usually presents in patients with secondary infertility and history of first trimester pregnancy loss, accompanied by severe dysmenorrhea and dyspareunia. The diagnosis is suspected by OB-GYN history and USG findings, therapeutic strategies range from D&C to hysterectomy, we propose diagnosis and management by hysteroscopy in order to preserve future fertility and minimize uterine damage. A review of four cases during 1985-2004 from a large assisted reproduction center in Mexico City is presented.

[Burnout syndrome associated factors in gynecologists]. / Factores relacionados con el síndrome de burnout en ginecólogos.

OBJECTIVE: To determine risk factors associated to Burnout Syndrome in medical gynecologist staff who works at the Gynecology-pediatrics with Family Medicine Hospital number 31 of the IMSS at Mexicali city, Baja California. MATERIAL AND METHOD: A cross sectional study was performed in 27 gynecologists (100% of the total gynecologist that works at that particular hospital). A validated survey instrument developed by Maslach was applied to them in order to identify the presence of the syndrome and a general questionnaire including sociodemographic information was also applied to the doctors. The statistical analysis was both descriptive and inferential including chi square, Student t and logistic regression. RESULTS: 74.1% of the doctors who showed signs of Burnout Syndrome were males and 25.9% were females. The average doctors age of the group who developed Burnout was 44.81 +/- 6.11 years. The mean time in years of work for the doctors with the syndrome was 15.56 +/- 7.11 years. Only one doctor was divorced and she presented Burnout Syndrome, on the other hand, 62.5% of the married doctors showed evidence of Burnout Syndrome (p > 0.05). The general prevalence was 59.2%. Of those who showed signs of burnout, 87.5% presented it in low degree, 6.2% presented moderate degree, 6.2% presented high burnout degree. Out of all the organizational factors type, none resulted significative. CONCLUSIONS: The prevalence of the reported syndrome is apparently high when compared to the medical anesthesiology staff of the same hospital; however this difference is not statistically significative. In the unvaried and multivariate analyses, no organizational factor shows significance as a potential risk. It is necessary to consider psychological support to the affected doctors and to value the organization of the service, looking for an administrative reengineering.

[Uterine and jejunum perforation due to intrauterine device. A report of a case and literature review]. / Perforación uterina y del yeyuno causada por un dispositivo intrauterino. Presentación de un caso con revisión de la literatura.

The application of a copper IUD can perforate completely the uterus and involve adjacent organs such as the bladder, small bowel, colon, rectum or appendix. Once the diagnosis is established, complete extraction must follow. We present a case report of a 33 year-old patient in which a copper IUD was placed in a medical office, three months after a third cesarean, without history of sepsis. Ninety days after placement, the patient complained of menstrual irregularities (opsomenhorrea) without any other symptoms. On physical examination with speculum, the IUD's guide strings were not visible; a transvaginal USG was performed without visualization of the IUD in the uterine cavity. An abdominal CAT scan showed the presence of the IUD outside the uterus. Hysteroscopy-laparoscopy was performed with transoperatory fluoroscopy, which revealed the copper IUD inside the yeyunum, a complete extraction followed with entero-entero anastomosis. This case will show that IUD placement is not innocuous and that adjacent organ damage must always be considered and resolved immediately.