[Clinical and radiographic factors associated with failure of the dynamic hip screw system]. / Factores clínicos y radiográficos asociados a la falla del sistema del tornillo dinámico de cadera.

Background: The most widely used fixation system for transtrochanteric fractures is the dynamic hip screw system, which has a failure prevalence of 10 to 17% and it is associated with the presence of clinical and radiographic factors. Objective: To evaluate the association of clinical and radiographic factors with the failure of the screw system in post-operative patients for transtrochanteric hip fracture. Material y methods: A case-control study was carried out. The inclusion criteria were: patients > 18 years, who underwent surgery due to transtrochanteric fracture, were treated with the hip screw system, and who attended the Trauma Service. The patient with failure of the hip screw system was selected as the case and the patient without failure of the system as control. The variables analyzed in these groups were: age, gender, body mass index and radiographic variables. Statistical analysis was performed with chi-squared and Mann-Whitney U. Results: 163 patients (median 73 years), 20 cases and 143 controls, were included. The radiographic factors with a significant association with hip screw system failure were the AO classification of fractures (p < 0.001), the tip apex distance (p = 0.03), the calcar-referenced tip apex (p = 0.02), the position of the screw (p < 0.001), and quality of reduction (p < 0.003). Clinical factors did not show a significant association. Conclusions: Radiographic factors are associated with failure in the hip screw system in patients in post-operative care due to transtrochanteric fracture.

Introducción: el sistema de fijación más usado para fracturas transtrocantéricas es el sistema del tornillo dinámico de cadera, el cual tiene una prevalencia de falla del 10 al 17% y se asocia a la presencia de factores clínicos y radiográficos. Objetivo: evaluar la asociación de los factores clínicos y radiográficos con la falla del sistema del tornillo en pacientes postoperados de fractura transtrocantérica de cadera. Material y métodos: se hizo un estudio de casos y controles. Los criterios de inclusión fueron: pacientes > 18 años, postoperados de fractura transtrocantérica, tratados con el sistema del tornillo de cadera, que acudieron a la consulta de Traumatología. Se seleccionó como caso al paciente con falla del sistema del tornillo de cadera y como control al paciente sin falla de este. Las variables analizadas en los grupos fueron la edad, el género, el índice de masa corporal y las variables radiográficas. El análisis estadístico se hizo con chi cuadrada y U de Mann-Whitney. Resultados: se incluyeron 163 pacientes (mediana de 73 años), 20 casos y 143 controles. Los factores radiográficos con asociación significativa con la falla del sistema del tornillo de cadera fueron la clasificación AO de la fractura (p < 0.001), la distancia punta-ápex (p = 0.03), punta ápex calcar (p = 0.02), la posición del tornillo (p < 0.001) y la calidad de la reducción (p < 0.003). Los factores clínicos no mostraron asociación significativa. Conclusiones: los factores radiográficos se asocian con la falla en el sistema del tornillo de cadera en pacientes postoperados de fractura transtrocantérica.

Factors associated with Cyclospora infection in a Venezuelan community: extreme poverty and soil transmission relate to cyclosporiasis.

BACKGROUND: Transmission dynamics of Cyclospora cayetanensis in endemic areas and the factors associated with soil contamination remain unclear. The effects of environmental factors on Cyclospora have been insufficiently studied, particularly in South America, thus a Venezuelan community was studied to profile risk factors for infection. METHODS: A cross-sectional stool survey of 732 individuals was conducted. For Cyclospora screening, an acid-fast-stained smear of formalin-ethyl acetate concentrate and ultraviolet (UV) epifluorescence examination of a wet mount were used. Water (n=14), soil (n=50) and produce (n=77) samples were collected, processed and examined by UV epifluorescence. Data were analysed using multivariate logistic regression. RESULTS: Cyclospora infections were identified in 73 (9.9%) subjects. Variables associated with the infection were age ≤10 y (odds ratio [OR] 14), hut living (OR 5), well water use (OR 18.5), drinking untreated water (OR 7.6), toilet absence (OR 8), having contact with faeces-contaminated soil (OR 4) and poultry exposure (OR 3). Infections (63%) were clustered in 25 huts. Oocysts were identified in 28.6%, 18% and 3.9% of the water, soil and produce samples, respectively. CONCLUSIONS: There was an explicit association of Cyclospora infection with extreme poverty and soil transmission reflecting the household socio-economic correlate of cyclosporiasis in this community.

The first record of Tremoctopus violaceus sensu stricto Delle Chiaje,1830 in southwestern Gulf of Mexico gives a hint of the taxonomic status of Tremoctopus gracilis.

Knowledge on species taxonomic identity is essential to understand biological and biogeographical processes and for studies on biodiversity. Species the genus Tremoctopus have been confused in the past and are inconsistently identified. To clarify of the taxonomic diagnosis Tremoctopus violaceus Delle Chiaje, 1830, an evaluation of morphological and meristic characters, as well as morphometric indices and genetic analyses, was undertaken. The analyzed octopod was an opportunistically collected mature female of 640 mm in total length, with a mantle length of 135 mm and a total weight of 1.02 kg. Evidence of autotomy as a defensive mechanism for protecting the egg mass is presented. The 16S haplotype sequenced from this specimen represents the first one publicly available for this species from the Gulf of Mexico. The genetic divergence between this haplotype and those reported from the Pacific Ocean is representative of interspecific variation in other taxa, which suggests that "T. violaceus" in the Pacific Ocean (KY649286, MN435565, and AJ252767) should be addressed as T. gracilis instead. Genetic evidence to separate T. violaceus and T. gracilis is presented. The studied specimen from the Gulf of Mexico represents the westernmost known occurrence of T. violaceus and the first record from the southwestern Gulf of Mexico.

An integrative taxonomic approach reveals Octopus insularis as the dominant species in the Veracruz Reef System (southwestern Gulf of Mexico).

The common octopus of the Veracruz Reef System (VRS, southwestern Gulf of Mexico) has historically been considered as Octopus vulgaris, and yet, to date, no study including both morphological and genetic data has tested that assumption. To assess this matter, 52 octopuses were sampled in different reefs within the VRS to determine the taxonomic identity of this commercially valuable species using an integrative taxonomic approach through both morphological and genetic analyses. Morphological and genetic data confirmed that the common octopus of the VRS is not O. vulgaris and determined that it is, in fact, the recently described O. insularis. Morphological measurements, counts, indices, and other characteristics such as specific colour patterns, closely matched what had been reported for O. insularis in Brazil. In addition, sequences from cytochrome oxidase I (COI) and 16S ribosomal RNA (r16S) mitochondrial genes confirmed that the common octopus from the VRS is in the same highly supported clade as O. insularis from Brazil. Genetic distances of both mitochondrial genes as well as of cytochrome oxidase subunit III (COIII) and novel nuclear rhodopsin sequences for the species, also confirmed this finding (0-0.8%). We discuss our findings in the light of the recent reports of octopus species misidentifications involving the members of the 'O. vulgaris species complex' and underscore the need for more morphological studies regarding this group to properly address the management of these commercially valuable and similar taxa.

Reduction of spinal PGE2 concentrations prevents swim stress-induced thermal hyperalgesia.

We evaluated the association between spinal PGE2 and thermal hyperalgesia following repeated stress. Thermal nociception was determined in male Sprague-Dawley rats using the hot-plate test, before and after forced-swimming; non-conditioned rats served as controls. Animals were pretreated with ketoprofen or meloxicam, preferential COX-1 and COX-2 inhibitors, respectively. After the second hot-plate test, we measured serum corticosterone (stress marker), and lumbar spinal PGE2 (neuroinflammation marker) under peripheral inflammation (1% formalin plantar injection). Stressed rats displayed response latencies 40% shorter and inflammatory spinal PGE2 levels 95% higher than controls. Pretreatment with ketoprofen or meloxicam prevented hyperalgesia and elevation of spinal PGE2, increasing the escape behavior time during forced swimming 95% respect to saline-treated rats. Corticosterone levels in stressed rats were 97% higher than controls; COX inhibitors reduced them by 84%. PGE2 could participate in stress-induced hyperalgesia, learned helplessness, and corticosterone production, supporting the use of non-steroidal anti-inflammatory drugs (NSAIDs) for persistent pain associated with chronic stress and depression.

[Science, reason for the existence of the University]. / Ciencia, razón de ser de la Universidad.

More than a century after the foundation of the illustrious University of Zulia, research is still the subject of unfair treatment; the importance of science in university life is discussed over and over again, with authorities feeling proud of the quantity and quality of researchers, but such pride is divorced from the support received by research centers, departments and institutes. However, science transcends all obstacles; research must be the ultimate goal of our University, so that it continues to be the University.

Stress-induced hyperalgesia is associated with a reduced and delayed GABA inhibitory control that enhances post-synaptic NMDA receptor activation in the spinal cord.

GABA and glutamate are both affected by stress and are involved in nociception. Thus, we determined whether stress-induced enhancement of inflammatory hyperalgesia is mediated by an imbalance between glutamate and GABA neurotransmission. Male rats were subjected daily to 10 to 20 minutes per day of either forced swimming (FS) or sham swimming for 3 consecutive days; nonconditioned rats served as controls. Some rats were treated i.p. with ketamine (5 mg/kg), diazepam (2 mg/kg), flumazenil (0.1 mg/kg), or vehicle (0.9% NaCl), 30 to 60 minutes before each conditioning session or nociception assessment. Pain behavior, spinal nociceptive neuronal activation and GABA and glutamate release were respectively evaluated by the formalin test, the expression of c-Fos and in vivo microdialysis of superficial laminae of the lumbar spinal cord, 48 hours after the last conditioning session. Nitric oxide metabolites (NO(x)) were determined as markers of post-synaptic NMDA receptor activation. FS stress enhanced formalin-induced hyperalgesia, increased pain-elicited c-Fos expression, decreased basal and delayed pain-induced GABA release, and increased basal and induced glutamate release. Hyperalgesia and c-Fos overexpression were blocked only by prestress treatment with diazepam and post-stress treatment with ketamine, whereas changes in GABA and glutamate release were reversed by prestress treatment with diazepam. Diazepam effects were blocked by flumazenil. NO(x) increased in lumbar spinal cord of FS rats by a mechanism antagonized by ketamine. Thus, stress-induced hyperalgesia is initiated by a decreased and delayed GABA release and GABA-A receptor activation, whereas it is maintained by increased glutamate release and NMDA glutamate receptor activation at the spinal level.

[Association between HSV-2 infection and serum anti-rat brain antibodies in patients with autism]. / Infecciones por HSV-2 y su relación con anticuerpos antiencéfalo de rata en suero de pacientes con autismo.

Some cases of autism could be linked to viral infections able to induce autoimmune mechanisms directed against the encephalon. Neurothophic virus infections in animals are associated with clinical signs that are similar to those observed in neurodevelopment disorders. Thus, in this study, we determined the co-existence of antibodies against nerve tissue and viruses with neurothophic competence (HSV-1/2, Epstein-Barr-EBV, cytomegalovirus, measles and rubella) in serum of forty autistic children and forty healthy children. The presence of antibodies against nerve tissue was detected in slices of rat encephalic tissue by indirect immunofluorescence. The levels of anti-viral IgG and IgM antibodies were measured by indirect ELISA. The proportion of autistics with anti-encephalon IgG antibodies (77% anti-amygdala, 70% anti-caudate nucleus, 47.5% anti-cerebellum y anti-brain stem, 45% anti-hippocampus, 40% anti-corpus callosum and 17,5% anti-cortex) was significantly greater than that of controls (10% anti- amygdala y 5% anti- cerebellum) and was directly related to the severity of the autism. The proportion of children with positive levels (greater than 1.1.mg/dL) for anti-HSV IgM antibodies (indicative of acute infection) was significantly greater in autistics (65%) than in healthy children (17.5%). Ninety six percent of the autistics with anti-HSV antibodies also had anti-encephalon antibodies, percentage that was significantly greater than that of autistics negative to the anti-HSV-antibody (43%). In contrast, there were no significant differences for IgG and IgM antibodies for EBV, cytomegalovirus, measles and rubella. This suggests that autoimmunity against encephalic structures elicited by HSV infections could be involved in autism.

Infecciones por HSV-2 y su relación con anticuerpos antiencéfalo de rata en suero de pacientes con autismo / Association between HSV-2 infection and serum anti-rat brain antibodies in patients witn autism

Algunos casos de autismo podrían estar vinculados a infecciones virales capaces de inducir mecanismos autoinmunes dirigidos contra el encéfalo. Las infecciones de virus neurotrópicos en animales se acompañan de síntomas similares a los observados en los trastornos del neurodesarrollo. Así, en este estudio evaluamos la co-existencia de anticuerpos contra tejido nervioso y contra virus con capacidad neurotrópica [HSV-1/2, Epstein-Barr (EBV), citomegalovirus, sarampión y rubéola] en el suero de cuarenta niños autistas y cuarenta niños sanos. La presencia de anticuerpos contra tejido nervioso se detectó en cortes de tejido encefálico de rata mediante inmunofluorescencia indirecta. Los niveles de anticuerpos IgG e IgM anti-virales se midieron por ELISA indirecta. La proporción de autistas con anticuerpos IgG anti-encéfalo (77% anti-amígdala, 70% anti-núcleo caudado, 47,5% anti-cerebelo y anti-tallo cerebral, 45% anti-hipocampo, 40% anti-cuerpo calloso y 17,5% anti-corteza) fue significativamente mayor que aquella de los controles (10% anti-amígdala y 5% anti-cerebelo) y se relacionó directamente con la severidad del autismo. La proporción de niños con niveles positivos (mayores a 1,1 mg/dL) para anticuerpos IgM anti-HSV (indicativo de infección aguda) fue significativamente mayor en autistas (65%) que en sanos (17,5%). El 96% de los autistas con anticuerpos anti-HSV también presentó anticuerpos anti-encéfalo, porcentaje que fue significativamente mayor que el de los autistas negativos al anticuerpo anti-HSV (43%). En contraste, no hubo diferencias significativas para los anticuerpos IgG e IgM para EBV, citomegalovirus, sarampión y rubéola. Esto sugiere que una autoinmunidad contra estructuras encefálicas desencadenada por infecciones por HSV podría estar involucrada en el autismo.

Some cases of autism could be linked to viral infections able to induce autoimmune mechanisms directed against the encephalon. Neurothophic virus infections in animals are associated with clinical signs that are similar to those observed in neurodevelopment disorders. Thus, in this study, we determined the co-existence of antibodies against nerve tissue and viruses with neurothophic competence (HSV-1/2, Epstein-Barr-EBV, cytomegalovirus, measles and rubella) in serum of forty autistic children and forty healthy children. The presence of antibodies against nerve tissue was detected in slices of rat encephalic tissue by indirect immunofluorescence. The levels of anti-viral IgG and IgM antibodies were measured by indirect ELISA. The proportion of autistics with anti-encephalon IgG antibodies (77% anti-amygdala, 70% anti-caudate nucleus, 47.5% anti-cerebellum y anti-brain stem, 45% anti-hippocampus, 40% anti-corpus callosum and 17,5% anti-cortex) was significantly greater than that of controls (10% anti- amygdala y 5% anti- cerebellum) and was directly related to the severity of the autism. The proportion of children with positive levels (greater than 1.1.mg/dL) for anti-HSV IgM antibodies (indicative of acute infection) was significantly greater in autistics (65%) than in healthy children (17.5%). Ninety six percent of the autistics with anti-HSV antibodies also had anti-encephalon antibodies, percentage that was significantly greater than that of autistics negative to the anti-HSV-antibody (43%). In contrast, there were no significant differences for IgG and IgM antibodies for EBV, cytomegalovirus, measles and rubella. This suggests that autoimmunity against encephalic structures elicited by HSV infections could be involved in autism.

Guía para el análisis de los programas y servicios de salud / Guide to the analysis of health programs and services

La presente publicación describe bases teóricas sencillas para el análisis, así como pautas para recolectar, evaluar y analizar la información general de los problemas y el análisis por unidades poblacionales, para establecer una priorización regional y de ámbito geográfico. Son cuatro guías: 1) Análisis de los factores condicionantes de la salud, como son los factores demográficos y socioeconómicos; 2) Análisis del proceso salud-enfermedad, para la descripción del estado de salud en términos de morbilidad y mortalidad, la priorización de daños y de ámbitos geográficos por riesgo; 3) Análisis de la respuesta social a los problemas de salud, con énfasis en los servicios; y 4) Análisis integral entre estos componentes, que termina con pautas para una priorización integral y el balance entre la oferta y la demanda

Guía para el análisis de los programas y servicios de salud / Guide to the analysis of health programs and services

La presente publicación describe bases teóricas sencillas para el análisis, así como pautas para recolectar, evaluar y analizar la información general de los problemas y el análisis por unidades poblacionales, para establecer una priorización regional y de ámbito geográfico. Son cuatro guías: 1) Análisis de los factores condicionantes de la salud, como son los factores demográficos y socioeconómicos; 2) Análisis del proceso salud-enfermedad, para la descripción del estado de salud en términos de morbilidad y mortalidad, la priorización de daños y de ámbitos geográficos por riesgo; 3) Análisis de la respuesta social a los problemas de salud, con énfasis en los servicios; y 4) Análisis integral entre estos componentes, que termina con pautas para una priorización integral y el balance entre la oferta y la demanda(AU)

Determinación de la presión arterial: una alternativa en situaciones de apremio / Measurement of arterial pressure: an alternative useful during emergencies

La medición de la presión arterial por método directo es una actividad cotidiana en las unidades de cuidados intensivos. Se hace énfasis en un método antiguo y a la vez sencillo, que permite la medición confiable y precisa de la presión arterial media sistémica, en situaciones de apremio, en lugares donde no se cuente con los recursos tecnológicos, durante el traslado de pacientes, cuando el equipo especial falla o existe duda acerca del valor indicado por los dispositivos electrónicos para vigilancia constante de signos vitales. En tales condiciones puede utilizarse una línea de agua, similar en su mecánica y uso a una línea para medir presión venosa central convencional, pero de mayor longitud. El principio fisico es infalible, la línea se prepara fácil y rápidamente, el método está libre de riesgo y a través de varios años lo hemos empleado como una buena alternativa de los métodos usuales de medición directa