Primary ciliary dyskinesia diagnosis and management and its implications in America: a mini review.

Introduction: Primary ciliary dyskinesia (PCD) is a rare genetic disorder that can result in significant morbidity and mortality if left untreated. Clinical manifestations of PCD include recurrent respiratory infections, laterality defects, and infertility, all of which arise from impaired or absent ciliary motility. Diagnostic approaches for PCD may include high-speed video microscopy, measurement of nasal nitric oxide levels, and genetic testing; however, no single definitive diagnostic test exists. The present study aims to highlight the lack of standardized diagnostic and treatment guidelines for PCD in Latin America (Central and South America, and the Caribbean). To this effect, we compared North American and European recommendations for the diagnosis and management of PCD and found that certain diagnostic tools and treatment options mentioned in these guidelines are not readily accessible in many Latin American countries. Methods & Results: This review gathers disease information in North America, Europe, and Latin America organizing guideline results into tables for clarity and potential interventions. Management information for Latin America is inferred from case reports, as most findings are from North American recommendations and studies on PubMed, Google Scholar, and Scopus. Treatment and management information is based on North American and European standards.Among 5,774 publications reviewed, only 15 articles met the inclusion criteria (focused on PCD management, peer-reviewed, and located in America). No clinical guideline for PCD in Latin America was found, but recommendations on respiratory management from Colombia and Chile were discovered. The lack of guidelines in Latin America may originate from limited resources and research on the disease in those countries. Discussion: PCD lacks documentation, research, and recommendations regarding its prevalence in Latin America, likely due to unfavorable economic conditions. This disadvantage results in limited access to diagnostic tests available in North America and Europe. The PICADAR score, discussed in this review, can be used in low-income nations as a screening tool for the disorder.

Spanish and Portuguese Societies of Internal Medicine consensus guideline about best practice in end-of-life care.

AIM: To develop consensus recommendations about good clinical practice rules for caring end-of-life patients. METHODS: A steering committee of 12 Spanish and Portuguese experts proposed 37 recommendations. A two rounds Delphi method was performed, with participation of 105 panelists including internists, other clinicians, nurses, patients, lawyers, bioethicians, health managers, politicians and journalists. We sent a questionnaire with 5 Likert-type answers for each recommendation. Strong consensus was defined when >95% answers were completely agree or >90% were agree or completely agree; and weak consensus when >90% answers were completely agree or >80% were agree or completely agree. RESULTS: The panel addressed 7 specific areas for 37 recommendations spanning: identification of patients; knowledge of the disease, values and preferences of the patient; information; patient's needs; support and care; palliative sedation, and after death care. CONCLUSIONS: The panel formulated and provided the rationale for recommendations on good clinical practice rules for caring end-of-life patients.

Manejo de la enfermedad de Parkinson y otros trastornos del movimiento en mujeres en edad fértil: Parte 1 / Management of Parkinson's disease and other movement disorders in woman of childbearing age: Part 1

INTRODUCCIÓN: El manejo de la enfermedad de Parkinson en la mujer en edad fértil nos plantea como principal reto el manejo de la enfermedad y los fármacos durante el embarazo y lactancia. El aumento de la edad gestacional de la mujer hace más probable que la incidencia de embarazos pueda incrementarse. OBJETIVO: Definir las características clínicas y los factores que condicionan la vida de la mujer en edad fértil con enfermedad de Parkinson y definir una guía de actuación y manejo del embarazo en estas pacientes. RESULTADOS: Este documento de consenso se ha realizado mediante una búsqueda bibliográfica exhaustiva y discusión de los contenidos realizados por un grupo de expertos en trastornos del movimiento de la Sociedad Española de Neurología. CONCLUSIONES: La enfermedad de Parkinson afecta a todos los aspectos relacionados con la salud sexual y reproductiva de la mujer en edad fértil. Se debe planificar el embarazo en las mujeres con enfermedad de Parkinson para minimizar los riesgos teratogénicos sobre el feto. Se recomienda un abordaje multidisciplinar de estas pacientes para tener en cuenta todos los aspectos implicados

INTRODUCTION: The main challenge of Parkinson's disease in women of childbearing age is managing symptoms and drugs during pregnancy and breastfeeding. The increase in the age at which women are having children makes it likely that these pregnancies will become more common in future. OBJECTIVES: This study aims to define the clinical characteristics of women of childbearing age with Parkinson's disease and the factors affecting their lives, and to establish a series of guidelines for managing pregnancy in these patients. RESULTS: This consensus document was developed through an exhaustive literature search and a discussion of the available evidence by a group of movement disorder experts from the Spanish Society of Neurology. CONCLUSIONS: Parkinson's disease affects all aspects of sexual and reproductive health in women of childbearing age. Pregnancy should be well planned to minimise teratogenic risk. A multidisciplinary approach should be adopted in the management of these patients in order to take all relevant considerations into account

Manejo de la enfermedad de Parkinson y otros trastornos del movimiento en mujeres en edad fértil: parte 2 / Management of Parkinson's disease and other movement disorders in women of childbearing age: Part 2

INTRODUCCIÓN: Muchas enfermedades que cursan con trastornos del movimiento hipercinético comienzan o afectan a mujeres en edad fértil. Es importante conocer los riesgos que tienen las mujeres con estas enfermedades durante el embarazo, así como los posibles efectos de los tratamientos sobre el feto. OBJETIVOS: Definir las características clínicas y los factores que condicionan la vida de la mujer en edad fértil con distonía, corea, síndrome de Tourette, temblor y síndrome de piernas inquietas. Definir una guía de actuación y manejo del embarazo y lactancia en las pacientes con esta enfermedad. DESARROLLO: Este documento de consenso se ha realizado mediante una búsqueda bibliográfica exhaustiva y discusión de los contenidos llevadas a cabo por un Grupo de Expertos en Trastornos del Movimiento de la Sociedad Española de Neurología (SEN). CONCLUSIONES: En todas las mujeres que padecen o comienzan con trastornos del movimiento hipercinéticos se debe valorar el riesgo-beneficio de los tratamientos, reducir al máximo la dosis eficaz o administrarlo de forma puntual en los casos en que sea posible. En aquellas enfermedades de causa hereditaria es importante un consejo genético para las familias. Es importante reconocer los trastornos del movimiento desencadenados durante el embarazo como determinadas coreas y síndrome de piernas inquietas

INTRODUCTION: Many diseases associated with hyperkinetic movement disorders manifest in women of childbearing age. It is important to understand the risks of these diseases during pregnancy, and the potential risks of treatment for the fetus. OBJECTIVES: This study aims to define the clinical characteristics and the factors affecting the lives of women of childbearing age with dystonia, chorea, Tourette syndrome, tremor, and restless legs syndrome, and to establish guidelines for management of pregnancy and breastfeeding in these patients. RESULTS: This consensus document was developed through an exhaustive literature search and a discussion of the content by a group of movement disorder experts from the Spanish Society of Neurology. CONCLUSIONS: We must evaluate the risks and benefits of treatment in all women with hyperkinetic movement disorders, whether pre-existing or with onset during pregnancy, and aim to reduce effective doses as much as possible or to administer drugs only when necessary. In hereditary diseases, families should be offered genetic counselling. It is important to recognise movement disorders triggered during pregnancy, such as certain types of chorea and restless legs syndrome

Guía de práctica clínica de consenso sobre buenas prácticas en los cuidados al final de la vida de las Sociedades Española y Portuguesa de Medicina Interna / Spanish and Portuguese Societies of Internal Medicine consensus guideline about best practice in end-of-life care

Objetivo Establecer recomendaciones de consenso sobre normas de buena práctica clínica en la atención a los pacientes al final de la vida. Métodos Un comité de 12 expertos españoles y portugueses propuso 37 recomendaciones. Se realizó un Proceso Delphi a dos rondas, con participación de 105 panelistas incluyendo internistas, otros médicos clínicos, enfermeras, enfermos, juristas, expertos en bioética, gestores sanitarios, políticos y periodistas. Para cada recomendación se envió un cuestionario con cinco respuestas tipo Likert. Se definió consenso fuerte cuando > 95% de las respuestas estaban totalmente de acuerdo o > 90% estaban de acuerdo y totalmente de acuerdo; consenso débil cuando > 90% estaban totalmente de acuerdo o > 80% estaban de acuerdo y totalmente de acuerdo. Resultados El panel abordó siete áreas específicas con 37 recomendaciones que abarcaban: Identificación de los pacientes; Conocimiento, valores y preferencias del paciente; Información; Necesidades del paciente; Atención y cuidados; Sedación paliativa y Atención tras la muerte. Conclusiones Un Proceso Delphi con participación multidisciplinar ha permitido establecer normas de buena práctica clínica en la atención al final de la vida con consenso de enfermos, agentes sociales y profesionales sanitarios (AU)

Aim To develop consensus recommendations about good clinical practice rules for caring end-of-life patients. Methods A steering committee of 12 Spanish and Portuguese experts proposed 37 recommendations. A two rounds Delphi method was performed, with participation of 105 panelists including internists, other clinicians, nurses, patients, lawyers, bioethicians, health managers, politicians and journalists. We sent a questionnaire with 5 Likert-type answers for each recommendation. Strong consensus was defined when > 95% answers were completely agree or > 90% were agree or completely agree; and weak consensus when > 90% answers were completely agree or > 80% were agree or completely agree. Results The panel addressed 7 specific areas for 37 recommendations spanning: identification of patients; knowledge of the disease, values and preferences of the patient; information; patient's needs; support and care; palliative sedation, and after death care Conclusions The panel formulated and provided the rationale for recommendations on good clinical practice rules for caring end-of-life patients (AU)

[Andean children with aneurysmal bone cyst treated with polidocanol (use off-label)]. / Niños andinos con quiste óseo aneurismático tratados con polidocanol (uso fuera de etiqueta).

INTRODUCTION: The aneurysmal bone cyst is a rare benign but aggressive osteolytic tumor for which there is still no ideal treatment, the reports on treatment by sclerotherapy in the pediatric population are scarce and in our region even less. The objective is to communicate the experience of the treatment of aneurysmal bone cyst with polydocanol 3%. MATERIAL Y METHODS: Retrospective, descriptive and cross-sectional study. Period: June/2017 to June/2021. Inclusion: patients with histological diagnosis of aneurysmal bone cyst; Under general anesthesia and fluoroscopic guidance, intralesional puncture with 16G needle was performed through which 3% polydocanol was slowly administered. Data: medical history. Quantitative variables shall be expressed in measures of central tendency and dispersion; qualitative variables shall be expressed as frequencies or percentages. RESULTS: Nine consecutive patients were included, all of whom had pain and tumor in one of the extremities. Gender: 3 female and 6 male. Age: median 10.5 years (range: 2-15.1). Weight: median 32.8 kg (range: 11-44.5). Total procedures: 44; procedures per patient: mean 4.9 (SD: ± 2.0). Procedure time: mean 33.9 minutes (SD: ± 18.3); radiation: mean 1.34 mGy (SD: ± 1.55). Hospitalization: one day, except one patient. Complications: skin damage in one case, no recurrences follow-up: 12 to 50 months. CONCLUSION: In this pediatric series, polydocanol 3% was useful and effective for the treatment of aneurysmal bone cyst, with few complications. One disadvantage is that it requires several sessions and in addition, no significant difference has been demonstrated between other forms of treatment in terms of the recurrence rate.

INTRODUCCIÓN: El quiste óseo aneurismático es un raro tumor osteolítico benigno, pero agresivo para el que aún no existe tratamiento ideal. Los comunicados sobre tratamiento mediante escleroterapia en población pediátrica son escasos y en nuestra región más aún. El objetivo es comunicar la experiencia del tratamiento del quiste óseo aneurismático con polidocanol 3%. MATERIAL Y MÉTODOS: Estudio retrospectivo, descriptivo y transversal. Período: Junio de 2017 a Junio de 2021. Inclusión: pacientes con diagnóstico histológico de quiste óseo aneurismático. Bajo anestesia general y guía fluoroscópica se realizó punción intralesional con aguja 16G a través de la cual se administró lentamente el polidocanol 3%. Datos: historia clínica. Las variables cuantitativas se expresarán en medidas de tendencia central y de dispersión; las variables cualitativas se expresarán como frecuencias o porcentajes. RESULTADOS: Se incluyeron nueve pacientes consecutivos, todos presentaban dolor y tumoración en alguna de las extremidades. Género: tres femeninos y seis masculinos. Edad: mediana 10.5 años (rango: 2-15.1). Peso: mediana 32.8 kg (rango: 11-44.5). Total de procedimientos: 44, procedimientos por paciente: promedio 4.9 (DE: ± 2.0). Tiempo de procedimiento: promedio 33.9 minutos (DE: ± 18.3); radiación: promedio 1.34 mGy (DE: ± 1.55). Hospitalización: un día, excepto un paciente. Complicaciones: Daño de piel en un caso, no recidivas. Seguimiento: de 12 a 50 meses. CONCLUSIÓN: En esta serie pediátrica el polidocanol 3% fue útil y efectivo para el tratamiento del quiste óseo aneurismático con escasas complicaciones. Una desventaja es que requiere varias sesiones y además, no se ha demostrado una diferencia significativa entre otras formas de tratamiento en términos de la tasa de recurrencia.

Management of Parkinson's disease and other movement disorders in woman of childbearing age: Part 1. / Manejo de la enfermedad de Parkinson y otros trastornos del movimiento en mujeres en edad fértil: Parte 1.

INTRODUCTION: The main challenge of Parkinson's disease in women of childbearing age is managing symptoms and drugs during pregnancy and breastfeeding. The increase in the age at which women are having children makes it likely that these pregnancies will become more common in future. OBJECTIVES: This study aims to define the clinical characteristics of women of childbearing age with Parkinson's disease and the factors affecting their lives, and to establish a series of guidelines for managing pregnancy in these patients. RESULTS: This consensus document was developed through an exhaustive literature search and a discussion of the available evidence by a group of movement disorder experts from the Spanish Society of Neurology. CONCLUSIONS: Parkinson's disease affects all aspects of sexual and reproductive health in women of childbearing age. Pregnancy should be well planned to minimise teratogenic risk. A multidisciplinary approach should be adopted in the management of these patients in order to take all relevant considerations into account.

Management of Parkinson's disease and other movement disorders in women of childbearing age: Part 2. / Manejo de la enfermedad de Parkinson y otros trastornos del movimiento en mujeres en edad fértil: parte 2.

INTRODUCTION: Many diseases associated with hyperkinetic movement disorders manifest in women of childbearing age. It is important to understand the risks of these diseases during pregnancy, and the potential risks of treatment for the fetus. OBJECTIVES: This study aims to define the clinical characteristics and the factors affecting the lives of women of childbearing age with dystonia, chorea, Tourette syndrome, tremor, and restless legs syndrome, and to establish guidelines for management of pregnancy and breastfeeding in these patients. RESULTS: This consensus document was developed through an exhaustive literature search and a discussion of the content by a group of movement disorder experts from the Spanish Society of Neurology. CONCLUSIONS: We must evaluate the risks and benefits of treatment in all women with hyperkinetic movement disorders, whether pre-existing or with onset during pregnancy, and aim to reduce effective doses as much as possible or to administer drugs only when necessary. In hereditary diseases, families should be offered genetic counselling. It is important to recognise movement disorders triggered during pregnancy, such as certain types of chorea and restless legs syndrome.

Spanish and Portuguese Societies of Internal Medicine consensus guideline about best practice in end-of-life care. / Guía de práctica clínica de consenso sobre buenas prácticas en los cuidados al final de la vida de las Sociedades Española y Portuguesa de Medicina Interna.

AIM: To develop consensus recommendations about good clinical practice rules for caring end-of-life patients. METHODS: A steering committee of 12 Spanish and Portuguese experts proposed 37 recommendations. A two rounds Delphi method was performed, with participation of 105 panelists including internists, other clinicians, nurses, patients, lawyers, bioethicians, health managers, politicians and journalists. We sent a questionnaire with 5 Likert-type answers for each recommendation. Strong consensus was defined when > 95% answers were completely agree or > 90% were agree or completely agree; and weak consensus when > 90% answers were completely agree or > 80% were agree or completely agree. RESULTS: The panel addressed 7 specific areas for 37 recommendations spanning: identification of patients; knowledge of the disease, values and preferences of the patient; information; patient's needs; support and care; palliative sedation, and after death care. CONCLUSIONS: The panel formulated and provided the rationale for recommendations on good clinical practice rules for caring end-of-life patients.

X-ray diffraction and Raman spectroscopy study of white decorations on tricolored ceramics from Northwestern Argentina.

White virgules, commas, and dot designs on tricolored ceramics are sporadically found in different archaeological sites located in Northwestern Argentina area, as Puna and Quebrada de Humahuaca. This decorating style has been reported in several articles, but few previous archaeometric studies have been carried out on the pigment composition. Fragments from Puna and Quebrada archaeological sites, belonging to Regional Development Period (900-1430 AD), were analyzed by X-ray diffraction and Raman spectroscopy in order to characterize the pigments employed. Red and black pigments are based on iron and manganese oxides, as it has been extensively reported for the NW Argentina area. White pigments from white virgules, comma, and dot designs have shown different composition. Hydroxyapatite was found in samples from Doncellas site (North Puna region), and calcium and calcium-magnesium containing compounds, as vaterite and dolomite, along with titanium containing compounds were detected on samples from Abralaite (Central Puna region) and Gasoducto (Quebrada de Humahuaca region). It has been concluded that pigment composition is not characteristic of a unique region.

Volatile Substances Produced by Fusarium oxysporum from Coffee Rhizosphere and Other Microbes affect Meloidogyne incognita and Arthrobotrys conoides.

Microorganisms produce volatile organic compounds (VOCs) which mediate interactions with other organisms and may be the basis for the development of new methods to control plant-parasitic nematodes that damage coffee plants. In the present work, 35 fungal isolates were isolated from coffee plant rhizosphere, Meloidogyne exigua eggs and egg masses. Most of the fungal isolates belonged to the genus Fusarium and presented in vitro antagonism classified as mutual exclusion and parasitism against the nematode-predator fungus Arthrobotrys conoides (isolated from coffee roots). These results and the stronger activity of VOCs against this fungus by 12 endophytic bacteria may account for the failure of A. conoides to reduce plant-parasitic nematodes in coffee fields. VOCs from 13 fungal isolates caused more than 40% immobility to Meloidogyne incognita second stage juveniles (J2), and those of three isolates (two Fusarium oxysporum isolates and an F. solani isolate) also led to 88-96% J2 mortality. M. incognita J2 infectivity decreased as a function of increased exposure time to F. oxysporum isolate 21 VOCs. Gas chromatography-mass spectrometry (GC-MS) analysis lead to the detection of 38 VOCs produced by F. oxysporum is. 21 culture. Only five were present in amounts above 1% of the total: dioctyl disulfide (it may also be 2-propyldecan-1-ol or 1-(2-hydroxyethoxy) tridecane); caryophyllene; 4-methyl-2,6-di-tert-butylphenol; and acoradiene. One of them was not identified. Volatiles toxic to nematodes make a difference among interacting microorganisms in coffee rhizosphere defining an additional attribute of a biocontrol agent against plant-parasitic nematodes.

Genetic characterization of hantaviruses associated with sigmodontine rodents in an endemic area for hantavirus pulmonary syndrome in southern Brazil.

An ecological assessment of reservoir species was conducted in a rural area (Jaborá) in the mid-west of the state of Santa Catarina in southern Brazil, where hantavirus pulmonary syndrome is endemic, to evaluate the prevalence of hantavirus infection in wild rodents. Blood and tissue samples were collected from 507 rodents during seven field trips from March 2004 to April 2006. Some of the animals were karyotyped to confirm morphological identification. Phylogenetic reconstructions of rodent specimens, based on the mitochondrial DNA cytochrome b gene sequences, were also obtained. Hantavirus antibody was found in 22 (4.3%) of the 507 rodents: 5 Akodon montensis, 2 Akodon paranaensis, 14 Oligoryzomys nigripes, and 1 Sooretamys angouya. Viral RNAs detected in O. nigripes and A. montensis were amplified and sequenced. O. nigripes virus genome was 97.5% (nt) and 98.4% (nt) identical to sequences published for Araucaria (Juquitiba-like) virus based on N and G2 fragment sequences. Viral sequences from A. montensis strain showed 89% and 88% nucleotide identities in a 905-nt fragment of the nucleocapsid (N) protein-coding region of the S segment when it was compared with two other Akodontine rodent-associated viruses from Paraguay, A. montensis and Akodon cursor, respectively. Phylogenetic analysis showed the cocirculation of two genetic hantavirus lineages in the state of Santa Catarina, one from O. nigripes and the other from A. montensis, previously characterized in Brazil and Paraguay, respectively. The hantavirus associated with A. montensis, designed Jaborá virus, represents a distinct phylogenetic lineage among the Brazilian hantaviruses.

Abordagem etnobotânica sobre plantas medicinais citadas por populações do entorno de uma unidade de conservação da caatinga do Rio Grande do Norte, Brasil / Ethnobotanical approach to medicinal plants mentioned by people from the environs of a caatinga conservation unit in Rio Grande do Norte, Brazil

As Caatingas, único Bioma exclusivamente brasileiro, têm sofrido grande extrativismo dos recursos, com perdas de diversidade biológica associadas ao fornecimento de madeira e extratos vegetais. As consequências impactantes sobre este Bioma têm levado a busca de estratégias para conservação, como a criação de Unidades de Conservação (UCs), a exemplo da Estação Ecológica do Seridó (ESEC Seridó), localizada no Estado do Rio Grande do Norte, cujas comunidades do entorno mantêm forte relação com esta ESEC. Como o mau uso dos recursos da Caatinga tem sido fortemente associado às necessidades das populações que ali habitam, este trabalho objetivou o estudo da percepção ambiental das comunidades do entorno da ESEC Seridó, focando sobre o conhecimento dessas sobre plantas de uso medicinal. Contabilizaram-se 48 espécies de plantas nativas e 39 exóticas, sendo 31 e 14 com propriedades medicinais, respectivamente. Foi constatado um rico conhecimento dessas comunidades sobre as plantas presentes nessa região, e a riqueza desses resultados são relevantes para futuras estratégias de gestão nesta Unidade de Conservação.

Caatinga, the only exclusively Brazilian biome, has suffered exploitation of its natural resources, with loss of biodiversity associated with wood and plant extract supply. The resulting impacts on this biome have led to the search for strategies for its conservation like the establishment of Conservation Units (CUs), such as the Ecological Station of Seridó (ESEC Seridó) located in Rio Grande do Norte State. The human communities in ESEC Seridó environs maintain a strong relationship with this conservation unit. Considering that the misuse of caatinga resources has been strongly linked to the needs of its inhabitants, this work aimed to investigate the environmental perception of communities from the environs of ESEC Seridó, focusing on the popular knowledge about plants of medicinal use. This investigation recorded 48 native and 39 exotic species, of which 31 and 14 species, respectively, had medicinal properties. The communities surveyed showed a deep knowledge of the plants found in that region and the wealth of these results is relevant for future management strategies in this Conservation Unit.

Nematode infection in the lizard Bogertia lutzae (Loveridge, 1941) from the Atlantic Forest in north-eastern Brazil.

Endoparasites associated with the small bromelicolous lizard Bogertia lutzae, a poorly studied phyllodactylid inhabitant of north-eastern Brazil, were studied. Fifty-seven specimens collected from the Atlantic Forest of Alagoas state were dissected. Only one species of parasite, the nematode Spauligodon oxkutzcabiensis, was found, with a prevalence of 22.8%. The intensity of infection was 2.62 +/- 1.19, and neither the prevalence nor mean intensity differed between the sexes. There was no correlation between lizard body size and intensity of infection. An aggregated pattern of distribution (D = 0.813) of S. oxkutzcabiensis was found in this lizard host population. Bogertia lutzae represents a new host recorded for S. oxkutzcabiensis, a parasite reported for the first time for Brazil.

Pentastomids infecting an invader lizard, Hemidactylus mabouia (Gekkonidae) in northeastern Brazil.

From January to April 2006, 37 specimens of Hemidactylus mabouia were collected in houses, in the municipality of Barbalha (7 degrees 20' S and 39 degrees 18' W), Ceará State, Northeast Brazil. Among the individuals captured, 17 were infected with pentastomids, totalling a prevalence of 45.9%, which did not differ between sexes. Host size did not influence the infection intensity. Two species of pentastomids were found: Raillietiella frenatus and R. mottae. The prevalence of R. frenatus (43.2%) was higher than R. mottae (2.7%), whereas the infection intensity of R. frenatus was comparatively lower (1.8 +/- 1.4) than R. mottae (36 parasites in a single host). Overall mean intensity of infection was 3.8 +/- 8.4 pentastomids. We found no pentastomid infecting juvenile geckos. The parameters of infection in this host population are in accordance to the findings of other studies, in which the high parasitism rate was associated to the feeding habits of geckos living in houses and buildings. Hemidactylus mabouia is a new host to R. mottae and the infection by R. frenatus is the first record of the occurrence this pentastomid species in Brazil.

Reservorios venosos centrales totalmente implantables, tipo Port-A-Cath, en pacientes oncológicos: revisión de Complicaciones / Totally implantable central venous devices (Port-A-Cath) in oncological patients: review of complications

El objetivo de esta revisión fue la de estudiar, describir y recoger las complicaciones relacionadas y derivadas de la utilización de dispositivos implantables de carácter permanente, tipo Port-A-Cath (PAC), en pacientes oncológicos. Durante las últimas décadas, estos dispositivos han experimentado una evolución tecnológica importante de manera que actualmente permiten su utilización de forma repetida, en régimen ambulatorio y para diferentes aplicaciones médicas, (administración de nutrición parenteral, administración de medicamentos o para la simple extracción de muestras sanguíneas). Gracias a esta evolución tecnológica, se ha incrementado la calidad de vida de los pacientes tanto por la mayor facilidad de utilización, como en la reducción del número de ingresos hospitalarios, mejorando así su balance coste/beneficio. Al igual que en cualquier otra técnica médico-quirúrgica, no están exentos de complicaciones derivadas bien del implante, utilización o mantenimiento en el tiempo de estos dispositivos y que es objeto principal de nuestra revisión. Consideramos necesario realizar esta revisión como control interno de las complicaciones surgidas así como herramienta de vigilancia sobre la técnica de implante y en relación con una apreciación subjetiva del incremento de las complicaciones de carácter trombótico en nuestra serie. Mostramos como la estandarización de la técnica de implante y la unificación de criterios a la hora de realizar el mantenimiento de los mismos por parte de los equipos de enfermería parece que reduce el número de complicaciones. Revisada la bibliografía, hemos constatado que nuestras cifras se presentan como buenas o muy buenas en el rango de las complicaciones advertidas y contabilizadas en una revisión de473 historias clínicas de pacientes oncológicos tratados con fármacos quimioterápicos a través de este tipo de dispositivos (AU)

This review, describe and depict the complications related from the use of permanently implantable Port-A-Cath (PAC) devices in oncological patients. These devices have undergone a substantial technological evolution such that they can currently be used repeatedly under an outpatient regime and for different medical applications (administration of parenteral nutrition, medications, or for the simple extraction of blood samples). Thanks to these technological developments, the quality of life of patients has improved from the point of view of ease of use and the reduction of the number of hospital admissions, which thereby also improves its cost-benefit balance. However, just like any other medical technique, these devices are not exempt from complications arising from their implantation, use and maintenance over time. This is the principal matter with which our review concerns itself. We have considered it necessary to carry out this review as an internal control of the complications that arise and of its merit as a tool for overseeing the implantation technique, and in relation to a subjective impression of a greater incidence of thrombotic complications in our series. We demostrate how the standarisation of the implantation technique and the unification of criteria when nursing staff carry out maintenance appears to reduce the number of complications. Having reviewed the bibliography, we conclude that our figures are good or very good for the range of noted and counted complications in a review of 473 clinical records of cancer patients treated with chemotherapy drugs using this type of device (AU)

Estimulación Medular (EEM) en el tratamiento de la enfermedad vascular periférica. Parte II / Spinal Cord Stimulation for peripheral vascular disease treatment

Las técnicas de neuromodulación suponen un abordaje no destructivo y reversible en el tratamiento del dolor. Su utilización se establece como estrategia de control del dolor no controlable dentro de las directrices de la O.M.S. y como alternativa a otras terapias invasivas menores o neuroablatibas que no han sido eficaces o que están contraindicadas. De entre ellas el uso clínico de la estimulación eléctrica medular (EEM) o neuroestimulación, demuestra día a día su utilidad y eficacia en el tratamiento de diferentes síndromes de dolor crónico. Estudios de Cook y cols en 1.976, ya demostraron en sus trabajos la efectividad de esta técnica en la manifestación clínica del dolor isquémico así como en la arterioesclerosis o vasculopatía diabética, o en el dolor isquémico producido por vasoespasmo periférico, en entidades específicas como la Enfermedad de Buerguer, Esclerodermia o Síndrome de Raynaud. Durante la última década, se ha extendido la utilización de la EEM en la cardiopatía isquémica de carácter intratable (angina de pecho refractaria a tratamientos, síndrome “X”,...) y la patología vascular periférica, objeto de esta revisión. Esta técnica se presenta como una de las principales indicaciones con altos niveles de efectividad (80%), tanto en el aspecto clínico por el alivio sintomático que produce, como en los beneficios isquémicos fisiopatológicos que induce la neuroestimulación (AU)

The Neuro-modulation technologies are a not destructive and reversible approach in the treatment of the pain. They are used as a strategy for the control of untreatable pain according to the directives of the OMS and as an alternative of other invasive minor or neuroablatives therapies that have been not effective or that are not indicated. Between them the clinical use of spinal cord stimulation (SCS) has demonstrated its usefulness and efficiency in the treatment of different syndromes of chronic pain. Cook’s and cols. in 1.976, demonstrated in their reports the efficiency of this technique in the clinical manifestation of ischemic pain as well as in the arteriosclerosis, diabetic vasculopaty, or in the ischemic pain related with peripheral vasospasm, in specific pathologies as the Buerguer´s disease, Scleroderma or Raynaud´s syndrome. During the last decade, the utilization of the SCS has spread in the ischemic cardiopathy of untreatable character (refractory angina pectoris, syndrome “X”,…) and vascular peripheral pathology, subject of this review. This technique appears as one of the main indications with high levels of efficiency (80%), so much in the clinical aspect for the symptomatic relief as well as in the ischemic physiopatologic benefits that induces the neuro-estimulation (AU)

Pentastomids infecting an invader lizard, Hemidactylus mabouia (Gekkonidae) in northeastern Brazil / Pentastomídeos infectando um lagarto invasor, Hemidactylus mabouia (Gekkonidae), na região nordeste do Brasil

From January to April 2006, 37 specimens of Hemidactylus mabouia were collected in houses, in the municipality of Barbalha (7° 20' S and 39° 18' W), Ceará State, Northeast Brazil. Among the individuals captured, 17 were infected with pentastomids, totalling a prevalence of 45.9 percent, which did not differ between sexes. Host size did not influence the infection intensity. Two species of pentastomids were found: Raillietiella frenatus and R. mottae. The prevalence of R. frenatus (43.2 percent) was higher than R. mottae (2.7 percent), whereas the infection intensity of R. frenatus was comparatively lower (1.8 ± 1.4) than R. mottae (36 parasites in a single host). Overall mean intensity of infection was 3.8 ± 8.4 pentastomids. We found no pentastomid infecting juvenile geckos. The parameters of infection in this host population are in accordance to the findings of other studies, in which the high parasitism rate was associated to the feeding habits of geckos living in houses and buildings. Hemidactylus mabouia is a new host to R. mottae and the infection by R. frenatus is the first record of the occurrence this pentastomid species in Brazil.

De janeiro a abril de 2006 foram coletados 37 espécimes de Hemidactylus mabouia em domicílios no município de Barbalha (7° 20' S e 39° 18' W), Estado do Ceará, Nordeste do Brasil. Entre os indivíduos capturados, 17 estavam infectados com pentastomídeos, totalizando uma prevalência de 45,9 por cento, sem diferenças significantes entre os sexos. O tamanho dos hospedeiros também não influenciou na intensidade de infecção. Duas espécies de pentastomídeos foram encontradas: Raillietiella frenatus e R. mottae. A prevalência de R. frenatus (43,2 por cento) foi mais alta do que a de R. mottae (2,7 por cento), enquanto que a intensidade média de infecção de R. frenatus foi comparativamente mais baixa (1.8 ± 1.4) do que a de R. mottae (36 parasitas em um único indivíduo). A intensidade geral de infecção foi de 3.8 ± 8.4 pentastomídeos. Não foi encontrado nenhum gecko juvenil infectado por pentastomídeo. Os parâmetros de infecção nesta população de hospedeiros estão de acordo com outros estudos, que indicam altas taxas de parasitismo associadas com os hábitos alimentares de geckos vivendo em domicílios e edificações. Hemidactylus mabouia representa um novo hospedeiro para R. mottae e a infecção por R. frenatus constitui o primeiro registro de ocorrência desta espécie de pentastomídeo no Brasil.