Síndrome serotoninérgico inducido por ayahuasca: a propósito de un caso

El síndrome serotoninérgico es un conjunto de signos y síntomas generados por hiperactividad serotoninérgica, caracterizado principalmente por alteración del sistema nervioso central. La medicina tradicional, históricamente utiliza herbales con fines curativos y religiosos que podrían tener efectos sobre el sistema serotoninérgico, receptores de dopamina, glutamato y noradrenalina, en este contexto se menciona la ayahuasca o "yagé" como un brebaje con potencial psicoactivo que por lo general se relaciona con síntomas psicóticos. En esta ocasión presentamos un caso clínico de una paciente con síndrome serotoninérgico posterior al consumo por primera vez de ayahuasca en un ritual indígena. Se trata de una paciente femenina de 31 años quien por primera vez ingirió yagé y en cantidad desconocida durante dos días consecutivos en el municipio de Cachipay, Cundinamarca, por sus síntomas clínicos se consideró que cursaba con un síndrome serotoninérgico, recibió tratamiento con adecuado control de su cuadro. Existen múltiples reportes bibliográficos sobre trastornos psicóticos derivados especialmente del uso de DMT en preparación de ayahuasca, sin embargo, la ocurrencia de síntomas psicóticos prolongados, más allá de 48 horas, se considera excepcional; se han descrito en pacientes con antecedentes personales y familiares de psicosis, manía, hipomanía o abuso de sustancias psicoactivas.

Serotonin syndrome is a set of signs and symptoms caused by serotonergic hyperactivity, primarily characterized by alterations in the central nervous system. Historically, traditional medicine has used herbal remedies for healing and religious purposes, which could affect the serotonergic system, dopamine, glutamate, and noradrenaline receptors. In this context, ayahuasca or «yagé» is mentioned as a brew with psychoactive potential that is generally associated with psychotic symptoms. Here, we present a clinical case of a patient with serotonin syndrome following her first-time consumption of ayahuasca in an indigenous ritual. The patient is a 31-year-old female who ingested an unknown quantity of yagé over two consecutive days in Cachipay, Cundinamarca. Given her clinical symptoms, she was considered to have serotonin syndrome and received treatment with adequate control of her condition. Multiple reports in the literature discuss psychotic disorders especially from DMT use in ayahuasca preparation; however, the occurrence of prolonged psychotic symptoms beyond 48 hours is considered exceptional and has been described in patients with personal and family histories of psychosis, mania, hypomania, or abuse of psychoactive substances.

Update of the PANCCO clinical practice guidelines for the treatment of ulcerative colitis in the adult population.

Ulcerative colitis (US) is a chronic disease of unknown etiology. It is incurable and its clinical course is intermittent, characterized by periods of remission and relapse. The prevalence and incidence of the disease has been increasing worldwide. The update presented herein includes the participation of healthcare professionals, decision-makers, and a representative of the patients, all of whom declared their conflicts of interest. Answerable clinical questions were formulated, and the outcomes were graded. The information search was conducted on the Medline/PubMed, Embase, Epistemonikos, and LILACS databases, and covered grey literature sources, as well. The search was updated on November 30, 2020, with no restrictions regarding date or language. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification system was implemented to establish the strength of the recommendation and quality of evidence. A formal consensus was developed, based on the RAND/UCLA methodology and the document was peer reviewed. The short version of the Clinical Practice Guidelines for the Treatment of Ulcerative Colitis in the Adult Population is presented herein, together with the supporting evidence and respective recommendations. In mild-to-moderate UC, budesonide MMX is an option when treatment with 5-ASA fails, and before using systemic steroids. In moderate-to-severe UC, infliximab, adalimumab, vedolizumab, ustekinumab, and tofacitinib can be used as first-line therapy. If there is anti-TNF therapy failure, ustekinumab and tofacitinib provide the best results. In patients with antibiotic-refractory pouchitis, anti-TNFs are the treatment of choice.

Prevalencia y biometría del espolón calcáneo en la población chilena: estudio radiológico / Prevalence and biometry of the calcaneal spur in the Chilean population: radiological study

RESUMEN: El dolor en la región calcánea del pie afecta aproximadamente a un tercio de los adultos mayores de 65 años. Asimismo, una gran cantidad de sujetos que consultan por esta condición, revelan hallazgos radiológicos de un crecimiento anormal en el hueso calcáneo, en su cara plantar, en forma de gancho denominado espolón calcáneo (EC). El objetivo del presente estudio fue relacionar la prevalencia y biometría de los EC en individuos chilenos según sexo y edad. Se realizó un estudio radiológico de tipo descriptivo-correlacional donde se revisaron al azar 400 radiografías de pies en proyección lateral de 200 sujetos chilenos entre 15 y 90 años. El análisis de los 200 exámenes radiográficos mostró que en 135 (67,5 %) de ellos presentaban EC de manera unilateral o bilateral. La presencia de al menos un EC era mayor en las mujeres 104 (52 %) que en los hombres 31 (15,5 %). Sin embargo, esta diferencia no es estadísticamente significativa p= 0,621. La edad promedio de los sujetos que presentaron EC era de 60,4 años, ampliamente superior a quien no lo presentaba (43,5 años), siendo esta diferencia estadísticamente significativa P<0,05. Se puede concluir una prevalencia del 67,5 % de EC en la población de estudio, mayor en las mujeres y directamente relacionada con la edad. Esta información podría ser de gran valor morfológico y médico debido a la escasa literatura existente sobre esta materia en individuos chilenos.

SUMMARY: Pain in the talar region of the foot affects approximately one third of people over 65 years of age. Likewise, a large number of patients who consult for this condition reveal radiological findings of an abnormal growth of the hook-shaped calcaneus called a calcaneal spur (CS). The objective of the present study was to relate the prevalence and biometrics of CS in Chilean individuals according to sex and age. A descriptive-correlational radiological study was carried out where 400 lateral projection radiographs of the feet of 200 Chilean patients between 15 and 90 years of age were randomly reviewed. The analysis of the 200 people examined showed that 135 (67.5%) presented CS unilaterally or bilaterally. The presence of at least one CS is greater in the female sex 104 (52%) than in the male sex 31 (15.5%), however, this difference is not statistically significant p = 0.621. The average age of the people who presented CS is 60.43 years, much higher than those who do not present (43.51 years), this difference being statistically significant P = Sig. It can be concluded a prevalence of 67.5% of CS in the study population, higher in the female sex and directly related to age. This information will be of great morphological and medical value due to the little existing literature on this matter in Chilean individuals.

Development and characterization of structured water-in-oil emulsions with ethyl cellulose oleogels.

The food industry confronts an enormous challenge to develop stable margarine-type water-in-vegetable oil (W/O) emulsion-based table spreads with reduced concentration of saturated fat and without trans fats. In the present work, we developed a gelled W/O emulsion (Gelled-W/O-E) containing 20% of water using a mixture of a conventional W/O emulsion (W/O-E) stabilized with glycerol monostearate (GMS), and an ethyl cellulose (EC) oleogel. The mechanical, microstructure and stability of the resulting gelled emulsion (Gelled-W/O-E) was compared with control systems consisting of conventional W/O emulsions (W/O-E) and EC-GMS oleogels (EC-GMS-O; no water added) formulated using the same GMS (0.5% and 1.0%) and EC (7%) concentration as in the Gelled-W/O-E. The Gelled-W/O-E showed higher elasticity and emulsion stability in comparison with the control systems. This in spite the EC and GMS concentrations used were below the minimal concentration required to develop a gel, and the tentatively lower solid content in the Gelled-W/O-E than in the EC-GMS-O because the presence of water. We observed that by increasing the GMS concentration in the Gelled-W/O-E, the water droplet size decreased as gel elasticity and W/O emulsion stability significantly increased. We associated this behavior to a synergistic GMS-EC interaction that kept the GMS at the water-oil droplet interface. These results showed the role of water droplets as active fillers in determining the rheological properties of the Gelled-W/O-E, and that the GMS efficiency as emulsifier increased in the presence of EC in the oil phase. After comparing the microstructural properties of commercial margarine spreads with those of the Gelled-W/O-E, we concluded that the structured W/O emulsion is a novel way to achieve similar functionality to margarine spreads, without the use of saturated and trans-fats.

Factores de riesgo del personal de enfermería del área quirúrgica de un hospital de tercer nivel / Risk factors of nursing staff in the surgical area of a third level hospital

Introducción: la Organización Mundial de la Salud (OMS) fundamenta que para luchar contra las infecciones asociadas a la atención sanitaria es necesario reducir las normas de bioseguridad para el personal ocupacionalmente expuesto. La bioseguridad es proteger la calidad de vida libre de daño, riesgo o peligro; el personal de enfermería que labora en el quirófano está expuesto a múltiples factores de riesgo, como el uso de químicos para procesar material quirúrgico, biológicos por el estrecho contacto con el paciente y fluidos corporales, psicosociales, por la carga de trabajo y ambientes tensos, o riesgos ergonómicos por estar en posiciones de pie por largos periodos de tiempo en procedimientos quirúrgicos. Objetivo: analizar los factores de riesgo del personal de enfermería del área quirúrgica de un hospital de tercer nivel. Material y métodos: estudio de tipo cuantitativo, descriptivo y transversal. Universo: integrado por el personal de enfermería del área quirúrgica de un hospital de tercer nivel. Muestra: no probabilística a criterio del investigador, integrado por 50 enfermeras y enfermeros de quirófano de todos los turnos. Criterios de inclusión: todos los enfermeros y enfermeras que se encuentren laborando en el área quirúrgica, con más de 2 meses dentro del área quirúrgica. Criterios de exclusión: personal de enfermería que no firmó consentimiento informado y no desearon participar, personal de enfermería de permiso, vacaciones, incapacidad, ausentismo, o no se encuentran laborando por algún otro motivo. El instrumento: cuestionario de 88 preguntas, con respuestas dicotómicas, con una confiabilidad de .99 utilizando fórmula de Kuder-Richardson. Resultados: personal de enfermería tiene un riesgo biológico del 100 %, en riesgos químicos 87 %, riesgos físicos 94 %, en cuanto a riesgos psicosocial 94 % de los encuestados consideran tener este riesgo, para riesgos ergonómicos el 67 % de los encuestados refieren presentar lesiones músculo esqueléticas. Conclusión: Los profesionales de enfermería dentro del área quirúrgica están expuestos a los diferentes riesgos. Estos peligros afectan individual y colectivamente, tienen la probabilidad de desencadenar una alteración a la salud, afectando inevitablemente el proceso de trabajo, conlleva al bajo rendimiento laboral e incumplimiento de los objetivos en las instituciones públicas y privadas. Se debe tener gran observancia al apego de las medidas de bioseguridad en la unidad quirúrgica para disminuir los riesgos de enfermedades infectocontagiosas.

Introduction: the World Health Organization (WHO) argues that in order to combat infections associated with health care, it is necessary to reduce biosecurity standards for occupational exposed personnel. Biosecurity is to protect quality of life free from damage, risk or danger; nursing staff working in the operating room are exposed to multiple risk factors, such as the use of chemicals to process surgical material; biological factores due to close contact with the patient and body fluids, psychosocial factors, due to workload and tense environments, or ergonomic risks to being in standing positions for long periods of time in surgical procedures. Objective: to analyze the risk factors of nursing staff in the surgical area of a third-level hospital. Material and methods: quantitative, descriptive and cross-sectional study. Universe: composed of the nursing staff from the surgical area of a third level hospital. Sample: non-probability at the investigator's discretion, consisting of 50 operating room nurses of all shifts. Inclusion criteria: all nurses who are working in the surgical area, with more than 2 months in the surgical area. Exclusion criteria: nursing staff who did not sign informed consent and did not wish to participate, nursing staff on leave, vacation, disability, absenteeism, or are not working for some other reason. The instrument: questionnaire consisting of eighty-eight questions, with dichotomous answers, with a reliability of. 99 using Kuder-Richardson formula. Results: the nursing staff has a biological risk of 100%, in chemical risks: 87%, physical risks: 94%, in terms of psychosocial risks, 94% of the respondents consider they have this risk; for ergonomic risks, 67% of those surveyed reported presenting musculoskeletal injuries. Conclusion: nursing professionals in the surgical area are exposed to different risks. These hazards affect individually and collectively, it has the probability of triggering a health disturbance, inevitably affecting the work process, leads to poor work performance and non-compliance with objectives in public and private institutions. Adherence to biosafety measures must be observed in the surgical unit to reduce the risks of infectious and contagious diseases.

Conflictos en la esfera sexual en adolescentes con Trastornos del Espectro Autista de alto funcionamiento / Conflicts in the Sexual Sphere in Adolescents with High-Functioning Autism Spectrum Disorders

Los Trastornos del Neurodesarrollo, en particular, los Trastornos del Espectro Autista (TEA) afectan la comunicación e interacción social, además de caracterizarse por conductas estereotipadas que en muchos casos se desajustan de la norma social. Dichas características nucleares de TEA pueden afectar el desarrollo afectivo-sexual y esto se puede ver exacerbado según el nivel de funcionamiento del niño o Adolescente. En este artículo revisaremos aspectos en conflicto en la sexualidad de Adolescentes con TEA de alto funcionamiento. Métodos: Se efectuó una revisión sistematizada de la evidencia reciente publicada y anexada a bases de datos en relación a conflictos en el área afectivo-sexual vivenciados por adolescentes con diagnóstico de Trastorno del Espectro Autista de alto funcionamiento. Se incluyeron estudios específicos respecto al tema, principalmente auto-reportes, denotando la escasez de revisiones sistemáticas. Se compara con literatura clásica de autismo. En la revisión se excluyó la población infantil con TEA, o sea, menores a 12 años al igual que jóvenes con TEA de bajo funcionamiento debido a las dificultades implícitas que la discapacidad intelectual y/o alteraciones del lenguaje generan en la interacción social y desarrollo afectivo-sexual. Resultados: En la revisión del tema se pesquisaron estudios enfocados en la comprensión de las dimensiones afectivo-sexuales afectadas en adolescentes con TEA de alto funcionamiento, comparaciones del desarrollo normativo en adolescentes sin TEA considerados casos controles y sus contrapartes con TEA, así mismo, se hizo énfasis en conflictos en común v/s conflictos específicos en TEA. Se evaluaron además, factores de riesgo en el ámbito sexual de jóvenes con TEA y las problemáticas en torno a educación sexual. Al respecto los estudios coincidieron en mayores porcentajes de conductas hipersexualizadas y parafílicas (principalmente fantasías sádicas y conductas voyeuristas y masoquistas) en adolescentes con TEA de alto funcionamiento. Además reportaron tasas más altas de orientación sexual "no heterosexual", disforia de género e identidad de género Trans. Discusión y Conclusiones: Del análisis de estudios en población específica de Adolescentes con diagnóstico de TEA catalogados como de alto funcionamiento, y en comparación con individuos controles sin TEA, la evidencia muestra un amplio espectro de dificultades relacionadas al desarrollo afectivo-sexual y su enfrentamiento en esta etapa del ciclo vital, así como la relación de los síntomas nucleares de TEA con conductas no normativas en torno a sexualidad del tipo "Hipersexualización" y "Parafilias". Se discuten además conflictos en orientación sexual e identidad de género. Se logró establecer una asociación entre las variables, lo que afecta su desempeño social global. Se evidenció además, la escasa educación sexual que reciben éstos adolescentes a nivel familiar y académico, lo que perpetúa tales conflictivas y establece un escenario de riesgo en su desarrollo. Se requiere mayor evaluación y utilización de escalas específicas adaptadas a TEA para mejorar y suplir tales falencias y así mejorar la calidad de vida de dichos jóvenes.

Neurodevelopmental Disorders, in particular Autism Spectrum Disorders (ASDs), affect social communication and interaction, as well as being characterized by stereotypical behaviors that in many cases are mismatched from the social norm. Such nuclear characteristics of ASD can have an impact on affective-sexual development and this may be exacerbated by the function level of the child or adolescent. In this article we will review conflicting aspects in the sexuality of adolescents with high-functioning ASD. Methods: A systematized review of recent evidence published and annexed to databases related to conflicts in the affective-sexual area lived by adolescents diagnosed with high-functioning Autism Spectrum Disorder was conducted. Specific studies were included on the subject, mainly self-reports, denoting the scarcity of systematic reviews. It was compared to classical autism literature. The review excluded the child population with ASD, i.e., under 12 years of age, as well as young people with low-functioning ASD due to the implicit difficulties that intellectual disability and/or language alterations generate in social interaction and affective-sexual development. Results: The review looked at studies focused on understanding the affective-sexual dimensions affected in adolescents with high-functioning ASD, comparisons of normative development in adolescents without ASD, considered control cases and their counterparts with ASD, as well as emphasizing common conflicts v/s specific conflicts in ASD. Risk factors in the sexual field of young people with ASD and sexual education issues were also assessed. In this regard, studies coincided with higher percentages of hypersexualized and paraphilic behaviors (mainly sadistic fantasies and voyeuristic and masochistic behaviors) in adolescents with high-functioning ASD. They also reported higher rates of "non-heterosexual" sexual orientation, gender dysphoria and transgender identity. Discussion and Conclusions: From the analysis of studies in the specific population of adolescents diagnosed with ASD listed as high functioning, and compared to individuals controls without ASD, the evidence shows a wide affective-sexual development and its confrontation at this stage of the life cycle, as well as the relationship of nuclear symptoms of ASD with non-normative behaviors around sexuality of the type "Hypersexualization" and "Paraphilias". Conflicts in sexual orientation and gender identity are also discussed. It was possible to establish a partnership between variables, which affects their overall social performance. It was also evident that these adolescents receive poor sex education within their families and at the academic levels, perpetuating such conflicts and establishing a scenario of developmental risk. Further evaluation and use of specific scales adapted to ASD are required to improve and supplement such false conditions and thus improve the quality of life of such young people.

Presencia y biometría de bazo accesorio en individuos chilenos: estudio por tomografía computarizada / Presence and biometry of accessory spleen in Chilean individuals: study by computerized tomography

El bazo se localiza en el cuadrante superior izquierdo del abdomen, relacionándose posteriormente con la 9a a 11a costilla, de las que se separa por el diafragma y el receso costodiafragmático, se localiza por detrás del estómago y lateralmente al riñón izquierdo. Por alteraciones en su desarrollo pueden generarse bazos accesorios (BA), considerándose un tejido ectópico del bazo. Se consideran tejido normal, con los mismos procesos fisiológicos que el bazo principal. Con el propósito de localizar y determinar aspectos biométricos de los mismos, se realizó un estudio de corte transversal y de carácter descriptivo, sobre una muestra de 220 exámenes de TC pertenecientes a pacientes mayores de 18 años del Hospital Regional Hernán Henríquez Aravena, Temuco, Chile. Para este estudio se excluyeron toda aquellas TC con antecedentes de esplenectomía y lesiones de Bazo o peri-esplénicas. El análisis de los datos mostró una prevalencia de 32,3 % de BA, pudiendo ser de una única presencia, dos e incluso tres BA por paciente.De un total de 71 personas que tienen al menos un BA, 34 (47,89 %) fueron de sexo femenino y 37 (52,11 %) de sexo masculino. Hubo 56 pacientes (78,9 %) con un BA, 29 (40,85 %) del sexo femenino y 27 (38,03 %) del masculino; 15 (21,1 %) presentaron más de un BA, 5 (7,04 %) de sexo femenino y 10 (14,08 %) de sexo masculino, si bien se puede observar variación en la cantidad de BA según sexo, no existe una relación estadísticamente significativa entre dichas variables. La ubicación más frecuente encontrada en el plano axial fue la zona antero-medial con 59 casos (66,29 %); asimismo, en el plano sagital, la localización más frecuente fue en el polo inferior con 40 casos (44,44 %). Datos biométricos de estos BA son mostrados en Tablas. Esta información será de gran valor morfológico y médico debido a la escasa literatura existente sobre esta materia en individuos chilenos.

The spleen is located in the upper left quadrant of the abdomen, subsequently related to the 9th to 11th rib, from which it is separated by the diaphragm and the cost-diaphragmatic recess, it is located behind the stomach and laterally to the left kidney. Due to alterations in its development, accessory spleens (AS) can be generated, being considered an ectopic tissue of the spleen. The AS are considered normal tissue, with the same physiological processes as the main spleen. With the purpose of locating and determining biometric aspects of them, a cross-sectional and descriptive study was carried out on a sample of 220 CT scans belonging to patients over 18 years of age at the Hernán Henríquez Aravena Regional Hospital, Temuco, Chile. For this study, all CT scans with a history of splenectomy and spleen or peri-splenic lesions were excluded. The analysis of the data showed a prevalence of 32.3 % of AS, being able to be of a single presence, two and even three AS per patient. Of a total of 71 people who have at least one AS, 34 (47.89 %) were female and 37 (52.11 %) male. There were 56 patients (78.9 %) with a one AS, 29 (40.85 %) of the female sex and 27 (38.03 %) of the male; 15 (21.1 %) presented more than one AS, 5 (7.04 %) female and 10 (14.08 %) male, although variation in the amount of AS according to sex can be observed, no there is a statistically significant relationship between these variables. The most frequent location found in the axial plane was the anteromedial zone with 59 cases (66.29 %); also, in the sagittal plane, the most frequent location was in the lower pole with 40 cases (44.44 %). Biometric data of these AS are shown in tables. This information will be of great morphological and medical value due to the limited existing literature on this subject in Chilean individuals.

Spectroscopic examination of Red Queen's funerary mask and her green stone offering from the Mayan site of Palenque, Mexico.

This work presents a non-invasive material study of the Red Queen's funerary offering via in situ infrared (FTIR) and Raman spectroscopies for mineral identification, and X-ray fluorescence spectroscopy (XRF) for elemental characterization. A second non-destructive laboratory stage on the main mask of the offering only was carried out by particle induced X-ray emission (PIXE) for further elemental analysis. The main FTIR results indicate that all of the tesserae of the main mask are composed of malachite, identified by their ν(CuO), ν(CuOH), ν1-ν4(CO32-) and δ(CO32-) infrared and T(CO32-) Raman vibrational modes. Moreover, the pupils are composed of obsidian (δ(SiOSi) and ν(SiO) infrared vibrational modes), and remarkably, jadeite was identified in the sclera of the eyes. Most of the accompanying mask's tesserae are green quartz and chalcedony (δ(SiOSi) and ν(SiO) infrared and Raman vibrational modes). The pendants are made of jadeite, while the headdress´ tesserae were identified as omphacite. The diadem and necklace's green beads were mostly jadeite, omphacite and albite. Jadeite, albite and omphacite were identified through their characteristic infrared and Raman vibrational modes: ν(SiOSi), δ(SiOSi), τ(SiO4) and AlSiO4 interactions. Yellow-orange beads in the diadem and in the pectoral are quartz. Green and blue pectoral beads are jadeite, omphacite and quartz. Limestones and shells identified in the figurine, valve and in some of the headdress and accompanying mask's tesserae, were properly classified by Raman spectroscopy, using their characteristic ν1 and ν4 (CO32-) vibrational modes for aragonite and beta-carotenes characteristic Raman shifts for Spondylus valves. These results indicate a special selection and the use of unique raw materials for the royal burial of the Red Queen, different to those used for other rulers of Palenque and other contemporary Mayan sites.

Presencia y biometría del os peroneum en individuos chilenos: estudio radiológico / Presence and biometry of os peroneum in Chilean individuals: radiological study

RESUMEN: El esqueleto está formado por 206 huesos constantes (200 huesos axiales y apendiculares más los 6 osículos del oído). Sin embargo, aparte de éstos existen otros huesos que pueden ser inconstantes, los que se denominan accesorios y sesamoideos. Basado en lo anterior, el objetivo fue identificar el os peroneum, que es uno de los huesos sesamoideos que podría estar presente en el pie humano, relacionando su presencia con el sexo, grupos etarios y dominancia, registrando también mediciones de cada hueso encontrado. Se realizó un estudio de tipo descriptivo, en donde se utilizaron radiografías de 200 pacientes, de ambos sexos, chilenos, de la IX región de La Araucanía, 50 de sexo masculino y 150 de sexo femenino, con edades entre 15 y 90 años. De los 200 pacientes estudiados, se encontraron 28 (14 %) con presencia de Os peroneum, 23 del sexo femenino y 5 de sexo masculino. En 16 (57,1 %) individuos se determinó que los huesos eran bilaterales. Los registros biométricos del hueso en estudio se muestran en tablas. Los datos obtenidos complementarán el conocimiento morfológico y médico acerca de este hueso en la población chilena, ya que el dolor en la zona lateral del pie puede ser causado por un espectro de etiologías, y con los datos obtenidos, caracterizar a nuestra población, aportando otra posible causa al dolor lateral de pie.

SUMMARY: The skeleton is made up of 206 constant bones (200 bones and the 6 ossicles of the ear). However, apart from these there are other bones that can be inconstant, which are called accessories and sesamoids. Based on the above, the objective was to identify to the Os peroneum, which is one of the sesamoid bones that could be present in the human foot, relating its presence with sex, age groups and dominance, also recording measurements of each bone found. A descriptive study was carried out, in which radiographs of 200 patients of both sexes were used, Chilean, from the IX region of La Araucanía, 50 male and 150 female, aged between 15 and 90 years. Of the 200 patients studied, 28 (14 %) were found with the presence of peroneal bone, 23 of the female sex and 5 of the male sex. In 16 (57.1 %) individuals it was determined that the bones were bilateral. The biometric records of the bone under study are shown in tables. The data obtained will complement the morphological and medical knowledge about this bone in the Chilean population, since the pain in the lateral zone of the foot can be caused by a spectrum of etiologies, and with the data obtained, characterize our population, providing another possible cause to lateral standing pain.

Methodology for the non-destructive characterization of jadeite-jade for archaeological studies.

The present paper proposes a methodology that complies with the requirements of identifying and characterizing jadeite (and its associated minerals) for archaeological studies, avoiding the acquisition of samples and ensuring the integrity of the object. The methodology exploits a carefully selected array of techniques (optical microscopy, UV fluorescence photography, X-Ray digital radiography, infrared and Raman spectroscopies, X-Ray fluorescence and particle induced X-ray emission spectroscopies) that, despite not definitively replacing laboratory procedures, provides a first mineral and elemental evaluation of jadeite archaeological objects. The proposed methodology was applied in the characterization of twelve different jade tones, allowing the identification of major - jadeite, albite and omphacite - and minor - pumpellyite, actinolite, analcime, rutile, grossular and titanite - mineral phases. To display its advantages and limitations, this methodology was also compared with a characterization employing specific gravity measurements and with an invasive methodology based on petrography and scanning electron microscopy with energy dispersive spectroscopy.

Comparación del tiempo de cicatrización entre N-butil cianoacrilato y ácido poliglicólico en caninos sometidos a esterilización / Comparison of healing times between N-butyl cyanoacrylate and polyglycolic acid in canines subjected to sterilization

RESUMEN El objetivo de este estudio fue comparar el tiempo de cicatrización entre N-butil cianocrilato (NBC) y ácido poliglicólico (AC) sobre el cierre tisular en caninos sometidos a operaciones de esterilización. Se realizó un estudio observacional, comparativo y descriptivo sobre una población de 80 perros (Canis familiaris) vivos. Los animales se dividieron en cuatro grupos de 20 perros cada uno según sexo y material de sutura, así: primero grupo, hembras que recibieron NBC; segundo grupo, machos y NBC; tercero grupo, hembras y AC como medio de sutura en piel y cuarto grupo, machos y AC. La técnica quirúrgica en hembras fue oforosalpingohisterectomia y en machos orquiectomia. El tiempo de cierre fue estadísticamente (p < 0,05) menor en los grupos de machos y hembras con el adhesivo NBC comparado con los dos grupos tratados con AC. Se concluye que el NBC es un material seguro y eficaz como medio de fijación tisular en ambas técnicas quirúrgicas que disminuye los días de cierre y recuperación.

ABSTRACT The aim of this study was to compare N-butyl cyanoacrylate (NBC) and polyglycolic acid (AC) in tissue closure in canines subjected to sterilization operations. An observational, comparative and descriptive study was conducted in a population of 80 living dogs (Canis familiaris). The animals were divided into 4 groups of 20 dogs each, according to gender and suture material: the first group consisted of females that received NBC; the second group consisted of males that received NBC; the third group consisted of females that received AC as skin suture; and the fourth group was formed by males that received AC. The surgical technique in females was salpingo-oophorectomy, and in males it was orchiectomy. The closure time was statistically (p < 0.05) lower in the male and female groups with the NBC adhesive in comparison to the two groups treated with AC. It was concluded that NBC is a safe and effective material for tissue fixation in both surgical techniques, decreasing times of closure and recovery.

Linfagioma quístico mesentérico en el diagnóstico diferencial de la enfermedad in-flamatoria pélvica / Mesenteric cystic lymphangioma in the differential diagnosis of pelvic inflammatory disease

RESUMEN La enfermedad inflamatoria pélvica (EIP) es un síndrome clínico que incluye todas aquellas alteraciones inflamatorias e infecciosas que comprenden los órganos de la pelvis menor. La infección es habitualmente polimicrobiana y está asociada a mujeres jóvenes con vida sexual activa, nulíparas y usuarias de dispositivo intrauterino (DIU Los abscesos tubo-ováricos son una complicación aguda o crónica, asociada a dicho proceso.). CASO CLÍNICO Presentamos el caso de una mujer de 47 años con dolor abdominal intenso, usuaria de DIU. La primera sospecha diagnóstica fue de EIP con presencia de absceso tuboovárico anexial. Sin embargo la exploración física no orientó en este sentido, por lo que se solicitó TAC abdominopélvico, en el que se informó de la posibilidad de linfangioma quístico mesentérico. Por ello, se contactó con el servicio de Cirugía General que procedió a su resección satisfactoria y sin incidencias. El estudio anatomopatológico confirmo la sospecha radiológica. CONCLUSIÓN Una adecuada exploración física es fundamental en el diagnóstico de la EIP y el absceso tuboovárico. El linfangioma quístico mesentérico puede formar parte del diagnóstico diferencial de las masas anexiales en este contexto.

ABSTRACT Pelvic inflammatory disease (PID) is a clinical syndrome involving all those inflammatory and infectious alterations affecting the minor pelvis organs. Any infection is often multibacterial and more frequent in sexually active nulliparous young women and intrauterine device (IUD) users. Tuboovarian abscesses can be an acute or chronic complication associated to that process. Our patient was a 47 year old IUD user consulting about intense abdominal pain. The initial clinical suspicion pointed at a case of PID associated to a tubo-ovarian anexial abscess. However, a physical examination did not support this suspicion and an abdominopelvian CAT scan was therefore requested, reporting a possible mesenteric cystic lymphangioma. The General Surgery service was reached for treatment, successfully excising the growth without further incident. Histological analysis confirmed the radiological diagnosis. An adequate physical examination is instrumental while diagnosing PID and tuboovarian abscesses. A mesenteric cystic lymphangioma should be included in a differential diagnosis of anexial growths in such a context

Presencia y biometría del os trigonum en individuos chilenos: estudio radiológico / Presence and biometry of the os trigonum in Chilean individuals: radiological study

El tubérculo lateral del proceso posterior del talo se fusiona generalmente con el cuerpo de este hueso, sin embargo, debido al estrés (flexión plantar forzada) aplicado durante los años de la adolescencia o cuando un centro osificado parcialmente e incluso totalmente osificado se fractura, se provoca una falta de unión, dando lugar a un hueso accesorio denominado Os trigonum (OT). En algunos casos puede producirse el síndrome os trigonum o síndrome de pinzamiento posterior, el cual se caracteriza por un dolor agudo o crónico de la región posterior del tobillo. Basado en lo anterior, se realizó un estudio retrospectivo entre el período de Agosto de 2017 a Mayo de 2018, en el cual se analizaron radiografías bilaterales de 205 pacientes concurrentes al Hospital Hernán Henríquez Aravena de Temuco, Chile. De la población estudiada, 154 fueron de sexo femenino y 51 de sexo masculino cuyas edades fluctuaron entre los 15 y 85 años, Las proyecciones radiológicas utilizadas fueron de pie lateral, tobillo lateral o calcáneo lateral, para así para determinar la prevalencia de OT y contribuir acerca de su distribución en pie derecho e izquierdo y aparición según sexo y edad. Del total de la muestra, se encontraron 24 individuos que presentaban OT (11,7 %) de los cuales 18 (75 %) correspondían al sexo femenino y 6 (25 %) al sexo masculino. Además se realizaron mediciones del largo y ancho del OT. Los datos obtenidos son una contribución al conocimiento de los huesos accesorios del pie en la población chilena.

The lateral tubercle of the posterior process of the talus is generally fused with the body of this bone, however, due to stress (forced plantar flexion) applied during the adolescent years. Also, when a partially ossified and even fully ossified center fractures, it causes a lack of union, giving rise to an accessory bone called Os trigonum (OT). In some cases Os trigonum syndrome or posterior impingement syndrome may occur, which is characterized by acute or chronic pain in the posterior region of the ankle. Based on the above, a retrospective study was conducted between August 2017 and May 2018, in which bilateral radiographs of 205 patients attending the Hernán Henríquez Aravena Hospital of Temuco were analyzed. Of the population studied, 154 were female and 51 were male, whose ages fluctuated between 15 and 85 years. The radiological projections used were lateral foot, lateral ankle and calcaneus lateral, to determine the prevalence of OT and provide information about its distribution in right and left foot and appearance according to sex and age. From the total sample, 24 individuals were found who had OT (11.7 %) of which 18 (75 %) corresponded to the female sex and 6 (25 %) to the male sex. In addition, measurements of the length and width of the OT were made. The data obtained is a contribution to the knowledge of the accessory bones of the foot in the Chilean population.

Phylogenetic analysis of ORF5 and ORF7 of porcine reproductive and respiratory syndrome (PRRS) virus and the frequency of wild-type PRRS virus in México.

Porcine reproductive and respiratory syndrome (PRRS) is caused by a genetically diverse RNA virus and is an economically significant disease in the swine industry. In this study, a total of 8,126 serum samples were obtained from 275 technified and semi-technified farms belonging to 30 of the 32 states of Mexico and representative of the eight regions of the country. Anti-PRRSv antibodies against the PRRS vaccine and an isolated wild Mexican virus were tested by ELISA. Antibodies were found in 15%-49% of the tested sera, with 2.4%-9.8% against the vaccine and 7.7%-26% against the wild virus. The PRRSv virus was detected by RT-PCR in 77 of the 1,630 pooled samples tested, representing seven of the eight geographic regions into which the Mexican Republic is divided. The complete sequences of open reading frames 5 and 7 from 20 PRRSv-positive samples were determined. The analysis of the sequences together with the previously published sequences of historic strains revealed that all the strains belonged to the one, five and eight lineages of the PRRSV2. Striking differences, particularly in ORF5 and ORF7, were found between sequences of the strains and the reference virus, due to insertions and substitutions in positions that play key roles in the recognition, structure and function of the virus. Overall, these results established the magnitude of PRRS virus genetic diversity, and the most frequent virus strain that predominates in Mexico. The PRRSV2 is presented in the porcine population of Mexico; the circulating strains have important changes in ORF5 and ORF7, which probably explain the results obtained in the serological analysis of the wild virus and vaccine strains.

Presencia, localización y biometría de la fabela en individuos chilenos: estudio radiológico / Presence, location and biometry of the fabella in Chilean individuals: radiological study

RESUMEN: Entre los huesos sesamoideos del cuerpo humano, se encuentra la fabela, hueso asociado al tendón de la cabeza lateral del músculo gastrocnemio. El objetivo del presente estudio fue localizar a este hueso, ya unilateral o bilateral, en relación al género y grupos etarios, además de registrar su longitud y anchura. Se utilizó una muestra de radiografías de 200 personas, de ambos sexos, 44 de sexo masculino y 156 de sexo femenino, cuyas edades fluctuaron entre los 10 y los 90 años. Del total de casos (200 personas), la presencia de la fabela fue observada en 75 (37,5 %), de las cuales 9 (12 %) eran del sexo masculino y 66 (88 %) del femenino. Su mayor presencia se observó en las personas con edades entre los 51 y 60 años, en las cuales se presentaron en 25 casos (18 de sexo femenino) y entre los 61 y 70 años con 29 casos (27 de sexo femenino). Los datos obtenidos complementarán el conocimiento morfológico acerca de este hueso sesamoídeo en la población Chilena.

SUMMARY: Among the sesamoid bones of the human body is fabela, a bone associated with the tendon of the lateral head of the gastrocnemius muscle. The objective of the present study was to locate this bone, either unilateral or bilateral, in relation to gender and age groups, in addition to recording its length and width. A sample of radiographs of 200 people, of both sexes, 44 male and 156 female, whose ages ranged from 10 to 90 years were used. Of the total cases (200 people), the presence of fabela was observed in 75 (37.5%), of which 9 (12%) were male and 66 (88%) female. Their greatest presence was observed in people aged between 51 and 60 years, in which they occurred in 25 cases (18 females) and between 61 and 70 years with 29 cases (27 females). The data obtained will complement the morphological knowledge about this sesamoid bone in the Chilean population.

Identification of genes associated with reproductive function in dairy cattle.

The use of genomics has improved response to selection for functional traits with low heritability such as fertility traits. Much of the work on fertility traits has been performed through use of genome-wide association studies (GWAS) to identify genetic loci associated with reproductive traits. Under a GWAS approach, the assumption is that the markers on the panel are in linkage disequilibrium with causative mutations. In many cases, identification of the causative mutation is difficult because an associated genetic marker can be in intergenic regions and can be in linkage disequilibrium with variants in several nearby genes. Another approach is to identify candidate genes using knowledge of the biological pathways controlling a trait to search for single nucleotide polymorphism (SNP) in genes in those pathways. This should reveal putative causative markers responsible for genetic variation in biological function, and it is expected that the marker will be more strongly associated with a trait than one in linkage disequilibrium. An example of how a series of candidate gene studies demonstrate that identification of markers in genes involved in reproductive processes can lead to discovery of additional markers associated with genetic variation in reproductive traits is presented. In addition, the inclusion of candidate markers for fertility can improve reliability of genetic estimates for fertility traits, and the repeatability of the effects across a separate population of animals gives confidence that association elucidated by this set of markers is likely to be real. More importantly, the use of candidate genes can provide insights into the biology underpinning genetic variation in fertility, and that this understanding can lead to physiological interventions to improve reproductive function.

Identification of genes associated with reproductive function in dairy cattle

The use of genomics has improved response to selection for functional traits with low heritability such as fertility traits. Much of the work on fertility traits has been performed through use of genome-wide association studies (GWAS) to identify genetic loci associated with reproductive traits. Under a GWAS approach, the assumption is that the markers on the panel are in linkage disequilibrium with causative mutations. In many cases, identification of the causative mutation is difficult because an associated genetic marker can be in intergenic regions and can be in linkage disequilibrium with variants in several nearby genes. Another approach is to identify candidate genes using knowledge of the biological pathways controlling a trait to search for single nucleotide polymorphism (SNP) in genes in those pathways. This should reveal putative causative markers responsible for genetic variation in biological function, and it is expected that the marker will be more strongly associated with a trait than one in linkage disequilibrium. An example of how a series of candidate gene studies demonstrate that identification of markers in genes involved in reproductive processes can lead to discovery of additional markers associated with genetic variation in reproductive traits is presented. In addition, the inclusion of candidate markers for fertility can improve reliability of genetic estimates for fertility traits, and the repeatability of the effects across a separate population of animals gives confidence that association elucidated by this set of markers is likely to be real. More importantly, the use of candidate genes can provide insights into the biology underpinning genetic variation in fertility, and that this understanding can lead to physiological interventions to improve reproductive function.(AU)