Tratamiento de la hipertensión arterial en la menopausia / Treatment of arterial hypertension in menopause

Introducción: la hipertensión arterial en la menopausia está influencia por el descenso de estrógenos que induce disfunción endotelial y aumento del índice de masa corporal. Objetivos: describir los mecanismos fisiopatológicos de la hipertensión arterial en la menopausia y los antihipertensivos recomendados en la actualidad. Metodología: se realizó una revisión bibliográfica en las bases de datos PubMed y SciELO utilizando las palabras claves: hipertensión arterial y menopausia. Resultados: no existen diferencias en la respuesta a los diferentes antihipertensivos y ambos sexos se benefician en la reducción de la morbimortalidad cardiovascular con la disminución de la presión arterial. La efectividad preventiva de complicaciones cardiovasculares con los antihipertensivos no difiere según el sexo y por lo tanto la elección del medicamento no puede basarse en este criterio en mujeres menopáusicas. Conclusión: la deficiencia de estrógeno induce disfunción endotelial y aumento del índice de masa corporal siendo las principales causas de hipertensión en la menopausia. Todos los antihipertensivos están recomendados en la menopausia.

Introduction: Arterial hypertension in menopause is influenced by the decrease in estrogen that induces endothelial dysfunction and increase in body mass index. Objectives: to describe the physiopathological mechanisms of arterial hypertension in menopause and the currently recommended antihypertensive drugs. Methodology: We conducted a literature review in PubMed and SciELO databases using the key words: arterial hypertension and menopause. Results: There are no differences in the response to different antihypertensive drugs and both sexes benefit in the reduction of cardiovascular morbidity and mortality with the reduction of blood pressure. The preventive effectiveness of cardiovascular complications with antihypertensive drugs does not differ according to sex and therefore the choice of medication cannot be based on this criterion in menopausal women. Conclusions: Estrogen deficiency induces endothelial dysfunction and increase in body mass index being the main causes of hypertension in menopause. All antihypertensive drugs are recommended at menopause.

Hiponatremia en pacientes adultos con lesión cerebral agudas / Hyponatremia in adult patients with acute brain injury

Las afecciones agudas del sistema nervioso central como los accidentes cerebrovasculares (ACV) y traumatismos de cráneo producen alteraciones en la homeostasis del sodio por diversos mecanismos. La hiponatremia es un fenómeno frecuente en la práctica clínica, constituye un desafío debido a la diversa etiología, las complicaciones de su evolución natural llegan a ser muy severas y hasta fatales. Objetivo: determinar la frecuencia y causas de hiponatremia en pacientes adultos con daño cerebral agudo internados en el Hospital Nacional. Materiales y metodos: estudio descriptivo, retrospectivo de corte transversal que incluyó 115 pacientes internados en el Hospital Nacional (Itauguá, Paraguay) en 2015. Se consideró como hiponatremia en cerebro agudo a los portadores de accidente cerebral vascular (ACV) hemorrágico (intra parenquimatoso, subaracnoideo o cerebro meníngeo), ACV isquémico o traumatismo de cráneo corroborados por tomografía axial computada de cráneo o resonancia magnética de menos de 10 días de evolución y hayan presentado Na sérico ≤135 mEq/L. Resultados: la prevalencia de hiponatremia fue 34%, con predominio del sexo masculino (54%). El diagnóstico más frecuente fue el ACV hemorrágico y la principal comorbilidad asociada fue la hipertensión arterial. Se diagnosticaron 15 pacientes con Síndrome de secreción inadecuada de hormona antidiurética y 6 con depleción cerebral de sal que representan 38,4% y 15,4% respectivamente. Conclusión: se halló alta prevalencia de hiponatremia en pacientes con daño cerebral agudo. El Síndrome de secreción inadecuada de hormona antidiurética y depleción cerebral de sal describen y explican con mayor frecuencia la presencia de hiponatremia asociada a natriuresis aumentada.

The acute afections of center sistem nervous as the stroke(ACV) and head trauma produce alterations in the Sodio Homeostasis For various mechanisms.The Hiponatremia is a frecuently event in our enviroment, It is a Desafy because to diverse etiology, the complications of their natural evolution become severity and to fatalytis. Objective: To determine the frequency and causes of hyponatremia in adult patients with acute brain injury admitted to the National Hospital. Materials and methods: descriptive, cross-sectional prospective study that included 1 15 patients in the National Hospital (Itauguá, Paraguay) in 2015. It was considered as hyponatremia in acute brain carriers of hemorrhagic stroke (intracerebral, subarachnoid), ischemic stroke or head injury confirmed by computed tomography or magnetic resonance image in patients submitted less than 10 days and serum Na + ≤135 mEq/L. Results: The prevalence of hyponatremia was 34%, with a predominance of males (54%). The most common diagnosis was hemorrhagic stroke and the most common comorbidity was arterial hypertension. There were diagnosed 15 patients with Syndrome of inappropriate ADH secretion and 6 with Cerebral salt wasting syndrome representing 38.4% and 15.4% respectively. Conclusion: we found high prevalence of hyponatremia in patients with acute brain damage. The Syndrome of inappropriate ADH secretion and Cerebral salt wasting syndrome are described as the 2 syndromes that more frequently explain the presence of hyponatremia associated with increased natriuresis.

A Paediatric Hernia with a Twist: The Presentation, Imaging Findings and Management of a Strangulated Ovarian Hernia.

Indirect inguinal hernias are the most commonly encountered congenital abnormality in infants. They may be complicated by herniation of abdominal or pelvic viscus. In girls, a herniated ovary is a relatively common finding, however torsion of the ovary is infrequent. A tender irreducible inguinal hernia in an infant girl should raise the possibility of a strangulated herniated ovary as it requires urgent surgical attention. When in doubt, ultrasound with colour Doppler easily confirms the diagnosis. Here we present the case of an ovarian inguinal hernia which had undergone torsion and review the presentation, imaging findings and management.

First Report of Alfalfa mosaic virus Infecting Tedera (Bituminaria bituminosa (L.) C.H. Stirton var. albomarginata and crassiuscula) in Australia.

Tedera (Bituminaria bituminosa (L.) C.H. Stirton vars albomarginata and crassiuscula) is being established as a perennial pasture legume in southwest Australia because of its drought tolerance and ability to persist well during the dry summer and autumn period. Calico (bright yellow mosaic) leaf symptoms occurred on occasional tedera plants growing in genetic evaluation plots containing spaced plants at Newdegate in 2007 and Buntine in 2010. Alfalfa mosaic virus (AlMV) infection was suspected as it often causes calico in infected plants (1,2) and infects perennial pasture legumes in local pastures (1,3). Because AlMV frequently infects Medicago sativa (alfalfa) in Australia and its seed stocks are commonly infected (1,3), M. sativa buffer rows were likely sources for spread by aphids to healthy tedera plants. When leaf samples from plants with typical calico symptoms from Newdegate (2007) and Buntine (2010) were tested by ELISA using poyclonal antisera to AlMV, Bean yellow mosaic virus (BYMV) and Cucumber mosaic virus (CMV), only AlMV was detected. When leaf samples from 864 asymptomatic spaced plants belonging to 34 tedera accessions growing at Newdegate and Mount Barker in 2010 were tested by ELISA, no AlMV, BYMV, or CMV were detected, despite presence of M. sativa buffer rows. A culture of AlMV isolate EW was maintained by serial planting of infected seed of M. polymorpha L. (burr medic) and selecting seed-infected seedlings (1,3). Ten plants each of 61 accessions from the local tedera breeding program were grown at 20°C in an insect-proof air conditioned glasshouse. They were inoculated by rubbing leaves with infective sap containing AlMV-EW or healthy sap (five plants each) using Celite abrasive. Inoculations were always done two to three times to the same plants. When both inoculated and tip leaf samples from each plant were tested by ELISA, AlMV was detected in 52 of 305 AlMV-inoculated plants belonging to 36 of 61 accessions. Inoculated leaves developed local necrotic or chlorotic spots or blotches, or symptomless infection. Systemic invasion was detected in 20 plants from 12 accessions. Koch's postulates were fulfilled in 12 plants from nine accessions (1 to 2 of 5 plants each), obvious calico symptoms developing in uninoculated leaves, and AlMV being detected in symptomatic samples by ELISA, inoculation of sap to diagnostic indicator hosts (2) and RT-PCR with AlMV CP gene primers. Direct RT-PCR products were sequenced and lodged in GenBank. When complete nucleotide CP sequences (666 nt) of two isolates from symptomatic tedera samples and two from alfalfa (Aq-JX112758, Hu-JX112759) were compared with that of AlMV-EW, those from tedera and EW were identical (JX112757) but had 99.1 to 99.2% identities to the alfalfa isolates. JX112757 had 99.4% identity with Italian tomato isolate Y09110. Systemically infected tedera foliage sometimes also developed vein clearing, mosaic, necrotic spotting, leaf deformation, leaf downcurling, or chlorosis. Later-formed leaves sometimes recovered, but plant growth was often stunted. No infection was detected in the 305 plants inoculated with healthy sap. To our knowledge, this is the first report of AlMV infecting tedera in Australia or elsewhere. References: (1) B. A. Coutts and R. A. C. Jones. Ann. Appl. Biol. 140:37, 2002. (2) E. M. J. Jaspars and L. Bos. Association of Applied Biologists, Descriptions of Plant Viruses No. 229, 1980. (3) R. A. C. Jones. Aust. J. Agric. Res. 55:757, 2004.

First Report of Phoma herbarum on Tedera (Bituminaria bituminosa var. albomarginata) in Australia.

Tedera (Bituminaria bituminosa (L.) C.H. Stirton var. albomarginata) has been successfully established across the mixed-farming (wheat-sheep) region of Western Australia because this species has remarkable drought tolerance and can survive the dry-summer period with strong retention of green leaf. A leaf spot symptom involving pale brown lesions with distinct dark brown margins had been observed in genetic evaluation plots of tedera at Medina and Mount Barker, Western Australia, and a Phoma sp. was isolated. Single-spore isolations of a typical Phoma sp. isolate were made onto potato dextrose agar and maintained at 20°C, and a representative culture has been lodged in the Western Australian Culture Collection Herbarium maintained at the Department of Agriculture and Food Western Australia (Accession No. WAC13435). Amplification of the internal transcribed spacer (ITS) 1 and ITS2 regions flanking the 5.8S rRNA gene were carried out with universal primers ITS1 and ITS4 according to published protocol (3). The DNA PCR products were sequenced and BLAST analyses was used to compare sequences with those in GenBank. The sequence had 99% nucleotide identity with the corresponding sequence in GenBank for Phoma herbarum. Isolates also showed morphological (e.g., 1) and molecular (e.g., 2) similarities with P. herbarum as described in other reports. The relevant sequence information for a representative isolate has been lodged in GenBank (Accession No. JQ282910). A conidial suspension of 107 conidia ml-1 from a single-spore culture was spray inoculated onto foliage of 6-week-old tedera plants maintained under >90% relative humidity conditions for 72-h postinoculation. Symptoms evident by 10 days postinoculation consisted of pale brown lesions, mostly 1.5 to 4 mm in diameter, which developed a distinct, dark brown margin. Occasional lesions also showed a distinct chlorotic halo extending 1 to 1.5 mm outside the boundary of the lesion. Infection studies were successfully repeated twice and P. herbarum was readily reisolated from infected foliage. No disease was observed on and no P. herbarum were isolated from water-inoculated control plants. Except for a recent published report of P. herbarum on field pea (Pisum sativum L.) (2), this pathogen has only been noted in the Australian Plant Pest Database as occurring on lucerne (Medicago sativa L.) and soybean (Glycine max (L.) Merr.) in Western Australia in 1985 and on a Protea sp. in 1991. To our knowledge, this is the first published report of P. herbarum as a pathogen on tedera in Australia or elsewhere. That P. herbarum occurs on other hosts in Australia and has a wide host range elsewhere together suggest its potential to be a pathogen on a wider range of host genera and species. References: (1) G. L. Kinsey. No. 1501 in: IMI Descriptions of Fungi and Bacteria. 2002. (2) Y. P. Li et al. Plant Dis. 95:1590, 2011. (3) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, CA, 1990.

Lotus tenuis tolerates the interactive effects of salinity and waterlogging by 'excluding' Na+ and Cl- from the xylem.

Salinity and waterlogging interact to reduce growth of poorly adapted species by, amongst other processes, increasing the rate of Na(+) and Cl(-) transport to shoots. Xylem concentrations of these ions were measured in sap collected using xylem-feeding spittlebugs (Philaenus spumarius) from Lotus tenuis and Lotus corniculatus in saline (NaCl) and anoxic (stagnant) treatments. In aerated NaCl solution (200 mM), L. corniculatus had 50% higher Cl(-) concentrations in the xylem and shoot compared with L. tenuis, whereas concentrations of Na(+) and K(+) did not differ between the species. In stagnant-plus-NaCl solution, xylem Cl(-) and Na(+) concentrations of L. corniculatus increased to twice those of L. tenuis. These differences in xylem ion concentrations, which were not caused by variation in transpiration between the two species, contributed to lower net accumulation of Na(+) and Cl(-) in shoots of L. tenuis, indicating that ion transport mechanisms in roots of L. tenuis were contributing to better 'exclusion' of Cl(-) and Na(+) from shoots, compared with L. corniculatus. Root porosity was also higher in L. tenuis, due to constitutive aerenchyma, than in L. corniculatus, suggesting that enhanced root aeration contributed to the maintenance of Na(+) and Cl(-) 'exclusion' in L. tenuis exposed to stagnant-plus-NaCl treatment. Lotus tenuis also had greater dry mass than L. corniculatus after 56 d in NaCl or stagnant-plus-NaCl treatment. Thus, Cl(-) 'exclusion' is a key trait contributing to salt tolerance of L. tenuis, and 'exclusion' of both Cl(-) and Na(+) from the xylem enables L. tenuis to tolerate, better than L. corniculatus, the interactive stresses of salinity and waterlogging.

Effects of increasing dietary L-carnitine on growth performance of weanling pigs.

Four experiments were conducted to evaluate the effects of supplementing graded levels (0 to 100 ppm) of L-carnitine to the diet of weanling pigs on growth performance during a 34- to 38-d experimental period. A fifth experiment was conducted to determine the effects of addition of L-carnitine to diets with or without added soybean oil (SBO) on growth performance. In Exp. 1, 128 pigs (initial BW = 5.5 kg) were allotted to four dietary treatments (six pens per treatment of four to six pigs per pen). Dietary treatments were a control diet containing no added L-carnitine and the control diet with 25, 50, or 100 ppm of added L-carnitine. In Exp. 2, 3, and 4, pigs (4.8 to 5.6 kg of BW) were allotted to five dietary treatments consisting of either a control diet containing no added L-carnitine or the control diet with 25, 50, 75, or 100 ppm of added L-carnitine. All diets in Exp. 1 to 4 contained added soybean oil (4 to 6%). There were seven pens per treatment (four to five pigs per pen) in Exp. 2, whereas Exp. 3 and 4 had five and six pens/treatment (eight pigs per pen), respectively. In general, dietary carnitine additions had only minor effects on growth performance during Phases 1 and 3; however, dietary L-carnitine increased (linear [Exp. 1], quadratic [Exp. 2 to 4], P < 0.03) ADG and gain:feed (G:F) during Phase 2. The improvements in growth performance during Phase 2 were of great enough magnitude that carnitine addition tended to increase ADG (linear, P < 0.10) and improve G:F (quadratic, P < 0.02) for the entire 38-d period. In Exp. 5, 216 weanling pigs (5.8 kg of BW) were allotted (12 pens/treatment of four to five pigs per pen) to four dietary treatments. The four dietary treatments were arranged in a 2 x 2 factorial with main effects of added SBO (0 or 5%) and added L-carnitine (0 or 50 ppm). Pigs fed SBO tended (P < 0.07) to grow more slowly and consumed less feed compared with those not fed SBO, but G:F was improved (P < 0.02). The addition of L-carnitine did not affect (P > 0.10) ADG or ADFI; however, it improved (P < 0.03) G:F. Also, the increase in G:F associated with L-carnitine tended to be more pronounced for pigs fed SBO than those not fed SBO (carnitine x SBO, P < 0.10). These results suggest that the addition of 50 to 100 ppm of added L-carnitine to the diet improved growth performance of weanling pigs. In addition, supplemental L-carnitine tended to be more effective when SBO was provided in the diet.

Effect of irradiation of individual feed ingredients and the complete diet on nursery pig performance.

A total of 1,210 nursery pigs was used in two experiments to evaluate the effects of irradiation of typical nursery diet ingredients, specialty protein products, and the whole diet on nursery pig performance. In Exp. 1, 880 barrows and gilts (15 +/- 2 d of age at weaning) were used in two growth trials (14 d and 12 d for Trials 1 and 2, respectively) to determine the effects of individual ingredient and whole-diet irradiation on nursery pig performance. Overall (d 0 to 14 of Trial 1 and d 0 to 12 of Trial 2), ADG was greater (P < 0.05) for pigs fed irradiated animal plasma compared with pigs fed the control, the diet containing irradiated microingredients, and the diet that was manufactured and irradiated. Also, pigs fed irradiated soybean meal had greater (P < 0.05) ADFI compared with pigs fed the manufactured diet that was irradiated. Pigs fed the diet containing irradiated animal plasma had improved feed efficiency (G:F; P < 0.05) compared with those fed the diet with irradiated microingredients and when all ingredients were irradiated before manufacturing of complete feed. Finally, pigs fed irradiated corn, whey, fishmeal, soybean oil, microingredients, or if all ingredients or the whole diet were irradiated, had similar ADG, ADFI, and G:F (P > 0.12) to control pigs. In Exp. 2, 330 nursery pigs (20 +/- 2 d of age at weaning) were used to determine the effects of irradiation of commercially available specialty protein products in diets for nursery pigs. Overall, ADG was greater (P < 0.05) when pigs were fed diets containing nonirradiated spray-dried animal plasma and egg combination (SDAPE) and dried porcine digest (DPD) compared with pigs fed the control diet containing no specialty protein products. In addition, G:F was improved (P < 0.05) when pigs were fed diets containing nonirradiated SDAPE, DPD, spray-dried beef muscle (SDBM), and spray-dried whole egg (SDWE) compared with pigs fed the control diet. Pigs fed irradiated SDAPE and SDBM had greater (P < 0.05) ADG than pigs fed the nonirradiated forms. Pigs fed irradiated SDBM had improved (P < 0.05) G:F compared with pigs fed the nonirradiated form. In Exp. 1 and 2, an irradiation treatment level of 8.5 kGy was effective in reducing the total bacterial concentration of all ingredients evaluated, as well as the whole diet in Exp.1. Irradiation of certain ingredients, but not the complete diet, increased growth performance of nursery pigs.

Effects of increasing dietary niacin on growth performance and meat quality in finishing pigs reared in two different environments.

We conducted two experiments to determine the effects of added dietary niacin on growth performance and meat quality in finishing pigs. Pigs were blocked by weight and assigned to one of six dietary treatments in both experiments. Dietary treatments consisted of a corn-soybean meal-based control diet (no added niacin) or the control diet with 13, 28, 55, 110, or 550 mg/kg of added niacin. In Exp. 1, pigs were housed at the Kansas State University research from with two pigs per pen (six pens per treatment per sex). In Exp. 2, pigs were housed with 26 pigs per pen (four pens per treatment per sex) in a commercial research barn. In Exp. 1, 144 pigs (initially 51.2 kg) were fed diets in two phases (d 0 to 25 and 25 to 62) that were formulated to 1.00 and 0.75% lysine, respectively. In Exp. 2, 1,248 pigs (initially 35.9 kg) were fed diets in four phases (d 0 to 28, 29 to 56, 57 to 84, and 85 to 117), with corresponding total lysine concentrations of 1.25, 1.10, 0.90, and 0.65% lysine, respectively. Added fat (6.0%) was included in the first three phases. In Exp. 1, average daily feed intake tended (quadratic, P < 0.07) to increase then return to values similar to control pigs as dietary niacin increased. Longissimus muscle (LM) 24-h pH (longissimus of pigs fed added niacin) tended to increase (control vs niacin, P < 0.06) for pigs fed added niacin. In the commercial facility (Exp. 2), increasing added niacin improved gain:feed (quadratic, P < 0.01) and subjective color score, and ultimate pH (linear, P < 0.01). Added niacin also decreased (linear, P < 0.04) carcass shrink, L* values, and drip loss percentage. Results from these two studies show that 13 to 55 mg/kg added dietary niacin can be fed to pigs in a commercial environment to improve gain:feed. It also appears that pork quality, as measured by drip loss, pH, and color, may be improved by higher concentrations of added dietary niacin.

Standard errors of heritabilities for forage breeding nurseries.

Estimators for standard errors of heritability for two typical and complex forage breeding models are illustrated with estimates of variance and covariance components from least-squares and restricted maximum likelihood methods. The first experiment (Model 1) is a factorial design (two grazing management factors) with two layers of split plots (populations and grazing periods) and with plants within populations nested beneath the first split. The second model is for a sites pooling of randomized complete block experiments, with plants nested inside plots and with a split in time. One definition of heritability was applied to the plant habit character for both models in a red clover germplasm. Heritability estimates were statistically the same for the two methods for both models.

Embarazo y enfermedades cardiovasculares / Preganancy and cardiovascular diseases

Se realizó una investigación en 150 embarazadas con enfermedades cardiovasculares asociadas, de un total de 1665 pacientes que tuvieron su parto en el período comprendido desde enero a diciembre de 1996, en el Hospital General Docente de Baracoa, lo que representó el 90

del total de ingresos. Indicadores como la edad, mostraron una moda de 24-27 años y como media, 26 años; la mujer primípara tuvo mayor incidencia que las de otro tipo de paridad. Las gestantes con hipertensión arterial crónica, estenosis mitral y comunicación interauricular, fueron las cardiopatías que prevalecieron. Predominaron los neonatos a término y los normopesos en las cardiopatías estudiadas. No hubo mortalidad perinatal ni materna en el período estudiado(AU)

Mapping of serotonin-like immunoreactivity in the ventral nerve cord of crayfish.

Whole-mount immunohistochemical technique using antibody to serotonin (5-HT) had been used to map presumptive serotoninergic structures in the ventral abdominal and thoracic nerve cord of crayfish Procambarus clarkii. 5-HT immunoreactivity was detected in more than 30 cell bodies, numerous fibers and peripheral nerve endings of root plexus and neuropilar regions. Immunoreactive fibers are arranged in 3 pairs of rostrocaudal bundles. The median (MFB) and the lateral fiber bundles run longitudinally through the entire thoracic and abdominal nerve cord (first thoracic T1 to sixth abdominal A6 ganglia). The central (CFB) fiber bundles extend only from the subesophageal to the fourth thoracic ganglia. In the 4 anterior thoracic ganglia (T1-T4), two lateroposterior cell bodies send their major processes in the ipsilateral MFB. In the fifth thoracic (T5) and first abdominal (A1) ganglia, the pattern of reactive structures is similar. Two large anterior cells which send a single prominent process to join the ipsilateral MFB and 4 smaller posterior cells. In other abdominal ventral ganglia, immunoreactive structures are smaller and less labeled. Cell bodies are displayed in two kinds of arrangement giving the appearance of two distinct homogeneous groups of ganglia: an anterior group (A2-A3-A4) that contained two pairs of small neurons and a posterior group (A5-A6) that contained only a large unpaired medial neuron. These results were discussed in relation to the serotonin-like immunoreactivity pattern previously described in lobster by Beltz and Krawitz.