Philippinozercon, a new genus of Heterozerconidae (Parasitiformes: Mesostigmata), with description of all active instars.

The generic classification of millipede associated Heterozerconidae in the Oriental region is revised. The genus Allozercon Vitzthum is re-diagnosed and Asioheterozercon Fain is designated as an subjective junior synonym of Allozercon. Philippinozercon gen. nov., with the type species P. makilingensis sp. nov., is described for all instars. This genus may be endemic for the Philippines, but is quite widespread in that country. All immature instars are described, making this the second species of Heterozerconidae known for all instars. The morphology of the immatures is compared with that of immatures of the temperate species Narceoheterozercon ohioensis and unnamed species from Brazil and Thailand. All immatures were collected from millipede frass and litter, never from millipedes. Adults are associated with millipedes in the family Trigoniulidae (Spirobolida).

Molecular characterization of Babesia vogeli in dogs from Belém, northern Brazil.

Babesiosis is an infectious hemolytic disease that occurs worldwide, and is caused by a protozoan of the Babesia genus (Apicomplexa). Little is known about this genus; therefore, this study conducted a molecular characterization of Babesia spp in naturally infected dogs in northern Brazil. Blood samples were collected from 172 dogs from metropolitan Belém, and screened for Babesia spp using semi-nested polymerase chain reactions. Subsequently, 18S rDNA gene fragments were amplified and sequenced. Alignments of the 27 nucleotide sequences returned fragments measuring 1023 bp in size, which did not include any polymorphic sites (100% identity). This genotype was very similar to the 18S rDNA gene in B. vogeli. This study provides an important molecular characterization of the parasite responsible for canine babesiosis in naturally infected dogs in metropolitan Belém. In addition, the 18S rDNA gene in B. vogeli may represent the most common genotype occurring in South America.

The "Fistula VAC," a technique for management of enterocutaneous fistulae arising within the open abdomen: report of 5 cases.

BACKGROUND: Management of intestinal fistulae in open abdominal wounds remains a significant clinical challenge for those caring for patients surviving damage control abdominal operations. Breaking the cycle of tissue inflammation, infection, and sepsis, resulting from leakage of enteric contents, should be a major goal in the approach to these complex patients. We describe a technique utilizing vacuum assisted closure (VAC) which achieves control of enteric flow from fistulae in open abdominal wounds. METHODS: The fistula-VAC is fashioned from standard sponge supplies, negative pressure pumps, and ostomy appliances. The fistula-VAC was changed every three days prior to split thickness skin grafting, and every five days following grafting. RESULTS: Five patients underwent application of the fistula-VAC. All patients had complete diversion of enteric contents. This enteric diversion allowed for successful skin grafting in all patients. CONCLUSION: Application of the fistula-VAC should be considered a useful option in treating patients with intestinal fistulae in open abdominal wounds.

Incisión subcostal vs paramediana en la cirugía biliar / Kochers incision vs right transrectal incision for biliary surgery: a retrospective comparison

Una serie de 932 pacientes fueron evaluados en forma retrospectiva,operados por patología biliar en forma electiva y consecutiva durante un período de 3 años.Se comparan las incisiones subcostal de Kocher y paramedia transrectal derecha.El seguimiento se realizó hasta el año de operados.del total de pacientes, 712 (76,3 por ciento fueron incisiones subcostales y 220 (23,6 por ciento) fueron incisiones paramedianas.Se observó infección posoperatoria en 49 (5,2 por ciento) pacientes,con un número de 34 (3,6 por ciento) eventraciones posoperatorias.Se encontró un mayor porcentaje de heridas paramedianas infectadas y eventradas en forma crónica.La eventración aguda fue porcentualmente más frecuente en la incisión subcostal

Incisión subcostal vs paramediana en la cirugía biliar / Kocher's incision vs right transrectal incision for biliary surgery: a retrospective comparison

Una serie de 932 pacientes fueron evaluados en forma retrospectiva,operados por patología biliar en forma electiva y consecutiva durante un período de 3 años.Se comparan las incisiones subcostal de Kocher y paramedia transrectal derecha.El seguimiento se realizó hasta el año de operados.del total de pacientes, 712 (76,3 por ciento fueron incisiones subcostales y 220 (23,6 por ciento) fueron incisiones paramedianas.Se observó infección posoperatoria en 49 (5,2 por ciento) pacientes,con un número de 34 (3,6 por ciento) eventraciones posoperatorias.Se encontró un mayor porcentaje de heridas paramedianas infectadas y eventradas en forma crónica.La eventración aguda fue porcentualmente más frecuente en la incisión subcostal

Incidence of memory of transoperative events during total intravenous general anesthesia with propofol.

The incidence of memories of events during the total intravenous general anesthesia is studied in a 400 adult patient group in order to establish the influence of the included doses of drugs in this scheme, upon the mentioned incidence. The anesthetic method included propofol, fentanyl and vecuronium. Two groups of patients were constituted according to the propofol infusion rate (PIR) required for the anesthetic maintenance: group I required a PIR < 6.0 mg.kg-1.h-1, and group II required a PIR > 6.0 mg.kg-1.h-1. Transanesthetic monitoring was done with cardiac frequency, systolic and diastolic arterial pressures, ECG, pulse oximeter oxygen saturation and end tidal CO2. The memory incidence of transoperative events was obtained through postoperative interviews about intraoperative events. Patients in group I had a significantly greater remembrance incidence both in real events and in dreams than the patients in group II. We conclude that a PIR of propofol < 6.0 mg.kg-1.h-1 can be associated with a high incidence of remembrances of transoperative events.

Taquicardia de complexos QRS alargados com manifestaçöes eletrocardiográficas atípicas elucidada através de cardio-exploraçäo transesofágica: relato de caso / Tachycardia of wide QRS complexes with atypical electrocardiography manifestations elucidated by transesophageal cardio-exploration: a case report

Taquicardia de complexos QRS alargados (com morfologia de bloqueio do ramo esquerdo) foi desencadeada durante Cardioexploraçäo Eletrofisiológica Transesofágica. O E.C.G. de 12 derivaçöes demonstrou duraçäo dos complexos superior a 140 ms., desvio do eixo elétrico para esquerda no plano frontal e sugestivos batimentos de fusäo, características que na ausência prévia de pré-excitaçäo anterógrada ou bloqueio de ramo, sugeriram uma origem ventricular da taquicardia. Obteve-se reversäo da mesma mediante aplicaçäo de manobras vagais e reproduçäo por estimulaçäo atrial programada. Numa etapa posterior, foi induzida taquicardia de complexos QRS estreitos, onde os impulsos iniciais apresentavam morfologia aberrante, idêntica ao padräo observado anteriormente. Tais achados conduziram ao diagnóticos de taquicardia supra-ventricular com conduçäo aberrante. A observaçäo de encurtamento do ciclo da mesma após estreitamento dos complexos QRS, permitiu pressupor a presença de uma via acessória esquerda oculta envolvida na sua origem. A análise isolada de critérios eletrocardiográficos no caso em questäo, poderia ter conduzido a erro diagnóstico. Uma avaliaçäo detalhada, através de cardioexploraçäo transesofágica (CETE) e manipulaçäo autonômica possibilitou a diferenciaçäo, assim como estabelecer o mecanismo preciso da taquicardia

Sequential versus alternating regimens in the treatment of advanced breast cancer. Argentine Breast Cancer Cooperative Group.

With the object of proving whether sequential or alternate forms of chemotherapy would be advantageous one over the other in treating advanced breast cancer and with the purpose of evaluating two different anthracyclines at equimolecular doses in the above-mentioned alternating regimens, 250 patients who had received no prior chemo- or hormonotherapy were entered in a prospective randomized trial. Group A was administered 4-epiadriamycin and cyclophosphamide for 8 courses, followed by 6 cycles of CMF, and medroxyprogesterone acetate (MPA) from the beginning of therapy until progression. In group B, adriamycin + cyclophosphamide were alternated with CMF every two courses until 14 cycles were completed. Group C received 4'-epiadriamycin + cyclophosphamide alternated with CMF for 14 courses. In groups B and C, MPA was administered as in group A. Two hundred and twenty-four patients were evaluated. CR + PR were observed in 55.8% of group A, 43.4% of group B, and 46.4% of group C. Median duration of responses was 16 months (m) in group A, 13 m in group B and 20 m in group C, and median survival (CR + PR) was 16.5 m in group A, 16 m in group B and 24 m in group C. There were no statistically significant differences among the three groups in terms of response rate, duration of response and survival; furthermore, toxicity was moderate in all groups. At equimolecular doses there were no differences between adriamycin and epirubicin in the alternating schedules.