New Constraint on the Local Relic Neutrino Background Overdensity with the First KATRIN Data Runs.

We report on the direct search for cosmic relic neutrinos using data acquired during the first two science campaigns of the KATRIN experiment in 2019. Beta-decay electrons from a high-purity molecular tritium gas source are analyzed by a high-resolution MAC-E filter around the end point at 18.57 keV. The analysis is sensitive to a local relic neutrino overdensity ratio of η<9.7×10^{10}/α (1.1×10^{11}/α) at a 90% (95%) confidence level with α=1 (0.5) for Majorana (Dirac) neutrinos. A fit of the integrated electron spectrum over a narrow interval around the end point accounting for relic neutrino captures in the tritium source reveals no significant overdensity. This work improves the results obtained by the previous neutrino mass experiments at Los Alamos and Troitsk. We furthermore update the projected final sensitivity of the KATRIN experiment to η<1×10^{10}/α at 90% confidence level, by relying on updated operational conditions.

Bound on 3+1 Active-Sterile Neutrino Mixing from the First Four-Week Science Run of KATRIN.

We report on the light sterile neutrino search from the first four-week science run of the KATRIN experiment in 2019. Beta-decay electrons from a high-purity gaseous molecular tritium source are analyzed by a high-resolution MAC-E filter down to 40 eV below the endpoint at 18.57 keV. We consider the framework with three active neutrinos and one sterile neutrino. The analysis is sensitive to the mass, m_{4}, of the fourth mass state for m_{4}^{2}≲1000 eV^{2} and to active-to-sterile neutrino mixing down to |U_{e4}|^{2}≳2×10^{-2}. No significant spectral distortion is observed and exclusion bounds on the sterile mass and mixing are reported. These new limits supersede the Mainz results for m_{4}^{2}≲1000 eV^{2} and improve the Troitsk bound for m_{4}^{2}<30 eV^{2}. The reactor and gallium anomalies are constrained for 100<Δm_{41}^{2}<1000 eV^{2}.

[Ellis van Creveld. Case report]. / Ellis van Creveld: reporte de caso.

INTRODUCTION: Ellis-van Creveld (EVC) (OMIM # 225500) syndrome is a rare skeletal dysplasia disorder transmitted by autosomal recessive inheritance. The diagnosis is made based on phenotypic characteristics such as chondrodysplasia, heart defects and polydactyly. The prognosis depends mainly on the severity of the disease, diagnosis and comprehensive management of the condition. OBJECTIVE: To describe a patient diagnosed with EVC syndrome. CASE REPORT: Newborn diagnosed with EVC syndrome who presented dysmorphic facies, shortened long bones, rhizomelic shortening, small hands, brachydactyly, single transverse palmar crease, postaxial polydactyly in the upper limbs, bilateral preaxial polysyndactyly in lower limbs and hypoplastic nails, complex heart defects and narrow thorax. The evolution was unfavorable; the patient died 8 weeks after birth from complications due to heart defects. CONCLUSIONS: EVC syndrome is rare and unknown; therefore, it is important to spread its characteristics within the pediatric community, emphasizing that it affects multiple organ systems and requires a multidisciplinary approach to treat individually each patient, to provide genetic and reproductive counseling to couples and to give information regarding child development expectations.

Reconstrucción facial con colgajos locales / Facial reconstruction with local flaps

Este trabajo tiene como objetivo conocer la evolución clínica de pacientes sometidos a reconstrucciones faciales con empleo de colgajos locales. Estudio prospectivo, descriptivo y observacional, diseño no experimental. Se presentan cuatro (4) casos clínicos, pacientes masculinos, a dos (2), se les diagnóstica mediante biopsia Carcinoma Basocelular, a uno (1) Carcinoma Espinocelular y al otro Carcinoma Epidermoide, se les practica excéresis de las lesiones que presentan y posteriormente en el mismo acto quirúrgico, se realiza colocación de colgajos, utilizando para ésto piel y en un caso músculo, de diferentes regiones de la cara. Evolución funcional y estética satisfactoria.

Quemaduras: rutina de atención quirúrgica / Burns: routine surgical care

La destrucción de los tegumentos, incluso en los tejidos subyacentes, bajo el efecto de un agente térmico, eléctrico, químico o radioactivo; está en relación con la extensión y profundidad de la lesión nos lleva como definición a una patología extremadamente grave y compleja. Presentamos de manera sucinta la incidencia de quemaduras, rutina de atención al quemado y el resultado de aplicación de esta rutina en el Instituto Autónomo Hospital Universitario de Los Andes, Hospital tipo IV, situado en Mérida Edo. Mérida desde el 2000 hasta el 2006 y que por su área de atención, nuestro Servicio está comprometido en el manejo quirúrgico de estas lesiones, sin embargo aun teniendo la necesidad de poseer un área especial para la atención de los pacientes quemados, no contamos con dicha infraestructura.

Factors affecting graft survival after living donor liver transplantation.

Living donor liver transplantation (LDLT) has been considered as an alternative option to resolve the shortage of cadaveric donor organs, despite the ethical aspects of the donor procedure. The objective of this study was to analyze the risk factors affecting graft survival in LDLT. From June 1996 to December 2002, 141 patients who underwent LDLT were retrospectively analyzed. Graft survival rates were 82.5%, 80%, 77.3%, and 77.3% at 6 months, 1 year, 3 years, and 5 years, respectively. The factors influencing graft survival in univariate analysis were graft-to-recipient body weight ratio (GRWR) less than 0.8% (P = .0009), intraoperative transfusion of more than six packed RBC units in addition to the use of cell saver amounts (P = .0001), left lobe grafts in adults causing small-for-size situations (P = .0135), and donor age (P = .0472). The multivariate analysis demonstrated that GRWR less than 0.8% (P = .002) and intraoperative transfusion of more than six packed RBC units (P = .014) were independent factors that decreased graft survival rates. The graft selection of greater than 0.8% of GRWR and reduction of intraoperative RBC transfusion improve graft survival.

Inflammo-coagulatory response, extrinsic pathway thrombin generation and a new theory of activated clotting time interpretation.

When blood is subjected to contact with foreign surfaces, as during cardiopulmonary bypass (CPB), the whole body inflammatory response is initiated, resulting in the expression of procoagulant molecules on the vascular endothelium and white blood cells. These surface bound procoagulants participate in the extrinsic coagulation pathway. It appears that the primary source of thrombin generation during CPB is due to extrinsic pathway activation. Thrombin not only converts fibrinogen to fibrin, it also acts as a proinflammatory agent resulting in a positive feedback loop or the inflammo-coagulatory response. Extrinsic pathway thrombin generation occurs as a membrane bound event. Membrane bound factors are resistant to heparin/ATIII inhibition. Therefore, the anticoagulant effect of heparin/ATIII is due to thrombin inhibition, not the inhibition of thrombin generation. Interpretation of the activated clotting time (ACT) must take into account the thrombin concentration [T]; this results in the coagulatory ratio, ACT is proportional to ([Hep -ATIII]/[T]). Considering this proportionality, it can be seen that the ACT cannot be used to quantitate heparin concentration. Changes in the ACT can reflect changes in [Hep - ATIII], changes in [T], or changes in both concentrations. Anti-inflammatory agents which suppress or inhibit the extrinsic pathway, such as aprotinin, result in decreased thrombin generation. As thrombin generation decreases, the ACT-heparin dose response curve is warped, resulting in a dose response curve resembling a PTT-heparin dose response curve. We can no longer assume that the disproportionate rise in the ACT relative to the [HEP - ATIII] when aprotinin is used as indicative of failure of the ACT to provide a credible indication of anticoagulation.

Cell saver efficacy for routine coronary artery bypass surgery.

A retrospective study was conducted to determine the effect of intraoperative Haemonetics Cell Saver (HCS) usage on postoperative homologous blood product requirements in CABG patients. From 1 January to 31 December 1993, 516 patients without renal disease or postoperative surgical or gastrointestinal haemorrhage had elective, first-time CABG surgery. The HCS was utilized in 435 of these patients (Group CS) and in 81 patients the HCS was excluded (Group NCS). Preoperative patient variables were similar in the group. We evaluated the HCS effect on blood product transfusion by comparing -x units of red blood cells (RBC), fresh frozen plasma (FFP) and platelets (PLTS) transfused per patient between groups CS and NCS. There were no differences in the -x units of RBC (1.9 +/- 2.7 CS vs. 1.8 +/- 1.5 NCS) or in the RBC transfusion rate (48% CS vs 50% NCS). There were also no significant differences between the groups in -x units of FFP (0.9 +/- 0.8 CS vs 0.4 +/- 0.9 NCS) or PLTS (0.7 +/- 3.1 CS vs 0.4 +/- 2.5 NCS), or in the percentage of patients receiving these products (12% CS vs 8% NCS). These data provide no evidence that the use of the HCS decreases the amount of homologous blood bank products required postoperatively in patients having routine first-time CABG surgery. The current era of aggressive blood conservation may have limited the role of the HCS in routine CABG surgery.

[Megaloblastic anemia and gastrointestinal manifestations in Lima. The tip of the iceberg?]. / Anemia megaloblástica y manifestaciones gastrointestinales en Lima. La punta del iceberg?

UNLABELLED: The records of the last three years from the Hematology service are reviewed and twenty patients (6.23%) fulfilling the inclusion criteria were chosen out of a total of 316. RESULTS: pallor and malaise 100%, change in bowel movements 75%, nausea, vomiting and hemorrhage 40%, jaundice 25%, nausea aroused by food 20%, infection 10%. Severe hyporegenerative anemia 100%, thrombocytopenia 75%, pancytopenia 60%. We found as associated conditions: gynecological and obstetric history 25%, enteric and peritoneal tuberculosis 15%, and without an apparent cause (primary) 40%. Levels of vitamin B12 and folic acid were measured in eleven patients and the finding were: B12 deficiency in six (54.5%), folic acid deficiency in three (27.2%) and deficiency of both in two (18.1%). With the exception of one patient who died from sepsis, all the other patients had a favorable outcome with vitamin treatment. We found folic acid deficiency associated with ferropenia mainly in those patients with obstetric history; the combined deficit in those patients with an associated pathological process, and B12 deficiency in the group without any apparent cause. From the available national information and our observations we can conclude that we are facing an outbreak of megaloblastic anemia that frequently goes on with gastrointestinal manifestations and for which the cause has not been elucidated.

[Effect of mechanical deboning process on the fat stability of 3 tropical fish species stored at -10 degrees C]. / Efecto del proceso de deshuesado mecánico en la estabilidad de las grasas de tres especies de pescado tropicales almacenadas a -10 grados C.

Maximum advantage of certain fish species captured with shrimp, at present not fully utilized, constitutes a necessity in Venezuela. The purpose of this research work was to evaluate the stability of three of those fish species: bagre, cunaro and caballa, based on the changes that might occur in their fat content. This was done by comparing both the edible part of the whole fish, as well as the deboned flesh of each of them. Evaluation of the changes was performed by means of the acid and peroxide indices, with previous fat extraction, and the thiobarbituric acid (TBA) index. On the other hand, the fatty acids profile of the three species studied was determined by gas chromatography. According to our findings, the greater alteration was detected in the deboned sample, obtaining the highest TBA and acidity index values of all species, on the third month of storage; then a reduction of these values was observed. On the other hand, the peroxide index presented heterogeneous values in the three species analyzed through their storage period. The predominant fatty acids were: palmitic (16:0) among the saturated, and oleic (18:1) among the unsaturated. A greater proportion of unsaturated fatty acids was found in the three species. An increment of these in the deboned sample with respect to the whole fish, was also observed.

Efecto del proceso de deshuesado mecánica en la estabilidad de las grasas de tres especies de pescado tropicales almacenadas A-10-C / Effect of mechanical deboning process on the fat stability of 3 tropical fish species stored at - 10 degrees C

En Venezuela es necesario aprovechar al máximo las especies sub-utilizadas de pescado que se capturan con el camarón. Este trabajo tuvo por propósito evaluar la estabilidad de tres especies de pescados sub-utilizados: bagre, cunaro y caballa, con base en los cambios que pueden ocurrir en las grasas. Ello se hizo comparando tanto la parte comestible del pescado sin deshuesar, como la carne deshuesada de cada uno de ellos. La evaluación de los cambios se efectuó por medio de los índices de acidez y peróxido, con extración previa de la grasa y el índice del ácido tiobarbitúrico (TBA). Por otra parte, se determinó el perfil de ácidos grasos de las tres especies investigadas, valiéndose de cromatografía de gases. En todos los casos, la mayor alteración se detectó en la muestra deshuesada, obteniéndose los valores más altos, tanto de TBA como del índice de acidez en el tercer mes de almacenamiento en todas las especies; luego se notó una disminución de estos valores. Por otro parte, el índice de peróxido acusó valores heterogéneos en las tres especies analizadas a lo largo del almacenamiento. Los ácidos grasos predominantes fueron: el palmítico (16:0) entre los saturados, y el oleico (18:1) entre los insaturados. En las tres especies se constató una mayor proporción de ácidos grasos insaturados. También se observó un incremento de éstos en la muestra dehuesada con respecto al pescado sin deshuesar