Bilirubin Molecular Species Play an Important Role in the Pathophysiology of Acute-on-Chronic Liver Failure.

Bilirubin plays a key role in early diagnosis, prognosis, and prevention of liver diseases. Unconjugated bilirubin (UCB) requires conversion to a water-soluble form through liver glucuronidation, producing monoglucuronide (BMG) or diglucuronide bilirubin (BDG) for bile excretion. This study aimed to assess the roles of bilirubin's molecular species-UCB, BMG, and BDG-in diagnosing and understanding the pathogenesis of liver cirrhosis in patients with acute-on-chronic liver failure (ACLF), compensated liver cirrhosis (LC) patients, and healthy individuals. The study included patients with ACLF and compensated LC of diverse etiologies, along with healthy controls. We collected laboratory and clinical data to determine the severity and assess mortality. We extracted bilirubin from serum samples to measure UCB, BMG, and BDG using liquid chromatography-mass spectrometry (LC-MS). The quantification of bilirubin was performed by monitoring the mass charge (m/z) ratio. Of the 74 patients assessed, 45 had ACLF, 11 had LC, and 18 were healthy individuals. Among ACLF patients, the levels of molecular species of bilirubin were UCB 19.69 µmol/L, BMG 47.71 µmol/L, and BDG 2.120 µmol/L. For compensated cirrhosis patients, the levels were UCB 11.29 µmol/L, BMG 1.49 µmol/L, and BDG 0.055 µmol/L, and in healthy individuals, the levels were UCB 6.42 µmol/L, BMG 0.52 µmol/L, and BDG 0.028 µmol/L. The study revealed marked elevations in the bilirubin species in individuals with ACLF compared to those with compensated cirrhosis and healthy controls, underscoring the progression of liver dysfunction. The correlation of BMG and BDG levels with commonly used inflammatory markers suggests a relationship between bilirubin metabolism and systemic inflammation in ACLF.

Diffusion in biological media: a comprehensive numerical-analytical study via surface analysis and diffusivities calculation.

The study of diffusion in biological materials is crucial for fields like food science, engineering, and pharmaceuticals. Research that combines numerical and analytical methods is needed to better understand diffusive phenomena across various dimensions and under variable boundary conditions within food matrices. This study aims to bridge this gap by examining the diffusion of substances through biological materials analytically and numerically, calculating diffusivity and conducting surface analysis. The research proposes a process for sweetening Bing-type cherries (Prunus avium) using sucrose/xylitol solutions and a staining technique utilising erythrosine and red gardenia at varying concentrations (119, 238 and 357 ppm) and temperatures (40, 50 and 60 °C). Given the fruit's epidermis resistance, the effective diffusivities of skin were inferior to those in flesh. Temperature and concentration synergise in enhancing diffusion coefficients and dye penetration within the food matrix (357 ppm and 60 °C). Red gardenia displayed significant temperature-dependent variation (p = 0.001), whereas erythrosine dye remained stable by temperature changes (p > 0.05). Gardenia's effective diffusivities in cherry flesh and skin, at 357 ppm and 60 °C, 3.89E-08 and 6.61E-09 m2/s, respectively, significantly differed from those obtained at lower temperatures and concentrations. The results highlight the temperature-concentration impacts on mass transfer calculations for food colouring processes and preservation methodologies.

Estimation of diffusion coefficients during carrots cooking in arsenious solution at different temperatures.

This study is based on an investigation of the transport phenomenon, specifically the quantification of arsenic diffusion in carrots within a temperature range of 89 °C-99 °C using a thin plate model. Studying the diffusion of arsenic in carrots is important due to its toxicity, as it can concentrate during cooking. The World Health Organization considers arsenic as one of the ten chemical substances of public health concern. In this study, biennial hybrid carrots of the Nantesa variety were cooked whole with their epidermis in an aqueous solution containing diarsenic trioxide with an As concentration of 5 mgL-1 at 89 °C, 94 °C, and 99 °C. The cooking times of the carrots at different temperatures were based on a specific degree of tenderness, with a value of ≤3 kg m-2. The evaluated data showed consistency with increasing temperature. The calculated effective diffusion coefficients at temperatures of 89 °C, 94 °C, and 99 °C were 5.84E-09 m2s-1, 1.08E-08 m2s-1, and 2.51E-08 m2s-1 for the flesh (DL), and 1.601E-11 m2s-1, 2.15E-11 m2s-1, and 4.39E-11 m2s-1 for the epidermis (DE), respectively. The activation energy for diffusion was determined to be 159.54 kJmol-1 for the and 110.68 kJmol-1 for the epidermis. Similar behaviours were observed in different radial positions of the carrot, where the arsenic content decreased from the periphery to the centre, consistent with studies on diffusion phenomena with other solutes in food. The novelty was the detailed quantification of arsenic diffusion in the Nantes-type hybrid carrot matrix. This study is limited to a specific concentration of 5 mgL-1 of arsenic solution. The findings of this study may have significant implications for public health and food safety.

Drosophila Nhe2 overexpression induces autophagic cell death.

Autophagy is a conserved catabolic process where double membrane-bound structures form around macromolecules or organelles targeted for degradation. Autophagosomes fuse with lysosomes to facilitate degradation and macromolecule recycling for homeostasis or growth in a cell autonomous manner. In cancer cells, autophagy is often up-regulated and helps cancer cells survive nutrient deprivation and stressful growth conditions. Here, we propose that the increased intracellular pH (pHi) common to cancer cells is sufficient to induce autophagic cell death. We previously developed tools to increase pHi in the Drosophila eye via overexpression of DNhe2, resulting in aberrant patterning and reduced tissue size. We examined fly eyes at earlier stages of development and found fewer interommatidial cells. We next tested whether this decrease in cell number was due to increased cell death. We found that the DNhe2-induced cell death was caspase independent, which is inconsistent with apoptosis. However, this cell death required autophagy genes, which supports autophagy as the mode of cell death. We also found that expression of molecular markers supports increased autophagy. Together, our findings suggest new roles for ion transport proteins in regulating conserved, critical developmental processes and provide evidence for new paradigms in growth control.

Predicting the potential distribution and coexistence of Chagas disease vectors in the Americas.

Predicting the potential distribution and coexistence of suitable geographic areas for Chagas disease vectors in the Americas is a crucial task for understanding the eco-epidemiological dynamics of this disease. The potential distribution and coexistence of 3 species-Rhodnius prolixus (Hemiptera: Reduviidae), Cavernicola pilosa (Hemiptera: Reduviidae), and Rhodnius pictipes (Hemiptera: Reduviidae) were modeled. Presence records were obtained and environmental variables were selected based on correlation analysis, Jackknife analysis and knowledge of the biology and natural history of the species. The MaxEnt algorithm included in the kuenm package of R software was used for modeling the potential distribution, and various scenarios of the BAM diagram (Biotic, Abiotic, and Movement variables) were evaluated. The variables contributing to the final models were different for each species. Rhodnius pictipes showed a potential distribution in South America, particularly in Brazil, Bolivia, Peru, Colombia, Venezuela, Guyana, and Suriname. Areas with environmentally suitable conditions for R. prolixus were located in southern Brazil, Peru, Colombia, southern Mexico, Guatemala, El Salvador, and Honduras, whereas for C. pilosa they were in southeastern Brazil, southeastern Central America, Peru, Ecuador, Colombia, Venezuela, Guyana, Suriname, and French Guiana. Co-occurrence analysis revealed distinct patterns in the neotropical region, with some areas indicating the potential distribution of 1 or more species. In Brazil, occurrence and co-occurrence areas were concentrated in the northwest and southeast regions. Overall, this study provides valuable information on the potential distribution and coexistence of vectors, which can inform targeted vector control strategies and contribute to global efforts in combating Chagas disease.

Biodegradable polydioxanone stents: histologic and structural effects in an experimental model of tracheal stenosis.

OBJECTIVES: To evaluate the biologic impact of polydioxanone (PDO) stenting in an animal model of inflammatory tracheal stenosis (TS). Additionally, to compare these results with those obtained in the same model without a stent and after placing one PDO stent in a healthy trachea. METHODS: 40 adult NZ rabbits were distributed into 3 groups: Group A, 8 animals with a healthy trachea and a PDO stent; group B, 17 rabbits with a TS and no stent; and group C, 15 animals with TS and a PDO stent. Histopathological studies included Masson's trichrome staining for submucosal fibrosis and Safranin O to assess structural integrity of cartilage. Morphometric analyses were performed in the 3 groups. RESULTS: Stent placement was successful in every case. Histological studies did not show a significant increase in tracheal wall collagen area and cartilage structure was not modified in those rabbits with a PDO stent, even in a TS scenario. Stent implantation permitted recovery of normal tracheal lumen levels in the TS model. CONCLUSIONS: PDO stenting in the normal trachea and in a model of TS neither caused increase in the collagen matrix nor modification of the cartilaginous support. Additionally, radial force exhibited by PDO stents was effective in restoring normal tracheal lumen when placed in a stenotic lesion. These findings suggest that they may be safe and useful in the setting of an acquired TS.

Further experience with polydioxanone airway stents in children.

INTRODUCTION: The aims of this study were to update our experience with biodegradable polydioxanone (PDO) airway stents in children, focusing on effectiveness and safety, and to analyze the factors involved in the different outcomes observed. MATERIALS AND METHODS: Retrospective study of patients managed with PDO stents from 2012 to 2023. Variables collected: demographics, comorbidities, indication, clinical baseline, stent size, location, complications, clinical outcome, and time of follow-up. Statistical analyses were performed to detect the eventual contribution of variables in the different outcomes observed. RESULTS: Fifty-four PDO stents were placed in 26 patients (median age, 4 months). All showed severe symptoms of central airway obstruction due to tracheomalacia in nine patients, bronchomalacia five, tracheobronchomalacia 10, and tracheal stenosis two. Stent placement was uneventful in every case: 29 stents in the trachea and 25 in the main bronchi. 53.8% of patients needed successive stenting, and all exhibited comorbidities. Complete clinical resolution was observed in eight cases (30.7%), partial improvement in 13 (50%), unchanged in 4 (15.3%), and worsened in one. Age had a significant positive impact on outcome (6 vs. 3 months; p = 0.024). Additionally, smaller stents were associated with a better outcome (20 vs. 26 mm; p = 0.044). Granulation tissue was the most frequent complication (34.6%). Five patients (19.2%) died due to severe comorbidities, follow-up was complete in survivors (median, 58 months). CONCLUSIONS: PDO stents are safe and effective when dealing with severe tracheobronchial obstruction. Stent-related granulation tissue continues to be a relevant matter of concern. This issue, together with increased degradation times, deserves further research.

Leptospirosis: A dual threat - predisposing risk for renal transplant and trigger for renal transplant dysfunction.

Leptospirosis (LTPS) is a bacterial infection that affects humans, often with mild or no symptoms. It is estimated that approximately 10 % of patients with LTPS may experience multi-organ dysfunction, including renal abnormalities. In regions where LTPS is widespread, a considerable number of instances involving acute kidney injury (AKI) and chronic kidney disease (CKD) of unknown etiology (CKDu) have been reported. Additionally, studies have shown a correlation between kidney graft dysfunction in patients with stable kidney transplants after LTPS. These findings indicate that exposure to LTPS may increase the likelihood of kidney transplantation due to the onset of both acute and chronic kidney injuries. Simultaneously, it poses a potential risk to the stability of kidney grafts. Unfortunately, there is limited scientific literature addressing this issue, making it difficult to determine the negative impact that LTPS may have, such as its role as a risk factor for the need of kidney transplantation or as a threat to individuals who have undergone kidney transplants. This study aims to shed light on the immune mechanisms triggered during LTPS infection and their importance in both kidney damage and allograft dysfunction.

Educational interventions in pharmacovigilance to improve the knowledge, attitude and the report of adverse drug reactions in healthcare professionals: Systematic Review and Meta-analysis.

OBJECTIVES: Underreporting of adverse drug reactions (ADRs) limits and delays the detection of signs. The aim of this systematic review with meta-analyses was to synthesize the evidence of educational interventions (EIs) efficacy in health professionals to increase ADR reporting, attitudes, and knowledge of pharmacovigilance. EVIDENCE ACQUISITION: A systematic literature review was carried out to identify randomized clinical trials evaluating the efficacy of EI in pharmacovigilance in health professionals to improve ADR reports, knowledge, and attitude toward pharmacovigilance. ADR reports were pooled by calculating Odds Ratio (OR) with a 95% confidence interval (95%CI), while pharmacovigilance knowledge and attitude were pooled by calculating a mean difference (MD) with 95%CI. In addition, the subanalysis was performed by EI type. Meta-analysis was performed with RevMan 5.4 software. PROSPERO registry CRD42021254270. RESULTS: Eight hundred seventy-five articles were identified as potentially relevant, and 11 were included in the systematic review. Metanalysis showed that EI increased ADR reporting in comparison with control group (OR = 4.74, [95%CI, 2.46 to 9.12], I2 = 93%, 5 studies). In subgroup analysis, the workshops (OR = 6.26, [95%CI, 4.03 to 9.73], I2 = 57%, 3 studies) increased ADR reporting more than telephone-based interventions (OR = 2.59, [95%CI, 0.77 to 8.73], I2 = 29%, 2 studies) or combined interventions (OR = 5.14, [95%CI, 0.97 to 27.26], I2 = 93%, 3 studies). No difference was observed in pharmacovigilance knowledge. However, the subanalysis revealed that workshops increase pharmacovigilance knowledge (SMD = 1.85 [95%CI, 1.44 to 2.27], 1 study). Only one study evaluated ADR reporting attitude among participants and showed a positive effect after the intervention. CONCLUSION: EI improves ADR reports and increases pharmacovigilance knowledge. Workshops are the most effective EI to increase ADR reporting.

Challenges in Treating Pediatric Cancer Patients during the COVID-19 Pandemic: Balancing Risks and Care.

The COVID-19 pandemic has resulted in millions of fatalities worldwide. The case of pediatric cancer patients stands out since, despite being considered a population at risk, few studies have been carried out concerning symptom detection or the description of the mechanisms capable of modifying the course of the COVID-19 disease, such as the interaction and response between the virus and the treatment given to cancer patients. By synthesizing existing studies, this paper aims to expose the treatment challenges for pediatric patients with COVID-19 in an oncology context. Additionally, this updated review includes studies that utilized the antiviral agents Remdesivir and PaxlovidTM in pediatric cancer patients. There is no specific treatment designed exclusively for pediatric cancer patients dealing with COVID-19, and it is advisable to avoid self-medication to prevent potential side effects. Managing COVID-19 in pediatric cancer patients is indeed a substantial challenge. New strategies, such as chemotherapy application rooms, have been implemented for children with cancer who were positive for COVID-19 but asymptomatic since the risk of disease progression is greater than the risk of complications from SARS-CoV-2.

Influence of Age, Gender and Body Mass Index on Intravenous Pharmacokinetics of Buprenorphine in Children Undergoing Orthopedic Surgery.

Background: Buprenorphine (BPN) is a widely used analgesic in the pediatric population, although there are few studies on the pharmacokinetics and pharmacodynamics of this drug. Objective: The objective was to characterize the pharmacokinetics of BPN after intravenous administration and analyze the effect of age, gender, weight, height, body mass index (BMI), and drug-drug interactions as covariates. Methods: Ninety-nine children (2-10 years), who underwent orthopedic surgery under regional, general, or combined anesthesia were included. Patients evaluated according to the American Society of Anesthesiologists Physical Status Classification, who received intravenous BPN 2 µg/kg were enrolled. Blood was collected from 1-240 min. Drug plasma concentrations were determined by LC-MS/MS. Population pharmacokinetic parameters were obtained with Monolix 2021R1 software. Pearson's correlation and/or ANOVA were used for statistical analysis. Results: Age was associated with changes in clearance and central compartment volume and the female gender was associated with lower intercompartmental clearance, while BMI modified clearance, central and peripheral compartment volume. Concomitant administration of BPN with fentanyl and dexamethasone produced decreases in clearance. Conclusions: The covariates of sex, age, and BMI are directly related to the increase or decrease in BPN pharmacokinetic parameters.

Diseño de Estrategias para la Inclusión Laboral de Personas con Diversidad Funcional Cognitiva en la segunda Ciudad más importante del Huila / Design of Strategies for the Labor Inclusion of People with Cognitive Functional Diversity in the Second Most Important City in Huila

Resumen En el municipio de Pitalito-Huila (Colombia) se evidencia un alto grado de des conocimiento sobre la diversidad funcional cognitiva, generando una proble mática social que levanta barreras e impide la inclusión de personas en esta con dición. Es así que, el problema de inclusión laboral para personas con diversidad funcional surge del desconocimiento de esta condición, de la percepción errada sobre sus capacidades, de las deficiencias educativas en torno a las competen cias laborales y de la falta de intervención gubernamental en la divulgación de las políticas públicas de inclusión. Finalmente, se proponen estrategias bajo el modelo de innovación de la triple hélice para lograr efectividad en los procesos inclusivos de inserción social, educativa y laboral.

Abstract In the municipality of Pitalito, Huila, Colombia, there is a high degree of igno rance about cognitive functional diversity, by generating a social problem, which raises barriers and prevents the inclusion of people in this condition. Thus, the problem of labor inclusion for people with functional diversity arises from the lack of knowledge of this condition, from the wrong perception of their capabil ities, from the educational deficiencies regarding labor competencies and from the lack of governmental intervention in the dissemination of public policies for inclusion. Finally, strategies are proposed under the triple helix innovation mod el to achieve effectiveness in the inclusive processes of social, educational, and labor insertion.

Profile of morphology teachers in Chilean universities / Perfil de los docentes de morfología en universidades chilenas

SUMMARY: University teaching in Chile has been influenced in recent decades by changes to the education system, which has increased universities and academic offerings and, therefore, the demand for new instructors. Teaching morphological sciences has not been exempt from these changes, with new instructors needed to fill the growing offerings of programs that include anatomy, embryology and histology. The aim was to understand the profile of the academics teaching morphology in Chile in 2020. A voluntary online survey was applied to 213 university morphology teachers, in which information was collected on professional and academic training, geographical distribution, gender, continuing academic education and employment situation. Overall, the results show that 65.9 % of instructors were men and 35.1 % women, and most (34.6 %) had between 5 and 10 years in morphology, and a master's degree was predominant (53.27 %). In the area of anatomy, 46 % of instructors were physiotherapists and 24.6 % dentists, whereas in the areas of histology and embryology, the group was diverse. In terms of employment, 49.06 % stated they worked full time, mainly in teaching.41.31 % of the instructors were concentrated in the Metropolitan Region. There was no association between gender and graduate training, maximum academic degree attained, type of workday or academic profile, but there was one by disciplinary area. The conclusion drawn is that morphology teachers in Chilean universities are part of a wide range of professionals dedicated to different disciplinary areas, with master's degree and/or specialization, located mainly in the Metropolitan Region. This multidisciplinary profile demonstrates the mainstreaming of morphology teaching in Chile.

RESUMEN: La docencia universitaria en Chile se ha visto influenciada en las últimas décadas por modificaciones del sistema educativo, las cuales generaron un incremento de universidades y oferta académica y, por ende, demanda de nuevos docentes. La enseñanza de las ciencias morfológicas no ha quedado exenta de estos cambios, teniendo que enfrentar la necesidad de nuevos docentes requeridos para suplir la creciente oferta de programas que incluyen a la anatomía, embriología e histología. El objetivo fue conocer el perfil de los académicos que realizaron docencia de morfología en Chile el año 2020. Se aplicó una encuesta online voluntaria a 213 académicos universitarios de morfología, en la cual se recopiló información sobre formación profesional, académica, distribución geográfica, género, perfeccionamiento académico y situación laboral. Los resultados, en general, muestran que el 65,9 % de los docentes eran hombres y un 35,1 % mujeres, los que en su mayoría (34,6 %) tenían entre 5 y 10 años vinculados a la morfología y donde prevalecía el grado académico de magíster (53,27 %). En el área de la anatomía el 46 % de los docentes correspondió a kinesiólogos y el 24,6 % a odontólogos, mientras que, en las áreas de histología y embriología el grupo fue misceláneo. En el ámbito laboral el 49,06 % declaró tener jornada completa, destinada principalmente a la docencia. El 41,31 % de los docentes se concentró en la Región Metropolitana. No hubo asociación entre género y formación de postgrado, máximo grado académico alcanzado, tipo de jornada y perfil académico, pero si hubo por área disciplinar. Se concluye que los docentes de morfología en Chile pertenecen a un amplio espectro de profesionales dedicados a distintas áreas disciplinares, con formación de magíster y/o especialización, ubicados principalmente en la Región Metropolitana. Este perfil multidisciplinar demuestra la transversalidad de la docencia morfológica en Chile.

Representaciones sociales de la violencia generada por el conflicto armado colombiano en estudiantes víctimas, de la institución educativa municipal Montessori del municipio de Pitalito-Huila / Social Representations of Violence Generated by the Colombian Armed Conflict in Student Victims, of the Municipal Montessori Educational Institution in the Municipality of Pitalito, Huila

Resumen La presente investigación tiene como propósito identificar las representaciones sociales hacia la violencia, de los estudiantes de la institución educativa municipal Montessori del Municipio de Pitalito Huila. Los estudiantes, a pesar de que tienen información de los hechos violentos a partir de sus familias, reflejan representaciones sociales hacia la violencia con imágenes de muer- te, asesinato, manipulación y privación, por cuanto fueron movilizados de sus asentamientos originales por los grupos armados. Igualmente, se perciben interpretaciones cognitivas de sentimientos de tristeza y miedo hacia la violencia y deducen que la paz podría ser una opción para evitar estas situaciones. Con respecto a las relaciones sociales u opinión del entorno hacia los hechos de violencia, los entrevistados expresaron que el entorno hizo caso omiso de la situación y los medios de comunicación nunca expresaron apoyos hacia las víctimas.

Abstract The purpose of this research is to identify the social representations toward violence, of the students of the Municipal Montessori Educational Institution of the Municipality of Pitalito, Huila. Although, the students have information on violent events from their families, they reflect social representations toward violence with images of death, murder, manipulation, and deprivation, as they were mobilized from their original settlements by armed groups. Similarly, cognitive interpretations of feelings of sadness and fear of violence are perceived and infer that peace could be an option to avoid these situations. With regard to the social relationships or opinion of the environment toward acts of violence, the interviewees expressed that the environment overlooked the situation, and the media never expressed support for the victims.

Tubérculo de Gerdy: una estructura olvidada en la terminología anatómica internacional / Gerdy's tubercle: a forgotten structure in the international anatomical terminology

En la enseñanza de la anatomía, el uso de los epónimos es cada vez más escaso, sin embargo su uso aún es evidente incluso en la literatura actualizada, en este caso el uso del epónimo se acompaña generalmente del término correcto según la Terminología Anatómica Internacional (TAI). El denominado "Tubérculo de Gerdy" (TG) es un epónimo ampliamente usado en la literatura y la comunidad científica para denominar un reparo óseo ubicado en el cóndilo lateral de la tibia, corresponde a un referente anatómico y clínico importante para inserción de músculos, ligamentos y procedimientos medicoquirúrgicos de la rodilla. A pesar de esta amplia denominación, y en comparación con otros epónimos, la TAI no la incluye y no relaciona algún término oficial con esta estructura anatómica. El objetivo del trabajo fue revisar libros usados en la enseñanza de la anatomía y artículos científicos actualizados para ver la presencia y descripción de esta estructura a fin de proponer un término que se ajuste a los principios básicos de la Terminología Anatómica Internacional en concordancia con la tarea del Programa Federativo Internacional de Terminología Anatómica (FIPAT), organismo de la Federación Internacional de Asociaciones de Anatomistas (IFAA). El TG se describe como una estructura ubicada entre la tuberosidad de la tibia y la cabeza de la fíbula, refiriéndose a él con sinónimos como tubérculo del músculo tibial anterior, tubérculo del músculo tensor de la fascia lata, tubérculo del tracto iliotibial y tubérculo anterolateral de la tibia. En revistas morfológicas aparece en artículos actuales relacionados al ligamento anterolateral. Según la descripción de la literatura proponemos como término anatómico para esta estructura "Tuberculum anterolateralis tibiae", cuya traducción es usada como sinónimo por otros autores, ajustándose así a los principios básicos de la TAI. Pretendemos que estos antecedentes sean discutidos por los expertos que conforman el FIPAT.

In teaching anatomy, the use of eponyms is increasingly scarce. Nonetheless, eponyms remain evident in updated literature, in this case the use of the eponym is accompanied by the correct term according to the International Anatomical terminology (TAI) Gerdy´s tubercle (GT) is an eponym widely used in the literature and scientific community to name a lateral tubercle of the tibia. It is an insertion site of muscles and ligaments and an important anatomical reference in knee surgical procedures. Despite its importance, it is not included in the International Anatomical Terminology (IAT) and an official name for this structure is lacking. The aim of this work was to review classic books used in the anatomy teaching and recent scientific papers, and further, to propose an anatomical term for the Gerdy tubercle that fit IAT basic principles, in agreement with the International Federal Program of Anatomical Terminology (IFPAT), and organism that is part of the International Federation of Anatomist Associations (IFAA). The TG is described as a structure located between the tuberosity of the tibia and the head of the fibula, referring to it with synonyms such as tubercle of the anterior tibia, tubercle of the tensor fascia lata, tubercle of iliotibial tract and anterolateral tibial tubercle. In morphological journals it appears in current articles related to the anterolateral ligament. We propose as an anatomical term for the Gerdy´s tubercle the name of "Tuberculum anterolteralis tibiae" its translation is used as a synonym by other authors and fits the basic principles of TAI. We hope that this information be considered by the experts that make up the FIPAT.

Ventilación colateral: una propuesta para terminologia histologica / Collateral ventilation: a terminologia histologica proposal

La correcta utilización de los términos morfológicos está estandarizada por las terminologías, una de ellas es la Terminologia Histologica (TH). Éstas sugieren la exclusión de los epónimos. Pese a esto, existen estructuras que continúan en esta condición. Específicamente, "Poros de Kohn, Canales de Martin y Canales de Lambert" son términos que componen la ventilación colateral (VC) y son ejemplo de esta situación. Así, el objetivo del presente estudio fue identificar en TH los términos asociados a la VC a fin de proponer denominaciones siguiendo las recomendaciones de la Federación Internacional de Programas de Terminologías Anatómicas (FIPAT). Se buscaron los términos relacionados a la VC en TH, posteriormente, se efectuó el mismo ejercicio en textos de histología, además de esto, en base de datos MedLine a través de su buscador PudMed con el siguiente algoritmo: (lung) AND (alveoli pulmonary) AND (airway) AND (collateral) AND (ventilation). En TH se encontró el término Porus septalis (H3. 05.02.0.00036) para referirse al término Poros de Kohn, en seis textos de histología se menciona el término Poros de Kohn, en 21 artículos revisados se menciona la VC, de estos, en diez se utiliza el epónimo Poro de Kohn, para referirse a los poros septales, el epónimo Canales de Lambert fue utilizado en seis artículos y el epónimo Canales de Martin, apareció en cinco artículos. A partir de la información encontrada, su desarrollo histórico, sumado a los lineamientos de la FIPAT, proponemos complementar e incluir en TH los términos Porus septalis alveolaris para los poros de Kohn, Ductus bronchiolaris alveolaris para los Canales de Lambert y Ductus interbronquiolaris para los canales de Martin, respectivamente.

The correct use of morphological terms is standardized by the Terminologies, one of them is the Histological Terminology (HT) For these Terminologies, the exclusion of eponyms is recommended. Despite this, there are structures that remain as eponyms. Three in particular: Pores of Kohn, Martin Channels and Lambert Channels are terms that make up collateral ventilation (CV) and are an example of this. Thus, the objective of the present study was to identify in the HT the terms associated with the CV in order to propose denominations following the recommendations of the Federative International Programme on Anatomical Terminologies (FIPAT). The terms related to CV in the TH were researched, and subsequently, the same exercise was carried out in histology texts. The MedLine database was also used through its PudMed search engine with the following algorithm: (lung) AND (alveoli pulmonary) AND (airway) AND (collateral) AND (ventilation). In HT the term Porus Septalis" (H3.05.0.0.036) was found to refer to the term "Pores of Kohn, in six histology texts the term Pores of Kohn is mentioned, in 21 reviewed articles the CV is mentioned, of these, in ten the eponymous Pores of Kohn is used, to refer to the Septal Pores, the eponymous Lambert Channels was used in six articles and the eponymous Martin Channels appeared in five articles. From the information found, its historical development, added to the guidelines of the FIPAT, we propose complementing and including in the HT the terms "Porus septalis alveolaris" for pores of Kohn, "Ductus bronchiolaris alveolaris" for the Lambert Channels and "Ductus interbronquiolaris" for the Martin Channels, respectively.

Guía de atención integral para la detección temprana y diagnóstico del episodio depresivo y trastorno depresivo recurrente en adultos. Atención integral de los adultos con diagnóstico de episodio depresivo o trastorno depresivo recurrente Parte II: Aspectos generales del tratamiento, manejo de la fase aguda, continuación y mantenimiento del paciente con diagnóstico de depresión / Guide for Early Detection and Diagnosis of Depressive Episodes and Recurrent Depressive Disorder in Adults. Integral Attention of Adults with a Diagnosis of Depressive Episodes and Recurrent Depressive DisorderPart II: General Aspects of Treatment, Management of the Acute Phase, Continuation and Maintenance of Patients with a Depression Diagnosis. Integral Care

Introducción: El presente artículo busca presentar las recomendaciones basadas en la evidencia que surgieron como respuesta a una serie de preguntas clínicas respecto al episodio depresivo y al trastorno depresivo recurrente, haciendo hincapié en los aspectos generales de tratamiento, el tratamiento en la fase aguda y el manejo de la fase de continuación/mantenimiento, con el fin de brindar parámetros de atención en salud basados en la mejor y más actualizada evidencia disponible para lograr los estándares mínimos de calidad en el abordaje de adultos con dichos diagnósticos. Método: Se elaboró una guía de práctica clínica bajo los lineamientos de la Guía Metodológica del Ministerio de la Protección Social. Se adaptaron las recomendaciones de las guías NICE90 y CANMAT para las preguntas que estas guías contestaban y se desarrollaron de novo para las preguntas no encontradas. Resultados: Se presentan las recomendaciones 5-22 correspondientes al manejo de la depresión...

Introduction: This article presents recommendations based on evidence gathered to answer a series of clinical questions concerning the depressive episode and the recurrent depressive disorder, with emphasis on general treatment aspects, treatment in the acute phase and management of the continuation/maintenance, all intended to grant health care parameters based on the best and more updated available evidence for achieving minimum quality standards with adult patients thus diagnosed. Methodology: A practical clinical guide was elaborated according to standards of the Methodological Guide of the Ministry of Social Protection. Recommendation from NICE90 and CANMAT guides were adopted and updated so as to answer the questions posed while de novo questions were developed. Results: Recommendations 5-22 corresponding to management of depression are presented...

Distribución del ramo profundo del nervio ulnar en los músculos intrínsecos del dedo mínimo en individuos Chilenos / Distribution of the deep branch of the ulnar nerve in the intrinsec muscles of the digiti minimi in Chilean individuals

El conocimiento detallado de la inervación de las estructuras de la mano permite la restauración de sus funciones frente a lesiones a las que se encuentra frecuentemente sometida. El objetivo de esta investigación fue determinar la distribución del ramo profundo del nervio ulnar en los músculos intrínsecos del dedo mínimo, localizando el origen de cada ramo y su punto de ingreso en el vientre muscular en un grupo de individuos chilenos. Se disecaron 23 manos de cadáveres formolizados de individuos chilenos, adultos, pertenecientes a la Unidad de Anatomía de la Universidad de la Frontera, Chile, en las cuales se realizó disección de la región palmar, exponiendo los músculos hipotenares y el ramo profundo del nervio ulnar (RPNU) localizando a los ramos dirigidos a los músculos del dedo mínimo, determinando su origen, identificando ramos independientes o comunes y registrando el punto de ingreso en el músculo. La distribución del ramo profundo del nervio ulnar se clasificó en 4 tipos: en el tipo I hubo 1 ramo independiente para el músculo abductor del dedo mínimo (ADM) y un ramo común para los músculos flexor corto ( FCM) y oponente (ODM) del dedo mínimo en 43,4 por ciento; el tipo II, un ramo común para el ADM y FCDM y un ramo independiente para el ODM en 21,7 por ciento; el tipo III, 3 ramos independientes, uno para cada músculo propio del dedo mínimo en 30,4 por ciento y el tipo IV, 2 ramos independientes, uno para el ADM y el otro para ODM en 4,3 por ciento, destacando en este tipo la ausencia del FCDM. El conocimiento de los padrones y variaciones aquí descritas es un importante aporte para la anatomía quirúrgica de la mano.

Detailed knowledge of the innervation of the structures of the hand allows the restoration of normal function when dealing with injuries to which are frequently subject. The present study aims to observe the distribution of the deep branch of ulnar nerve in the intrinsic muscles of the digiti minimi, determining the origin of each branch and its point of entry into the muscle belly in a group of Chilean individuals. 23 formalized hands of Chilean individuals belonging to the unit of Anatomy at the Universidad de La Frontera, Chile, Were dissected. Dissection was performed in palmar regions, exposing the hypothenar muscles and the deep branch of ulnar nerve following muscular branches to determine the origin as independent or common trunk and recording the entry point into the muscle. According to the findings we classified the distribution of the deep branch of the ulnar nerve in 4 types: type I, we found 1 independent branch for abductor digiti minimi (ADM) and a common branch in flexor digiti minimi brevis (FDMB) and opponens digiti minimi (ODM) in 43.4 percent; in type II, a common branch for ADM and independent FDMB and an independent branch for the ODM in 21.7 percent; in type III, 3 independent branches, one for each muscle of the digiti minimi in 30.4 percent and a type IV, 2 independent branches, one for the ADM and the other for ODM, highlighting the absence of the FDMB. The knowledge of these patterns and variations is an important contribution for the surgical anatomy of the hand.

Mieloma múltiple de cadenas ligeras, un reto diagnóstico / Light chain multiple myeloma, a challenging diagnostic

El mieloma múltiple es una neoplasia derivadade células de estirpe linfoide B (células plasmáticas)capaces de sintetizar inmunoglobulinas monoclonales. 1-2 En frecuencia, constituye la segunda neoplasia hematológica luego del linfoma. La edad promedio de aparición es a los 69 años. Se presume una mayor incidencia en negros americanos en comparación a otras poblaciones. Se trata de una entidad que en sus criterios diagnósticos, a sí como en otras características, ha sufrido varias modificaciones importantes en los últimos años...