Addition of ß-glucans in diets for tropical gar (Atractosteus tropicus) larvae: effects on growth, digestive enzymes and gene expression of intestinal epithelial integrity and immune system.

The effect of ß-glucans 1,3/1,6 from Saccharomyces cerevisiae yeast at different inclusion percentages (0.0, 0.2, 0.4, 0.6, and 0.8%) in the diet for tropical gar (Atractosteus tropicus) larvae was evaluated on growth, digestive enzyme activity and, relative expression of the immune system genes. The bioassay started on the third day after hatching (DAH) and lasted 21 days, using a total of 1500 larvae of 0.055 ± 0.008 g and, a total length of 2.46 ± 0.26 cm. Larviculture was carried out in a recirculation system with 15 tanks of 70 L using a density of 100 organisms per experimental unit. No significant differences in larval growth were observed by the inclusion of ß-glucans (p > 0.05). Digestive enzymes showed changes in lipase and trypsin activities, presenting higher values in fish fed 0.6% and 0.8% ß-glucans diets compared to the other treatments (p < 0.05). Leucine-aminopeptidase, chymotrypsin, acid phosphatase, and alkaline phosphatase activity showed higher activities in larvae fed with a 0.4% ß-glucan diet compared to the control group. The relative expression of intestinal membrane integrity (mucin 2) muc-2, (occludins) occ, (nucleotide-binding oligomerization domain) nod-2, and immune system lys (lysosome) genes showed over-expression in larvae fed the 0.4% ß-glucan diet to the rest of the treatments (p < 0.05). The inclusion of ß-glucans at 0.4-0.6% in diets for A. tropicus larvae could improve larviculture, as effects on the increase in the activity of several digestive enzymes and the expression of genes of the immune system.

Supraclavicular nerve entrapment by the external jugular vein: An unreported finding.

OBJECTIVE: We aim to describe the supraclavicular nerve's vascular entrapment by the external jugular vein as an unreported anatomical finding. CASE DESCRIPTION: In a routine cadaveric dissection, the superficial emergence of the first division of the left supraclavicular nerve emerged along a duct formed through the external jugular vein. No other vascular or neural anatomical abnormalities were found in the surrounding structures. CONCLUSION: This unreported vascular entrapment of the supraclavicular nerve by the external jugular may harbour clinical implications for surgical and endovascular procedures on the external jugular vein and in refractory thoracic and scapular waist pain.

Protein and lipid requirements of three-spot cichlid Cichlasoma trimaculatum larvae.

Determination of the main nutritional requirements at different developmental stages is a prerequisite in the formulation of feeds for newly cultured fish species. In the present study, the lipid and protein requirements of larvae of a native Mexican fish, the three-spot cichlid Cichlasoma trimaculatum, were assessed using a two-factor experimental design that considered four protein (35, 40, 45, and 50%) and two lipid levels (16 and 22%) on growth, survival, and digestive enzyme activities. The best growth and feed efficiency results were obtained when larvae were fed diets including 45% protein and 22% lipids. Comprehensive evaluation of the profile of digestive enzymes using multivariate analysis also demonstrated significant differences in nutritional condition generated by varying inclusion of nutrients. Thus, an increase in protein led to an increase in alkaline protease activity and a reduction in leucine aminopeptidase activity, and the reduction of dietary lipid content led to a significant increase in lipase and trypsin enzymatic activities. Based on our results, C. trimaculatum larvae have a high capacity to hydrolyze both nutrients (protein and lipids) for the high digestive enzyme activities and increase their growth, particularly with a diet containing 45% protein and 22% lipids.

Survival of patients with Duchenne muscular dystrophy. / Sobrevida de pacientes con distrofia muscular de Duchenne.

INTRODUCTION: Duchenne muscular dystrophy (DMD) leads to a progressive deterioration of the mus cle function and premature death. There are no longitudinal studies on the course of this pathology in Chile. OBJECTIVE: To determine survival between the years 1993-2013, divided into two periods (1993-2002 and 2003-2013), and the effect of social determinants in patients with DMD admitted in Teleton Institutes of Chile (TI). PATIENTS AND METHOD: Prospective follow-up study in a clinical series of 462 patients with DMD. The information was obtained by searching for patients with DMD in OLAP cube (Online Analytical Processing). From the clinical records of the TI of Santiago, the variables corresponding to the diagnostic method, stage of DMD described in terms of muscle de terioration and function according to Swinyard classification were recorded; existence and type of tests that conclude the diagnosis and, in the cases reported, the existence of family history. Kaplan Meier survival analysis was applied, where global survival was defined between birth and age of death. The determinant factors analyzed were estimated through the Cox-Snell's proportional risk model. RESULTS: Survival at 20 years of age from TI entry was 51.7% (CI95%: 45.1-57.8), 48.5% in the period 1993-2002 and 72.8% between 2003-2013. The percentage of survival at the same age according to socioeconomic status (SES) was 82% in high SES, 67% in middle SES, and 42% in low SES, with a statistically significant difference between high and middle SES in relation to extreme poverty. Ac cording to country areas, the survival was close to 75 % at 17 years of age. CONCLUSIONS: The survival information from patients with DMD from childhood to adult life is valuable for predicting the clinical course of the disease with the current medical care. There is evidence of improvement in the probability of survival at the age of 20 and marked inequity according to the socioeconomic variable.

Cholecystoduodenal fistula, an infrequent complication of cholelithiasis: Our experience in its surgical management. / Fístula colecistoduodenal, complicación infrecuente de litiasis vesicular: nuestra experiencia en su manejo quirúrgico.

INTRODUCTION: Bilioenteric fistulas are the abnormal communication between the bile duct system and the gastrointestinal tract that occurs spontaneously and is a rare complication of an untreated gallstone in the majority of cases. These fistulas can cause diverse clinical consequences and in some cases be life-threatening to the patient. AIM: To identify the incidence of bilioenteric fistula in patients with gallstones, its clinical presentation, diagnosis through imaging study, surgical management, postoperative complications, and follow-up. MATERIALS AND METHODS: A retrospective study was conducted to search for bilioenteric fistula in patients that underwent cholecystectomy at our hospital center due to cholelithiasis, cholecystitis, or cholangitis, within a 3-year time frame. RESULTS: Four patients, 2 men and 2 women, were identified with cholecystoduodenal fistula. Their mean age was 81.5 years. Two of the patients presented with acute cholangitis and 2 presented with bowel obstruction due to gallstone ileus. All the patients underwent surgical treatment and the diagnostic and therapeutic management of each of them was analyzed. CONCLUSIONS: The incidence of cholecystoduodenal fistula was similar to that reported in the medical literature. It is a rare complication of gallstones and its diagnosis is difficult due to its nonspecific symptomatology. It should be contemplated in elderly patients that have a contracted gallbladder with numerous adhesions.

[Children's scalds from tearing of hot water bottle]. / Quemaduras en niños provocadas por rotura de bolsa para agua caliente.

INTRODUCTION: Children scalded by the tearing of hot-water bottles presented a sudden and significa tive increase around 2000 in Chile. For this reason the Aid to Burned Children Corporation (COA-NIQUEM) publicized prevention concepts concerning the careful use of this device and raised a voice of alarm to authorities. Later, the National Normalization Institute introduced quality certification standards for hot water bottles sold in the country. OBJECTIVES: Determine the impact of preventive measures and quality certification for hot water bottles in burns caused by tearing of the device on children. PATIENTS AND METHOD: Review of 795 patients under 15 admitted with injuries caused by hot-water bottle rupture between 2000 and 2014 at COANIQUEM Santiago. The frecuency of burns by the ethiological agent is determined and the epidemiological profile are compared in the initial and final quinquenial period. RESULTS: Between 2000-2004, an increase of 272.7% was recorded and then a decrease of 81.3 % was found between 2005-2014. Demographic characteristics, month of occurrence and need of some kind of surgery were similar in both periods. The number of locations and injuries diminished, and are concentrated in one burn (77.8%). In the first period the main anatomical region affected was lower limbs and in the second period abdominal and pelvis are also frequent. CONCLUSIONS: An important decrease of burns by hot-water bottle rupture with significant changes in their epidemiological characteristic is verified. This coincides with preventive measures and manufacturing standards regulations and quality control.

Changes on digestive enzymes during initial ontogeny in the three-spot cichlid Cichlasoma trimaculatum.

A study was performed in order to understand the development of digestive enzymes during initial ontogeny of Cichlasoma trimaculatum, for which the activity of acidic and alkaline proteases, lipases, amylases and phosphatases was determined by means of biochemical and electrophoretic analysis. Our results showed that the activity of alkaline proteases, trypsin and chymotrypsin is present from day 6 after hatching (dah) during exogenous feeding with Artemia nauplii. The activities of carboxypeptidase A and leucine aminopeptidase are present from the first days, increasing at 6 dah and reaching their maximum activity at 9 dah while acid protease activity started at 9 dah. Furthermore, the lipase activity is detected on 6 dah and keeps increasing and decreasing on 17 dah. Amylase activity is detected on 3 dah, presenting fluctuations until 45 dah, where it reaches its maximum activity. Acid and alkaline phosphatases are detected from 3 dah and reach a maximum activity between 13 and 19 dah. The SDS-PAGE electrophoresis revealed six types of bands in the alkaline proteases, with molecular weight between 113.4 and 20.4 kDa. First three bands appear on 6 dah, but it is until 11 dah when all isoforms appear. Based on these results, it is considered that this species completes its digestive enzymatic machinery from day 9 after hatching, therefore is recommended to perform the transition from live feed to inert feed at 15 dah.

[Self-concept level in children with burns sequelae: A comparative study]. / Nivel de autoconcepto en niños con secuelas de quemaduras: estudio comparativo.

INTRODUCTION: Self-concept is the set of ideas and attitudes that a person has about him/herself. OBJECTIVE: To evaluate whether there are differences in the level of self-concept in children 8-12 years old with and without burns sequelae. To identify predictive variables of self-concept in children with sequelae. PATIENTS AND METHOD: A comparative cross-sectional study of self-concept in 109 children with burns sequelae, from 8 to 12 years old, with 109 children without burns sequelae, and of the same age and socioeconomic status. The Piers-Harris self-concept scale is used, which provides a general measurement of self-concept and behavioural, intellectual and school status, appearance, and physical attributes, anxiety, popularity, happiness and satisfaction dimensions. RESULTS: There were no significant differences in the level of general self-concept or their dimensions (P>.05). In the group with burns sequelae, the protective factor was the variable number of sequels was associated with the dimensions of anxiety, popularity, happiness-satisfaction and general self-concept. The location variable emerged as a risk factor for the behavioural dimension. DISCUSSION: The absence of differences in self-concept between children with burns sequelae and children without them is similar to that reported in the literature. The finding in the risk and protective factors encourages to further research, and perhaps incorporating pre-morbidity and family background.

[Epidemiology of burns in children and adolescents from Chile's Metropolitan Region]. / Epidemiología de las quemaduras en niños y adolescentes de Región Metropolitana de Chile.

OBJECTIVE: To determine demographic, clinical and health care factors associated to prevalence of burns in children less than 20 years of age in the districts of Cerro Navia, Lo Prado and Pudahuel, and their comparison with incidence in 2011. PATIENTS AND METHOD: Population survey based on probability and two-stage stratified complex sample of households, registering 4,968 households. In 302 of them randomly selected, the mother/adult present at the time of the injury took a survey. A questionnaire of 50 questions (20 minutes), created by 6 experts and previously validated, was conducted by 10 interviewers and 3 supervisors. People were contacted by telephone before visiting them at their homes. The non-response rate was 6%, after up to 3 home visits. RESULTS: Regarding prevalence, the male-to-female ratio was 1.16:1. Main reasons were hot objects (42.4%) and liquids (41.5%). 84.1% of burns occurred inside the home and in the afternoon (50.7%). 93.3% of the burns took place with an adult present. Hands were the most affected areas (46.7%). 30.2% were left with scars the first time of the accident. 34.4% of the burn victims did not require health care and 8.4% of them required hospitalizations. Over 60% of respondents reported that they poured cold water on the burn as a first step. CONCLUSION: Relevant information was obtained to be used in burn prevention in children and adolescents. Recall bias is the main limitation of the study.

[Incidence and prevalence of burn injuries in children under the age of 20 years]. / Incidencia y prevalencia de las lesiones por quemaduras en menores de 20 años.

OBJECTIVE: To estimate the incidence of burn injuries in 2011 and prevalence in population < 20 years old in three districts of Chile's Metropolitan Region. PATIENTS AND METHOD: A Prevalence census study of 4,968 households in the mentioned areas. Probability, representative, and two-stage cluster sampling, with sampling error < 5%, was applied. Complex sample modules were used to analyze data using SPSS 17.0. The census was conducted in the site, asking in each selected household those 18 and older, about household composition by gender and age to identify those < 20 years with burns that occurred sometime in their life or in 2011. RESULTS: A burn incidence of 2.02% [95% CI: 1.63-2.61%] and a prevalence of 13.50% [95% CI: 11.8815.31%] were obtained. The highest incidence was reported in female patients (2.31%) [95% CI: 1.77- 2.99%]. In males < 5 years of age, the incidence was 2.76% [95% CI: 1.42-5.28%] and in females, it was 2.46% [95% CI: 1.37-4.36%]. The municipality of Lo Prado had the highest incidence (2.73%) [95% CI: 1.82-4.07%]; Pudahuel recorded the highest prevalence (14.01%) [95% CI: 11.87-16.46%]. CONCLUSION: In 20 years, the incidence of burns in patients < 15 years of age fell by 46.4%. On average in the communities studied, 1 in 7 children/adolescent has suffered burns between birth and the time of his 20th birthday.

Hospital Oxygen Supply Overwhelmed Due to COVID-19: When Demand Exceeds Supply.

BACKGROUND: During the first wave of COVID-19, we experienced problems with our hospital oxygen supply system. This study aimed to analyze factors that stressed this system and rethink the design criteria of the gas pipeline system considering the varying oxygen demand. METHODS: A retrospective study was conducted to describe problems that occurred at different stages in the oxygen supply system at our hospital due to increases in oxygen use in general, and the creation of an intermediate respiratory care unit (IRCU) and use of high-flow nasal cannula (HFNC) in particular. Herein, the characteristics and design criteria of the medical gas pipeline system are analyzed, and the steps taken to avoid future problems are outlined. RESULTS: Increases in oxygen use were observed at times of maximum occupancy, and these created vulnerabilities in the oxygen supply due to insufficient capacity in terms of cryogenic tanks, evaporators, and the piping network. The peak consumption was 3 times higher than the peak in the preceding 4 years. The use of HFNC therapy aggravated the problem; IRCU use accounting for as much as two-fifths of the total across the hospital. Steps taken subsequently prevented the recurrence of vulnerabilities. CONCLUSIONS: The design criteria for storage and distribution networks of medical gases in hospitals need to be revised considering new parameters for their implementation and the use of HFNC therapy in an IRCU. In particular, the cryogenic tanks, evaporators, and piping network for hospital wards are critical.

In vitro susceptibility of high virulence microorganisms isolated in heart valve banking.

Storage preparation of human heart valves for implants generally includes incubation in an antimicrobial disinfection solution and cryopreservation. Changes in patterns of microorganisms susceptibility to antibiotics is a variable process of that promote its inefficiency. The aim of this study has been an evaluation of in vitro susceptibility of high virulence microorganisms isolated in our tissue bank for 14 years in order to evaluate the efficiency, and to promote changes for further antibiotics mixtures as well. Data presented in this study show that microorganisms isolates in valve banking display susceptibility patterns similar to those shown in other clinical circumstances, and the most commonly used antibiotics regimes are useful to date. An antibiotic cocktail containing aminoglicoside in addition to ciprofloxacin and vancomycin is an efficient mixture to be used in valve banking. Further studies will be necessary for monitoring patterns changes of in vitro susceptibility of microbiological isolates in tissue banking.

[Bacterial colonization in areas of burnt skin and healthy children younger than 15 years, seen COANIQUEM, Santiago, Chile]. / Colonización bacteriana de piel sana versus quemada de niños bajo 15 años tratados en COANIQUEM, Santiago de Chile.

UNLABELLED: Bacterial colonization in patients with burns skin without infection and outpatient management has been poorly studied. OBJECTIVE: To quantify and identify the type of bacteria that colonize healthy body areas homologous location of the skin in children from 1 to 15 years, seen COANIQUEM, Santiago, Chile. Per patient, we studied 204 samples from each zone. The isolated microorganisms were S. epidermidis 35, 3%; others Staphylococcus coagulase negative, 25.8%; S. aureus, 4.4%; and S. viridans group 1.4%. In the subgroup of children who had a count between 1 and 1000 cfu, there was a higher proportion of cfu in burned skin healthy skin (p = 0.0359). The association between depth of the lesion and the bacterial count obtained p = 0.034. CONCLUSION: In outpatient treatment, the microorganisms are expected in healthy skin, burned skin is evident in lower counts probably associated with epithelial damage.

[Effects of COVID-19 lockdown on the demand for health care of children and adolescents with burns in three specialized outpatient centers in Chile]. / Efectos del confinamiento por COVID-19 en la demanda de atención de niñas, niños y adolescentes con quemaduras en tres centros ambulatorios especializados de Chile.

INTRODUCTION: COVID-19 pandemic has meant adapting to a different reality, with long-term lockdowns that might cause an increase of burns in children at home. OBJECTIVE: To compare the epidemiological situation of patients admitted to the Corporación de Ayuda al Niño Quemado (COANIQUEM) due to out patient burn injuries management at the beginning of COVID-19 lockdown with the same period the year before. PATIENTS AND METHODS: Analytical and cross-sectional study. A population of 2,027 patients under the age of 20, who were admitted to COANIQUEM for the first time with burn inju ries, between April and July of 2019 and 2020 was analyzed. The number of patients admitted each month was registered as well as their demographic, social, and clinical characteristics. The monthly percentage variation was calculated by comparing patient data in both years. RESULTS: During 2020, there was a 48.7% decrease in overall outpatient admissions. There was a relative increase of 10.5% in burns in patients under 5 years old, 18.3% in scalds, 33.1% in the number of burns in 3 or more body locations, and 16.8% in burns occurring at home. These parameters were not influenced by geographic location, sex, or socioeconomic level. CONCLUSIONS: In the first period of the COVID-19 pandemic, with strict lockdown strategies, there was a decrease in the demand for burn care, affecting both outpatients with acute burns and those who were admitted for sequelae rehabilitation, as a result of the effective decrease in the burns incidence and the reduced access to health care.

Result of the implementation of telematic consultations in orthopaedic surgery and traumatology during COVID-19 laparoscopic surgery. / Resultado de la implantación de consultas telemáticas en cirugía ortopédica y traumatología durante la pandemia COVID-19.

The COVID pandemic has made telematic consultations a basic tool in daily practice. AIMS: The main objective of the study is to assess the results of the application of telematic consultations to limit the mobility of patients. The operational objectives are; to propose a consultation plan, to know how attendance limits consultations and to define which pathologies benefit the most from this plan. METHODS: A scheme is proposed with the creation of pre-scheduled clinic to assess suitability and the possibility of carrying them out in a single non face-to-face act. RESULTS: Phone call to 5,619 patients were made with a lack of response of 19%. The cases of 74% of the patients that answered were resolved virtually. There is a difference between units, obtaining a higher answering rate from patients appointed to specific clinic units, OR = 0.60, or to general trauma ones, OR = 0.67. The lowest answering rate was obtained from those derived from the emergency department. Twenty per cent of the consultations were not accompanied by complementary tests that would have favored the resolution in a single act. The general trauma consultations, OR = 0.34, postoperative control, OR = 0.49, and specific unit ones, OR = 0.40, were the ones that better met this requirement. Out of the remaining patients, the general trauma consultations, OR = 0.50, and those referred to units, OR = 0.54, were the ones that had a higher resolution rate without in- person consultation. CONCLUSIONS: The cases of 74% of the patients who answered the phone call were resolved virtually. Cases of 20% of the patients cannot be solved in a single act because they are derived without complementary tests. Osteosynthesis and postoperative arthroscopic follow-up consultations are the ones that need to be carried out in person the most.

[Investigation of Enterococcus faecalis antimicrobial resistance]. / Investigación de las resistencias a antimicrobianos en Enterococcus faecalis.

We performed an antibiotic resistance study on Enterococcus faecalis isolated from intrahospitalary and extrahospitalary samples between january 2004 and january 2008. Three different samples were studied; urine, blood and wound swabs, considering a strain per patient. We included in the study a global amount of 3,641 Enterococcus faecalis isolations from clinical samples received at Hospital Universitario Reina Sofía microbiology service in Córdoba (Spain). We employed semiautomatic system WIDER I (Soria Melguizo) for identification and sensibility testing. We considered sensibility and resistance criteria recommended by MENSURA group. We found a sensitivity rate of 98.04% to betalactamics.The highest resistance rates were obtained with aminoglycosides, between 33.82% and 48.01%. Linezolid and Vancomycin sensitivity was 100%. It seems that vancomycin resistance is not a worrying issue today, but it should be controlled.

[Communication based on the P300 component of event-related potentials: a proposal for a matrix with images]. / Comunicación basada en el componente P300 de los potenciales relacionados con eventos: propuesta de una matriz con imágenes.

INTRODUCTION: For more than two decades, several research groups have tried to build a device called "brain computer interface" (BCI) to make it available for people having several disabilities such as the locked in syndrome through the use of the recording of electroencephalography activity while the patients are being visually stimulated. AIM. To obtain a P300 component elicited by intensifications of images arranged in a matrix in an oddball paradigm in two selection modes: assigned and free. SUBJECTS AND METHODS: A 5 x 5 matrix for communication purposes was used to visually stimulate 12 volunteers while their event related potentials were recorded in three leads (Fz, Cz and Pz). Off-line analyses were performed to obtain the P300 component which was elicited by targets images intensified randomly by rows or columns. RESULTS: In both modalities assigned and free, all volunteers generated a reliable P300 component. Confirmation of the selected images was made through a comparison of the P300 when each target, row and column matched. In the free selection mode, higher amplitude and a broader activation including frontal leads was observed. No significant differences in the P300 latency were found. CONCLUSION: In all volunteers the elicited P300 allows the identification of the selected images in the 5 x 5 matrix. In the present study the use of drawings representing ideas instead of letters might increase the communication rate in a P300-based BCI.

[Evolution of methicillin resistance in Staphylococcus aureus in Cordoba (Spain) in the years 2002-2005]. / Evolución de la resistencia a la meticilina de Staphylococcus aureus en la provincia de Córdoba (España) en los años 2002-2005.

In the last few years, methicillin-resistant Staphylococcus aureus (MRSA) has become a very important human pathogen. Our aim was to study the evolution of methicillin resistance of Staphylococcus aureus strains isolated in our hospital over a four-year period and to compare our situation with the rest of Spain and Europe. The rates varied from 39.9% in 2002 to 46.4% in 2005. Units with the highest rate were ICU and surgical wards. We found no glycopeptide-resistant strains.

[Semantic verbal fluency in Spanish-speaking people: a comparative analysis]. / Fluidez verbal semántica en hispanohablantes: un análisis comparativo.

INTRODUCTION: Semantic verbal fluency (SVF) is the most commonly used test in the evaluation of normal and pathological functioning, whether it be clinically or experimentally. Several studies have suggested that the age, schooling and culture of the subject all affect performance in this test. To date no research has been conducted that proves whether there are differences between subjects who speak the same language but who come from different countries. PATIENTS AND METHODS: Data from the 'animals' category of the SVF in adult Spanish-speaking subjects and also the influence exerted by culture, age and schooling on the outcomes in this test were both submitted to analysis. The aforementioned variables were compared with the data reported by five research groups. RESULTS: The SVF test yields similar data from one Spanish-speaking country to another, provided that the subjects' age and schooling are taken into account. The differences found in this study may be due to variations in the way the tests are administered and scored rather than any cultural effect. We propose a standardised method of applying the test, so as to allow these variables to be unified in the future. CONCLUSION: Age and schooling are factors that determine performance in the SVF, although this is not true of culture.