Short-term physical exercise controls age-related hyperinsulinemia and improves hepatic metabolism in aged rodents.

PURPOSE: Aging is associated with changes in glucose homeostasis related to both decreased insulin secretion and/or impaired insulin action, contributing to the high prevalence of type 2 diabetes (T2D) in the elderly population. Additionally, studies are showing that chronically high levels of circulating insulin can also lead to insulin resistance. In contrast, physical exercise has been a strategy used to improve insulin sensitivity and metabolic health. However, the molecular alterations resulting from the effects of physical exercise in the liver on age-related hyperinsulinemia conditions are not yet fully established. This study aimed to investigate the effects of 7 days of aerobic exercise on hepatic metabolism in aged hyperinsulinemic rats (i.e., Wistar and F344) and in Slc2a4+/- mice (hyperglycemic and hyperinsulinemic mice). RESULTS: Both aged models showed alterations in insulin and glucose tolerance, which were associated with essential changes in hepatic fat metabolism (lipogenesis, gluconeogenesis, and inflammation). In contrast, 7 days of physical exercise was efficient in improving whole-body glucose and insulin sensitivity, and hepatic metabolism. The Slc2a4+/- mice presented significant metabolic impairments (insulin resistance and hepatic fat accumulation) that were improved by short-term exercise training. In this scenario, high circulating insulin may be an important contributor to age-related insulin resistance and hepatic disarrangements in some specific conditions. CONCLUSION: In conclusion, our data demonstrated that short-term aerobic exercise was able to control mechanisms related to hepatic fat accumulation and insulin sensitivity in aged rodents. These effects could contribute to late-life metabolic health and prevent the development/progression of age-related T2D.

Clinical outcomes after tricuspid surgery : The role of previous cardiac surgery.

BACKGROUND: The aim of our study was to assess the outcomes of surgical treatment for severe tricuspid regurgitation according to whether cardiac surgery had been performed before the tricuspid valve intervention. METHODS: Between 1996 and 2013, 201 consecutive patients with severe tricuspid regurgitation underwent tricuspid surgery at our center. Patients were classified according to whether or not they had undergone previous cardiac surgery, which 33% of the sample had. Perioperative as well as long-term morbidity and mortality were analyzed. RESULTS: Mean patient age was 62.3 years. 32.8% underwent suture annuloplasty, 41.3% underwent ring annuloplasty, 15.4% received a bioprosthesis, and 10.4% received a mechanical prosthesis. There were no significant differences in perioperative mortality between the group that had not undergone previous cardiac surgery and the group that had (12.7% vs. 17.9%, respectively; p = 0.32). The long-term mortality rate (median follow-up time: 53 months) was 43.3%. Long-term survival curves showed no significant differences between the two groups (p = 0.884), and previous cardiac surgery was not a predictive factor for long-term mortality (hazard ratio = 1.211; p = 0.521). CONCLUSION: In a series of patients who underwent tricuspid valve surgery, no significant differences were observed in perioperative mortality or in long-term survival according to whether or not subjects had undergone previous cardiac surgery.

[Conservative management of traumatic priapism in paediatric patients]. / Manejo conservador del priapismo traumático en la edad pediátrica.

INTRODUCTION: High-flow priapism is infrequent in pediatric patients. It is mostly secondary to perineal trauma resulting in laceration of a penile artery and the formation of an arterio-cavernous fistula. It does not constitute a medical emergency in itself, and allows conservative management awaiting spontaneous resolution. CLINICAL CASE: A six-year-old boy with painless persistent erection preceded by perineal trauma. Ultrasound imaging confirmed the clinical suspicion of high flow priapism secondary to arterio-cavernous fistula. After adopting a conservative approach, the patient presented progressive detumescence, as well as ultrasound resolution one month after the episode. COMMENTS: In high-flow priapism, venous drainage of the penis is preserved. The classical approach in adults is based on therapeutic angiography, which presents greater technical complexity and the risk of iatrogenic hypoxia in pediatric patients.

INTRODUCCION: El priapismo de alto flujo es una entidad infrecuente en la edad pediátrica. Es, en su mayoría, secundario a traumatismo perineal que provoca la laceración de una arteria peneana y formación de una fístula arterio-cavernosa. No constituye una emergencia médica, permitiendo un manejo conservador a la espera de su resolución espontánea. CASO CLINICO: Niño de seis años con erección persistente e indolora tras traumatismo perineal. El diagnóstico ecográfico confirma la sospecha de priapismo de alto flujo secundario a fístula arteria-cavernosa. Tras manejo conservador, presenta detumescencia progresiva y resolución ecográfica al mes del episodio. COMENTARIOS: En el priapismo de alto flujo el drenaje venoso del pene se encuentra conservado. El manejo clásico en adultos se fundamenta en la angiografía terapéutica, de mayor complejidad técnica y riesgo de hipoxia iatrogénica en el paciente pediátrico.

Uncovering iron regulation with species-specific transcriptome patterns in Atlantic and coho salmon during a Caligus rogercresseyi infestation.

Salmon species cultured in Chile evidence different levels of susceptibility to the sea louse Caligus rogercresseyi. These differences have mainly been associated with specific immune responses. Moreover, iron regulation seems to be an important mechanism to confer immunity during the host infestation. This response called nutritional immunity has been described in bacterial infections, despite that no comprehensive studies involving in marine ectoparasites infestation have been reported. With this aim, we analysed the transcriptome profiles of Atlantic and coho salmon infected with C. rogercresseyi to evidence modulation of the iron metabolism as a proxy of nutritional immune responses. Whole transcriptome sequencing was performed in samples of skin and head kidney from Atlantic and coho salmon infected with sea lice. RNA-seq analyses revealed significant upregulation of transcripts in both salmon species at 7 and 14 dpi in skin and head kidney, respectively. However, iron regulation transcripts were differentially modulated, evidencing species-specific expression profiles. Genes related to heme degradation and iron transport such as hepcidin, transferrin and haptoglobin were primary upregulated in Atlantic salmon; meanwhile, in coho salmon, genes associated with heme biosynthesis were strongly transcribed. In summary, Atlantic salmon, which are more susceptible to infestation, presented molecular mechanisms to deplete cellular iron availability, suggesting putative mechanisms of nutritional immunity. In contrast, resistant coho salmon were less affected by sea lice, mainly activating pro-inflammatory mechanisms to cope with infestation.

An oxidative burst and its attenuation by bacterial peroxidase activity is required for optimal establishment of the Arachis hypogaea-Bradyrhizobium sp. symbiosis.

AIMS: The main purpose of this study was to determine whether the Arachis hypogaea L. root oxidative burst, produced at early stages of its symbiotic interaction with Bradyrhizobium sp. SEMIA 6144, and the bacterial antioxidant system are required for the successful development of this interaction. METHODS AND RESULTS: Pharmacological approaches were used to reduce both plant oxidative burst and bacterial peroxidase enzyme activity. In plants whose H2 O2 levels were decreased, a low nodule number, a reduction in the proportion of red nodules (%) and an increase in the bacteroid density were found. The symbiotic phenotype of plants inoculated with a Bradyrhizobium sp. SEMIA 6144 culture showing decreased peroxidase activity was also affected, since the biomass production, nodule number and percentage of red nodules in these plants were lower than in plants inoculated with Bradyrhizobium sp. control cultures. CONCLUSIONS: We demonstrated for the first time that the oxidative burst triggered at the early events of the symbiotic interaction in peanut, is a prerequisite for the efficient development of root nodules, and that the antioxidant system of bradyrhizobial peanut symbionts, particularly the activity of peroxidases, is counteracting this oxidative burst for the successful establishment of the symbiosis. SIGNIFICANCE AND IMPACT OF THE STUDY: Our results provide new insights into the mechanisms involved in the development of the symbiotic interaction established in A. hypogaea L. a legume infected in an intercellular way.

Measurement of mean thickness of transparent samples using simultaneous phase shifting interferometry with four interferograms.

In this research a novel interferometric system is reported, which allows the generation of four simultaneous interferograms with phase shifts of π/2. The system consists of three coupled interferometers: a rectangular Sagnac interferometer which generates a primary pattern with crossed circular polarizations, coupled to two Michelson interferometers which operate as a multiplexing system, and generating replicas of the primary pattern. The two coupled Michelson interferometers generate four patterns retaining their polarization properties, which allow independent phase shifts by placing a linear polarizer over each pattern, thereby, four interferograms with relative phase shifts of π/2 are obtained. The optical phase is calculated using the well-known four-step algorithm. With knowledge of the optical phase, different properties of the samples can be calculated or analyzed; in this case, by knowing the mean refractive index, we can calculate the mean thickness of test objects. The results obtained for static transparent samples are presented. The capability of the system to analyze dynamic events is shown when results for the calculation of a temperature field of a heat flow are presented.

One-shot phase stepping with a pulsed laser and modulation of polarization: application to speckle interferometry.

For applications involving time varying optical phase distributions, fast cameras and/or pulsed lasers have to be used. To apply phase-shifting interferometry techniques (PSI) as well, single shot capture is required. Among others, modulation of polarization and phase grating interferometry is a possible technique to be considered. In this paper, a report about the use of this technique based on a double pulse laser system is presented. Single-pulse and twin-pulse operations are considered both in optical interferometers as well as in ESPI systems (mainly in subtraction mode). In ESPI a reduction of the degree of polarization appears due to scattering, so some measures have to be taken to prevent such deletereous effect. To show the feasibility of the proposed variants some experimental results are presented.

Role of reactive oxygen species generation and Nod factors during the early symbiotic interaction between bradyrhizobia and peanut, a legume infected by crack entry.

AIMS: We evaluated whether reactive oxygen species (ROS) production and the plant antioxidant system are involved in the symbiotic interaction between bradyrhizobia and legumes infected by crack entry, without intracellular infection threads (IT) formation, such as Arachis hypogaea L. (peanut). The role of bradyrhizobial Nod factors (NF) in modulating the plants' oxidative burst was also analysed. METHODS AND RESULTS: Histochemical and quantitative procedures were used to detect ROS levels in inoculated and in NF-treated peanut roots. Increase in root H2O2 production was determined at 10 min postinoculation with Bradyrhizobium sp. SEMIA 6144 or after NF addition. ROS production was modulated by NF. From 15 to 30 min postinoculation, the compatibility of Bradyrhizobium sp.-peanut interaction depends mostly on the H2O2 detoxification via catalase. CONCLUSIONS: We demonstrated for the first time that the early events of the symbiotic interaction in legumes invaded by crack entry trigger an increase in ROS production (represented exclusively by a higher H2O2 content) in which NADPH-oxidase seems not to be involved. NF modulate this response by enhancing the plant antioxidant machinery, contributing to the creation of adequate conditions for symbiosis development. SIGNIFICANCE AND IMPACT OF THE STUDY: Our data provide new insights into the mechanism involves in the symbiotic interaction that establish legumes infected by crack entry and suggest that ROS response shows differences compared with legumes invaded by IT formation.

[Uroflowmetric review of pediatric distal urethroplasty]. / Revisión uroflujométrica de pacientes intervenidos de hipospadias distales.

INTRODUCTION: Urethral stricture is the most common complication in hypospadias surgery. The monitoring of operated patients allows rapid detection of this complication and the uroflowmetry is the main diagnostic method. OBJECTIVES: To study of functional results in patients who underwent distal urethroplasty, using uroflowmetry. PATIENTS AND METHODS: A retrospective chart review was conducted of 81 patients who underwent distal hypospadias repair (7 coronal, 51 subcoronal and 23 distal penile shaft) and a postoperatory uroflowmetric study. The patients were divided into two groups, in each type of hypospadias, according to the presence or absence of stenotic complications (0 coronal, 10 subcoronal and 5 distal penile shaft). The functional effects in both groups were studied. RESULTS: All patients with stenotic complications showed maximum flow rates and mean flow rates below 15 and 20 percentiles respectively and a plateauing layout of the urinary flow curve. The treatment of these conditions resulted in the normalization of the maximum flow values ​​(in 100% of the subcoronal and 100% of the distal penile shaft hypospadias), as well as in the mean flow values ​​(in 88% of the subcoronal and 75% of the distal penile shaft hypospadias). The curve also adapted a bell-shaped in 100% of the H. coronal and 50% of the H. distal penile shaft. The uroflowmetry presented a spontaneous improvement in all patients without stenotic complications but with low flows in their first uroflowmetric. CONCLUSIONS: Uroflowmetry is an objective method for the evaluation of hypospadias surgery, being easy to perform, noninvasive and reliable. Obstructed uroflow patterns point to the presence of a stenotic complication.

INTRODUCCION: La estenosis uretral es la complicación más frecuente de la cirugía del hipospadias. El seguimiento de los pacientes intervenidos permite su rápida detección, siendo la uroflujometría su principal método diagnóstico. OBJETIVOS: Estudiar la repercusión funcional, mediante la uroflujometría, en pacientes intervenidos de hipospadias distal. MATERIALES Y METODOS: Se presenta un estudio descriptivo, retrospectivo, en el que se revisaron las historias clínicas de 81 pacientes intervenidos de hipospadias distal (7 balánicos, 51 balanopeneanos y 23 peneanos anteriores) y a los que les realizaron estudios uroflujométricos. En cada tipo de hipospadias, se dividieron los pacientes en dos grupos según la presencia de complicaciones estenóticas (0 balánicos, 10 balanopeneanos y 5 peneanos anteriores) o la ausencia de estas y se estudiaron las repercusiones funcionales en ambos grupos. RESULTADOS: Todos aquellos pacientes con complicaciones estenóticas presentaron flujos máximos y medios por debajo de los percentiles 15 y 20 respectivamente, así como un trazado de la curva anormal. El tratamiento de estas complicaciones estenóticas se tradujeron en una normalización tanto en los valores de flujo máximo (en el 100% de los hipospadias balanopeneanos y en el 100% de los hipospadias peneanos anteriores), como en los valores de flujo medio (en el 88% de los hipospadias balanopeneanos y el 75% de los hipospadias peneanos anteriores). La curva, además, adaptó un trazado en forma de campana en el 100% de los hipospadias balanopeneanos y el 50% de los hipospadias peneanos anteriores. Se detectó una mejoría uroflujométrica espontánea en aquellos pacientes que, sin complicaciones estenóticas, presentaron en su primer control uroflujométrico flujos bajos. CONCLUSIONES: La uroflujometría es un método objetivo para la evaluación de la cirugía del hipospadias, siendo una técnica fácil, reproducible y no invasiva. Los parámetros uroflujométricos bajos indican la presencia de una complicación estenótica.

[Infantile hypertrofic pyloric stenosis or gastric adenomyoma? Differential diagnosis of gastric outlet obstruction in children]. / ¿Estenosis hipertrófica de píloro o adenomioma pilórico? Diagnóstico diferencial de obstrucción gástrica en niños.

PURPOSE: Gastrointestinal adenomyoma is a rare benign tumor most frequently located in the stomach. The differential diagnosis is wide because of its large clinical spectrum and unspecific radiological findings. Surgical excision is both diagnostic and therapeutic. CASE REPORT: A 49-days old girl presented with nonbilious vomiting of 48 hours of evolution. Infantile hypertrofic pyloric stenosis was suspected. Ultrasound showed a nonobstructive nodular lesion in the anterior pyloric wall. MRI suggested a myofibroblastic tumor. We proceeded to laparotomy and complete resection of the pyloric tumor. Histologic diagnosis was gastric adenomyoma. CONCLUSIONS: Pyloric adenomyoma causes obstructive symptoms similar to other common entities such as hypertrophic pyloric stenosis or cystic duplication. We have to consider this condition in children with digestive symptoms and radiological images of intussusceptions or duplication. Surgical excision is recommended to reach a definitive diagnosis and to avoid a possible malignant degeneration.

INTRODUCCION: El adenomioma gastrointestinal es una tumoración benigna rara cuya localización más frecuente es gástrica. Su diagnóstico diferencial es amplio debido a su gran espectro clínico y baja especificidad radiológica. La escisión quirúrgica es diagnóstico-terapeútica. CASO CLINICO: Niña de 49 días que presenta vómitos no biliosos de 48 horas de evolución. Ante sospecha de estenosis hipertrófica de píloro se solicita ecografía que muestra lesión nodular no obstructiva en pared anterior del píloro. Se realiza RM sugestiva de tumor miofibroblástico. Se procede a laparotomía y resección completa de tumoración pilórica, informada histológicamente como adenomioma gástrico. COMENTARIOS: El adenomioma pilórico produce clínica obstructiva y se confunde con entidades comunes como la estenosis hipertrófica de píloro o la duplicación quística. En un niño con síntomas digestivos e imagen radiológica de invaginación o duplicación, debemos tener en cuenta esta patología. La resección quirúrgica es de elección para un diagnóstico certero y para evitar una posible degeneración maligna.

Solar wind thermally induced magnetic fluctuations.

A kinetic description of Alfvén-cyclotron magnetic fluctuations for anisotropic electron-proton quasistable plasmas is studied. An analytical treatment, based on the fluctuation-dissipation theorem, consistently shows that spontaneous fluctuations in plasmas with stable distributions significantly contribute to the observed magnetic fluctuations in the solar wind, as seen, for example, in [S. D. Bale et al., Phys. Rev. Lett. 103, 211101 (2009)], even far below from the instability thresholds. Furthermore, these results, which do not require any adjustable parameters or wave excitations, are consistent with the results provided by hybrid simulations. It is expected that this analysis contributes to our understanding of the nature of magnetic fluctuations in the solar wind.

TLR and IMD signaling pathways from Caligus rogercresseyi (Crustacea: Copepoda): in silico gene expression and SNPs discovery.

The Toll and IMD signaling pathways represent one of the first lines of innate immune defense in invertebrates like Drosophila. However, for crustaceans like Caligus rogercresseyi, there is very little genomic information and, consequently, understanding of immune mechanisms. Massive sequencing data obtained for three developmental stages of C. rogercresseyi were used to evaluate in silico the expression patterns and presence of SNPs variants in genes involved in the Toll and IMD pathways. Through RNA-seq analysis, which used 20 contigs corresponding to relevant genes of the Toll and IMD pathways, an overexpression of genes linked to the Toll pathway, such as toll3 and Dorsal, were observed in the copepod stage. For the chalimus and adult stages, overexpression of genes in both pathways, such as Akirin and Tollip and IAP and Toll9, respectively, were observed. On the other hand, PCA statistical analysis inferred that in the chalimus and adult stages, the immune response mechanism was more developed, as evidenced by a relation between these two stages and the genes of both pathways. Moreover, 136 SNPs were identified for 20 contigs in genes of the Toll and IMD pathways. This study provides transcriptomic information about the immune response mechanisms of Caligus, thus providing a foundation for the development of new control strategies through blocking the innate immune response.

[Enterocolitis episodes in patients who have previously undergone Hirschsprung disease surgery]. / Episodios de enterocolitis postoperatorios en pacientes intervenidos de enfermedad de Hirschsprung.

OBJECTIVES: To highlight the risk factors for the occurrence of this complication in order to achieve an early diagnosis. METHODS: Retrospective descriptive study in which the medical records of patients diagnosed with enterocolitis and who have previously undergone surgery for Hirschsprung's disease in a tertiary hospital from 1994 to 2013, inclusive (N=29), were reviewed. Epidemiological, surgical and clinical data from two groups of patients: Group A (6 patients with ECPD) and Group B (23 patients without ECPD) were compared. Enterocolitis episode data in the Group A were studied too. RESULTS: The incidence of an episode of ECPD was 20.6% and the incidence of two episodes of ECPD was 33.3%. The onset occurred at 12.17 months (SD 13.04) after pull-through procedure. The incidence was higher in patients operated at a younger age [10 months in Group A [6-16] versus 14 months in the group B (1-153)] and in those patients with the longest segment resected [23.20 cm in group A (DS 10,52) versus 19.20 cm in group B (DS 6.92)]. No patient with a discharge colostomy before pull-through surgery showed this complication. It must be highlighted the highest incidence in patients undergone by Swenson's technique (25%) compared to other surgical techniques (Georgeson (15.80%), Soave (0%)). CONCLUSION: Just the length of the resected segment and the patient's age at the time of the pull-through procedure appear to influence the outcome. It is considered advisable to be extremely vigilant in children operated at an early age and subjected to extensive intestinal resection for an early diagnosis and establishment of a treatment to avoid high morbidity.

OBJETIVOS: Identificar los factores de riesgo de la aparición de esta complicación para conseguir un diagnóstico precoz. MATERIAL Y METODOS: Estudio descriptivo retrospectivo en el que se revisan las historias clínicas de pacientes diagnosticados de enterocolitis e intervenidos previamente de la enfermedad de Hirschsprung en un hospital de tercer nivel desde 1994 hasta el 2013, ambos inclusive (N=29). Se comparan datos epidemiológicos, quirúrgicos y clínicos entre dos grupos de pacientes: grupo A (6 pacientes con enterocolitis postdescenso abdómino-perineal (ECPD) y grupo B (23 pacientes sin ECPD). Se estudian, además, los datos sobre el episodio de ECPD en el grupo A. RESULTADOS: La incidencia de un episodio de ECPD fue de 20,6% y la incidencia de dos episodios de ECPD fue de 33,3%. El inicio del cuadro se produjo a los 12,17 meses (DS 13,04) tras la cirugía. Su incidencia fue más alta en aquellos pacientes intervenidos con menor edad [10 meses en el Grupo A (6-16) frente a 14 meses en el grupo B (1-153)] y con mayor longitud del segmento resecado [23,20 cm del grupo A (DS 10,52) frente a 19,20 cm del grupo B (DS 6,92)]. Ningún paciente portador de una colostomía de descarga previa a la cirugía de descenso presentó esta complicación. Destaca, además, la mayor incidencia en pacientes intervenidos mediante la técnica de Swenson (25%) frente a otras técnicas quirúrgicas [Georgeson (15,80%), Soave (0%)]. CONCLUSION: Solo la longitud del segmento resecado y la edad del paciente en el momento de la cirugía de descenso parecen influir en la evolución de los pacientes. Se considera aconsejable extremar la vigilancia en los niños intervenidos a edades tempranas y sometidos a una resección intestinal amplia para realizar un diagnostico precoz e instaurar un tratamiento precoz que evite su alta morbilidad.

[Compressive anterior thoracoplasty (modified Abramson's repair) for pectus carinatum repair]. / Toracoplastia anterior compresiva (técnica de Abramson modificada) para el tratamiento del pectus carinatum.

OBJECTIVES: For anterior protruding chest wall deformities treatment, mainly pectus carinatum, pediatric surgeons have been managing either orthotic methods or open surgical repairs. Anterior compressive thoracoplasty (Abramson's technique) has widened the therapeutic options. We describe herein a modification of this technique in the first reported Europen series. PATIENTS AND METHODS: From 2010 to 2012, a total of five patients (four male and one female) underwent a modified Abramson's technique to correct pectus carinatum or combined protrusion of the chest at our center. We report the operative technique used for these reconstructions. RESULTS: In all five cases, the operation was completed uneventfully and with excellent results either for the surgical team or the patients. Mean operative time was 190 minutes and hospitalization lasted for three to six days, at the time of analgesic drugs withdrawal. CONCLUSIONS: We consider the anterior compresive thorocoplasty (modified Abramson's technique) a safe and feasible method to correct protruding chest deformities, particularly in those patients with stiff chest or lack of compliance, in order to avoid the agressive open procedures.

INTRODUCCION: Entre las opciones terapéuticas para las deformidades anteriores del tórax, la cirugía pediátrica ha dispuesto de tratamientos ortóticos y de técnicas quirúrgicas "abiertas". La toracoplastia compresiva anterior se une a las anteriores y amplía las opciones terapéuticas. Se describe aquí esta técnica en lo que supone la primera serie europea comunicada. MATERIAL Y METODOS: Revisión retrospectiva de las toracoplastias por técnica de Abramson modificada para el tratamiento del pectus carinatum y protrusiones costales en nuestro servicio entre 2010 y 2012. Descripción de la técnica a partir de los primeros cinco casos completados de nuestra serie, cuatro varones y una mujer, con edades entre los 13 y los 19 años. RESULTADOS: En todos los casos la técnica se ha podido completar sin complicaciones intra o perioperatorias y con resultados excelentes, tanto para el equipo quirúrgico como para los pacientes. El tiempo operatorio medio ha sido de 190 minutos y el alta hospitalaria se ha conseguido entre los tres y seis días después de la intervención, una vez completado el control analgésico. CONCLUSIONES: Consideramos que la toracoplastia compresiva anterior es una técnica mínimamente invasiva para la corrección del pectus carinatum y deformidades afines que resulta particularmente útil en los casos en los que la rigidez del tórax impide la adopción de tratamientos ortopédicos, en casos de no aceptación del tratamiento ortótico o cuando la cirugía convencional se considera demasiado agresiva.

Economic losses due to foot-and-mouth disease (FMD) in Ethiopian cattle.

Ethiopia's cattle population is among the largest in Africa and is burdened by frequent foot-and-mouth disease (FMD) outbreaks. FMD is caused by several distinct and highly contagious viral strains that can result in acute disease in cattle, causing losses in productivity and impeding international trade. This economic simulation study considered four main sources of losses due to FMD in cattle: reduced milk yield, draft power yield, fertility, and increased mortality. Economic losses were estimated per case across age-sex strata in 89 Ethiopian administrative zones for the years 2010-2021 using a wide range of data to estimate distributions for 30 input variables in a series of Monte Carlo simulations. It was estimated that an average case of FMD in Ethiopian cattle results in losses (mean values reported followed 95 % confidence intervals in brackets) of US dollars (USD) 11 (USD 7-USD 16) per case. Losses resulting from an average outbreak were estimated to be USD 2300 (USD 1400-USD 3300), while national annual losses were estimated to be USD 0.9 Mil. (USD 0.2 Mil.-USD 2.3 Mil.). Per cow-year, based on a national cow population of approximately 39 Mil. head, these estimated annual losses are equivalent to losses of only USD 0.02 (USD 0.01-USD 0.06). Nationally, these losses were significantly less than previously estimated in the literature, with currently estimated losses more accurately reflecting the economic burden of FMD in Ethiopian cattle over the past decade. The relatively small estimated losses suggest that control efforts based on widespread vaccination in countries with primarily extensive cattle production systems, such as Ethiopia, are unlikely to be economically sound. Sensitivity analyses suggested losses would be far greater in intensive systems, and that certainty surrounding incidence rates is paramount to the formulation of economically sound animal healthpolicy in regions with endemic FMD.

[Abdominal lymphatic malformation (ALM). Our experience]. / Malformación linfática abdominal (MLA). Nuestra experiencia.

INTRODUCTION: Lymphatic malformations are congenital lesions usually placed in the head and neck, the abdominal location is infrequent. OBJECTIVES: Analyze our experience in ALM management. METHOD: Retrospective study of pediatric patients with ALM from 1996 to 2011. It is a descriptive analysis of clinical, diagnostic and therapeutic features. RESULTS: 10 patients with ALM were treated (6 girls: 4 boys), with a median age of 4.03 years (3 days-13 years). Acute abdomen was the most common presenting feature (40%). Ultrasound was carried out in all these cases, completing the study with CT (9 cases), MRI (1) or both (1). Treatment was surgical, excepting one case that presented infection of the ALM. The approach by laparotomy allowed total resection in all cases, involving bowel resection in 6. The mass was located in small bowel mesentery (6), mesocolon (1), liver (1), and in retroperitoneum (1). The final pathologic diagnosis showed an error in diagnostic imaging of 60%.The mean follow-up was 18 months (SD: 12.8), with not recurrences. CONCLUSIONS: ALM often manifests in a non-specific form and it may remain silent. Imaging studies guide the diagnosis, but only the histology provides a definitive result. Total resection is the best option to prevent recurrences and minimize complications.

Pediatric Surgery and University. / Cirugía Pediátrica y Universidad.

INTRODUCTION: Pediatric Surgery studies in Spanish universities are not regulated, and their situation varies significantly from one region to another. MATERIALS AND METHODS: A descriptive study by means of a survey directly addressed to the heads of the 47 Spanish healthcare units was carried out. RESULTS: Only 33 pediatric surgeons currently teach at the university level. Most of them are employed (associate professors) and assigned to non-surgical departments. The degree of teaching accreditation of these professionals is meager. CONCLUSION: It is necessary to reflect deeply on the absence of our specialty in universities and, conversely, on the scarce presence of university studies and research in healthcare units.

INTRODUCCION: Los estudios de Cirugía Pediátrica en las universidades del Estado Español no están reglados y su situación es muy variable de unas regiones a otras. MATERIAL Y METODOS: Estudio descriptivo a través de una encuesta dirigida directamente a los responsables de las 47 unidades asistenciales españolas. RESULTADOS: Tan solo 33 cirujanos pediátricos ejercen actualmente docencia universitaria, en su inmensa mayoría con vinculación laboral (profesores asociados) y adscritos en su mayoría a departamentos no quirúrgicos. El grado de acreditación docente de estos profesionales es muy bajo. CONCLUSIONES: Se hace necesaria una profunda reflexión sobre la ausencia de nuestra especialidad en las universidades y, viceversa, sobre la escasa presencia de los estudios universitarios y de la investigación en las unidades asistenciales.

[Duodenal bleeding due to metastasis from lung adenocarcinoma controlled by radiotherapy: A case report and literature review]. / Saignement duodénal dû à une métastase d'un cancer pulmonaire contrôlé par radiothérapie : cas clinique et revue de la littérature.

INTRODUCTION: Gastrointestinal (GI) metastases in lung cancer rarely occur. CASE REPORT: We report here the case of a 43-year-old male active smoker who was admitted to our hospital for cough, abdominal pain and melena. Initial investigations revealed poorly differentiated adenocarcinoma of the superior-right lobe of the lung: positive for thyroid transcription factor-1 and negative for protein p40 and for antigen CD56, with peritoneal, adrenal and cerebral metastasis, as well as anemia requiring major transfusion support. Over 50% of cells were positive for PDL-1, and ALK gene rearrangement was detected. GI endoscopy showed a large ulcerated nodular lesion of the genu superius with active intermittent bleeding, as well as an undifferentiated carcinoma with positivity for CK AE1/AE3 and TTF-1, and negativity for CD117, corresponding to metastatic invasion originating from lung carcinoma. Palliative immunotherapy with pembrolizumab was proposed, followed by targeted therapy with brigatinib. Gastrointestinal bleeding was controlled with a single 8Gy dose of haemostatic radiotherapy. CONCLUSION: GI metastases are rare in lung cancer and present nonspecific symptoms and signs but no characteristic endoscopic features. GI bleeding is a common revelatory complication. Pathological and immunohistological findings are critical to diagnosis. Local treatment is usually guided by the occurrence of complications. In addition to surgery and systemic therapies, palliative radiotherapy may contribute to bleeding control. However, it must be used cautiously, given a present-day lack of evidence and the pronounced radiosensitivity of certain gastrointestinal tract segments.