Simple radiologic assessment of visceral obesity and prediction of surgical morbidity in endometrial cancer patients undergoing laparoscopic aortic lymphadenectomy: A reliability and accuracy study.

AIM: To evaluate the reliability of sagittal abdominal diameter (SAD)-a surrogate of visceral obesity-in magnetic resonance imaging, and its accuracy to predict the surgical morbidity of aortic lymphadenectomy. METHODS: We conducted a multicenter reliability (phase 1) and accuracy (phase 2) cohort study in three Spanish referral hospitals. We retrospectively analyzed data from the STELLA-2 randomized controlled trial that included high-risk endometrial cancer patients undergoing minimally invasive surgical staging. Patients were classified into subgroups: conventional versus robotic-assisted laparoscopy, and transperitoneal versus extraperitoneal technique. In the first phase, we measured the agreement of three SAD measurements (at the umbilicus, renal vein, and inferior mesenteric artery) and selected the most reliable one. In phase 2, we evaluated the diagnostic accuracy of SAD to predict surgical morbidity. Surgical morbidity was the main outcome measure, it was defined by a core outcome set including variables related to blood loss, operative time, surgical complications, and para-aortic lymphadenectomy difficulty. RESULTS: In phase 1, all measurements showed good inter-rater and intra-rater agreement. Umbilical SAD (u-SAD) was the most reliable one. In phase 2, we included 136 patients. u-SAD had a good diagnostic accuracy to predict surgical morbidity in patients undergoing transperitoneal laparoscopic lymphadenectomy (0.73 in ROC curve). It performed better than body mass index and other anthropometric measurements. We calculated a cut-off point of 246 mm (sensitivity: 0.56, specificity: 0.80). CONCLUSIONS: u-SAD is a simple, reliable, and potentially useful measurement to predict surgical morbidity in endometrial cancer patients undergoing minimally invasive surgical staging, especially when facing transperitoneal aortic lymphadenectomy.

A multidisciplinary approach to identify priority areas for the monitoring of a vulnerable family of fishes in Spanish Marine National Parks.

BACKGROUND: Syngnathid fishes (Actinopterygii, Syngnathidae) are flagship species strongly associated with seaweed and seagrass habitats. Seahorses and pipefishes are highly vulnerable to anthropogenic and environmental disturbances, but most species are currently Data Deficient according to the IUCN (2019), requiring more biological and ecological research. This study provides the first insights into syngnathid populations in the two marine Spanish National Parks (PNIA-Atlantic- and PNAC-Mediterranean). Fishes were collected periodically, marked, morphologically identified, analysed for size, weight, sex and sexual maturity, and sampled for stable isotope and genetic identification. Due the scarcity of previous information, habitat characteristics were also assessed in PNIA. RESULTS: Syngnathid diversity and abundance were low, with two species identified in PNIA (Hippocampus guttulatus and Syngnathus acus) and four in PNAC (S. abaster, S. acus, S. typhle and Nerophis maculatus). Syngnathids from both National Parks (NP) differed isotopically, with much lower δ15N in PNAC than in PNIA. The dominant species were S. abaster in PNAC and S. acus in PNIA. Syngnathids preferred less exposed sites in macroalgal assemblages in PNIA and Cymodocea meadows in PNAC. The occurrence of very large specimens, the absence of small-medium sizes and the isotopic comparison with a nearby population suggest that the population of Syngnathus acus (the dominant syngnathid in PNIA) mainly comprised breeders that migrate seasonally. Mitochondrial cytochrome b sequence variants were detected for H. guttulatus, S. acus, and S. abaster, and a novel 16S rDNA haplotype was obtained in N. maculatus. Our data suggest the presence of a cryptic divergent mitochondrial lineage of Syngnathus abaster species in PNAC. CONCLUSIONS: This is the first multidisciplinary approach to the study of syngnathids in Spanish marine NPs. Habitat preferences and population characteristics in both NPs differed. Further studies are needed to assess the occurrence of a species complex for S. abaster, discarding potential misidentifications of genus Syngnathus in PNAC, and evaluate migratory events in PNIA. We propose several preferential sites in both NPs for future monitoring of syngnathid populations and some recommendations for their conservation.

Screening for antimicrobial activity of ten medicinal plants used in Colombian folkloric medicine: a possible alternative in the treatment of non-nosocomial infections.

BACKGROUND: The antimicrobial activity and Minimal Inhibitory Concentration (MIC) of the extracts of Bidens pilosa L., Bixa orellana L., Cecropia peltata L., Cinchona officinalis L., Gliricidia sepium H.B. & K, Jacaranda mimosifolia D.Don, Justicia secunda Vahl., Piper pulchrum C.DC, P. paniculata L. and Spilanthes americana Hieron were evaluated against five bacteria (Staphylococcus aureus, Streptococcus beta hemolític, Bacillus cereus, Pseudomonas aeruginosa, and Escherichia coli), and one yeast (Candida albicans). These plants are used in Colombian folk medicine to treat infections of microbial origin. METHODS: Plants were collected by farmers and traditional healers. The ethanol, hexane and water extracts were obtained by standard methods. The antimicrobial activity was found by using a modified agar well diffusion method. All microorganisms were obtained from the American Type Culture Collection (ATCC). MIC was determined in the plant extracts that showed some efficacy against the tested microorganisms. Gentamycin sulfate (1.0 microg/ml), clindamycin (0.3 microg/ml) and nystatin (1.0 microg/ml) were used as positive controls. RESULTS: The water extracts of Bidens pilosa L., Jacaranda mimosifolia D.Don, and Piper pulchrum C.DC showed a higher activity against Bacillus cereus and Escherichia coli than gentamycin sulfate. Similarly, the ethanol extracts of all species were active against Staphylococcus aureus except for Justicia secunda. Furthermore, Bixa orellana L, Justicia secunda Vahl. and Piper pulchrum C.DC presented the lowest MICs against Escherichia coli (0.8, 0.6 and 0.6 microg/ml, respectively) compared to gentamycin sulfate (0.9 8 g/ml). Likewise, Justicia secunda and Piper pulchrum C.DC showed an analogous MIC against Candida albicans (0.5 and 0.6 microg/ml, respectively) compared to nystatin (0.6 microg/ml). Bixa orellana L, exhibited a better MIC against Bacillus cereus (0.2 microg/ml) than gentamycin sulfate (0.5 microg/ml). CONCLUSION: This in vitro study corroborated the antimicrobial activity of the selected plants used in folkloric medicine. All these plants were effective against three or more of the pathogenic microorganisms. However, they were ineffective against Streptococcus beta hemolytic and Pseudomonas aeruginosa. Their medicinal use in infections associated with these two species is not recommended. This study also showed that Bixa orellana L, Justicia secunda Vahl. and Piper pulchrum C.DC could be potential sources of new antimicrobial agents.

Análisis participativo de la situación de la salud del Departamento Ancasti, provincia de Catamarca / Participative analysis of the health situation in the department of Ancasti, province of Catamarca

La heterogeneidad desde el punto de vista político, cultural,productivo, geográfico y poblacional del DepartamentoAncasti, Provincia de Catamarca, representa un llamado deatención respecto a la articulación del sistema sanitario de laProvincia con el ámbito rural. Por ello el objetivo del presentetrabajo fue describir la situación de salud del DepartamentoAncasti en relación a la opinión que tienen los pobladores delos determinantes del proceso salud/enfermedad/atención ya la capacidad de gestión de los efectores locales.La investigación que se describe vinculó las opinionesde los usuarios de los servicios de salud de una zona ruralde Catamarca con la capacidad de gestión de su propiosistema sanitario. Para el desarrollo de la investigación, seconsideraron marcos teóricos que caracterizaron el territoriorural de manera integral; de esta manera, durante el año 2009se realizó un estudio descriptivo de corte transversal queincluyó a la población a los efectores a través de las variables oferta de servicios, demanda de servicios.

Análisis participativo de la situación de salud del Departamento Ancasti / Participatory analysis of the health situation of the Department Ancasti

Analizar de la construcción de los sistemas de salud en determinados contextos demanda esfuerzos teóricos y metodológicos para incluir diferentes visiones respecto a los procesos salud-enfermedad-atención y a las opciones que la programación local debe considerar para garantizar la implementación exitosa de las políticas sanitarias en contextos heterogéneos. Esta investigación estuvo orientada a determinar si la oferta de servicios sanitarios de Departamento Ancasti – Provincia de Catamarca coincidía con la construcción que, respecto a la demanda de atención, tienen sus pobladores. Para eso, serealizó un estudio descriptivo de corte transversal que incluyó a la población y a los efectores a través de las variables ‘oferta de servicios’ / ‘demanda de atención’. El relevamiento de información fue a través de un modelo de encuestas que incluyó categorías de análisis para el primer de atención.

Análisis participativo de la situación de salud del Departamento Ancasti-Provincia de Catamarca / Participatory analysis of health status-Ancasti Department Catamarca Province

Analizar de la construcción de los sistemas de salud en determinados contextos demanda esfuerzos teóricos y metodológicos para incluir diferentes visiones respecto a los procesos salud-enfermedad-atención y a las opciones que la programación local debe considerar para garantizar la implementación exitosa de las políticas sanitarias en contextos heterogéneos. Esta investigación estuvo orientada a determinar si la oferta de servicios sanitarios de Departamento Ancasti – Provincia de Catamarca coincidía con la construcción que, respecto a la demanda de atención, tienen sus pobladores. Para eso, serealizó un estudio descriptivo de corte transversal que incluyó a la población y a los efectores a través de las variables ‘oferta de servicios’ / ‘demanda de atención’. El relevamiento de información fue a través de un modelo de encuestas que incluyó categorías de análisis para el primer de atención.