Dispersal of Late Triassic clam shrimps across Pangea linking northwestern Gondwana and central Pangea rift basins.

Clam shrimps are a group of freshwater crustaceans who prospered during the Late Triassic. They were abundant in lacustrine sedimentary records of continental basins distributed throughout Pangea during this time. However, they show significant taxonomic differences between the clamp shrimp faunas from the rift basins of central Pangea and the southern Gondwanan basins. In this contribution, we show new fossil clam shrimp assemblages from the lacustrine sedimentary successions of the Eastern Cordillera of Colombia (the Bocas and Montebel formations), providing information on the Late Triassic species that inhabited the northwestern Gondwana basins. This study demonstrates that the basins of northwestern Gondwana shared Norian clamp shrimp species with rift basins of central Pangea and differed in their faunas with the basins of the southern portion of Gondwana. In addition, the Late Triassic clam shrimps paleobiogeographic distribution reflects the dispersal of this fauna throughout fluvial-lacustrine environments established in the rift valleys along the central Pangea. Therefore, the rift valleys produced during the early fragmentation of central Pangea could have acted as corridors for dispersion. Simultaneously, rift valleys also provided paleobiogeographic barriers that isolated the central Pangea clam shrimp faunas from southern Gondwana.

Synthesis, docking study and relaxant effect of 2-alkyl and 2-naphthylchromones on rat aorta and guinea-pig trachea through phosphodiesterase inhibition.

Chromone (4), which form the base structure of various flavonoids isolated as natural products, is capable of relaxing smooth muscle. This is relevant to the treatment of high blood pressure, asthma and chronic obstructive pulmonary disease. The former disorder involves the contraction of vascular smooth muscle (VSM), and the latter two bronchoconstriction of airway smooth muscle (ASM). One of the principal mechanisms by which flavonoids relax muscle tissue is the inhibition of phosphodiesterases (PDEs), present in both VSM and ASM. Therefore, a study was designed to analyze the structure-activity relationship of chromone derivatives in vaso- and bronchorelaxation through the inhibition of PDE. Docking studies showed that these chromones bind at the catalytic site of PDEs. Consequently, we synthesized analogs of chromones substituted at position C-2 with alkyl and naphthyl groups. These compounds were synthesized from 2-hydroxyacetophenone and acyl chlorides in the presence of DBU and pyridine, modifying the methodology reported for the synthesis of 3-acylchromones by changing the reaction temperature from 80 to 30°C and using methylene chloride as solvent, yielding the corresponding phenolic esters 10a-10h. These compounds were cyclized with an equivalent of DBU, pyridine as solvent, and heated at reflux temperature, yielding the chromones 11a-11h. Evaluation of the vasorelaxant effect of 4, 11a-11h on rat aorta demonstrated that potency decreases with branched alkyl groups. Whereas the EC50 of compound 11d (substituted by an n-hexyl group) was 8.64±0.39 µM, that of 11f (substituted by an isobutyl group) was 14.58±0.64 µM. Contrarily, the effectiveness of the compound is directly proportional to the length of the alkyl chain, as evidenced by the increase in maximal effect of compound 11c versus 11d (66% versus 100%) and 11e versus 11f (60% versus 96%). With an aromatic group like naphthyl as the C-2 substituent, the effectiveness was only 43%. All compounds tested on guinea pig trachea showed less than 55% effectiveness. Compounds 4, 11a-11h were evaluated as PDE inhibitors in vitro, with 11d showing the greatest effect (73%), corroborating the importance of a long alkyl chain, which inhibits the decomposition of cGMP. Docking studies showed that the compound 11d was selective for the inhibition of PDE-5.

Neurosurgical emergency management during the lockdown period in health care regions in Spain with different COVID-19 impact: lessons learned to improve outcomes on the future waves.

BACKGROUND: COVID-19 has overloaded health care systems, testing the capacity and response in every European region. Concerns were raised regarding the impact of resources' reorganization on certain emergency pathology management. The aim of the present study was to assess the impact of the outbreak (in terms of reduction of neurosurgical emergencies) during lockdown in different regions of Spain. METHODS: We analyzed the impact of the outbreak in four different affected regions by descriptive statistics and univariate comparison with same period of two previous years. These regions differed in their incidence level (high/low) and in the time of excess mortality with respect to lockdown declaration. That allowed us to analyze their influence on the characteristics of neurosurgical emergencies registered for every region. RESULTS: 1185 patients from 18 neurosurgical centers were included. Neurosurgical emergencies that underwent surgery dropped 24.41% and 28.15% in 2020 when compared with 2019 and 2018, respectively. A higher reduction was reported for the most affected regions by COVID-19. Non-traumatic spine experienced the most significant decrease in number of cases. Life-threatening conditions did not suffer a reduction in any health care region. CONCLUSIONS: COVID-19 affected dramatically the neurosurgical emergency management. The most significant reduction in neurosurgical emergencies occurred on those regions that were hit unexpectedly by the pandemic, as resources were focused on fighting the virus. As a consequence, life-threating and non-life-threatening conditions' mortality raised. Results in regions who had time to prepare for the hit were congruent with an organized and sensible neurosurgical decision-making.

Possible Association between Selected Tick-Borne Pathogen Prevalence and Rhipicephalus sanguineus sensu lato Infestation in Dogs from Juarez City (Chihuahua), Northwest Mexico-US Border.

Tick-borne bacterial pathogens (TBBPs) show a worldwide distribution and represent a great impact on public health. The brown dog tick (Rhipicephalus sanguineus) is a vector of several pathogens that affect dogs and sometimes humans as well. In addition, TBBPs represent a diagnostic challenge and imply financial resources and medical treatment for long periods of time. In the present study, R. sanguineus s. l. was identified as the main tick species naturally parasitizing dogs that inhabit. Juárez City, Chihuahua, in the Paso del Norte region, Mexico-US Border, representing 99.8% of the cases. Additionally, an end-point PCR was performed to search for whether pathogens in R. sanguineus s. l. can transmit in DNA extracted from ticks and dog blood samples. This is the first molecular detection of Rickettsia rickettsi infecting domestic dogs in Mexico; however, other pathogens were also identified, such as Ehrlichia canis and Anaplasma platys in both ticks and dog blood samples, while Anaplasma phagocytophilum was identified only in dog blood samples. Moreover, co-detection in tick pools and co-infection in the analyzed dog blood samples could be found. Similarly, this research showed that dogs were found mostly parasitized by adult female ticks, increasing the possibility of transmission of E. canis.

Mitochondrial DNA haplogroups J and T increase the risk of glioma.

The presence of different sets of mitochondrial polymorphisms generated by the accumulation of mutations in different maternal lineages has allowed differentiating mitochondrial haplogroups in human populations. These polymorphisms, in turn, may have effects at the phenotypic level, considering a possible contribution of these germinal mutations to the development of certain diseases such as cancer. The main goal of the present study is to establish a possible association between mitochondrial haplogroups and the risk of suffering glioma. Blood samples were obtained from 32 patients from Catalonia (Spain) diagnosed with different grades of glioma (II, III and IV), according to the World Health Organization. The mitochondrial genome was amplified and sequenced using MiSeq 2000 (Illumina). The HaploGrep tool implemented in mtDNA-Server v.1.0.5 was used for the identification of mitochondrial haplogroups. Data obtained in the present study was further pooled with data from previous European studies including glioma patients from Galicia (Spain) and Italy. Results for the Catalonian samples showed an association between individuals with haplogroup J and the increased risk of suffering glioma, with a significant increase of the frequency of individuals with this haplogroup (25%) regarding the general population (7%). Combining different sets of patients with European origin, it appears that individuals with haplogroups J and T have a significantly higher risk of suffering glioma (p < 0.001; OR: 2.407 and p = 0.007; OR: 1.82, respectively). This is the first study that establishes an association between different mitochondrial haplogroups and the risk of suffering glioma, highlighting the role of mitochondrial variants in this disease.

Molecular Detection of Tick-Borne Pathogens in American Bison (Bison bison) at El Uno Ecological Reserve, Janos, Chihuahua, Mexico.

American bison (Bison bison) is listed as near-threatened and in danger of extinction in Mexico. Recent studies have demonstrated the presence of several emerging pathogens at the Janos Biosphere Reserve (JBR), inhabited by one wild herd of American bison. Blood samples were collected from 26 American bison in the JBR. We tested for the presence of Anaplasma marginale, Babesia bigemina, B. bovis, Borrelia burgdorferi sensu lato, and Rickettsia rickettsii DNA using nested and semi-nested PCR protocols performing duplicates in two different laboratories. Results showed three animals (11.5%) positive for B. burgdorferi s. l., three more (11.5%) for Rickettsia rickettsii, and four (19.2%) for B. bovis. Two individuals were co-infected with B. burgdorferi s. l. and B. bovis. We found no animals positive for A. marginale and B. bigemina. This is the first report in America of R. rickettsii in American bison. American bison has been described as an important reservoir for pathogens of zoonotic and veterinary importance; thus, the presence of tick-borne pathogen DNA in the JBR American bison indicates the importance of continuous wildlife health surveys.

Detection of Antibodies to Lokern, Main Drain, St. Louis Encephalitis, and West Nile Viruses in Vertebrate Animals in Chihuahua, Guerrero, and Michoacán, Mexico.

We conducted serologic surveillance for flaviviruses and orthobunyaviruses in vertebrate animals in Mexico in 2018-2019. Sera were collected from 856 vertebrate animals, including 323 dogs, 223 horses, and 121 cows, from 16 species. The animals were from 3 states: Chihuahua in northwest Mexico (704 animals) and Guerrero and Michoacán on the Pacific Coast (27 and 125 animals, respectively). Sera were assayed by plaque reduction neutralization test using four flaviviruses (dengue type 2, St. Louis encephalitis, West Nile, and Zika viruses) and six orthobunyaviruses from the Bunyamwera (BUN) serogroup (Cache Valley, Lokern, Main Drain, Northway, Potosi, and Tensaw viruses). Antibodies to West Nile virus (WNV) were detected in 154 animals of 9 species, including 89 (39.9%) horses, 3 (21.4%) Indian peafowl, and 41 (12.7%) dogs. Antibodies to St. Louis encephalitis virus (SLEV) were detected in seven animals, including three (0.9%) dogs. Antibodies to Lokern virus (LOKV) were detected in 22 animals: 19 (8.5%) horses, 2 (1.7%) cows, and a dog (0.3%). Antibodies to Main Drain virus (MDV) were detected in three (1.3%) horses. WNV and LOKV activity was detected in all three states, SLEV activity was detected in Chihuahua and Michoacán, and MDV activity was detected in Chihuahua. None of the animals was seropositive for Cache Valley virus, the most common and widely distributed BUN serogroup virus in North America. In conclusion, we provide serologic evidence that select flaviviruses and BUN serogroup viruses infect vertebrate animals in Chihuahua, Guerrero, and Michoacán. We also provide the first evidence of LOKV and MDV activity in Mexico.

Demonstrating the presence of Ehrlichia canis DNA from different tissues of dogs with suspected subclinical ehrlichiosis.

BACKGROUND: Nowadays, Ehrlichia canis receives increasing attention because of its great morbidity and mortality in animals. Dogs in the subclinical and chronic phases can be asymptomatic, and serological tests show cross-reactivity and fail to differentiate between current and past infections. Moreover, there could be low parasitaemia, and E. canis might be found only in target organs, hence causing results to be negative by polymerase chain reaction (PCR) on blood samples. METHODS: We evaluated by PCR the prevalence of E. canis in blood, liver, spleen, lymph node and bone marrow samples of 59 recently euthanised dogs that had ticks but were clinically healthy. RESULTS: In total, 52.55% of the blood PCRs for E. canis were negative, yet 61.30% yielded positive results from tissue biopsies and were as follows: 63.15% from bone marrow; 52.63% from liver; 47.36% from spleen; and 15.78% from lymph node. In addition, 33% had infection in three tissues (spleen, liver and bone marrow). CONCLUSIONS: Our results show the prevalence of E. canis from tissues of dogs that were negative by blood PCR. Ehrlichia canis DNA in tissue was 30% lower in dogs that tested negative in PCR of blood samples compared to those that were positive. However, it must be taken into account that some dogs with negative results were positive for E. canis in other tissues.

Anatomic study of the central core of the cerebrum correlating 7-T magnetic resonance imaging and fiber dissection with the aid of a neuronavigation system.

BACKGROUND: Different strategies have been used to study the fiber tract anatomy of the human brain in vivo and ex vivo. Nevertheless, the ideal method to study white matter anatomy has yet to be determined because it should integrate information obtained from multiple sources. OBJECTIVE: We developed an anatomic method in cadaveric specimens to study the central core of the cerebrum combining traditional white matter dissection with high-resolution 7-T magnetic resonance imaging (MRI) of the same specimen coregistered using a neuronavigation system. METHODS: Ten cerebral hemispheres were prepared using the traditional Klingler technique. Before dissection, a structural ultrahigh magnetic field 7-T MRI study was performed on each hemisphere specifically prepared with surface fiducials for neuronavigation. The dissection was then performed from the medial hemispheric surface using the classic white fiber dissection technique. During each step of the dissection, the correlation between the anatomic findings and the 7-T MRI was evaluated with the neuronavigation system. RESULTS: The anatomic study was divided in 2 stages: diencephalic and limbic. The diencephalic stage included epithalamic, thalamic, hypothalamic, and subthalamic components. The limbic stage consisted of extending the dissection to complete the Papez circuit. The detailed information given by the combination of both methods allowed us to identify and validate the position of fibers that may be difficult to appreciate and dissect (ie, the medial forebrain bundle). CONCLUSION: The correlation of high-definition 7-T MRI and the white matter dissection technique with neuronavigation significantly improves the understanding of the structural connections in complex areas of the human cerebrum.

Evaluation of a Bochdalek diaphragmatic hernia rabbit model for pediatric thoracoscopic training.

BACKGROUND/AIM: This study evaluated the usefulness of a Bochdalek hernia rabbit model as a tool for advanced thoracoscopic training, teaching the specific skills required for thoracoscopic repair of congenital diaphragmatic hernia. MATERIALS AND METHODS: An incision was made in the Bochdalek triangle of 25 New Zealand rabbits (weighing 3-3.5 kg) to induce an experimental diaphragmatic hernia. At 72 hours later, a thoracoscopic repair of the hernia as described for newborns was performed by 25 pediatric surgeons divided into two groups: expert and novice. The tasks assessed were organ relocation and diaphragm suture. A visual analog scale was used to evaluate technical performance. The objective performance measure was completion time. Complications were recorded, and suture quality was scored. The surgeons evaluated the model by completing a questionnaire, grading items on a 5-point scale. RESULTS: All 25 animals developed a diaphragmatic hernia with protrusion of the intestine into the thoracic cavity. Expert trainees had significantly shorter completion times and better performance scores than novices. Experts also received higher scores for suture quality. Five novices caused perforations or bleeding, but no experts did. The surgeons rated the model positively, highlighting the similarities between the model and newborn hernias and its usefulness for pediatric training programs. CONCLUSIONS: The Bochdalek hernia rabbit model can be used to detect different levels of experience in pediatric thoracoscopy. This realistic and easily reproducible model can help to perfect thoracoscopic skills in a realistic recreation of a pediatric Bochdalek hernia repair.

Development of an optimal diaphragmatic hernia rabbit model for pediatric thoracoscopic training.

Our objectives were to standarize the procedure needed to reproduce a similar surgical scene which a pediatric surgeon would face on repairing a Bochdalek hernia in newborns and to define the optimal time period for hernia development that achieve a realistic surgical scenario with minimimal animal suffering. Twenty New Zealand white rabbits weighing 3-3.5 kg were divided into four groups depending on the time frame since hernia creation to thoracoscopic repair: 48 h, 72 h, 96 h and 30 days. Bochdalek trigono was identified and procedures for hernia creation and thoracoscopic repair were standarized. Blood was collected for hematology (red blood cells, white blood cells, platelets, hemoglobin and hematocrit), biochemistry (blood urea nitrogen, creatinine, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase and creatine kinase) and gas analysis (arterial blood pH, partial pressure of oxygen, partial pressure of carbón dioxide, oxygen saturation and bicarbonate) at baseline and before the surgial repairment. Glucocorticoid metabolites concentration in faeces was measured. Thoracoscopy video recordings were evaluated by six pediatric surgeons and rated from 0 to 10 according to similarities with congenital diaphragmatic hernia in newborn and with its thoracoscopic approach. Statistical methods included the analysis of variance, and comparisons between groups were followed by a post-hoc Tukey's test. Fourty -eight h showed to be the optimal time frame to obtain a diaphragmatic hernia similar to newborn scenario from a surgical point of view with minimal stress for the animals.

Caracterización clínica paraclínica y epidemiológica de los pacientes con Lupus Eritematoso Sistémico del Hospital Universitario Hernando Moncaleano Perdomo de Neiva / Clinical, paradinical and epidemiological characterization of patients with Systemic Lupus Erythematosus at Hospital Universitario Hernando Moncaleano Perdomo, from Neiva Huila

Objetivo: Caracterizar clínica paraclínica y epidemiológicamente el Lupus Eritematoso Sistèmico en los pacientes del Hospital Universitario Hernando Moncaleano Perdomo de Neiva Diseño: Descriptivo de corte transversal. Población: Pacientes atendidos en el Hospital Universitario de Neiva Hernando Moncaleano Perdomo con diagnóstico de lupus eritematoso sistèmico. Método: Recolección de datos a través de revisión documental de historias clínicas del Hospital Universitario de Enero 2009 a Enero 2014. Resultados: De un total de 104 pacientes con lupus eritematoso sistèmico encontrados en el periodo de estudio, la relación mujer: hombre fue de 5:1. Las comorbilidades de mayor frecuencia en el género femenino fueron la hipertensión arterial con un 26,7%, la fibromialgia con 12,7% y el síndrome de antifosfolípidos con 12, 7%; en el género masculino la hipertensión arterial, la fibromialgia y la falla cardiaca se presentaron cada una en un 27,7%. El 61,5% de las pacientes femeninas tuvieron manifestaciones en piel, el 51,1% refirieron artralgias y solo un 25,5% presentaron compromiso articular caracterizado por derrame sinovial. En los hombres las manifestaciones en piel estuvieron presentes en un 50%, las artralgias y el compromiso articular caracterizado por derrame sinovial fueron un 50% y 22,2% respectivamente. En los exámenes paraclínicos entre el 12,7% y el 31,4% de los pacientes tenían un lupus activo, determinado por la presencia de leucopenia, proteinuria y C3-C4 consumidos. En la muestra de pacientes femeninas las alteraciones paraclínicas más frecuentes se caracterizaron por hemoglobina <12 g/dl en 53,4% y trombocitopenia en 26,7%. Por su parte, 33,3% de los hombres presentaron trombocitopenia y 6,3% hemoglobina <12 g/dl.

Objective: To characterize clinically, paraclinical, and epidemiologically Systemic Lupus Erythematosus in patients at Hospital Universitario in Neiva Design: Descriptive cross sectional. Place: Hospital Universitario Hernando Moncaleano Perdomo, Neiva-Colombia. Population: Patients at Hospital Universitario Hernando Moncaleano Perdomo with diagnosis of Systemic Lupus Erythematosus. Method: Data collection of medical histories was performed. Results: Of 104 medical histories, the disease occurs five times more often in women than in men (ratio of 5:1). The most frequent comorbidities in females were hypertension with 26.74%, fibromyalgia and anti-phospholipid syndrome both with 12, 79%; In male patients hypertension, fibromyalgia and heart failure were presented each in a 27.78%. 61.53% of female patients had skin manifestations, 51.16% reported arthralgia and only 25.58% had joint involvement characterized by synovial effusion; in men skin manifestations were 50%, 50% arthralgia and articular involvement characterized by synovial effusion was 22.22%. In the laboratory test between 12.79% and 31.40% of patients had active lupus, determined by the presence of leukopenia, proteinuria and C3 and C4 consumed. In the sample of female patients the most frequent paraclinical alterations were characterized by hemoglobin <12 g / dl in 53.48% and 26, 74% of patients present thrombocytopenia. Meanwhile, 33.33% of men had thrombocytopenia and 6.38% had hemoglobin <12 g / dl.

Síndrome de Kabuki: presentación de un Caso y Revisión de la Literatura / Kabuki Syndrome: A case report and literature review

Resumen El síndrome de Kabuki (SK) es una patología muy rara, descrita por primera vez en 1981 por Niikawa y Kuroki en Japón. Se han publicado cerca de 400 casos a nivel mundial. En Colombia se conocen cinco casos diagnosticados y publicados; el caso objeto de este estudio sería el sexto en nuestro país. Presentamos la descripción del caso de una paciente de 2 años y 6 meses con rasgos dismórficos compatibles con síndrome de Kabuki. Examen físico: fisuras palpebrales elongadas, eversión del tercio lateral párpado inferior, cejas arqueadas con tercio lateral más despoblado, puente nasal deprimido, boca en carpa, paladar hendido, pabellones auriculares de baja implantación con rotación posterior. El síndrome de Kabuki se caracteriza por sus anomalías faciales peculiares que se consideran son la única manifestación que puede orientar al diagnóstico del mismo sin excepciones. Recientemente se han identificado mutaciones sin sentido y de corrimiento del marco de lectura, entre otras en el gen MLL2 en aproximadamente el 75 % de los casos y en una menor proporción deleciones y mutaciones sin sentido en el gen KDM6A.

Abstract Kabuki syndrome is a rare disease described by Kuroki and Niikawa in Japanese population in 1981. There are over 400 cases over the world and 5 cases described in Colombian population. Therefore this is the 6th Kabuki syndrome found in Colombia. We report a 2 years old female with Kabuki syndrome phenotype. Clinical examination showed: long palpebral fissures with eversion of the lateral third of the lower eyelids, a broad and depressed nasal tip, left palate and low setup ears. Kabuki syndrome includes facial features whit specific characteristics enough to classify the patients. However, there are some mutations in MLL2 gene present in almost 75 % of Kabuki syndrome. In addition there are some deletion and duplications abnormalities in KMD6A gene described in Kabuki syndrome patients.

Profile of canine patient with esophageal foreign bodies / Perfil del paciente canino con cuerpos extraños esofágicos

Objective. Determine the profile of the canine patient with esophageal foreign bodies to identify risk factors associated with the foreign bodies. Materials and Methods. This is a retrospective study made by the Veterinary Hospital Clinic of the Universidad de Extremadura (VHC). Different factors were analyzed in dogs with an endoscopic diagnosis of esophageal foreign bodies. Results. This pathology was more commonly found in young adult dogs and in small breeds. This pathology was present for the first time in the Portuguese Warren Hound, which was also the breed with the highest risk. Conclusions. The results obtained in this investigation are in agreement with the previous description of a patient that presents esophageal foreign bodies. Also, the Portuguese Warren Hound was found to be predisposed to this problem, with a higher risk factor than other breeds previously mentioned in the literature. To prevent esophageal foreign bodies, dogs should be fed raw meat and bones, especially small breeds. This pathology should always be kept in mind in dogs with esophagitis symptomology regardless of age, although it is most common in young adult dogs.

Objetivo. Determinar el perfil del paciente canino que presenta cuerpos extraños esofágicos para identificar las características de riesgo al presentar esta entidad. Materiales y métodos. Este es un estudio retrospectivo realizado en el Hospital Clínico Veterinario de la Universidad de Extremadura (HCV). Se analizaron diferentes parámetros de los perros que presentaron un diagnóstico endoscópico de cuerpos extraños esofágicos. Resultados. Esta patología se presentó más comúnmente en perros adultos jóvenes y en pacientes de raza pequeña. Se presenta por primera vez al Podenco Portugués, el cual además representó la raza con mayor factor de riesgo. Conclusiones. Los resultados obtenidos en esta investigación concuerdan con lo descrito anteriormente en cuanto a las características del paciente con cuerpo extraño esofágico. Asimismo, se reporta el Podenco Portugués como predispuesto a esta entidad, con un factor de riesgo mayor al de otras razas anteriormente mencionadas en la literatura. Para prevenir los cuerpos extraños esofágicos, se debe alimentar con carne cruda y huesos a los perros, especialmente a los de raza pequeña. Siempre se debe tener en cuenta esta patología en los perros con sintomatología de enfermedad esofágica sin importar su edad, pues su presentación es más común en perros adultos jóvenes.

Gastroesophageal reflux in anesthetized dogs: a review / Reflujo gastroesofágico en perros anestesiados: revisión de literatura / Refluxo gastroesofágico em cães anestesiados: revisão de literatura

Gastroesophageal reflux can be a catastrophic illness in small animals during anesthesia since its complications can cause serious pathologies, such as esophagitis, esophageal stenosis and aspiration pneumonia. With an incidence from 12 to 78.5% in anesthetized dogs, gastroesophageal reflux is normally silent during anesthesia and will be notices only if regurgitation occurs and stomach acid is present in the nasal or oral cavities. In humans, gastroesophageal reflux disease (GERD) is a well-defined pathology where the lower esophageal sphincter has a sustained weakness. However, in dogs, gastroesophageal reflux disease as such is not well established, if at all; it has only been described as gastroesophagic reflux, occurring principally in anesthetized animals. There are several factors influencing the presentation of reflux in anesthetized dogs, which may be inherent to the patient (e.g. age, sex, breed, weight, or body condition), medications used prior to and during anesthesia, type of surgery or position of the animal during surgery. The objective of this review is to discuss a series of conditions that could predispose dogs to gastroesophageal reflux during anesthesia and to assist in the prevention and diagnosis of this condition.

El reflujo gastroesofágico durante la anestesia puede ser una entidad catastrófica en la clínica de pequeñas especies, ya que sus complicaciones derivan en entidades realmente graves como esofagitis, estenosis esofágica y neumonía por aspiración. Con una incidencia del 12 al 78.5% en perros anestesiados, el reflujo gastroesofágico durante la anestesia es generalmente silencioso y sólo se observa cuando existe regurgitación y el reflujo pasa a cavidad oral o nasal. En el humano, la enfermedad por reflujo gastroesofágico (ERGE) es una patología bien definida, donde el esfínter esofágico inferior presenta una debilidad sostenida. Sin embargo, en el perro esta enfermedad como tal no está bien establecida, si acaso se describe el reflujo gastroesofágico, que ocurre principalmente en animales anestesiados. Existen diversos factores que influyen en la presentación del reflujo en los perros anestesiados. Estos pueden ser inherentes al paciente (por ejemplo: edad, sexo, raza, peso o condición corporal), a medicamentos utilizados previamente y durante la anestesia, al tipo de cirugía o a la posición del animal durante la cirugía. El objetivo de esta revisión es discutir una guía de las condiciones que predisponen a la aparición de reflujo gastroesofágico durante la anestesia en perros con el fin de facilitar el diagnóstico y la prevención de esta condición.

O refluxo gastroesofágico durante a anestesia pode ser uma entidade catastrófica na clínica de pequenas espécies, já que suas complicações resultam em entidades realmente graves, como esofagite, estenose esofágica e pneumonia por aspiração. O refluxo gastroesofágico em cães anestesiados é geralmente silencioso, com uma incidência de 12 até 78.5% e só é observada quando há regurgitação e o refluxo passa até a cavidade oral ou nasal. Nos humanos, a doença pelo refluxo gastroesofágico (ERGE) é uma patologia bem definida, onde o esfíncter esofágico inferior apresenta uma debilidade continua. Porém, esta doença em cães não está bem estabelecida, pelo qual só se descreve o refluxo gastroesofágico, que ocorre principalmente em animais anestesiados. Existem diversos fatores que influenciam na apresentação do refluxo em cães anestesiados. Estes podem ser inerentes ao paciente (por exemplo: idade, sexo, raça, peso ou condição corporal), a medicamentos utilizados previamente e durante a anestesia, ao tipo de cirurgia ou a posição do animal durante a cirurgia. O objetivo da revisão foi discutir uma guia das condições que predispõem à aparição de refluxo gastroesofágico durante a anestesia em cães com o fim de facilitar o diagnóstico e a prevenção dessa condição.

Movimientos convulsivos durante la inducción inhalatoria con sevoflurano / Convulsive movements during inhalational induction with sevoflurane

La inducción inhalatoria con sevoflurano se ha asociado con actividad epileptógena y movimientos convulsivos. Se diseñó un estudio para determinar la incidencia de movimientos convulsivos durante la inducción inhalatoria con sevoflurano y sus posibles factores de riesgo. Para llevar a cabo estos objetivos, desde marzo a julio de 2011 se solicitó a los anestesiólogos de Clínica Dávila registrar la ocurrencia de movimientos convulsivos en todo paciente en que se realizara inducción inhalatoria con sevoflurano, en el período comprendido entre la etapa III de la anestesia y la inyección de drogas endovenosas. El tamaño muestral calculado fue de 400 pacientes para obtener un intervalo de confianza de 95 por ciento con un error menor a 2,5 por ciento. Se obtuvo información de 405 pacientes con una mediana de edad de 4 años (rango: 2 días a 16 años de edad), predominantemente hombres y ASA I. La incidencia de convulsiones fue de 3,5 por ciento (IC 95 por ciento: 1,9 por ciento; 5,7 por ciento) y fueron más frecuentes en mujeres (5,9 por ciento versus 2 por ciento en hombres, p = 0,039). En conclusión, la incidencia de convulsiones durante la inducción inhalatoria con sevoflurano fue de 3,5 por ciento y su único factor de riesgo fue pertenecer al género femenino...

Introduction: Mask induction with Sevoflurane has been associated with epileptic form changes of the EEG and sometimes with tonic-clonic movements. Objectives: To determine the incidence rate of convulsive movements during the induction of anesthesia with Sevoflurane and its risk factors. Methods: From march 1st to july 31st 2011, we asked to the anesthesiologists of our institution to watch the occurrence of tonic-clonic movements during Sevoflurane induction, after the loss of eyelash reflex and before the injection of intravenous drugs. The sample size was calculated in 400 patients to obtain a 95 percent confidence interval with an error lesser than 2.5 percent. Results: We obtain data from 405 patients with a median age of 4 years old (range 2 days to 16 years old), predominantly males and ASA physical status I. The incidence rate of convulsions was 3.5 percent (CI 95 percent 1.9; 5.7), more frequent in females (5.9 percent versus 2.0 percent in males, p = 0.039). Conclusions: The incidence rate of convulsions during inhalatory induction with Sevoflurane was 3.5 percent and associated to female gender...

Implantes dentales para mejorar la biomecánica y estética de la prótesis parcial removible: [revisión] / Dental implants to improve the biomechanic and aesthetic aspects of removable partial dentures: [review]

Existe un alto porcentaje de la población mundial que presenta algún grado de edentulismo parcial; es por eso que han surgido diferentes alternativas de tratamiento para poder solucionar y dar calidad de vida a estos pacientes. La prótesis parcial removible convencional surgieron en un inicio, para ayudar a estos pacientes, pero presentaban algunos inconvenientes en retención, soporte y estabilidad sobre todo en prótesis dentomucosoportadas, con la introducción de los implantes estos inconvenientes que se presentaban podían ser solucionados o atenuados, dando así un mejor confort al paciente.

A high percentage of world population has some degree of partial edentulism, which is why alternatives have arisen to treatment and to address quality of life for these patients. Conventional removable partial denture initially appeared to help these patients, but had some problems in retention, support and stability especially in prosthesis that are supported by teeth and mucosa, and with the introduction of implants presenting these problems could be solved or attenuated, giving better patient comfort.

Sobredentadura sobre implantes en paciente con múltiples caries: reporte de caso / Overdenture on implants in patients with caries multiple: case report

Hasta hace poco tiempo el tratamiento de pacientes desdentados totales era mediante la instalación de prótesis que iban a ser soportadas por las estructuras remanentes de los maxilares sobre la mucosa y la retención, estabilidad y soporte dependían de la cantidad de hueso remanente, forma de los maxilares, calidad de saliva presente, todos éstos influenciados por la capacidad psicomotriz del paciente. Con la introducción de los implantes dentales y más aun los implantes endo-óseos se ha revolucionado gran parte de los tratamientos dentales ya sea para la rehabilitación fija o removible, teniendo beneficios al aumentar la retención, estabilidad y soporte de la prótesis dental.

Until recently, the treatment of edentulous patients was through the installation of prosthesis supported by the remaining structures of the jaws over the mucosa and stability and support retention depended on the amount of remaining bone, shape of the jaws, saliva quality, all of these influenced by the patient's psychomotor performance. With the advent of dental implants and even more, the endosseous implants, has revolutionized much of dental care for rehabilitation of either fixed or removable, with the benefits of increased retention, stability and support of dental prostheses.

Parto pretérmino: aspectos socio-demográficos en gestantes del hospital gineco-obstétrico “Enrique C. Sotomayor”, Guayaquil, Ecuador / Preterm delivery: socio-demographic aspects in expectant mothers of the “Enrique C. Sotomayor” ob/gyn hospital, Guayaquil, Ecuador

Objetivo: conocer las características socio-demográficas del parto pretérmino que presentaron las mujeres gestantes del hospital gineco-obstétrico “Enrique C. Sotomayor”. Metodología: se estudiaron mujeres gestantes que presentaron parto pretérmino inducido o espontáneo entre junio y agosto de 2009, en el hospital gineco-obstétrico “Enrique C. Sotomayor”, mediante un estudio descriptivo que enumera las características socio-demográficas más importantes. Resultados: en total se evaluaron 300 gestantes, 260 pacientes de raza mestiza (87%) con edades entre 20 y 30 años (54%). Generalmente con grado de escolaridad menor de 12 años (81%), menos de cinco controles prenatales (49%), fumadoras (51%). Se evaluó estado nutricional: Hb <12mg/dl (57%) e IMC <18.5 (38%). Relación entre nivel de escolaridad y controles prenatales (R2 =0.75), relación Hb y antecedentes de parto prematuro p=0.04 OR=1.77, relación IMC con APP p=0.04. Conclusión: los factores de riesgo encontrados demostraron tener relación con los mencionados en las publicaciones científicas lo que indica la significancia que presentaron las variables descritas. Se evidenció que existe una estrecha relación entre la actitud de las pacientes y el conocimiento que tenían acerca del parto prematuro.

Objective: to know the socio-demographic characteristics of preterm delivery among pregnant women of the “Enrique C. Sotomayor” ob/gyn hospital. Methodology: pregnant women who had induced or spontaneous pre-term delivery between June and August 2009 at the “Enrique C. Sotomayor” ob/gyn hospital were evaluated through a descriptive study that lists their most important socio-demographic characteristics. Results: in total, 300 pregnant women were evaluated, with 260 patients of mixed race (87%), aged between 20 and 30 years (54%), generally with an educational level of less than 12 years (81%), with less than five prenatal visits (49%), and smokers (51%). Nutritional status was assessed: Hb <12mg/dl (57%) and BMI <18.5 (38%). Relationship between education level and prenatal care (R2 = 0,75); relationship between Hb and a history of pre-term delivery p=0.04 OR=1.77; relationship between BMI and APP p=0.04. Conclusion: the risk factors found were related to those factors mentioned in the scientific literature, which explains the significance of the relationships with the described variables. It was evident that there was a close relationship between the attitudes of patients and the knowledge that they had about premature birth.

La enseñanza de las enfermedades venéreas en las escuelas de medicina / The teaching of venereal diseases in medical schools

Both medical schools and national health services have been given less attention to the venereal disease problem in the last twenty years, because of the obvious initial success of the penicillin treatment of these infections. Venereology as a regular and compulsory subject in most of the medical schools disappeared, and epidemiological methods of contact tracing were neglected. As a result, a serious national and international public health problem has arisen

The reality of this situation was brought out in the information supplied by PAHO and by a great many of the specialists who sent data concerning clinical instruction in 28 medical schools in the Hemisphere

To deal with this problem it is recommended that the efforts of health authorities, medical educators and interested institutions be coordinated in order to improve the education of physicians and other health personnel in venereology. Specially, it is recommended that venereology be made a compulsory subject in the undergraduate and postgraduate curricula in all medical schools, so that they include as a minimum such subjects as classification, clinical aspects, diagnosis, treatment and control of venereal diseases, as well as laboratory methods, epidemiology, and venereological investigations. Among other recommendations mention was made of the preparation and distribution throughout the Hemisphere of a handbook on venereal ...(AU)