Polyphenolic content and bactericidal effect of Mexican Citrus limetta and Citrus reticulata.

In this study, total phenolics, total flavonoids, hesperidin and ascorbic acid contents in bagasse, juice and seed of mexican sweet lime (Citrus limetta) and mandarine (Citrus reticulata) were determined at two commercial maturity stages (maturation index), as well as their bactericidal effect on Escherichia coli and Staphylococcus aureus. The results showed that bagasses had the highest total phenolics, total flavonoids, and hesperidin content for both, C. limetta, and C. reticulata; highest ascorbic acid contents were found in C. limetta juice (3.36 ± 0.25 mg g-1 DW) and C. reticulata bagasse (3.83 ± 0.37 mg g-1 DW). All tested extracts showed bacterial growth inhibition at 50 and 800 µg mL-1. Bagasse extracts of both fruits showed the highest inhibitions (>90%) on tested bacteria. Total phenolics, total flavonoids, and hesperidin contents, as well as bactericidal effect increased with maturity. Results indicated that both Mexican citric fruits (C. limetta and C. reticulata) were good sources of antioxidant and bactericidal agents.

Male and female meiosis in the mountain scorpion Zabius fuscus (Scorpiones, Buthidae): heterochromatin, rDNA and TTAGG telomeric repeats.

All cytogenetically studied scorpions present male achiasmatic meiosis and lack heteromorphic sex chromosomes. In contrast, information about female meiosis in scorpions is scarce due to the difficulty of finding meiotic cells. The genus Zabius includes three described species and no chromosome studies have been performed on it until now. We analyzed the constitutive heterochromatin distribution, NORs and telomeric sequences in mitosis and meiosis of males and females of different populations of Zabius fuscus. All specimens presented 2n = 18 holokinetic chromosomes that gradually decreased in size. Male meiosis presented nine bivalents and a polymorphism for one reciprocal translocation in one population. Telomeric signals were detected at every terminal region, confirming also the presence of a (TTAGG) n motif in Buthidae. Constitutive heterochromatin was found in three chromosome pairs at a terminal region; moreover, NORs were embedded in the heterochromatic region of the largest pair. Chromosome size and landmarks allowed us to propose the chromosomes involved in the rearrangement. In four females, cells at different prophase I stages were analyzed. We describe a diffuse stage and the presence of ring-shaped bivalents. We discuss the possible origin of these bivalents in the framework of chiasmatic or achiasmatic female meiosis. These results contribute to increase the scarce evidence of female meiosis in scorpions and raise new questions about its mechanism.

Aortic Endoprosthesis for the Treatment of Native Aortic Coarctation and Concomitant Aneurysm in an Octogenarian Patient.

We report a case of an 82-year-old female patient with native coarctation of the aorta and poststenotic aneurysm of the descending thoracic aorta. On consultation, she was receiving 4 antihypertensive drugs, and physical examination revealed nonpalpable lower-limb pulses with intermittent claudication at 50 min. Because of her age, high surgical risk and combination of lesions, endovascular treatment was suggested. Placement of a Valiant thoracic aorta endoprosthesis followed by coarctation angioplasty was performed. At 48 hr, the patient was discharged on 1 antihypertensive drug, palpable pulses on both limbs and a normal ankle-brachial index. At 1 month follow-up, the patient remained as discharged and multislice computed tomography angiography depicted complete coarctation expansion without residual stenosis, exclusion of the aortic aneurysm, and no signs of endoleaks.

Microcavity phonoritons - a coherent optical-to-microwave interface.

Optomechanical systems provide a pathway for the bidirectional optical-to-microwave interconversion in (quantum) networks. These systems can be implemented using hybrid platforms, which efficiently couple optical photons and microwaves via intermediate agents, e.g. phonons. Semiconductor exciton-polariton microcavities operating in the strong light-matter coupling regime offer enhanced coupling of near-infrared photons to GHz phonons via excitons. Furthermore, a new coherent phonon-exciton-photon quasiparticle termed phonoriton, has been theoretically predicted to emerge in microcavities, but so far has eluded observation. Here, we experimentally demonstrate phonoritons, when two exciton-polariton condensates confined in a µm-sized trap within a phonon-photon microcavity are strongly coupled to a confined phonon which is resonant with the energy separation between the condensates. We realize control of phonoritons by piezoelectrically generated phonons and resonant photons. Our findings are corroborated by quantitative models. Thus, we establish zero-dimensional phonoritons as a coherent microwave-to-optical interface.

Innominate Artery Dissection Caused by Video-Mediastinoscopy.

Mediastinoscopy is considered a safe technique to biopsy mediastinal lesions. Among its complications, vascular ones are the most common. We present a rare case of intimal dissection of the innominate artery during the performance of a mediastinoscopy that caused an ischemic attack from which the patient recovered completely without long-term sequelae. We analyze the possible causes and risk factors of this complication.

Effects of Exposure to Cola-Based Soft Drink on Bleaching Effectiveness and Tooth Sensitivity of In-Office Bleaching: A Blind Clinical Trial.

OBJECTIVE: The purpose of this single-blind (evaluators) and parallel design study was to evaluate whether exposure to a cola-based soft drink during bleaching treatment with 35% hydrogen peroxide (HP) affects color change and bleaching-induced tooth sensitivity. MATERIAL AND METHODS: Forty-four patients with central incisors darker than A2 were selected. Participants who did not drink cola-based soft drinks were assigned to the control group (CG), while participants who drank a cola-based soft drink at least twice a day were assigned to the experimental group (EG). For the CG, foods with staining dyes were restricted. For the EG, there was no restriction on food and patients were asked to rinse their mouths with a cola-based soft drink for 30 s, 4 times daily. For both groups, 2 sessions with three 15 min applications of 35% HP were performed. Shade evaluation was assessed via subjective (VITA classical and VITA bleacheguide shade guides) and objective methods (Easyshade spectrophotometer) at baseline, during bleaching (first, second, and third weeks), and post bleaching (1 week and 1 month). Patients recorded their sensitivity perceptions using a numerical rating scale and 0-10 visual analog scales. Variation in shade guide units and the 2 colors (DE) were evaluated with a Student's t-test (α = 0.05) and Mann-Whitney test (α = 0.05). Absolute risk of tooth sensitivity and intensity of tooth sensitivity were evaluated by a Chi-square test (α=0.05). RESULTS: Effective bleaching was observed for both groups after 30 days, without statistical difference (p > 0.08). There was no significant difference in absolute risk of bleaching-induced tooth sensitivity between the 2 groups (p = 0.74). Higher and significant scores in pain scales were detected for the EG in comparison to the CG (p < 0.05). CONCLUSION: Even that the cola-based soft drink exposure during in-office bleaching treatments did not affect the bleaching's effectiveness; patients reported a higher intensity in bleaching-induced tooth sensitivity.

Asociación entre disfunción cráneocervical y trastornos temporomandibulares en adultos jóvenes / Association between craniocervical dysfunction and temporomandibular disorders young adults

RESUMEN Objetivo: Determinar la asociación entre disfunción cráneocervical y Trastornos Temporomandibulares en adultos jóvenes. Material y Métodos: Se realizó un estudio observacional, transversal y retrospectivo en una muestra probabilística donde se evaluaron 180 adultos jóvenes entre 18 y 35 años, distribuidos en dos grupos con y sin trastorno temporomandibular según el Eje I del Índice de Criterios Diagnósticos para Trastornos Temporomandibulares. El primer grupo estuvo conformado por 87 estudiantes con diagnóstico de trastorno temporomandibular y el segundo por 93 estudiantes sin este diagnóstico. Posteriormente, se les realizó el Índice de Disfunción Cráneocervical y Movilidad Cervical para medir el grado de movimiento cervical y postura cráneocervical. Los datos fueron analizados mediante estadística descriptiva e inferencial utilizando la prueba de Chi-cuadrado (p=0,05). Resultados : Los trastornos temporomandibulares predominaron en el género femenino (69 %). El diagnóstico de dolor relacionado a trastorno temporomandibular predominó para mialgia y artralgia (38 %) y el grado de disfunción cráneocervical predominante fue leve (40,4 %). Los estudiantes con disfunción cráneocervical leve presentaron mialgia (83,3 %) y los estudiantes con disfunción cráneocervical severa presentaron ambos (mialgia y artralgia: 55,6 %). Los estudiantes sin trastorno temporomandibular presentaron disfunción cráneocervical leve (61,9 %) y los con trastorno temporomandibular presentaron disfunción cráneocervical moderada (27 %). Los estudiantes con disfunción cráneocervical presentaron trastorno temporomandibular en un 64,7 %. Conclusiones: En este estudio encontramos que existió una asociación entre disfunción cráneocervical y trastornos temporomandibulares en los adultos jóvenes evaluados.

ABSTRACT Introduction : The close anatomical and functional relationship involving the cranio-cervico-mandibular system has caused a high prevalence of signs and symptoms of craniocervical dysfunction in subjects with temporomandibular disorder, especially postural and pain problems. Objective: To determine the association between craniocervical dysfunction and Temporomandibular Disorders in young adults. Material and Methods: 180 young adults between 18 and 35 years old were evaluated, distributed in two groups with and without temporomandibular disorder according to Axis I of the Index of Diagnostic Criteria for Temporomandibular Disorders. The first group consisted of 87 students with a diagnosis of temporomandibular disorder and the second of 93 students without this diagnosis. Subsequently, the Craniocervical Dysfunction and Cervical Mobility Index was performed to measure the degree of cervical movement and craniocervical posture. The data were analyzed by descriptive and inferential statistics using the Chi-square test (p = 0.05). Results: Temporomandibular disorders predominated in the female gender (69%). The diagnosis of pain related to temporomandibular disorder predominated for myalgia and arthralgia (38%) and the predominant degree of craniocervical dysfunction was mild (40.4%). Students with mild craniocervical dysfunction presented myalgia (83.3%) and students with severe craniocervical dysfunction presented both (myalgia and arthralgia: 55.6%). Students without temporomandibular disorder had mild craniocervical dysfunction (61.9%) and those with temporomandibular disorder had moderate craniocervical dysfunction (27%). Students with craniocervical dysfunction presented temporomandibular disorder in 64.7%. Conclusions: In this study we found that there was an association between craniocervical dysfunction and temporomandibular disorders in the young adults evaluated.

Sex-Linked Chromosome Heterozygosity in Males of Tityus confluens (Buthidae): A Clue about the Presence of Sex Chromosomes in Scorpions.

Scorpions of the genus Tityus show holokinetic chromosomes, achiasmatic male meiosis and an absence of heteromorphic sex chromosomes, like all Buthidae. In this work, we analysed the meiotic behaviour and chromosome rearrangements of a population of the scorpion Tityus confluens, characterising the cytotypes of males, females and embryos with different cytogenetic techniques. This revealed that all the females were structural homozygotes, while all the males were structural heterozygotes for different chromosome rearrangements. Four different cytotypes were described in males, which differed in chromosome number (2n = 5 and 2n = 6) and meiotic multivalent configurations (chains of four, five and six chromosomes). Based on a detailed mitotic and meiotic analysis, we propose a sequence of chromosome rearrangements that could give rise to each cytotype and in which fusions have played a major role. Based on the comparison of males, females and a brood of embryos, we also propose that the presence of multivalents in males and homologous pairs in females could be associated with the presence of cryptic sex chromosomes, with the male being the heterogametic sex. We propose that the ancestral karyotype of this species could have had homomorphic XY/XX (male/female) sex chromosomes and a fusion could have occurred between the Y chromosome and an autosome.

Características clínicas de adultos mayores con neumonía adquirida en la comunidad / Clinical characteristics of older adults with community-acquired pneumonia

La neumonía adquirida en la comunidad es una enfermedad infecciosa común que causa una morbilidad y mortalidad sustanciales. Las personas mayores son las más frecuentemente afectadas, y se deben considerar varios aspectos relacionados con el cuidado de esta condición en los ancianos. El patógeno más común en esta patología sigue siendo Streptococcus pneumoniae, seguido de Haemophilus influenzae, Mycoplasma pneumoniae. El objetivo de este estudio fue determinar las características clínicas de adultos mayores con esta patología en el hospital "Alfredo Noboa Montenegro". Para las variables cualitativas fue empleada la frecuencia absoluta y el por ciento. Para la asociación entre variables cualitativas se utilizó la prueba Jicuadrado de independencia. En caso de las tablas de contingencia 2x2 cuando tuvo alguna celda con frecuencia esperada menor que 5 se utilizó el test exacto de Fisher. Más del 54% de los pacientes estudiados fue clasificado como grado II; de ellos el mayor porcentaje (66,7%) correspondió a los hombres. Le siguió en orden de frecuencia el grado III con 25% y alrededor del 83% fue del sexo femenino. No se obtuvo asociación estadística entre el sexo y el grado de los pacientes estudiados por lo que se pude afirmar que ambas variables fueron independientes. En la mayoría de casos los pacientes resultan infra diagnosticados desde los niveles primarios de atención al confundirlos con otro tipo de patologías, lo que provoca un retraso en la identificación y tratamiento del paciente que en el futuro influye en un pronóstico negativo de este(AU)

Community-acquired pneumonia is a common infectious disease that causes substantial morbidity and mortality. Elderly people are frequently affected, and several issues related to care of this condition in the elderly have to be considered. The most common pathogen in this pathology is still Streptococcus pneumoniae, followed by other pathogens such as Haemophilus influenzae, Mycoplasma pneumonia. The objective of this study was to determine the clinical characteristics of older adults with this disease in hospital "Alfredo Noboa Montenegro". For the qualitative variables the absolute frequency and the percent were used. For the association between qualitative variables, the Chi-square independence test was used. In the case of the 2x2 contingency tables, when Fisher had an expected cell shorter than 5, Fisher's exact test was used. More than 54% of the patients studied were classified as grade II; of them, the highest percentage (66.7%) corresponded to men. Next in order of frequency was grade III with 25% and about 83% was female. There was no statistical association between sex and the degree of the patients studied, so we could say that both variables were independent. In the majority of cases, patients are diagnosed from the primary care levels when they are confused with other types of pathologies, which causes a delay in the identification and treatment of the patient that in the future influences a negative prognosis(AU)

Out-of-pocket payments and utilization of health care services in Albania: evidence from three districts.

Like most countries in Central and Southeastern Europe, Albania is currently considering a number of alternative health sector reform strategies to improve the availability, quality and use of primary health care services. However, in order to assess the likely success of such reforms, more needs to be known about the current levels, distribution and determinants of household out-of-pocket spending on health. The purpose of this paper is to use the 2002 Albania Baseline Health Survey, a survey of 2,000 households in Berat, Kucova, and Fier, to understand the magnitude and distribution of out-of-pocket payments for health care services and to identify the factors that operate at the household- and provider-levels that determine whether individuals pay for health care and how much is paid within the month prior to the survey. Of particular interest in the study is examining the extent to which households incur out-of-pocket payments across a number of dimensions-including health insurance status, socio-economic status (SES), type of service, and type of facility. The findings suggest that out-of-pocket payments for care provided in government facilities are widespread, with marked differences in payment practices between inpatient and outpatient care. For outpatients using Primary Health Centers (PHCs), the type of facility that is the focus of the government's primary health care program, average payments appear to be nominal (0.6% of estimated total monthly household expenditure per capita). The multivariate findings indicate that insurance coverage significantly reduces the likelihood of paying for medicines to treat acute and chronic health problems, but not of paying for consultations. The policy implications of the findings on alternative health care financing reforms are briefly discussed.

Atención, diagnóstico y manejo de pacientes pediátricos sospechosos y/o confirmados COVID-19 / Attention, diagnosis and management of suspected and / or confirmed COVID-19 pediatric patients

La enfermedad producida por el Coronavirus asociado al SARS 2 (SARS-CoV 2) o Enfermedad por Coronavirus (COVID-19) como se le conoce actualmente, demostró, desde su primera identificación en Wuhan (China) en Diciembre del 2019, un incremento rápido y desproporcionado del número de casos. Tanto impacto tuvo en la población, que en solo 3 meses nos encontrábamos frente a una pandemia de dimensiones catastróficas tanto poblacionales como económicas. Entre febrero y marzo se observó un incremento exponencial de la curva de enfermos y fallecidos en Europa, llevando al colapso del sistema de salud en estos países; aproximadamente dos meses después, eventos con las mismas características se vivieron en el continente americano pese al cierre de fronteras1. Sin embargo, y contrario a todas las predicciones de vulnerabilidad, los niños demostraron ser un grupo poco afectado por COVID-19 tanto en términos de cantidad de casos y de gravedad de los mismos. China por ejemplo, reportó solamente un 5,8% de casos severos o críticos en niños versus un 18,5% en adultos; así mismo en Italia se reportó tan sólo un 1% de niños graves y 1% críticos1,2. En nuestro continente, un reporte muy completo del Ministerio de Salud Pública de Ontario confirma una baja de severidad en niños del 5% que coincide con las cifras de otros continentes y añade que al menos 23% de los niños infectados puede ser asintomático; cifras muy parecidas se encuentran en países de américa latina3, 4. El Centro de Enfermedades Contagiosas (CDC) ha determinado que aproximadamente 2 a 3% de niños COVID-19 positivos requerirían hospitalización siendo equivalente a 0,3 por cada 100 000 niños 5. Los servicios de Emergencia son puertas de entrada al hospital de miles de pacientes en todo el mundo, es aquí donde este 2 a 3% debe ser captado y hospitalizado de manera precoz para el manejo oportuno y eficiente de la patología en cuestión. Pese a la gran difusión de medidas preventivas contra el COVID-19 a nivel mundial, los casos nuevos siguen en ascenso y el nivel de contagio es indiscutiblemente alto. El virus SARS Cov 2 nos ha mostrado manifestaciones clínicas tan floridas que la única manera de manejarlo de manera eficaz es contar con un protocolo de manejo de pacientes que sea aplicable al el Área de Urgencias Peiátricas, minimizando la exposición y potencial contagio tanto de trabajadores del sector salud como de otras personas y tomando en cuenta tanto las rutas de flujo de pacientes como la estricta desinfección de las áreas una vez realizada la atención médica.

The disease caused by the Coronavirus associated with SARS 2 (SARS-CoV 2) or Coronavirus Disease (COVID-19) as it is currently known, showed, since its first identification in Wuhan (China) in December 2019, a rapid increase and disproportionate in the number of cases. It had such an impact on the population that in just 3 months we were facing a pandemic of catastrophic dimensions, both population and economic. Between February and March, an exponential increase in the curve of sick and deceased was observed in Europe, leading to the collapse of the health system in these countries; approximately two months later, events with the same characteristics were experienced on the American continent despite the closure of borders1. However, and contrary to all predictions of vulnerability, children proved to be a group little affected by COVID-19 both in terms of number of cases and their severity. China, for example, reported only 5,8% of severe or critical cases in children versus 18,5% in adults; Likewise, in Italy only 1% of serious and 1% critical children were reported1,2. In our continent, a very complete report from the Ontario Ministry of Public Health confirms a 5% decrease in severity in children that coincides with the figures from other continents and adds that at least 23% of infected children may be asymptomatic; very similar figures are found in Latin American countries3, 4. The Center for Communicable Diseases (CDC) has determined that approximately 2 to 3% of COVID-19 positive children would require hospitalization, which is equivalent to 0,3 per 100 000 children5. Emergency services are gateways to the hospital for thousands of patients worldwide, it is here that this 2 to 3% must be recruited and hospitalized early for the timely and efficient management of the pathology in question. Despite the widespread dissemination of preventive measures against COVID-19 worldwide, new cases continue to rise and the level of contagion is indisputably high. The SARS Cov 2 virus has shown us clinical manifestations so flowery that the only way to manage it efectively is to have a patient management protocol that is applicable to the Area of Pediatric Emergencies, minimizing the exposure and potential contagion of both workers in the health sector like other people and taking into account both the flow routes of patients and the strict disinfection of the areas once medical care has been performed.

Radioguided Adrenal Surgery: Access in Complex Situations: Technical Notes.

The laparoscopic adrenalectomy is considered as the procedure of choice for the treatment of adrenal hyperplasia and tumor lesions. However, some special situations may limit the use of this method due to the difficulty to locate the gland and perform the lesion excision. We analyze 2 patients of a left adrenal tumor, explaining how they have overcome the difficulties in both situations. The first case was a patient with a history of intra-abdominal surgery and the other patient suffered from severe obesity. We performed with the use of the gamma probe, and the 2 cases, was of great help to access and glandular localization. The help of gamma probe test was achieved in the surgical bed, that removal was complete. The use of the portable gamma probe facilitated the access to the left adrenal gland as well as conducting the glandular excision without delay, despite the difficulties due to the intra abdominal surgery caused by the previous surgery, and in the case of severe obesity.

Rescue Radioguided Laparoscopy Surgery for Meckel's Diverticulum: Technical Notes.

The extirpation of Meckel's diverticulum (MD) via conventional or laparoscopic surgery is the definitive treatment. However, certain circumstances may modify or alter this situation and require the application of exceptional measures.We report a case under our observation who previously had an exploratory abdominal laparotomy for a suspected MD; however, the findings were negative. At that time, the diagnosis was established based on low-level gastrointestinal bleeding and isotopic tests that confirmed the existence of the diverticulum. Given the findings of gamma-graphic exploration and the previous negative surgical exploration, a decision was made to remove the lesion by laparoscopic radioguided surgery.The patient underwent bilateral laparoscopic radioguided surgery using a gamma radiation detection probe. The exploration of the abdominal cavity noted the existence of the diverticulum about 60 to 70  cm from the ileocecal valve. In this way, it was possible to proceed with the resection of the bowel loop and perform an intracorporeal anastomosis termino lateral. The postoperative course was uneventful, and the patient was discharged on the fifth postoperative day.We believe that the combination of radioguided surgery and single photon emission computed tomography/computed tomography could be useful for treating lesions in locations that are surgically difficult because of the characteristics of the lesion itself or the peculiarities of an individual patient.

[Intra-abdominal desmoplastic small round cell tumour]. / Tumor intraabdominal desmoplásico de células pequeñas y redondas.

BACKGROUND: The desmoplastic small round cell tumour is a rare and aggressive intra-abdominal neoplasia, with only 200 cases reported, and a higher incidence in men and predilection for the second decade of life. Histologically characterized by the presence of small nests of undifferentiated tumour cells, wrapped in fibrous desmoplastic stroma. CLINICAL CASE: A 24 year old male started with abdominal pain of 4 weeks onset in the right upper quadrant, colic type, sporadic, self-limiting and accompanied by early satiety, decreased appetite, and involuntary weight loss of 10 kg in 3 months. At the time of admission the abdomen was globular, with decreased peristalsis, soft, depressible. Computed tomography of the abdomen showed multiple enlarged lymph nodes in the abdominal-pelvic cavity. A laparotomy was performed, with a subsequent omentum resection due to the presence of multiple tumours, which microscopically were characterised by groups of small, round, blue cells, separated by a desmoplastic stroma. The immunohistochemistry was positive for desmin (> 75%), epithelial membrane antigen (> 75%), CD99 (> 50%), and S100 (25%), concluding with an abdominal tumour of small, round, blue cells as a diagnosis. Chemotherapy treatment was initiated based on IMAP plus GM-CSF. CONCLUSIONS: The desmoplastic small round cell tumour is a rare neoplasia, with diagnostic complexity and a lethal course. Its clinical presentation is unspecific. Histologically, it is classified as an aggressive soft tissue sarcoma that shares similar characteristics with the family of the small and blue cells tumours.

Carcinoma epidermoide metastásico asociado a epidermólisis ampollosa distrófica / Metastasic squamous cell carcinoma in dystrophic epidermolysis bullosa

Caso clínico: femenino de 18 años con diagnóstico de epidermolisis ampollosa distrófica (EAD) quién desarrolló una neoformación nodular sobre una úlcera crónica. Se diagnosticó carcinoma epidermoide (CE) invasor al que se realizó resección. Sin embargo, 5 meses después del tratamiento quirúrgico presentó metástasis a ganglios, pulmón e hígado con desenlace fatal. Comentarios: el CE es la causa más importante de muerte en pacientes con EAD. Suele ser agresivo y metastásico. Se recomienda una vigilancia cada 3 a 6 meses para realizar diagnóstico y tratamiento oportunos (AU)

Case report: 18-year-old female patient with dystrophic epidermolysis bullosa (DEB) who developed a tumor over a chronic ulcer. She was diagnosed with invasive squamous cell carcinoma (SCC) and underwent surgical resection. However, 5 months later she presented metastases to the lymph nodes, lung and liver with a fatal outcome. Comments: SCC is the most important cause of death in patients with DEB. It is usually aggressive and metastatic. Surveillance every 3 to 6 months is recommended for prompt diagnosis and treatment (AU)

Cytogenetic analysis on geographically distant parthenogenetic populations of Tityus trivittatus Kraepelin, 1898 (Scorpiones, Buthidae): karyotype, constitutive heterochromatin and rDNA localization.

Tityus trivittatus Kraepelin, 1898 is the most medically important scorpion species of Argentina, and parthenogenetic populations are present in the major cities of this country. We performed a detailed cytogenetic analysis of specimens of three synanthropic parthenogenetic populations, all distant about 900 km from each other, using Ag-NOR, C-banding, DAPI/CMA3 staining and FISH with autologous 28S rDNA probes. The karyotype of females and embryos from the three populations showed 2n=6, with two large and four middle-sized holokinetic chromosomes. Constitutive heterochromatin was found in terminal and interstitial location and its pattern allowed the identification of three chromosome pairs. NORs were found on the terminal heterochromatic region of one pair of middle-sized chromosomes. The use of fluorochromes to characterize heterochromatin showed the absence of GC-rich heterochromatin and a low and variable number of AT-rich heterochromatic regions. We propose that a possible explanation for the lack of karyotypic variation between these geographically distant populations could be a recent colonization of urban areas by human means of synanthropic specimens from a single lineage of northeastern Argentina.

[Bilateral ovarian Burkitt's lymphoma. A case presentation]. / Linfoma tipo Burkitt bilateral de ovario. Presentación de un caso.

BACKGROUND: Burkitt lymphoma, is described as an aggressive form of non-Hodgkin lymphoma of B cells which occurs most often in children and young adults, ovarian lymphoma can appear as a primary lesion or more commonly referred to as a metastasis. Primary ovarian lesions are rare manifestations corresponding to 0.5% of non-Hodgkin lymphoma and 1.5% of ovarian tumors. Clinic case: 31 years old female with general weakness, march incapacity, dyspnea, hyporexia, fever, diaphoresis, weight loss of 20 kg, flat abs with abdominal pain; Ca125 610 U/ml. Abdominal computed tomography shows a solid aspect tumor which affects the right pelvic cavity. Bilateral ovarian tumors were removed. Microscopically, both lesions show a "starry sky" pattern composed by a monotonous infiltration of lymphocytes mixed with large and clear macrophages, several atypical mitoses, and necrosis and hemorrhage areas. Immunohistochemistry was positive for CD10, CD20, and negative for CD3 and high Ki67 proliferation index. Bilateral ovarian Burkitt's lymphoma was diagnosed. CONCLUSION: Bilateral ovarian Burkitt's lymphoma is a rare entity, with a variability of presentations, the abdominal pain and abdominal tumors are the most frequent. The patient's prognosis at short term is poor, therefore it's necessary to know this entity and make an early diagnosis.

Antecedentes: el linfoma de Burkitt es una forma agresiva de los linfomas no Hodgkin de células B que ocurre con mayor frecuencia en niños y adultos jóvenes; el linfoma de ovario puede aparecer como lesión primaria o, más comúnmente, como una metástasis. Las lesiones primarias de ovario son manifestaciones raras que corresponden a 0.5% de los linfomas no Hodgkin y 1.5% de los tumores de ovario. Caso clínico: paciente femenina de 31 años de edad, con debilidad generalizada, incapacidad para la marcha, disnea, hiporexia, fiebre, diaforesis, pérdida de 20 kg de peso, abdomen plano, con dolor abdominal; Ca125 610 U/mL. La tomografía computada abdominal mostró un gran tumor de aspecto sólido que afectaba a la cavidad pélvica derecha. Se extirparon los tumores ováricos bilaterales. Desde el punto de vista microscópico ambas lesiones muestran una imagen en "cielo estrellado" compuesta por un patrón de infiltrado monótono de linfocitos mezclada con macrófagos de citoplasma amplio y claro, abundantes mitosis atípicas, zonas de necrosis y hemorragia. La inmunohistoquímica reveló positividad para CDI0 y CD20, negativo con CD3, índice de proliferación Ki67 alto. Se diagnosticó linfoma tipo Burkitt bilateral de ovario. Conclusiones: el linfoma de Burkitt de ovario bilateral es poco frecuente, con variabilidad de presentación; el dolor abdominal y los tumores abdominales son lo más frecuente. El pronóstico a corto plazo de las pacientes es malo, por lo que es necesario conocer esta afección para poder establecer el diagnóstico temprano.

Usefulness of MRI in takotsubo cardiomyopathy: a review of the literature.

Takotsubo cardiomyopathy (TC) is a disease that can be misinterpreted as a more serious acute coronary syndrome. Its clinical characteristics resemble those of a myocardial infarct, while its imaging characteristics are critical on correctly characterizing and diagnosing the disease. From angiography, where coronary anatomy is evaluated, to cardiac magnetic resonance (CMR), where morphology and tissue characterization is assessed, the array of imaging options is quite extent. In particular, CMR has achieved great improvements (stronger magnetic fields, better coils, etc.) in the last decade which in turn has made this imaging technology more attractive in the evaluation and diagnosis of TC. With its superior soft tissue resolution and dynamic imaging capabilities, CMR is currently, perhaps, the most useful imaging technique in TC as apical ballooning or medio-basal wall motion abnormalities (WMA), presence of wall edema and late gadolinium enhancement (LGE) characteristics are critical in the diagnosis and characterization of this pathology. In this review, CMRs role in TC will be evaluated in light of the current available evidence in medical literature, while also revising the clinical and physiopathologic characteristics of TC.

Conocimientos de los estudiantes de medicina sobre las afecciones oftalmológicas más frecuentes en la práctica de la reumatología / Medical student´s knowledge about the most common ophthalmological conditions in the practice of rheumatology

Introducción: en la formación de pregrado debe concederse la debida importancia a la enseñanza de la reumatología dado su carácter multidisciplinar, que demanda un futuro profesional de la salud capaz de valorar y reconocer aún desde aulas y laboratorios, las implicaciones sociales y de salud entre enfermedades reumáticas y oculares ya que el diagnóstico correcto de estas, puede ayudar a destacar el rol del proceso sistémico y viceversa. Objetivo: evaluar el nivel de conocimientos de estudiantes de medicina sobre las afecciones oftalmológicas más frecuentes en la práctica de la reumatología. Métodos: la investigación se realizó en la facultad de Medicina perteneciente a la Universidad Regional Autónoma de los Andes en el período comprendido de marzo a mayo de 2017. Se trata de un estudio descriptivo, transversal y analítico. El universo estuvo constituido por 166 estudiantes de VI y VII semestres y la muestra de estudio la constituyeron 75 estudiantes de cada semestre seleccionados al azar. Resultados: la presencia mayoritaria de mujeres caracteriza a la muestra objeto de estudio (53.3 por ciento, contra 46,7 por ciento de hombres). Las edades máximas y mínimas fueron 21 y 26 años respectivamente, con edad promedio superior en el VII semestre. Se aplicó una encuesta validada previamente que permitió evaluar el conocimiento relacionado con las manifestaciones oftalmológicas más frecuentes. Conclusiones: el nivel de conocimiento sobre las manifestaciones oftalmológicas en la práctica de la reumatología no es bueno, por lo que se sugiere redimensionar el proceso docente, privilegiando la formación práctica que debe caracterizar la enseñanza de pregrado al profundizar en el manejo de estas entidades(AU)

Introduction: In the undergraduate training must be given due importance to the teaching of rheumatology because of its multidisciplinary character, which demands a future health professional able to assess and recognize even from classrooms and laboratories, the social and health implications between rheumatic and ocular diseases because the correct diagnosis of these can help highlighting the role of the systemic process and vice versa. Objective: To assess the level of medical students´ knowledge about the most common ophthalmological conditions in the practice of rheumatology. Methods: The research was carried out in the Faculty of Medicine belonging to the Universidad Regional Autónoma de los Andes from March to May, 2017. It is a descriptive, transversal and analytical study. The universe was constituted by 166 students of sixth and seventh semesters and the sample of study was constituted by 75 students of each semester selected at random. Development: The majority presence of women characterizes the sample object of study (53.3 percent against 46.7 percent of men). The maximum and minimum wages were 21 and 26 years old respectively, with a higher average age in the seventh semester. A previously validated survey was applied that allowed evaluating the knowledge related to the most frequent ophthalmologic manifestations. Conclusions: The level of knowledge on the ophthalmologic manifestations in the practice of rheumatology is not good, so it is suggested to resize the teaching process, favoring the practical training that must characterize the teaching of undergraduate to deepen the management of these entities(AU)