Description of Sheep Pox Outbreak in Spain in 2022-2023: Challenges Found and Lessons Learnt in Relation with Control and Eradication of This Disease.

Sheep pox and goat pox are infectious viral diseases that affect ovine and caprine animals and are caused by two viruses of the family Poxviridae, genus Capripoxvirus. Sheep pox has been traditionally endemic in Africa, the Middle East, and several Southeast Asian countries, but it is considered a transboundary disease capable of affecting previously free countries epidemically. It is a disease of compulsory immediate notification to the World Organization for Animal Health (WOAH) and the European Union (EU). On 19 September 2022, the disease reemerged in Spain, which had been free of it since 1968, causing a total of 30 outbreaks until 17 May 2023, when the last outbreak of the disease was reported. The control and eradication measures implemented were those laid down in EU legislation, based on the total stamping out of positive herds, zoning and restriction of movement, and strengthening of biosecurity and passive surveillance. This manuscript describes the outbreak, as well as assesses the challenges and lessons learned in relation to its management, with the aim of helping in the effective management of future outbreaks of this disease.

Neutrino-Induced Coherent π

MINERvA has measured the ν_{µ}-induced coherent π^{+} cross section simultaneously in hydrocarbon (CH), graphite (C), iron (Fe), and lead (Pb) targets using neutrinos from 2 to 20 GeV. The measurements exceed the predictions of the Rein-Sehgal and Berger-Sehgal PCAC based models at multi-GeV ν_{µ} energies and at produced π^{+} energies and angles, E_{π}>1 GeV and θ_{π}<10°. Measurements of the cross-section ratios of Fe and Pb relative to CH reveal the effective A scaling to increase from an approximate A^{1/3} scaling at few GeV to an A^{2/3} scaling for E_{ν}>10 GeV.

Simultaneous Measurement of Muon Neutrino ν_{µ} Charged-Current Single π

Neutrino-induced charged-current single π^{+} production in the Δ(1232) resonance region is of considerable interest to accelerator-based neutrino oscillation experiments. In this Letter, high statistic differential cross sections are reported for the semiexclusive reaction ν_{µ}A→µ^{-}π^{+}+ nucleon(s) on scintillator, carbon, water, iron, and lead targets recorded by MINERvA using a wideband ν_{µ} beam with ⟨E_{ν}⟩≈6 GeV. Suppression of the cross section at low Q^{2} and enhancement of low T_{π} are observed in both light and heavy nuclear targets compared with phenomenological models used in current neutrino interaction generators. The cross sections per nucleon for iron and lead compared with CH across the kinematic variables probed are 0.8 and 0.5 respectively, a scaling which is also not predicted by current generators.

Simultaneous Measurement of ν_{µ} Quasielasticlike Cross Sections on CH, C, H_{2}O, Fe, and Pb as a Function of Muon Kinematics at MINERvA.

This Letter presents the first simultaneous measurement of the quasielasticlike neutrino-nucleus cross sections on C, water, Fe, Pb, and scintillator (hydrocarbon or CH) as a function of longitudinal and transverse muon momentum. The ratio of cross sections per nucleon between Pb and CH is always above unity and has a characteristic shape as a function of transverse muon momentum that evolves slowly as a function of longitudinal muon momentum. The ratio is constant versus longitudinal momentum within uncertainties above a longitudinal momentum of 4.5 GeV/c. The cross section ratios to CH for C, water, and Fe remain roughly constant with increasing longitudinal momentum, and the ratios between water or C to CH do not have any significant deviation from unity. Both the overall cross section level and the shape for Pb and Fe as a function of transverse muon momentum are not reproduced by current neutrino event generators. These measurements provide a direct test of nuclear effects in quasielasticlike interactions, which are major contributors to long-baseline neutrino oscillation data samples.

Measurement of the axial vector form factor from antineutrino-proton scattering.

Scattering of high energy particles from nucleons probes their structure, as was done in the experiments that established the non-zero size of the proton using electron beams1. The use of charged leptons as scattering probes enables measuring the distribution of electric charges, which is encoded in the vector form factors of the nucleon2. Scattering weakly interacting neutrinos gives the opportunity to measure both vector and axial vector form factors of the nucleon, providing an additional, complementary probe of their structure. The nucleon transition axial form factor, FA, can be measured from neutrino scattering from free nucleons, νµn → µ-p and [Formula: see text], as a function of the negative four-momentum transfer squared (Q2). Up to now, FA(Q2) has been extracted from the bound nucleons in neutrino-deuterium scattering3-9, which requires uncertain nuclear corrections10. Here we report the first high-statistics measurement, to our knowledge, of the [Formula: see text] cross-section from the hydrogen atom, using the plastic scintillator target of the MINERvA11 experiment, extracting FA from free proton targets and measuring the nucleon axial charge radius, rA, to be 0.73 ± 0.17 fm. The antineutrino-hydrogen scattering presented here can access the axial form factor without the need for nuclear theory corrections, and enables direct comparisons with the increasingly precise lattice quantum chromodynamics computations12-15. Finally, the tools developed for this analysis and the result presented are substantial advancements in our capabilities to understand the nucleon structure in the weak sector, and also help the current and future neutrino oscillation experiments16-20 to better constrain neutrino interaction models.

Using integrated wildlife monitoring to prevent future pandemics through one health approach.

In the One Health context, Integrated Wildlife Monitoring (IWM) merges wildlife health monitoring (WHM) and host community monitoring to early detect emerging infections, record changes in disease dynamics, and assess the impact of interventions in complex multi-host and multi-pathogen networks. This study reports the deployment and results obtained from a nationwide IWM pilot test in eleven sites representing the habitat diversity of mainland Spain. In each study site, camera-trap networks and sampling of indicator species for antibody and biomarker analysis were used to generate information. The results allowed identifying differences in biodiversity and host community characteristics among the study sites, with a range of 8 to 19 relevant host species per point. The Eurasian wild boar (Sus scrofa) was the most connected and central species of the host communities, becoming a key target indicator species for IWM. A negative relationship between biodiversity and disease risk was detected, with a lower number and prevalence of circulating pathogens in the sites with more species in the community and larger network size. However, this overall trend was modified by specific host-community and environmental factors, such as the relative index of wild boar - red deer interactions or the proximity to urban habitats, suggesting that human-driven imbalances may favour pathogen circulation. The effort of incorporating wildlife population monitoring into the currently applied WHM programs to achieve effective IWM was also evaluated, allowing to identify population monitoring as the most time-consuming component, which should be improved in the future. This first nationwide application of IWM allowed to detect drivers and hotspots for disease transmission risk among wildlife, domestic animals, and humans, as well as identifying key target indicator species for monitoring. Moreover, anthropogenic effects such as artificially high wildlife densities and urbanisation were identified as risk factors for disease prevalence and interspecific transmission.

Consultas nutricionales en menores de 9 años en la región del Maule, Chile, entre 2017-2021, efecto de estallido social y pandemia COVID-19

Introducción: La consulta nutricional es la primera línea de atención en niñas y niños en salud pública que presentan condiciones de malnutrición por déficit o exceso. Sin embargo, la atención a estos niños y niñas fue afectada por las movilizaciones sociales y la pandemia por COVID-19. Objetivo: Evaluar la tendencia de las consultas realizadas a menores de 9 años por profesional nutricionista en la región del Maule, Chile, desde el año 2017 a 2021. Métodos: Estudio descriptivo de corte longitudinal histórico basado en los datos de los Registros Estadísticos Mensuales (REM) del Servicio de Salud del Maule, las tendencias fueron analizadas con coeficiente de determinación (R2) mediante la regresión de Prais-Winsten. Resultados: Se analizaron 274.377 consultas nutricionales de niños/as menores de 9 años. 53,8% en clasificación de malnutrición por exceso y 12,1% en déficit. Se registró una disminución de 56,8% en las consultas nutricionales durante las movilizaciones sociales y un 92% al inicio de pandemia. Se observó una tendencia al aumento de las consultas por déficit nutricional, especialmente en menores de 12 meses (R2 0,633, β=4,45, p<0,001). Conclusión: La situación social y epidemiológica afectaron significativamente las atenciones nutricionales en salud pública. Es necesario dar una mayor visibilidad de los profesionales nutricionistas y promover el desarrollo de estrategias innovadoras para afrontar este escenario epidemiológico.

Background: The nutritional appointments is the first line of care for children with malnutrition or overweight in public primary health, but its normal functioning was affected by social mobilizations and the COVID-19 pandemic. Objective: To evaluate trends in consultations among children under 9 years of age in the Maule region, Chile, between 2017 and 2021. Methods: Descriptive longitudinal study based on data from the Monthly Statistical Records (REM) of the Maule Health Service, the trends were analyzed with coefficient of determination (R2) using Prais-Winsten regression. Results: 274,377 nutritional consultations were analyzed, of which 53.8% were overweight and 12.1% with malnutrition. A 56.8% decrease in nutritional consultations was recorded during social mobilizations and 92% at the beginning of the pandemic. A tendency to increase consultations due to malnutrition was observed, especially in children under 12 months of age (R2 0.633, β=4.45, p<0.001). Conclusion: The social and epidemiological situations significantly affected nutritional care in public health. It is necessary to give nutrition professionals greater visibility and promote the development of innovative strategies to deal with this epidemiological scenario.

Simultaneous Measurement of Proton and Lepton Kinematics in Quasielasticlike ν_{µ}-Hydrocarbon Interactions from 2 to 20 GeV.

Neutrino charged-current quasielastic-like scattering, a reaction category extensively used in neutrino oscillation measurements, probes nuclear effects that govern neutrino-nucleus interactions. This Letter reports the first measurement of the triple-differential cross section for ν_{µ} quasielastic-like reactions using the hydrocarbon medium of the MINERvA detector exposed to a wideband beam spanning 2≤E_{ν}≤20 GeV. The measurement maps the correlations among transverse and longitudinal muon momenta and summed proton kinetic energies, and compares them to predictions from a state-of-art simulation. Discrepancies are observed that likely reflect shortfalls with modeling of pion and nucleon intranuclear scattering and/or spectator nucleon ejection from struck nuclei. The separate determination of leptonic and hadronic variables can inform experimental approaches to neutrino-energy estimation.

High-Statistics Measurement of Neutrino Quasielasticlike Scattering at 6 GeV on a Hydrocarbon Target.

We measure neutrino charged-current quasielasticlike scattering on hydrocarbon at high statistics using the wideband Neutrinos at the Main Injector beam with neutrino energy peaked at 6 GeV. The double-differential cross section is reported in terms of muon longitudinal (p_{∥}) and transverse (p_{⊥}) momentum. Cross section contours versus lepton momentum components are approximately described by a conventional generator-based simulation, however, discrepancies are observed for transverse momenta above 0.5 GeV/c for longitudinal momentum ranges 3-5 and 9-20 GeV/c. The single differential cross section versus momentum transfer squared (dσ/dQ_{QE}^{2}) is measured over a four-decade range of Q^{2} that extends to 10 GeV^{2}. The cross section turnover and falloff in the Q^{2} range 0.3-10 GeV^{2} is not fully reproduced by generator predictions that rely on dipole form factors. Our measurement probes the axial-vector content of the hadronic current and complements the electromagnetic form factor data obtained using electron-nucleon elastic scattering. These results help oscillation experiments because they probe the importance of various correlations and final-state interaction effects within the nucleus, which have different effects on the visible energy in detectors.

Genetic (co)variation in skin pigmentation patterns and growth in rainbow trout.

From a physiological-behavioral perspective, it has been shown that fish with a higher density of black eumelanin spots are more dominant, less sensitive to stress, have higher feed intake, better feed efficiency and therefore are larger in size. Thus, we hypothesized that genetic (co)variation between skin pigmentation patterns and growth exists and it is advantageous in rainbow trout. The objective of this study was to determine the genetic relationships between skin pigmentation patterns and BW in a breeding population of rainbow trout. We performed a genetic analysis of pigmentation traits including dorsal color (DC), lateral band (LB) intensity, amount of spotting above (SA) and below (SB) the lateral line, and BW at harvest (HW). Variance components were estimated using a multi-trait linear animal model fitted by restricted maximum likelihood. Estimated heritabilities were 0.08±0.02, 0.17±0.03, 0.44±0.04, 0.17±0.04 and 0.23±0.04 for DC, LB, SA, SB and HW, respectively. Genetic correlations between HW and skin color traits were 0.42±0.13, 0.32±0.14 and 0.25±0.11 for LB, SA and SB, respectively. These results indicate positive, but low to moderate genetic relationships between the amount of spotting and BW in rainbow trout. Thus, higher levels of spotting are genetically associated with better growth performance in this population.

Sand fly fauna (Diptera, pcychodidae, phlebotominae) in different leishmaniasis-endemic areas of ecuador, surveyed using a newly named mini-shannon trap.

To study the sand fly fauna, surveys were performed at four different leishmaniasis-endemic sites in Ecuador from February 2013 to April 2014. A modified and simplified version of the conventional Shannon trap was named "mini-Shannon trap" and put to multiple uses at the different study sites in limited, forested and narrow spaces. The mini-Shannon, CDC light trap and protected human landing method were employed for sand fly collection. The species identification of sand flies was performed mainly based on the morphology of spermathecae and cibarium, after dissection of fresh samples. In this study, therefore, only female samples were used for analysis. A total of 1,480 female sand flies belonging to 25 Lutzomyia species were collected. The number of female sand flies collected was 417 (28.2%) using the mini-Shannon trap, 259 (17.5%) using the CDC light trap and 804 (54.3%) by human landing. The total number of sand flies per trap collected by the different methods was markedly affected by the study site, probably because of the various composition of species at each locality. Furthermore, as an additional study, the attraction of sand flies to mini-Shannon traps powered with LED white-light and LED black-light was investigated preliminarily, together with the CDC light trap and human landing. As a result, a total of 426 sand flies of nine Lutzomyia species, including seven man-biting and two non-biting species, were collected during three capture trials in May and June 2014 in an area endemic for leishmaniasis (La Ventura). The black-light proved relatively superior to the white-light with regard to capture numbers, but no significant statistical difference was observed between the two traps.

Récord de incidencia malárica en Venezuela / Malaria incidence record in Venezuela

Venezuela reportó en 2012, el más alto registró malárico de su historia con 51.264 casos, superando en 5.893 (12,6%), el anterior de 1990. Bolívar aumentó su incidencia a 44.180 casos (86,2% del país), con tres municipios en “epidemia” y dos en “alarma”. En Amazonas, la malaria aumentó y sigue presentándose mayoritariamente entre los menores de 15 años (41,3%), aportando este grupo; 39,8% de la incidencia a plasmodium vivax, 50,8% de plasmodium falciparum, 82,6% de plasmodium malariae y 47,1% de infecciones mixtas. La epidemia en Benítez y el aumento de casos en cuatro municipios más en Sucre, lo convierten en estado de alto riesgo, dada su receptividad y vulnerabilidad. Una Cura Radical Masiva, acompañada de nebulizaciones espaciales de insecticida en las 20 localidades de mayor incidencia en el municipio Sifontes, podría controlar 48,3% de la malaria del municipio, 34,3% del estado Bolívar y 29,6% del país. Se tiene el conocimiento, la experticia y el personal capacitado para su realización. De las autoridades de Salud depende el futuro de la enfermedad, manejada en estos momentos mediante un Programa Nacional de Prevención y Control, cuyas actividades, mezcla de “erradicación” y “control”, con muy bajo cumplimiento, han llevado a producir tan negativo registro.

In 2012 Venezuela reported the highest recorded incidence of malaria in its history with 51,264 cases, surpassing the previous high of 5,893 (12.6%) in 1990. Bolivar state increased to 44,180 incidence cases (86.2% of the country), with three municipalities in "epidemic" and two in "alarm" status. In Amazonas state, malaria increased and continued to occur mainly in children under 15 years (41.3%) with this group having 39.8% of the incidence of Plasmodium vivax, 50.8%, of Plasmodium falciparum, 82.6% Plasmodium malariae and 47.1% of mixed infections. The Benitez's epidemic and increased cases in four municipalities in Sucre make Bolivar state an high-risk state, given its openness and vulnerability The Massive Radical Cure, accompanied by spatial fogging of insecticide in the 20 localities with the highest incidence in Sifontes municipality could control 48.3% of malaria in the municipality, 34.3% in Bolívar state and 29.6% in the whole country. Venezuela has the knowledge, expertise and trained personnel for implementation of Malaria eradication programme. The future of the disease depends on the health authorities as it is right now driven by a "National Programme for Prevention and Control", whose activities are a mixture of "eradication" and "control" with very low compliance, and the current results are a negative record.

Lenalidomide promotes p53 degradation by inhibiting MDM2 auto-ubiquitination in myelodysplastic syndrome with chromosome 5q deletion.

Allelic deletion of the RPS14 gene is a key effector of the hypoplastic anemia in patients with myelodysplastic syndrome (MDS) and chromosome 5q deletion (del(5q)). Disruption of ribosome integrity liberates free ribosomal proteins to bind to and trigger degradation of mouse double minute 2 protein (MDM2), with consequent p53 transactivation. Herein we show that p53 is overexpressed in erythroid precursors of primary bone marrow del(5q) MDS specimens accompanied by reduced cellular MDM2. More importantly, we show that lenalidomide (Len) acts to stabilize MDM2, thereby accelerating p53 degradation. Biochemical and molecular analyses showed that Len inhibits the haplodeficient protein phosphatase 2A catalytic domain alpha (PP2Acα) phosphatase resulting in hyperphosphorylation of inhibitory serine-166 and serine-186 residues on MDM2, and displaces binding of RPS14 to suppress MDM2 autoubiquitination whereas PP2Acα overexpression promotes drug resistance. Bone marrow specimens from del(5q) MDS patients resistant to Len overexpressed PP2Acα accompanied by restored accumulation of p53 in erythroid precursors. Our findings indicate that Len restores MDM2 functionality in the 5q- syndrome to overcome p53 activation in response to nucleolar stress, and therefore may warrant investigation in other disorders of ribosomal biogenesis.

Malaria epidémica en Venezuela, año 2011 / Epidemic malaria in Venezuela, 2011

En el año 2011, en Venezuela fueron diagnosticados 46.904 casos de malaria, cifra técnicamente igual a los 46.910 reportados en 1990 como el mayor registro de la enfermedad en el país. El canal endémico señaló epidemia entre cinco y doce meses en trece parroquias de tres estados, las cuales totalizaron 77% de los reportes. Se presentaron incidencias maláricas históricas en las parroquias: Curiapo y Francisco Lugo del estado Delta Amacuro; San Isidro, Sucre, Tumeremo, Aripao y Moitaco del estado Bolívar. El municipio Sifontes (Bolívar) reportó 28.142 casos (71,6% del estado, 60% de Venezuela), su más alto registro de casos, manteniéndose todo el año en epidemia. El municipio Benítez del estado Sucre, está en epidemia desde septiembre de 2010. En Delta Amacuro, los menores de 15 años de edad presentan 46,1% del total de infecciones. En el grupo menor de 10 años de edad se observaron 32,9% de los casos, correspondiendo 49% al género femenino. La malaria en Venezuela se puede controlar, pero es necesaria la voluntad política de las autoridades, la presencia de equipos técnicos competentes para el manejo del programa, la participación activa de la comunidad y los recursos indispensables para lograr la mayor eficacia en los objetivos planteados.

In 2011, in Venezuela 46,904 cases of malaria were diagnosed, technically amount equal to 46,910 reported in 1990 as the greatest record of the disease in the country. The epidemic endemic channel was five to twelve months in thirteen parishes of three states, which totaled 77% of the reports. Malarious historical incidents occurred in the parishes and Francisco Lugo Curiapo Delta Amacuro state, San Isidro, Sucre, Tumeremo, and Moitaco Aripao Bolivar state. Sifontes Township (Bolivar) reported 28,142 cases (71.6% of the state, 60% of Venezuela), the highest record of cases, maintaining a year-round epidemic. The municipality of Sucre state Benitez is in epidemic since September 2010. In Delta Amacuro, those under 15 years old are 46.1% of all infections. In the age group under 10 years old 32.9% of cases were observed, corresponding to 49% female. Malaria in Venezuela can be controlled, but it still requires the political will of the authorities, the presence of competent technical staff to manage the program, the active participation of the community and the resources needed to achieve greater efficiency in the objectives.

Actividad sexual en adolescencia temprana: problema de salud pública en una ciudad colombiana / Sexual activity in early adolescence: a public health problem in a Colombian city

Antecedentes: El inicio de Ia actividad sexual en adolescentes, está asociada a pobre planificación familiar (PF), mayor tasa de fecundidad y riesgo de adquisición de enfermedades de transmisión sexual (ETS). Objetivo: Evaluar el impacto sobre la fecundidad, planificación familiar y lesiones de cuello uterino en una población de adolescentes y jóvenes, que iniciaron actividad sexual en la adolescencia. Método: Estudio de cohorte retrospectiva. Incluyó 845 adolescentes y jóvenes que iniciaron actividad sexual en la adolescencia y que consultaron a una Institución Prestadora de Servicios de Salud en Tuluá, Colombia. El análisis incluyó estadísticas descriptivas, análisis de riesgo relativo (RR) y atribuible a la exposición (RAexp) expresado en porcentaje, como indicadores de asociación. Resultados: Hubo 203 adolescentes y 642 jóvenes. El promedio de edad de inicio de la actividad sexual fue 16 años (+/-1,6 años). El 49 por ciento no realizaba PF, 34,7 por ciento tenía ≥1 hijo y 6,9 por ciento alguna lesión en cuello uterino. Hubo asociación entre actividad sexual en la adolescencia temprana y tener un hijo, al compararlo con el inicio de la actividad sexual en la adolescencia media (RR: 1,6; IC 95 por ciento: 1,2-2,1. RAexp0/35,7 por ciento; IC 95 por ciento: 13,3-52,4 por ciento) y tardía (RR: 2; IC 95 por ciento: 1,5-2,6. RAexp0/49 por ciento; IC 95 por ciento: 31,7-62 por ciento). Conclusiones: Nuestros resultados confirman el inicio precoz de la actividad sexual en adolescentes, el bajo uso de anticonceptivos y el riesgo de lesiones cervicales. Programas educativos conducentes al retraso del inicio de la actividad sexual, el uso de métodos anticonceptivos efectivos y de barrera, permitirán reducir las cifras encontradas en este estudio.

Background: The onset of sexual activity in adolescents is associated with poor family planning, a higher fertility rate and risk of acquiring sexually transmitted diseases. Objective: To evaluate the impact on fertility, family planning and cervical lesions in a population who initiated sexual activity in adolescence. Method: A retrospective cohort study. Included 845 adolescents and young people who initiated sexual activity during adolescence and who consulted a Lender Institution Health Services in Tuluá, Colombia. The analysis included descriptive statistics, analysis of relative risk (RR) and attributable to exposure (RAexp) expressed in percentage, as indicators of association. Results: There were 203 adolescents and 642 young people. The average age of onset of sexual activity was 16 (+/- 1.6 years). 49 percent did not perform family planning, 34.7 percent had ≥ 1 child and 6.9 percent cervical lesions. There was an association between sexual activity in early adolescence and have a child, when compared with the onset of sexual activity in middle (RR: 1.6, 95 percent CI 1.2 to 2.1. RAexp percent: 35.7 percent, 95 percent CI: 13.3 to 52.4 percent) and late adolescence (RR: 2, 95 percent CI: 1.5 to 2.6. RAexp percent: 49 percent, 95 percent CI: 31.7-62 percent). Conclusions: Our results confirm the early onset of sexual activity in adolescents, low contraceptive use and risk of cervical lesions. Educational programs leading to delayed onset of sexual activity, the use of effective contraceptive methods and barrier methods will reduce the numbers found in this study.

Prevalencia de lesiones de bajo y alto grado de cuello uterino en una ciudad colombiana / Prevalence of lesions of low and high grade cervical in a Colombian city

Objetivo: Determinar la prevalencia de las lesiones de bajo y alto grado de cuello uterino en una Institución Prestadora de Servicios de Salud de Tuluá, Colombia, entre los años 2008-2010. Métodos: Se realizó un estudio descriptivo retrospectivo en el que se incluyeron mujeres entre los 15 y 75 años, residentes en el Municipio de Tuluá. Se evaluó la normalidad de las variables cuantitativas, empleándose la mediana o el promedio con sus varianzas según su distribución, y frecuencias y proporciones para las variables categóricas. Resultados: Se incluyeron 3.539 mujeres. La mediana de la edad fue 38 años con rango intercuartil (RI: 29-46 años), la mediana del número de partos 1 (RI: 0-3). En relación a la seguridad social y uso de métodos anticonceptivos, la mayoría eran particulares y no utilizaban ningún método. El 87,5 por ciento de las citologías se reportaron como negativas, 8,2 por ciento lesión de bajo grado (LSIL), 2,6 por ciento células escamosas atípicas de significado indeterminado (ASC-US), 0,9 por ciento lesiones de alto grado (HSIL), 0,4 por ciento células escamosas atípicas de significado indeterminado de alto grado ASC-H, 0,4 por ciento células glandulares atípicas de significado incierto (ASGUS) y 0,2 por ciento carcinoma invasor. Conclusión: La prevalencia de las anormalidades citológicas fue baja en todos los grupos analizados, sin embargo, existe un mayor número de LSIL hacia la cuarta década de la vida y en aquellas que iniciaron su vida sexual después de los 40 años. De igual manera se encontró una relación inversa entre el número de partos, planificación familiar hormonal y aparición de lesiones pre neoplásicas.

Objective: To determine the prevalence of lesions of low and high grade cervical in a Lender Institution Health Services, Tuluá, Colombia, 2008-2010. Methods: We performed a retrospective study which included women between 15 and 75 years living in Tuluá. We evaluated the normality of quantitative variables, using the median or average with their variances for quantitative variables according to their distribution and frequencies and proportions for categorical variables. Results: 3539 women were included. The median age was 38 years with interquartile range (IR: 29-46 years) and the median parity was 1 (IR: 0-3). In relation to social security and family planning birth control, most were private and did not use any method. The 87.5 percent of smears was reported as negative, low-grade squamous intraepitelial lesions (LSIL) 8.2 percent atypical squamous cells of undetermined significance (ASC-US) 2.6 percent, high-grade squamous intraepitelial lesions (HSIL) 0.9 percent, atypical squamous cells cannot rule out a high grade lesion (ASC-H) 0.0 percent, atypical squamous glandular cells of undetermined significance (ASGUS) 0.4 percent and invasive carcinoma 0.2 percent. Conclusion: The prevalence of cytological abnormalities was low in all groups studied, however, a greater number of LSIL to the fourth decades of life and those who began their sexual life after 40 years. Similarly, an inverse relationship was found between parity, hormonal family planning and pre-neoplastic lesions.

Fístula aortocava como complicación de aneurisma aórtico abdominal / Aortocaval fistula as a complication of abdominal aortic aneurysm

Aortocaval fistula (ACF) is an infrequent complication of abdominal aortic aneurysm (AAA). Diagnosis is suspected by the presence of a continuous abdominal bruit and pulsatile abdominal mass, with variable signs of venous congestion and acute heart failure. Multislice computed tomography (MSCT) is useful in establishing the diagnosis, showing early enhancement of inferior vena cava and, in some cases, identifying the arteriovenous comunication. Surgical treatment is usually complex, with high morbidity and mortality rates. Endovascular treatment seems to be a promising alternative for the management of these patients. We report a case of ACF treated with open surgery and a literature review of this rare condition.

La fístula aortocava (FAC) es una complicación infrecuente del aneurisma aórtico abdominal (AAA). El diagnóstico se sospecha por la detección de un soplo continuo en el hemiabdomen inferior, asociado a masa abdominal pulsátil y signos variables de congestión venosa e insuficiencia cardíaca. La tomografía computada multicorte (TCM) permite confirmar el diagnóstico, evidenciando contraste de la vena cava inferior en fase arterial e identificando la zona anatómica de la comunicación arteriovenosa, en algunos casos. La reparación quirúrgica suele ser compleja, reportándose una alta morbi-mortalidad asociada. El uso de técnicas endovasculares pareciera mejorar el pronóstico de esta entidad. Reportamos un caso de FAC tratado mediante cirugía abierta. Se incluye una revisión de la literatura respecto a esta rara condición.

La Malaria en el estado Bolívar, Venezuela: 10 años sin control / Malaria in Bolívar state, Venezuela: 10 Years without control

La incidencia malárica del estado Bolívar en el decenio 2001-2010 fue de 235.288 casos. Desde el 2001, cuando produjo 4.998 (21,4% de la malaria de Venezuela), el estado ha registrado una tendencia continua al aumento de la misma, produciéndose un incremento de 795,2%, hasta el año 2010, cuando fueron diagnosticados 39.744 casos (86,5% de la malaria nacional), su más alta incidencia histórica, siendo su fórmula parasitaria 78,3% a P. vivax, 19,6% a P. falciparum, 0,1% a P. malariae y 2% de infecciones mixtas (P. vivax + P. falciparum). El municipio Sifontes, fue el de mayor incidencia en el 2010, aportando su parroquia San Isidro, 15.767 casos: 73,9% de la enfermedad en el municipio, 39,7% del estado Bolívar y 34,9% del país, con una IPA de 658 por un mil habitantes. Contribuyen al aumento de la incidencia: deficiencias presupuestarias, administrativas y logísticas del programa, acceso y coberturas diagnósticas deficientes, tratamientos incompletos, actividades de control no supervisadas, ausencia de toma de decisiones y análisis situacional inexistente. Es importante, retomar la figura de equipos técnicos competentes para el manejo del programa en los ámbitos de gestión y vigilancia, desarrollar competencias y recursos técnicos a nivel local con la participación de la comunidad.

The incidence of malaria in Bolívar state in the decade 2001-2010 was 235,288 cases. Since 2001, when it produced 4998 (21.4% of malaria in Venezuela), the state has registered a continue trend, resulting an increase of 795.2% to 2010, when 39,744 were diagnosed cases (86.5% of the national malaria), their highest historical impact, and its parasite formula 78.3% to P. vivax, 19.6% P. falciparum, 0.1% P. malariae and 2% of mixed infections (P. vivax + P. falciparum). The municipality Sifontes, had the highest incidence in 2010, bringing his parish of San Isidro, 15,767 cases: 73.9% of the disease in the municipality, Bolívar State 39.7% and 34.9% of the country, with an IPA 658 per thousand inhabitants. Contribute to incidence increase: budget deficiencies, administrative and logistics of the program, poor diagnostic access and covering, incomplete treatments, unsupervised control activities, lack of decision making and situational analysis nonexistent. It is important to resume the form of technical teams responsible for program management in the areas of management and vigilance, develop technical expertise and resources at local level with community participation.

Síndrome metabólico en estudiantes de sexto año de medicina Universidad de Carabobo, sede Aragua, 2009 / Metabolic syndrome in students from the sixth year of medicine at the University of Carabobo, Aragua, 2009

Se realizó un estudio descriptivo de corte transversal, en el cual participaron 91 (63,2%), de los 144 cursantes de sexto año de medicina de la Universidad de Carabobo, Sede Aragua, período académico 2008-2009, con el objetivo de determinar la prevalencia del Síndrome Metabólico. Se aplicó una encuesta que brindó información acerca de: edad, género, diagnóstico previo de hipertensión arterial, antecedentes familiares, sedentarismo, hábitos alimentarios y tabáquicos. Se midieron presión arterial, circunferencia abdominal y se tomó muestra hemática para determinar niveles de glicemia, lipoproteínas de alta densidad (HDL) y triglicéridos. Se definió síndrome metabólico de acuerdo a los criterios de la Federación Internacional de Diabetes (FID), consenso 2005. Doce participantes (13,2%) fueron diagnosticados con síndrome metabólico. Las prevalencias de las variables analizadas fueron: 23,1% sobrepeso, 12,1% obesidad, 11% Hipertensión Arterial, 6,6% hiperglicemia, 17,6% hipertrigliceridemia y 86,8% disminución global de los valores de HDL. Se hace necesario el control de los factores determinantes del Síndrome Metabólico en los estudiantes de medicina, bajo un programa educativo y preventivo a lo largo de su carrera, practicado por los servicios médicos de la universidad.

It was made a cross-sectional descriptive study, in which participated 91 of the 144 students from the sixth year of medicine at the Universidad de Carabobo, Aragua, academic period 20082009, to determine the prevalence of Metabolic Syndrome. A survey was performed which provided information about age, gender, prior diagnosis of hypertension, family background, sedentary lifestyle, eating and smoking habits. Measured blood pressure, abdominal circumference, and blood sample were taken to determine blood glucose levels, high density of lipoprotein (HDL) and triglycerides. MS was defined according to the criteria of the International Diabetes Federation consensus (IDF) 2005. Twelve participants (13.2%) were diagnosed with Metabolic Syndrome. The prevalence of variables were analyzed: 23.1% were overweight, 12.1% obese, 11% hypertension, hyperglycemia 6.6%, 17.6% hypertriglyceridemia and 86.8% overall decrease in the values of HDL . It becomes necessary to control the determinants of the Metabolic Syndrome in medical students under an education and prevention program throughout his career, practiced by the medical services of the university.