Soil Fungal Diversity of the Aguarongo Andean Forest (Ecuador).

Fungi represent an essential component of ecosystems, functioning as decomposers and biotrophs, and they are one of the most diverse groups of Eukarya. In the tropics, many species are unknown. In this work, high-throughput DNA sequencing was used to discover the biodiversity of soil fungi in the Aguarongo forest reserve, one of the richest biodiversity hotspots in Ecuador. The rDNA metabarcoding analysis revealed the presence of seven phyla: Ascomycota, Basidiomycota, Mortierellomycota, Mucoromycota, Glomeromycota, Chytridiomycota, and Monoblepharomycota. A total of 440 identified species were recorded. They mainly belonged to Ascomycota (263) and Basidiomycota (127). In Mortierellomycota, 12 species were recorded, among which Podila verticillata is extremely frequent and represents the dominant species in the entire mycobiota of Aguarongo. The present research provides the first account of the entire soil mycobiota in the Aguarongo forest, where many fungal species exist that have strong application potential in agriculture, bioremediation, chemical, and the food industry. The Aguarongo forest hides a huge number of unknown fungal species that could be assessed, and its protection is of the utmost importance.

Early versus late switch: How long should we extend the anti-vascular endothelial growth factor therapy in unresponsive diabetic macular edema patients?

PURPOSE: To compare the results of early versus late switch to the dexamethasone intravitreal implant Ozurdex® in patients with diabetic macular edema who had a poor response to vascular endothelial growth factor inhibitors. METHODS: Retrospective and single-center study conducted, in a real setting, on consecutive diabetic macular edema patients who were switch to an intravitreal dexamethasone implant after a poor response to anti-vascular endothelial growth factor treatment. Study sample was divided into two groups: (1) early-switch group, included those eyes who received three anti-vascular endothelial growth factor injections before switch and (2) late-switch group, included those eyes that received six or more anti-vascular endothelial growth factor injections before switch. The primary end-point was the difference in mean change in best-corrected visual acuity and in central subfoveal thickness. RESULTS: A total of 69 (31 early-switch group and 38 late-switch group) eyes were included. In the early-switch group, median (25-75 quartile range) best-corrected visual acuity significantly increase from 0.2 (0.2-0.5) at baseline to 0.4 (0.3 -0.7) at month 24 (p = 0.0043). Whereas, in the late-switch group, best-corrected visual acuity did not increase (p = 0.8602). Central subfoveal thickness was significantly reduced in both early- and late-switch groups, p = 0.0002 and 0.0038, respectively. The proportion of eyes obtaining a central subfoveal thickness reduction ⩾ 10% was significantly greater in the early-switch group than in the late-switch group (71.0% vs 47.4%, respectively, p = 0.0498). Three (9.7%) and 10 (26.3%) eyes have developed ocular hypertension during the study in the early- and late-switch groups, respectively, p = 0.0816. CONCLUSION: Early switch to Ozurdex in patients who did not adequately respond to anti-vascular endothelial growth factor therapy provided better functional and anatomical outcomes.

Prognostic factors in hemodialysis patients: experience of a Havana hospital.

INTRODUCTION: Knowledge of prognostic factors in end-stage renal disease patients has improved dialysis management and methods for reducing morbidity and mortality, underlining the importance of identification, prevention and control of these factors. OBJECTIVE: Identify factors affecting prognosis (survival or death) in hemodialysis patients at the Medical-Surgical Research Center in Havana over a ten-year period. METHODS: Descriptive, prospective study of 81 end-stage renal disease patients who received hemodialysis at the Medical-Surgical Research Center from 1995 to 2004. Prognostic factors were identified at initiation of and during dialysis treatment, using chi square, t test, McNemar test, Kaplan Meier analysis, log-rank test and Cox regression model, with significance threshold set at p <0.05. RESULTS: Hypertension and diabetes were the leading causes of end-stage renal disease. Six patients were referred late. Mean survival was 4.4 years; with survival of 86.6%, 54.7% and 26.6% at one, three and five years respectively. Factors predictive of decreased survival that were most frequent at initiation of hemodialysis were hypertension and chronic anemia (both present in 95.9% of cases); malnutrition, hypoalbuminemia, cardiovascular disease and chronic liver disease increased during treatment while hypertension decreased. In multivariate analysis, prognostic factors that significantly predicted decreased survival were hypertension, inadequate vascular access and diabetes. Patients aged ≥ 60 years and those with malnutrition, hypoalbuminemia, anemia, cardiovascular disease or liver disease had lower survival figures at the end of the study period. Leading causes of death were infections (45.2%) and cardiovascular disease (41.9%); the latter was present in 93.5% of deaths, independent of underlying cause of death. CONCLUSIONS: Survival of hemodialysis patients diminished at five years. Some negative predictive factors are present at initiation of hemodialysis, such as diabetes, hypertension and chronic anemia; others increased later, including malnutrition, hypoalbuminemia, cardiovascular disease and liver disease.

Cambios histológicos en dientes pulpotomizados tratados con formocresol y agregado de trióxido mineral en canis familiaris / Histological changes in pulpotomized teeth produced by formocresol and mineral trioxide aggregate in canis familiaris

Objetivo. Evaluar las alteraciones histopatológicas que produce el formocresol comparado con el agregado de trióxido mineral en pulpotomías. Material y método. Investigación de tipo experimental, comparativa, prospectiva, longitudinal. Se utilizaron cuatro (04) Canis familiaris, raza mestiza de un año de edad. Los premolares de cada arcada fueros tratados siguiendo la técnica clásica de pulpotomía. Los muñones pulpares fueron cubiertos con formocresol en la hemi arcada izquierda tanto superior como inferior y con pasta de agregado de Trióxido Mineral (MTA), en la hemi arcada derecha. La primera toma de muestra se realizó a las 48 horas, y la segunda se obtuvo a los 40 días. Resultados. Se evaluaron las alteraciones generadas en la pulpa, nivel de inflamación y grado de regeneración dentinaria; luego de analizar los datos mediante la prueba t de Student, se encontraron diferencias significativas entre las alteraciones producidas en dientes pulpotomizados de Canis familiaris al utilizar formocresol y MTA. Conclusiones. El MTA produjo mejores resultados en cuanto a las alteraciones generadas, nivel de inflamación y regeneración dentinaria.

Objective. To evaluate histopathological changes produced by formocresol compared with mineral trioxide aggregate in pulpotomy. Material and method. Experimental, comparative, prospective, longitudinal study. Four (4) crossbred Canis Familiaris, one year old were used. The premolars of each arch were treated with the classical technique of pulpotomy. The pulp stumps were covered with formocresol on the left hemi arch top and bottom and with MTA paste on the right hemi arch. After 48 hours was taken the first sample; 40 days after, the second sample. Results. The changes generated in the pulp, inflammation levels and degrees of dentin regeneration were evaluated. After analyzing the data using student t test, significant differences were found in the use of formocresol or mineral trioxide aggregate in pulpotomized teeth of Canis Familiaris. Conclusions. MTA exhibited better results in the changes generated in the pulp, inflammation levels and degrees of dentin regeneration.

Bioseguridad: su comportamiento / Biosecurity: its behavior

Fundamento: La seguridad biológica ha sido tema candente en la opinión pública de muchos países en los últimos 60 años. Objetivo: Analizar el comportamiento de la seguridad biológica en los hospitales provinciales docentes Manuel Ascunce Domenech y Eduardo Agramonte Piña, de la provincia de Camagüey. Método: Se realizó un estudio descriptivo desde enero a diciembre del 2006. El universo de estudio estuvo constituido por los dos hospitales anteriormente mencionados, seleccionados por el método aleatorio simple. Se procedió a la aplicación en los servicios o departamentos con riesgo biológico de un cuestionario confeccionado según criterio de expertos, el cual pasó a ser el registro fundamental de la investigación. Además, fue aplicada una encuesta destinada a medir el nivel de conocimientos sobre bioseguridad al 33.3 por ciento de los trabajadores con riesgo biológico. Resultados: En ambos hospitales los trabajadores expuestos a riesgo biológico representaron el 57 por ciento , con predominio de las enfermeras, los médicos y los auxiliares, se obtuvo evaluación de mal en los indicadores del Programa de bioseguridad hospitalaria. Se registraron mayor número de incidentes en el Hospital Pediátrico Provincial, existió un subregistro en ambos centros, prevalecieron las exposiciones y las averías, sobre todo en el laboratorio de Microbiología, las causas más frecuentes fueron los derrames de sangre y otros líquidos, roturas de tubos y frascos y los pinchazos, fundamentalmente en el personal técnico. Conclusiones: No se reportaron enfermedades profesionales por agentes biológicos.

Background: The biological security has been burning theme in the public opinion of many countries in the last 60 years. Objective: To analyze the behavior of biological security in the educational provincial hospitals Manuel Ascunce Domenech and Eduardo Agramonte Piña, of Camagüey province. Method: A descriptive study from January to December 2006 was performed. The universe of study was constituted by the two hospitals previously mentioned, selected by the simple random method. It was proceed to the application of a questionnaire created according to experts criterion, in the services or departments with biological risk, which constituted the fundamental registry of the investigation. Besides, a survey to measure the level of knowledge on biosecurity to the 33,3 percent of workers with biological risk was applied. Results: In both hospitals workers exposed to biological risk represented the 57 percent, with predominance of nurses, doctors and auxiliaries; bad evaluation in the indicators of the Program of hospital biosecurity was obtained. Greater numbers of incidents in the Provincial Pediatric Hospital were recorded, a subregistry in both centers existed, exposures and damages prevailed, especially in the Microbiology laboratory, the most frequent causes were spills of blood and other liquids, breaks of pipes and flasks and pricks, fundamentally in the technical personnel. Conclusions: No professional diseases by biological agents were reported.

Uso de estradiol transdérmico continuo y medroxiprogesterona oral trimestral / Continous transdermal estradiol use and medroxiprogesterone oral quarterly

Uno de los métodos para reducir o evitar los efectos colaterales de los progestágenos y así mejorar el cumplimiento de la hormonoterapia de reemplazo(HTR) es el agregado de dichos esteroides a los estrógenos en esquemas no diarios en esquemas no mensuales. El objetivo de este estudio fue evaluar el uso de uno de estos esquemas alternativos: estrógeno continuo y progrestágeno cada tres meses sobre los síntomas climatéricos, el sangrado uterino, la presión arterial, el peso corporal, los lípidos en sangre, la histología endometrial y su aceptabilidad. Ciento siete pacientes posmenopáusicas recibieron 50 mcg de estradiol transdérmico en forma continua durante seis meses y 10 mg de acetato de medroxiprogesterona (AMP) por vía oral durante 14 días cada tres meses.En síntesis, el uso de estradiol transdérmico continuo y AMP oral trimestral mostró ser un tratamiento eficaz los síntomas climatéricos, inducir un sangrado uterino aceptable, siendo bien tolerado por las pacientes y sin provocar lesiones de riesto en el endometrio

La cirugía ambulatoría en la Policlínica Dr. Joaquín J. Vallarino Z / Ambulatory Surgery at Dr.Joaquin J. Vallarino Z. Polyclinic

Servicios de cirugía ambulatoria en la policlínica J.J. Vallarino, surge con el propósito de destacar y contribuir a un nuevo cambio positivo en el personal, como en la población, para que éstos servicios puedan externderse a todas las policlínicas del país, ofreciendo a la población servicios de calidad y eficiencia en materia de salud pública. También con el objetivo de demostrar el grado de importancia que tiene el implementar este proceso de cirugía para observar los cambios para los nuevos procesos de la modernización