A randomized trial comparing transanal irrigation and percutaneous tibial nerve stimulation in the management of low anterior resection syndrome.

AIM: To assess the effectiveness of transanal irrigation (TAI) compared with posterior tibial nerve stimulation (PTNS) in severe and chronic low anterior resection syndrome (LARS). METHOD: A two-group parallel, open-label randomized controlled trial carried out in a single university hospital. The study population included patients with a LARS scale score of more than 29 points who had undergone rectal surgery more than 1 year previously. These were randomly allocated, with a central randomization system, following a 1:1 sequence to TAI or PTNS. The main study outcome was to achieve a reduction of at least one LARS grade in at least 50% of the patients, for each intervention. RESULTS: A total of 27 patients (TAI = 13, PTNS = 14) were randomized. Both groups were similar with regard to confounding factors. Four patients were excluded because of intercurrent disease or early dropout, leaving 23 (TAI, n = 10; PTNS, n = 13) for analysis. Eight out of 10 and 4 out of 13 patients were downgraded with TAI and PTNS, respectively. The median LARS score decreased from 35 [interquartile range (IQR) 32-39] to 12 (IQR 12-26) (P = 0.021) for the TAI group and from 35 (IQR 34-37) to 30 (IQR 25-33) (P = 0.045) for the PTNS group. The Vaizey score fell from 15 (IQR 11-18) to 6 (IQR 4-7) (P = 0.037) and from 14 (IQR 13-17) to 9 (IQR 7-10) (P = 0.007) with TAI and PTNS, respectively, with 80% and 38% of patients, respectively, showing decreases of more than 50%. Improvement in quality of life was observed in both groups. CONCLUSION: Both treatments improved the LARS score in this study but this was only significant in the TAI group.

Dual Ion Species Plasma Expansion from Isotopically Layered Cryogenic Targets.

A dual ion species plasma expansion scheme from a novel target structure is introduced, in which a nanometer-thick layer of pure deuterium exists as a buffer species at the target-vacuum interface of a hydrogen plasma. Modeling shows that by controlling the deuterium layer thickness, a composite H^{+}/D^{+} ion beam can be produced by target normal sheath acceleration (TNSA), with an adjustable ratio of ion densities, as high energy proton acceleration is suppressed by the acceleration of a spectrally peaked deuteron beam. Particle in cell modeling shows that a (4.3±0.7) MeV per nucleon deuteron beam is accelerated, in a directional cone of half angle 9°. Experimentally, this was investigated using state of the art cryogenic targetry and a spectrally peaked deuteron beam of (3.4±0.7) MeV per nucleon was measured in a cone of half angle 7°-9°, while maintaining a significant TNSA proton component.

Parasite search in strawberries from Irapuato, Guanajuato and Zamora, Michoacan (Mexico).

A seasonal research was carried out in Irapuato, Guanajuato and Zamora, Michoacan, Mexico, the location of the most important producers of strawberries, in order to assess fecal contamination through the finding of protozoan cysts and helminth eggs, specifically of Taenia sp eggs. Three techniques were used: direct observation, flotation and sedimentation. Low numbers of protozoan cysts and only one Ascaris egg were found. What is most interesting is that no Taenia eggs were identified. Results indicate that although strawberries are contaminated with human feces, contamination is minimal.

Importance of Triatoma pallidipennis (Hemiptera: Reduviidae) as a vector of Trypanosoma cruzi (Kinetoplastida: Trypanosomatidae) in the state of Morelos, Mexico, and possible ecotopes.

We performed a transversal-type epidemiological study in the state of Morelos, Mexico, to determine the presence of triatomines, their ecotopes, and importance in transmission of Trypanosoma cruzi Chagas. Sampling sites included domestic, peridomestic, and wild areas with collection based on the person per hour technique. We determined the entomological indices related to infestation, density, overcrowding, colonization, infection, and dispersion, which were used to calculate transmission risk. During the study, observations were made on the predominant building material, presence of cracks and illumination as factors fostering colonization. The most important results were related to infection indices, which were higher for domestic type triatomines (29%), whereas it was 4% for peridomestic sites, and 20% for sylvatic areas. The actual risk of human contact with the vector was of 0.51%, and the predominating ecotopes were stone heaps.

Association between anatomopathologic graft disorders during reperfusion and vena cava sIL-2r in orthotopic liver transplantation.

UNLABELLED: Graft ischemia-reperfusion injury during orthotopic liver transplantation (OLT) is associated with anatomic and pathologic disorders in the graft, which may cause initial dysfunction. The object of this paper was to evaluate sIL-2r as an indicator of liver damage during graft reperfusion. MATERIAL AND METHODS: Blood samples were drawn from 20 consecutive patients who required OLT secondary to chronic end-stage insufficiency various sites (portal vein, vena cava, pulmonary artery) and during different surgical phases. Following centrifugation and storage at -70 degrees C, sIL-2r was quantitated by chemiluminescence (Immulite, EURO/DPC). In addition biopsies were graded from 0 to III according to the anatomic and pathologic findings. Base excess and ammonia were measured to evaluate the function of the new liver. STATISTICAL ANALYSES: Parameter associations were explored using Spearman's Rho and Kendall's Tau-b methods. RESULTS: There was a correlation between the degree of graft preservation and sIL-2R both during vena cava reperfusion (r=.0591, P=.05) and for the initial 2 hours after reperfusion (r=0.61, P=.062). CONCLUSION: sIL-2r levels drawn from the vena cava after graft reperfusion are associated with its degree of injury.

[Qualitative and quantitative study of Taenia solium posoncospheres in the muscular tissue of pigs with and without cysticercosis]. / Estudio cualitativo y cuantitativo de la presencia de posoncosferas de Taenia solium en el tejido muscular de cerdos con y sin cisticercosis.

It was determined the presence of posoncospheres in muscular tissues in 20 natural cysticercotic pigs and in 20 pigs apparently free of Taenia solium metacestodes. Ten differents anatomical regions were dissected, giving 400 samples in total. The animals were slaughtered in Ecatepec, Mexico State, Mexico. The samples were kept in bottles with saline and were processed in the Laboratorio de Biología de Parásitos, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM); cysticercus were counted and later on the resulting muscular mass was grinded and observations were made in the sediment, for posoncospheres search. Mann-Whitney statistical method revealed meaningful differences between postoncospheres in cysticercotic pigs and not apparently cysticercotic pigs. The Linear Correlation Analysis showed no relation between cysticercus quantity and postoncospheres quantity in the same samples. Postoncospheres were found in cysticercotic animals and in those apparently free of cysticercus, in the last group the quantity was bigger.

Chagas disease in Mexico.

Mexico - the northernmost country of Latin America - has long been thought to have an unusually low prevalence of Chagas disease compared with other Latin American countries. This has seemed unusual because of the large number of vector species and subspecies reported from the country, and the social and ecological conditions that seem to parallel those in other countries where Chagas disease is recognized as a major public health priority. This review seeks to clarify the question, and suggests that the epidemiological, parasitological, and entomological pattern of Chagas disease in Mexico may also parallel that of other endemic regions, but has been masked by poor awareness of the disease both at local and institutional levels.

[Biology of the taeniasis-cysticercosis binomial]. / Biología del binomio teniasis-cisticercosis.

We present a review of the biological aspects of taeniasis-cysticercosis binomial, emphasizing those related to its biotic potential, resistance, and viability of eggs in the environment, as well as the morphological features of the corresponding adults, which are instrumental for the diagnosis of taeniasis. A new infection mechanism through the ingestion of posoncospheres present in macerated meat is discussed. The significance of unifying epidemiological criteria to control this important binomial is pointed out.

[Validation of data collection for an American trypanosomiasis epidemiologic study in the State of Morelos, México]. / Validación del proceso de obtención de datos para un estudio sobre trypanosomiasis americana en el estado de Morelos, México.

The purpose of this paper is to show up the importance of the standardization concepts in American Trypanosomiasis epidemiological studies. The consistence in the measurement of some dwelling characteristics was evaluated. A validation of the Queretaro antigen for indirect hemagglutination reaction as a diagnostic test and the interobserver concordance for the serologic readings were also made. The observers were instructed in some sessions. The pretests were made in the laboratory with positive and negative sera, with sera from the studied population. Results show that the interobserver concordance after the instruction, for the dwelling variables ranged from 70% to 100%. Sensitivity of the Queretaro antigen was 100%, specificity 55%, the predictive value of a positive test 55%, and the predictive value of a negative test 93%. The interobserver concordance was 47%. The pretest and the pilot study are very important in getting the objectives of the principal study.

Tres especies de triatominos y su importancia como vectores de Trypanosoma cruzi en México / Importance of three triatoma vectors of Trypanosoma cruzi in Mexico

Observations made in the field and in the laboratory on three vectors of Trypanosoma cruzi: Triatoma barberi, T. pallidipennis and T. dimidiata are here presented. Results are compared in relation with their ecotopes, vectorial capacity, biological characteristic, entomological indexes and capture places. In relation with their ecotopos T. barberi has preference for the interior of the human home, in walls, directly in contact with beds; T. pallidipennis, when it is inside the houses, prefers floors and among clothes, although their main ecotope is wild; T. dimidiata has localization in floors, specially under the beds, in the angle between wall and floor; T. barberi and T. dimidiata are attracted by the light. The cycles of life were of 523, 171 and 510 days, respectively for Triatoma barberi, T. pallidipennis and T. dimidiata. The vectorial capacity was determined according to the time taken in defecating during or after its sucking blood: T. barberi defecates during its feeding, while T. pallidipennis and T. dimidiata make it from 10 to 20 and of 20 to 30 minutes after starting the process, respectively. The indexes of natural infection were of 56.6 for T. barberi, 29 for T. pallidipennis and 15.6 for T. dimidiata, The metacyclogenics indexes that indicate percentages of metacyclics trypomastigotes in later intestine of vectors was in T. barberi 76.6, T. pallidipennis 15 and T. dimidiata 26, with what it can be concluded that the first species is the best transmitter of T. cruzi in Mexico.

Se presentan observaciones hechas en el campo y en el laboratorio sobre tres vectores de Trypanosoma cruzi: Triatoma barberi, T. pallidipennis y T. dimidiata. Se comparan resultados en relación con sus ecotopos, capacidad vectorial, características biológicas, índices entomológicos y sitios de captura. En relación con sus ecotopos, T. barberi tiene preferencia por el interior del domicilio humano, en paredes, directamente en contacto con las camas; T. pallidipennis, cuando se encuentra dentro de las casas, prefiere pisos y entre la ropa, aunque su principal ecotopo es silvestre; T. dimidiata tiene localización en pisos, especialmente bajo las camas, en el ángulo entre pared y piso; T. barberi y T. dimidiata son atraídas por la luz. Los ciclos de vida fueron de 523, 171 y 510 días, respectivamente para Triatoma barberi, T. pallidipennis y T. dimidiata. La capacidad vectorial se determinósegún el tiempo que tarda en defecar durante o después de su ingesta de sangre: T. barberi defeca durantesu alimentación, mientras que T. pallidipennis y T. dimidiata lo hacen de 10 a 20 y de 20 a 30 minutos después de iniciado el proceso, respectivamente. Los índices de infección natural fueron de 56.6 para T.barberi, 29 para T.pallidipennis y 15.6 para T. dimidiata. Los índices metaciclogénicos, que indican porcentajes de tripomastigotesmetacíclicos en intestino posterior de los vectores fueron en T. barberi 76.6, T. pallidipennis 15 y T. dimidiata 26,con lo que se concluye que la primera especie es el mejor transmisor de T. cruzi en México.