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A vast body of research demonstrates that many ecological and evolutionary processes can only be understood from a tri-trophic viewpoint, that is, one that moves beyond the pairwise interactions of neighbouring trophic levels to consider the emergent features of interactions among multiple trophic levels. Despite its unifying potential, tri-trophic research has been fragmented, following two distinct paths. One has focused on the population biology and evolutionary ecology of simple food chains of interacting species. The other has focused on bottom-up and top-down controls over the distribution of biomass across trophic levels and other ecosystem-level variables. Here, we propose pathways to bridge these two long-standing perspectives. We argue that an expanded theory of tri-trophic interactions (TTIs) can unify our understanding of biological processes across scales and levels of organisation, ranging from species evolution and pairwise interactions to community structure and ecosystem function. To do so requires addressing how community structure and ecosystem function arise as emergent properties of component TTIs, and, in turn, how species traits and TTIs are shaped by the ecosystem processes and the abiotic environment in which they are embedded. We conclude that novel insights will come from applying tri-trophic theory systematically across all levels of biological organisation.
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Ecosistema , Cadena Alimentaria , Biomasa , EcologíaRESUMEN
Grazing can induce changes in both plant productivity and nutritional quality, which may subsequently influence herbivore carrying capacity. While research on Soay sheep (Ovis aries L.) dynamics on Hirta Island in the St. Kilda archipelago has elucidated the complexity of population drivers, including parasites, the role of herbivore-generated feedbacks as an intrinsic regulating factor remains unclear. The sheep lack large predators and every 3-9 years undergo population crashes (overcompensatory mortality). We investigated the effects of grazing on (1) sward productivity and (2) quality (toxicity) of the primary forage species, red fescue (Festuca rubra L.), which is highly infected by an alkaloid-synthesizing fungal endophyte. Grazing had a negative impact on both forage quantity and quality. At higher sheep densities, impacts on sward growth were magnified, resulting in a nonlinear relationship with plant productivity. Simultaneously, endophyte hyphal load (and by inference, toxicity) peaked close to the time of a crash. A greenhouse experiment showed that alkaloid concentration in F. rubra increased in response to artificial defoliation. We conclude that at high sheep densities, grazing-mediated reductions in productivity, together with sustained alkaloid production, are likely to influence sheep dynamics. Future research should consider the interactive effects of forage toxicity, quantity, and nutritional content.
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Endófitos/fisiología , Festuca/fisiología , Cadena Alimentaria , Ovinos/fisiología , Animales , Festuca/química , HerbivoriaRESUMEN
Predators can decrease herbivore damage to plants, and this is often assumed to be beneficial to plant growth/reproduction without actual quantification. Moreover, previous studies have been biased towards strict carnivores and neglected the role of omnivorous predators in prey-suppression. Here, we examined the costs (reduction in growth) and benefits (increase in growth) of enemy-mediated plant protection via the omnivorous (prey and plant-feeding) Orthotylus marginalis, relative to herbivory by a detrimental insect pest of Salix spp. plantations, the beetle Phratora vulgatissima. In a first experiment, we compared the cost of adult beetle versus omnivore nymph plant-feeding, and assessed the (non-) additive effects of the two types of damage. In a second experiment, we quantified the reduction in plant damage resulting from beetle-egg feeding by omnivorous nymphs and subsequent benefits to plants. We found that plant-feeding by omnivores negatively affected plant growth and this effect was similar to the cost imposed by beetle herbivory. Furthermore, simultaneous damage effects were additive and more detrimental than individual effects. While egg-predation by omnivore nymphs completely prevented beetle damage to plants, there was no difference in plant growth relative to only herbivore-damaged plants and growth was still reduced compared to control plants. Thus, despite herbivore suppression, there was no benefit to plant growth of omnivore-mediated plant protection and the negative effects of omnivore plant-feeding remained. These results are a first for an omnivorous enemy, and provide novel and timely insights on the underlying assumptions of tri-trophic associations and their use for biocontrol of insect pests.
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Herbivoria , Salix , Animales , Escarabajos , Análisis Costo-Beneficio , Control de Insectos , PlantasRESUMEN
Organ biobanking is the pending subject of cryopreservation. Although the problem is multifaceted, advances in recent decades have largely related it to achieving rapid and uniform rewarming of cryopreserved samples. This is a physical challenge largely investigated in past in addition to cryoprotectant toxicity studies, which have also shown a great amount of advancement. This paper presents a proof-of-principle, based on the nematode Caenorhabditis elegans, of a technology capable of performing such a function: high intensity focused ultrasound. Thus, avoiding the problem of recrystallization, this worm, in its adult state, preserved at - [Formula: see text], has been systematically brought back to life after being heated with High Intensity Focused Ultrasound (HIFU) waves. The great advantage of this technology is that it is scalable; in addition, rewarming can be monitored in real time by MRI thermography and can be controlled by acoustic interferometry. We anticipate that our findings are the starting point for a possible approach to rewarming that can be used for cryopreservation of millimeter scale systems: either alone or in combination with other promising ways of heating, like nanowarming or dielectric heating, the present technology provides new ways of solving the physical aspects of the problem of recrystallization in cryopreservation, opening the door for the long-term storage of larger samples.
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Bancos de Muestras Biológicas , Criopreservación , Crioprotectores , Termografía , SonidoRESUMEN
Utilizing plants with enhanced resistance traits is gaining interest in plant protection. Two strategies are especially promising for increasing resistance against a forest insect pest, the pine weevil (Hylobius abietis): exogenous application of the plant defense hormone methyl jasmonate (MeJA), and production of plants through the clonal propagation method somatic embryogenesis (SE). Here, we quantified and compared the separate and combined effects of SE and MeJA on Norway spruce resistance to pine weevil damage. Plants produced via SE (emblings) and nursery seedlings (containerized and bare-root), were treated (or not) with MeJA and exposed to pine weevils in the field (followed for 3 years) and in the lab (with a non-choice experiment). Firstly, we found that SE and MeJA independently decreased pine weevil damage to Norway spruce plants in the field by 32-33% and 53-59%, respectively, compared to untreated containerized and bare-root seedlings. Secondly, SE and MeJA together reduced damage to an even greater extent, with treated emblings receiving 86-87% less damage when compared to either untreated containerized or bare-root seedlings in the field, and by 48% in the lab. Moreover, MeJA-treated emblings experienced 98% lower mortality than untreated containerized seedlings, and this high level of survival was similar to that experienced by treated bare-root seedlings. These positive effects on survival remained for MeJA-treated emblings across the 3-year experimental period. We conclude that SE and MeJA have the potential to work synergistically to improve plants' ability to resist damage, and can thus confer a strong plant protection advantage. The mechanisms underlying these responses merit further examination.
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Herbivores may damage both leaves and reproductive structures, and although such combined damage may affect plant fitness non-additively, this has received little attention. We conducted a 2-year field experiment with a factorial design to examine the effects of simulated leaf (0, 12.5, 25, or 50% of leaf area removed) and inflorescence damage (0 vs. 50% of inflorescences removed) on survival, growth and reproduction in the perennial herb Arabidopsis lyrata. Leaf and inflorescence damage negatively and independently reduced flower, fruit and seed production in the year of damage; leaf damage also reduced rosette size by the end of the first season and flower production in the second year. Leaf damage alone reduced the proportion of flowers forming a fruit and fruit production per plant the second year, but when combined with inflorescence damage no such effect was observed (significant leaf × inflorescence damage interaction). Damage to leaves (sources) caused a greater reduction in future reproduction than did simultaneous damage to leaves and inflorescences (sinks). This demonstrates that a full understanding of the effects of herbivore damage on plant fitness requires that consequences of damage to vegetative and reproductive structures are evaluated over more than 1 year and that non-additive effects are considered.
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Arabidopsis/crecimiento & desarrollo , Herbivoria , Inflorescencia , Hojas de la Planta/crecimiento & desarrollo , Animales , Flores/crecimiento & desarrollo , Mariposas Nocturnas , Semillas/crecimiento & desarrolloRESUMEN
BACKGROUND: The pine weevil (Hylobius abietis) is a major forest regeneration pest causing high levels of seedling mortality and economic losses. Current management relies on silviculture, stem coatings and insecticides. Here we evaluated for the first time the effects of Bacillus thuringiensis (Bt) strains on H. abietis adults: two producing the Coleoptera-targeted toxins Cry3Aa (Bt tenebrionis NB-176) and Cry8Da (Bt galleriae SDS-502), and one producing the Diptera-targeted Cry10A (Bt israelensis AM65-52). Choice and nonchoice assays using individual and mixtures of Bt formulations, containing these strains respectively, were conducted. RESULTS: We found that Bt had toxic and lethal effects on H. abietis, but effects varied with strain and formulation concentration. The Diptera-targeted Bt israelensis had the most negative effects on weevil weight, feeding and mortality (70-82% feeding reduction, 65-82% greater mortality than control), whereas the effect was lower for the Coleoptera-specific Bt tenebrionis (38-42%; 37-42%) and Bt galleriae (11-30%; 15-32%). Reduced weevil feeding was observed after 3 days, and the highest mortality occurred 7-14 days following Bt exposure. However, we found no synergistic toxic effects, and no formulation combination was better than Bt israelensis alone at reducing consumption and survival. Also, pine weevils were not deterred by Bt, feeding equally on Bt-treated and non-Bt treated food. CONCLUSION: There is potential to develop forest pest management measures against H. abietis that include Bt, but only the Diptera-targeted Bt israelensis would provide effective seedling protection. Its Diptera-specificity may need reconsideration, and evaluation of other Bt strains/toxins against H. abietis would be of interest. © 2020 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
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Bacillus thuringiensis , Escarabajos , Dípteros , Gorgojos , Animales , Bosques , Control Biológico de VectoresRESUMEN
Global change poses new challenges for pest management. Omnivorous predatory arthropods play an important role in pest management, yet their potential has not been fully explored. Not only do they consume prey, but their plant-feeding induces plant defences that decrease herbivores' performance, and increases production of volatiles that attract natural enemies. Growing evidence from different plant-arthropod systems indicates the generality of plant defence induction following omnivore plant-feeding. Furthermore, these responses appear to affect other organisms (e.g. plant viruses), altering multi-trophic interactions. Here, we review the dual role of omnivores (as predators and plant inducers), identify knowledge gaps and provide future perspectives to increase our understanding of omnivores' multiple functions, and how this can be applied to advance plant protection strategies.
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Artrópodos , Animales , Herbivoria , Plantas , Conducta PredatoriaRESUMEN
Exogenous application of the plant hormone methyl jasmonate (MeJA) can trigger induced plant defenses against herbivores, and has been shown to provide protection against insect herbivory in conifer seedlings. Other methods, such as mechanical damage to seedlings, can also induce plant defenses, yet few have been compared to MeJA and most studies lack subsequent herbivory feeding tests. We conducted two lab experiments to: (1) compare the efficacy of MeJA to mechanical damage treatments that could also induce seedling resistance, (2) examine if subsequent insect damage differs depending on the time since induction treatments occurred, and (3) assess if these induction methods affect plant growth. We compared Scots pine (Pinus sylvestris) seedlings sprayed with MeJA (10 or 15 mM) to seedlings subjected to four different mechanical bark damage treatments (two different bark wound sizes, needle-piercing damage, root damage) and previous pine weevil (Hylobius abietis) damage as a reference treatment. The seedlings were exposed to pine weevils 12 or 32 days after treatments (early and late exposure, hereafter), and resistance was measured as the amount of damage received by plants. At early exposure, seedlings treated with needle-piercing damage received significantly more subsequent pine weevil feeding damage than those treated with MeJA. Seedlings treated with MeJA and needle-piercing damage received 84% less and 250% more pine weevil feeding, respectively, relative to control seedlings. The other treatments did not differ statistically from control or MeJA in terms of subsequent pine weevil damage. For the late exposure group, plants in all induction treatments tended to receive less pine weevil feeding (yet this was not statistically significant) compared to control seedlings. On the other hand, MeJA significantly slowed down seedling growth relative to control and all other induction treatments. Overall, the mechanical damage treatments appeared to have no or variable effects on seedling resistance. One of the treatments, needle-piercing damage, actually increased pine weevil feeding at early exposure. These results therefore suggest that mechanical damage shows little potential as a plant protection measure to reduce feeding by a bark-chewing insect.
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An essential component of plant defense is the change that occurs from a constitutive to an induced state following damage or infection. Exogenous application of the plant hormone methyl jasmonate (MeJA) has shown great potential to be used as a defense inducer prior to pest exposure, and could be used as a plant protection measure. Here, we examined (1) the importance of MeJA-mediated induction for Norway spruce (Picea abies) resistance against damage by the pine weevil Hylobius abietis, which poses a threat to seedling survival, and infection by the spruce bark beetle-associated blue-stain fungus Endoconidiophora polonica, (2) genotypic variation in MeJA-induced defense (terpene chemistry), and (3) correlations among resistance to each pest. In a semi-field experiment, we exposed rooted-cuttings from nine different Norway spruce clones to insect damage and fungal infection separately. Plants were treated with 0, 25, or 50 mM MeJA, and planted in blocks where only pine weevils were released, or in a separate block in which plants were fungus-inoculated or not (control group). As measures of resistance, stem area debarked and fungal lesion lengths were assessed, and as a measure of defensive capacity, terpene chemistry was examined. We found that MeJA treatment increased resistance to H. abietis and E. polonica, but effects varied with clone. Norway spruce clones that exhibited high constitutive resistance did not show large changes in area debarked or lesion length when MeJA-treated, and vice versa. Moreover, insect damage negatively correlated with fungal infection. Clones receiving little pine weevil damage experienced larger lesion lengths, and vice versa, both in the constitutive and induced states. Changes in absolute terpene concentrations occurred with MeJA treatment (but not on proportional terpene concentrations), however, variation in chemistry was mostly explained by differences between clones. We conclude that MeJA can enhance protection against H. abietis and E. polonica, but the extent of protection will depend on the importance of constitutive and induced resistance for the Norway spruce clone in question. Trade-offs among resistances do not necessarily hinder the use of MeJA, as clones that are constitutively more resistant to either pest, should show greater MeJA-induced resistance against the other.
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Somatic embryogenesis (SE), a clonal propagation method utilizing somatic cells, occurs under conditions that activate plant stress adaptation mechanisms such as production of protective secondary metabolites. Surprisingly, possible differences in susceptibility to insect pests between SE-generated and conventionally cultivated plants have not been previously explored. Here, we recorded frequencies and levels of bark-feeding damage by pine weevils (Hylobius abietis) in two large field trials, consisting of emblings (SE-propagated plants) and seedlings from 50 half-sib Norway spruce (Picea abies) families. We found that emblings were less frequently attacked by pine weevils, and when attacked, they were damaged to a lesser extent than seedlings. Moreover, we detected significant additive genetic variation in damage levels received by plants, indicating a heritable component to differences in resistance to insect herbivory among half-sib families. We present first-time evidence that emblings can be more resistant than seedlings to herbivorous insect damage, thus, SE appears to confer a previously unknown plant protection advantage. This finding indicates novel avenues to explore mechanisms underlying plant resistance and new approaches to develop non-toxic measures against insect pests.
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Understanding the stability of the G matrix in natural populations is fundamental for predicting evolutionary trajectories; yet, the extent of its spatial variation and how this impacts responses to selection remain open questions. With a nested paternal half-sib crossing design and plants grown in a field experiment, we examined differences in the genetic architecture of flowering time, floral display, and plant size among four Scandinavian populations of Arabidopsis lyrata. Using a multivariate Bayesian framework, we compared the size, shape, and orientation of G matrices and assessed their potential to facilitate or constrain trait evolution. Flowering time, floral display and rosette size varied among populations and significant additive genetic variation within populations indicated potential to evolve in response to selection. Yet, some characters, including flowering start and number of flowers, may not evolve independently because of genetic correlations. Using a multivariate framework, we found few differences in the genetic architecture of traits among populations. G matrices varied mostly in size rather than shape or orientation. Differences in multivariate responses to selection predicted from differences in G were small, suggesting overall matrix similarity and shared constraints to trait evolution among populations.
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Arabidopsis/genética , Evolución Molecular , Flores/genética , Modelos Genéticos , Arabidopsis/crecimiento & desarrollo , Flores/crecimiento & desarrollo , Variación Genética , Carácter Cuantitativo Heredable , Selección GenéticaRESUMEN
Abstract Introduction Hip fracture pain is frequently acute and disabling and increases perioperative complications in the patient; hence it requires a multimodal analgesia approach. This case series describes the continuous erector spinae plane block at the lumbar level for hip fracture analgesia. Methods A search was conducted of patients with hip fracture referred to the pain service of Hospital Universitario San Vicente Fundación (HUSVF) from August 2019 to March 2020, who had undergone continuous erector spinae plane block as part of their analgesic regimen. Results A total of 6 patients, 4 females and 2 males with an average age of 75 years were identified. A reduction in pain intensity from acute to mild or absent was observed in every case, up to 24 hours after the initial injection. 66 % experienced a relapse of severe pain after 24 hours and 2 patients the catheter functionality failed after 24 hours. One patient underwent dermatome pinprick assessment. Conclusions The continuous erector spinae plane block with a single injection provided analgesic efficacy similar to other single injection peripheral blocks, although continuous analgesia for more than 24 hours was not achieved. Some variations in the block technique described may improve the analgesic effectiveness in patients with hip fracture pain.
Resumen Introducción El dolor de la fractura de cadera suele ser fuerte e incapacitante y aumenta las complicaciones perioperatorias en el paciente, lo que hace indispensable el enfoque de analgesia multimodal. En esta serie de casos se describe la experiencia del bloqueo continuo del plano erector de la espina a nivel lumbar para analgesia en fractura de cadera. Métodos Se realizó una búsqueda de los pacientes con fractura de cadera remitidos al servicio de dolor del Hospital Universitario San Vicente fundación (HUSVF) desde agosto de 2019 hasta marzo de 2020, a quienes se les realizó bloqueo continuo del plano erector de la espina como parte de su esquema analgésico. Resultados Se encontraron 6 pacientes, 4 mujeres y 2 hombres, con una edad promedio de 75 años. Se observó reducción de la intensidad del dolor de fuerte a leve o ausente en todos los casos hasta las 24 horas posteriores a la inyección inicial. El 66 % tuvo recaída del dolor fuerte posterior a las 24 horas y en 2 pacientes no se logró funcionalidad del catéter por más de 24 horas. En un paciente se hizo evaluación dermatómica por pinprick (prueba de pinchazo). Conclusiones El bloqueo continuo del plano erector de la espina con inyección única ofreció eficacia analgésica similar a otros bloqueos periféricos en inyección única, aunque no se logró analgesia continua con el catéter por más de 24 horas. Ciertas variaciones en la técnica del bloqueo descrita podrían mejorar la efectividad analgésica en pacientes con dolor por fractura de cadera.
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Humanos , Masculino , Femenino , Anciano , Dolor , Fracturas de Cadera , Columna Vertebral , Analgesia , Anestesia de ConducciónRESUMEN
Abstract Introduction: Postoperative pain in thoracic surgery in adults is usually severe, and to control it there are many analgesic methods that include paravertebral blockade (PVB). Until now, there is no clarity on which is the most effective technique to perform this blockade. Objective: To describe the different PVB techniques and its analgesic effect in thoracic surgery. Methods: A systematic review of the literature was performed. We included studies that analyzed patients in open chest surgery and used PVB as analgesic technique. The Cochrane and Grading of Recommendation Assessment, Development and Evaluation strategies were used to analyze biases and evidence. The results are presented graphically by means of a visual analog scale (VAS) pain and opioid consumption equivalent to morphine for each technique found. We summarize the results with a qualitative approach without meta-analysis. Results: A total of 38 articles were analyzed (2188 patients). 13 using PVB guided by surface anatomy (SA-PVB), 7 Ultrasound-guided PVB (US-PVB), 1 neurostimulation guided PVB (NE-PVB) and the remaining using PVB performed under direct visualization by the surgeon (S-PVB). A VAS of less than 3 was found in studies with SA-PVB and US-PVB, and greater than 5 in studies with S-PVB; however, opioid consumption in the postoperative period was similar between the techniques described. Conclusion: PVB can be performed through 4 techniques. Techniques of US-PVB or SA-PVB have shown better consistency to manage postoperative acute pain in thoracic surgery.
Resumen Introducción: El dolor posoperatorio en cirugía de tórax en adultos usualmente es grave, y para su control existen varios métodos analgésicos que incluyen el bloqueo paravertebral (BPV). En la actualidad no hay claridad acerca de la técnica más efectiva para su realización. Objetivo: Describir las diferentes técnicas de colocación del BPV y su efecto en el control analgésico en cirugía de tórax. Métodos: Se realizó una revisión sistemática de la literatura. Se incluyeron estudios que analizaron pacientes sometidos a cirugía de tórax abierta y que utilizaron el BPV como técnica analgésica. Se emplearon las estrategias Cochrane y GRADE (Grading of Recommendation Assessment, Development and Evaluation) para valorar la evidencia disponible. Se presentan los resultados de manera gráfica mediante escala visual análoga de dolor y consumo de opioide equivalente a morfina para cada técnica encontrada. Se realizó síntesis cualitativa de los resultados sin metanálisis. Resultados: Se analizaron en total 38 artículos (2188 pacientes). 13 estudios usaban BPV guiado por anatomía de superficie (BPV-AS), 7 BPV con guía ecográfica (BPV-US), 1 BPV guiado por neuroestimulación (BPV-NE) y los restantes BPV bajo visualización directa por el cirujano (BPV-C). Se encontró una escala visual análoga (EVA) menor a 3 en los estudios con BPV-AS y BPV-US y mayor a 5 en estudios con BPV-C; sin embargo, el consumo de opioides en el posoperatorio fue similar entre las técnicas descritas. Conclusión: Se han descrito cuatro técnicas para la realización del BPV. Las técnicas de BPV-US o BPV-AS han mostrado mejor consistencia para el manejo del dolor agudo posoperatorio en cirugía de tórax.
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Humanos , Cirugía Torácica , Dolor Postoperatorio , Periodo Posoperatorio , Tórax , Estrategias de Salud , Actividad Extravehicular , Dolor Agudo , Analgésicos , Analgésicos OpioidesRESUMEN
Introduction: Intravenous rescue analgesia in the postoperative anesthesia care unit (PACU) is the most effective method for reducing postoperative pain (POP) when perioperative multimodal analgesia fails to control it. Appropriate analgesia during these first postoperative hours may prevent morbidity associated with pain. Objective: To compare the effectiveness of intravenous morphine versus fentanyl in the PACU for reducing severe POP. Methods: Randomized, prospective, double blind trial that included patients with severe POP using VAS in the PACU. Rescue was performed on one group with 01 mg/kg morphine and with another with 1 mcg/kg of fentanyl every 5 min intravenously until pain was reduced from severe to mild (VAS<4). 30 patients were included in both groups. Results: There were no significant differences in the percentage of patients with reduction of severe POP to mild 5 min after the injection of morphine or fentanyl, or in the subsequent rescue analgesia intervals (p > 0.05). Similarly, there were no significant differences in mean VAS (95% CI) in morphine or fentanyl groups beginning 5 min after the first analgesic dose (p > 0.05) between the groups. There were no significant differences in side effects such as respiratory depression, nausea, vomiting or pruritus (p = 1.0). There was a high satisfaction in both groups (p > 0.05). Conclusions: Morphine and fentanyl were equally effective in treating severe POP after 5 min and following intervals after rescue analgesia was initiated, during 25 min at PACU, with no differences in efficacy or adverse effects between groups Register # NCT02145975 clinical-trials.gov, prospective.
Introducción: La analgesia intravenosa de rescate en la unidad de cuidados postanestesicos (UCPA), es la forma más efectiva de reducir el dolor POP, cuando la analgesia mutimodal perioperatoria falla en controlarlo. Una adecuada analgesia en las primeras horas previene la morbilidad asociada al dolor. Objetivo: Compararla efectividad para reducir el dolor POP severo de fentanilo versus morfina en recuperación postanestésica. Metodología: Estudio aleatorizado, prospectivo, doble ciego, en pacientes con dolor severo POP medido con la escala EVA. El rescate se hizo con un grupo morfina a 0,1 mg/kg versus fentanilo a 1 mcg/kg, cada 5 minutos, vía intravenosa, hasta reducir el dolor de severo a leve (EVA <4). Se incluyeron 30 pacientes en el grupo morfina y 30 en el grupo fentanilo. Resultados: No se observaron diferencias en porcentaje de pacientes con reducción del dolor severo a leve desde los 5 minutos luego del rescate entre morfina o fentanilo, ó en los intervalos restantes (p>0,05). Similarmente, no se encontraron diferencias significativas en la media de EVA (IC 95%) desde los 5 minutos luego del rescate (p > 0.05) entre los grupos. No hubo diferencias en efectos adversos como depresión respiratoria, náuseas, vómitos o prurito entre grupos (p = 1,0). La satisfacción fue comparable en ambos grupos (p >0,05). Conclusiones: La morfina y el fentanilo fueron igualmente efectivos para el rescate en dolor severo desde los primeros 5 minutos, sin diferencias en los efectos adversos en ambos grupos. Registro # NCT02145975 (clinicaltrials.gov, prospectivo).
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HumanosRESUMEN
Se presentan dos casos de inyección subdural accidental durante procedimientos epidurales para control del dolor. El primero fue un hombre con dolor lumbar crónico quien sufrió dicha complicación durante la inyección epidural de esteroides por vía interlaminar; el segundo, una mujer con síndrome de hipotensión endocraneana que requirió la aplicación de un parche hemático epidural para controlar múltiples fístulas de LCR, que debió ser abortada en dos ocasiones debido al patrón subdural que se evidenció luego de la administración del medio de contraste. El bloqueo subdural accidental es una complicación rara de la inyección epidural con fines analgésicos o anestésicos. Es de suma importancia la identificación temprana del patrón de distribución subdural y epidural del medio de contraste con el fin de disminuir el riesgo y aumentar la seguridad de los procedimientos en el espacio epidural.
Two cases are reported of accidental subdural injection during epidural procedures for pain control. The first one was a man with chronic lumbar pain who suffered such complication during an epidural injection of steroids using the interlaminar approach. The second one was a woman with intracranial hypotension syndrome who required the application of an epidural blood patch in order to control multiple CSF fistulae. The procedure had to be aborted twice due to the subdural pattern observed after injection of the contrast medium. Accidental subdural block is a rare complication of epidural injection for analgesic or anesthetic procedures.
Se apresentam dois casos ocorridos durante a execução de procedimentos da prática diária do especialista de dor. O primeiro, um doente com diagnóstico de dor lombar crónico quem apresenta uma injeção subdural acidental durante uma injeção epidural de esteroides por via interlaminar; o segundo uma doentecom síndrome de hipotensão endocraniana quem precisou da colocação de um curativo hemático epidural o qual teve que ser abortado em 2 ocasiões devido ao padrão subdural que se evidenciou logo da administração de meio de contraste. O bloqueio subdural acidental é uma rara complicação da injeção epidural com fins analgésicos ou anestésicos. Por tanto, resulta de suma importância a precoce identificação do padrão de distribuição do meio de contraste subdural e epidural com o fim de diminuir o risco e aumentar a segurança dos procedimentos no espaço epidural.
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Adulto , Anciano de 80 o más Años , Analgesia Epidural , Anestesia Epidural , Espacio Subdural/lesiones , Inyecciones Epidurales , AnalgesiaRESUMEN
El objetivo de esta investigación es determinar si hay diferencias entre grupos de adolescentes de grado 7° de la ciudad de Bogotá, con diferentes tiempos de uso de las redes sociales en problemáticas de tipo internalizante, externalizante, la soledad percibida, el funcionamiento familiar y el sexo. El estudio con diseño ex post facto valoró el efecto del tiempo de uso de redes sociales a tres niveles (bajo, medio y alto) a través de un cuestionario socio demográfico diseñado para tal fin: el LSRQ, el FACES III, CDI y el YSR. Participaron 96 estudiantes con un rango de edades entre los 11 y 15 años. Se encontró que entre los participantes con un elevado tiempo de uso de las redes sociales, eran mayores los problemas de tipo externalizante (conducta agresiva, ruptura de reglas y problemas de atención). Se discute la necesidad de que en futuras investigaciones se enfaticen los factores positivos que para el desarrollo de los adolescentes puede tener el uso de las redes sociales a través de Internet.
The aim of this study was to explore the relationship between the amount of time spent in social networking and the presence of internalizing and externalizing behavior problems in adolescents. Participants were 96 seventh grade students aged between 11 and 15 years who were attending schools in Bogotá, Colombia. An ex-post facto design was used and the amount of time spent in social networking was divided into three categories: high, medium and low. The instruments included a sociodemographic questionnaire especially designed for this purpose, the Loneliness and Social Dissatisfaction Questionnaire by Cassidy & Asher (LSDQ for its English acronym), the Youth Self- Report by Achenbach (YSR, for its English acronym), the Child Depression Inventory by Kovacs (CDI, for its English acronym) and the Family Adaptability and Cohesion Evaluation Scales by Olson, Portner & Lavee (FACES III, for its English acronym). Findings showed that participants with a greater amount of time spent on social networking had more externalyzing disorders (aggressive behavior, rule breaking and attention deficits) than students in the other two categories. The need for future research that stresses the positive factors that the use of Internet social networking can have on adolescents' development is discussed.
El objetivo desta pesquisa é determinar se existem diferenças entre grupos de adolescentes da 7° série da cidade de Bogotá, com diferentes tempos de uso das redes sociais em problemáticas de tipo internalizante, externalizante, a solidão percebida, o funcionamento familiar e o sexo. O estudo com desenho ex pós fato avaliou o efeito do tempo de uso de redes sociais em três níveis (baixo, médio e alto) através de um questionário sóciodemográfico desenhado para esse fim: o LSRQ, o FACES III, CDI e o YSR. Participaram 96 estudantes da faixa etária de 11 a 15 anos. Encontrou-se que entre os participantes com um elevado tempo de uso das redes sociais, eram maiores os problemas de tipo externalizante (conduta agressiva, ruptura de regras e problemas de atenção). Discute-se a necessidade de que em pesquisas futuras sejam enfatizados os fatores positivos que para o desenvolvimento dos adolescentes pode ter o uso das redes sociais através de Internet.
Asunto(s)
Humanos , Adolescente , Adolescente , Internet , Red SocialRESUMEN
Se presenta el caso de un paciente con aparición muy temprana (18 h) de miembro fantasma doloroso (MFD) luego de la amputación de la extremidad inferior. Se describen los datos clínicos preexistentes al evento, la fisiopatología, las manifestaciones clínicas y el tratamiento para el MFD. Se realiza una revisión de la literatura sobre el estado actual de la etiología del MFD y las intervenciones analgésicas que puedan controlar su aparición e intensidad. También se describen intervenciones que pudieron modificar dicho desenlace para el presente reporte de caso con una aplicación oportuna.
This is a case of a patient with very early occurrence (18 h) of phantom limb pain (PLP) following amputation of a lower extremity. The clinical data prior to the event, the pathophysiology, the clinical manifestations and the treatment of the phantom limb pain are described. A literature review on the current status of the PLP etiology and any analgesia interventions that may control its occurrence and intensity was performed anda description is given of the timely interventions affecting the outcome.
Asunto(s)
HumanosRESUMEN
Objetivo . Dado el potencial analgésico y de reducción del consumo de opiáceos de la ketamina, se evaluó el efecto de adicionar ketamina a la morfina a la bomba de analgesia controlada por el paciente, y se midieron desenlaces como alivio del dolor, consumo de opiáceos y efectos adversos frecuentes por opiáceos. Pacientes y métodos. Ensayo clínico prospectivo, aleatorio, doble ciego en pacientes para laparotomía electiva. Ciento doce pacientes con clasificación American Society of Anesthesiologists (ASA) I, II o III entre los 18 y 85 años sometidos a laparotomía fueron distribuidos de manera aleatoria para recibir 1 mg/ml de morfina (grupo 1, n=53) o 1 mg/ml de morfina más 1mg/ml de ketamina (grupo 2, n=59). Se evaluaron las dosis acumulativas de morfina de cada grupo a las 12, 24, 36 y 48 horas después de instalada la bomba de analgesia controlada por el paciente, escalas de alivio de dolor (escala verbal numérica en reposo y dinámico y escala categórica) y los efectos adversos: náusea y vomito, sedación, prurito y presión arterial. Resultados. La intensidad del dolor fue comparable en ambos grupos. El grupo 2 (morfina más ketamina) tuvo un consumo de morfina menor (17% de reducción de la dosis de morfina), sin que fuera estadísticamente significativo. No se hallaron diferencias significativas en la frecuencia de efectos adversos entre los dos grupos. Conclusiones. La ketamina iniciada en la analgesia controlada por el paciente con morfina para el control del dolor postoperatorio no reduce significativamente el consumo de morfina después de la laparotomía .
Objective : Given the analgesic potential and opioid sparing effect of ketamine, we compared the effect of additioning ketamine to morphine on IV PCA (patient controlled analgesia) in a laparotomy model. We evaluated pain level, opioid consumption and frequent adverse effects of morphine in both groups. Pattients and methods: Randomized controlled trial in patients scheduled for elective laparotomy. One hundred and twelve patients (112) ASA I, II or III aged 18 to 85 years old were randomly assigned to receive morphine 1mg/ml (group 1, n=53) or morphine 1 mg/ml plus ketamine 1mg/ml (group 2 n=59). We assessed cumulative doses of morphine for each group at 12, 24,36 and 48 hours after installation of intravenous PCA, pain level at rest and movement, hemodynamic (arterial pressure) and opioid related effects: nausea and vomiting, sedation and pruritus between groups. Results: Pain intensity level was similar in both groups. In group 2 (morphine plus ketamine) there was a 17% less in opioid consumption, however, this difference did not reach statistical significance. Considering adverse effects derivate from opioids, there was not a significant difference between groups. Conclusion: Ketamine initiated with IV PCA for postoperative pain control after laparotomy does not reduce significantly morphine consumption or adverse effects related to opioid effect .