Papillary Tumor of the Pineal Gland: Series of Four Clinical Cases.

The papillary tumor of the pineal region (PTPR) is a rare neuroepithelial tumor originating from specialized ependymocytes. It primarily affects structures within the pineal region, including the pineal gland, epithalamus, quadrigeminal cistern, and posterior wall of the third ventricle. Here, we present a series of four cases characterized by symptoms associated with obstructive hydrocephalus such as headaches, seizures, visual disturbances, gait disturbances, and Parinaud syndrome. Imaging studies revealed lesions in the pineal region, prompting surgical intervention. Histopathological examination, including biopsy and intraoperative analysis, confirmed the diagnosis of PTPR. Despite advancements, the etiology and pathogenesis of PTPR remain incompletely understood, warranting further research to refine management strategies.

Depression scores correlate with glycosylated hemoglobin a levels in type 2 diabetics from a mayan community / Los puntajes de depresión se correlacionan con los niveles de hemoglobina glucosilada en diabéticos tipo 2 de una comunidad maya

Abstract Objective: To assess whether depression and quality of life scores correlate with glycosylated hemoglobin A (HbA1c) levels in type 2 diabetes mellitus (T2DM) patients of predominant Mayan ethnicity, from a rural community in the state of Yucatán, Mexico. Materials and methods: Instruments: for depression, CES-D (cutoff ≥ 16); for quality of life, D-39; criterion for poor glycemic control, HbA1c ≥ 8%. Results: Depression was detected in 36.3% of 33 diabetic subjects (10 men, 23 women), and their HbA1c levels (mean ± SD) were higher (10.7 ± 2.5%) than for those without depression (8.6 ± 2.2%, p = 0.015; unpaired Student's t-test, two-tailed). Depression occurred in 33.3% of diabetics with HbA1c ≥8%, but only in 3.0% of those with HbA1c < 8% (p = 0.027, Fisher's exact test). HbA1c levels positively correlated with CES-D scores (r2 =0.135; p = 0.035; Pearson). D-39 "Anxiety-Worry" (AW) dimension scores were higher in diabetics with depression (43.3 ± 22.2) than in those without depression (17.7 ± 17.8; p = 0.005, Mann-Whitney U-test). A positive correlation was found between CES-D and AW scores (r2 = 0.304; p = 0.001; Pearson). Conclusions: Considering that depression and anxiety have been related to poor self-care for achieving a good glycemic control, we propose the concomitant use of CES-D and D-39, which are validated and easy-to-apply instruments, as screening tests to detect depression and anxiety in T2DM patients residing in rural communities. Therefore, if patients test positive on one or both instruments, they can be referred to a psychiatrist to confirm the diagnosis and provide appropriate therapy. This would help to promote adherence to diabetes control measures and improve their quality of life.

Resumen Objetivo: Evaluar si las puntuaciones de depresión y calidad de vida se correlacionan con los niveles de hemoglobina glucosilada (HbA1c) en pacientes con diabetes mellitus tipo 2 (DM2) de etnia maya predominante, de una comunidad rural en el estado de Yucatán, México. Materiales y Métodos: Instrumentos: para depresión, CES-D (punto de corte ≥ 16); para calidad de vida, D-39; criterio de mal control glucémico, HbA1c ≥ 8%. Resultados: Se detectó depresión en el 36.3% de 33 sujetos diabéticos (10 hombres, 23 mujeres), y sus niveles de HbA1c (media ± DE) fueron más altos (10.7 ± 2.5%) que para los que no tenían depresión (8.6 ± 2.2%, p = 0.015; prueba t de Student, no pareada). La depresión se presentó en el 33.3% de los diabéticos con HbA1c ≥ 8%, pero solo en el 3.0% de aquellos con HbA1c <8% (p = 0.027, prueba exacta de Fisher). Los niveles de HbA1c se correlacionaron positivamente con las puntuaciones CES-D (r2 = 0.135; p = 0.035; Pearson). Los puntajes de la dimensión "Ansiedad-Preocupación" (AW) del D-39 fueron más altos en diabéticos con depresión (43.3 ± 22.2) que en aquellos sin depresión (17.7 ± 17.8; p = 0.005, prueba U de Mann-Whitney). Se encontró una correlación positiva entre las puntuaciones CES-D y AW (r2 = 0.304; p = 0.001; Pearson). Conclusiones: Considerando que la depresión y la ansiedad han sido asociadas a autocuidados inadecuados para alcanzar un buen control glicémico, proponemos el uso concomitante de CES-D y D-39, que son instrumentos validados y de fácil aplicación, como pruebas de cribado para detectar depresión y ansiedad en pacientes con DM2 residentes en comunidades rurales. Por lo tanto, si los pacientes dan positivo en uno o ambos instrumentos, se les puede derivar a un psiquiatra para confirmar el diagnóstico y proporcionar la terapia adecuada. Esto ayudaría a promover el cumplimiento de las medidas de control de la diabetes y a mejorar su calidad de vida.

Healthcare and Indirect Cost of the Laparoscopic vs. Vaginal Approach in Benign Hysterectomy.

Background and Objectives: The aim of this study was to analyze indirect costs of vaginal and laparoscopic routes for hysterectomy to determine whether this makes a difference in total costs when considering route for surgery. Methods: A five-year observational retrospective cohort study was conducted in an academic tertiary care center. A total of 517 patients scheduled for total laparoscopic hysterectomy (n = 137) and vaginal hysterectomy (n = 380) for benign conditions between January 1, 2008 and December 31, 2012 meeting inclusion criteria were reviewed. Results: Indirect costs were higher in the vaginal hysterectomy group compared to the laparoscopic hysterectomy group (mean cost €3,239.86 vs. €1,371.58; cost increase of €1,868.28; p < .001). Indirect costs due to lost-work-productivity were the most important, represented by 97.7% in the vaginal group and 93.6% in the laparoscopic group. Conclusion: Among women undergoing hysterectomy for benign disease, laparoscopic hysterectomy appears to be superior to vaginal hysterectomy when indirect costs are analyzed in a five-year temporal horizon. Laparoscopic hysterectomy is a good alternative to vaginal hysterectomy when technically feasible as both present comparable advantages. The surgical approach to hysterectomy should be decided in light of the relative benefits and hazards, which will depend on clinical circumstances and surgical expertise.

Estudio comparativo de la capacidad denominativa y la memoria episódica de los pacientes con demencia degenerativa / Comparative Study of the Word Capacity and Episodic Memory of Patients with Degenerative Dementia

RESUMEN Introducción: Aunque la ausencia de deterioro de la memoria se consideró entre los criterios diagnósticos para diferenciar la enfermedad de Alzheimer (EA) de la demencia frontotemporal variante conductual (DFTvC), la evidencia actual, en aumento, sería la un importante porcentaje de casos de DFTvC con déficits de la memoria episódica. El presente estudio se diseñó con el fin de comparar el perfil de desempeño de la capacidad denominativa y de la memoria episódica de los pacientes con EA y DFTvC. Métodos: Estudio transversal y analítico con grupo de control (n = 32). Se incluyó a 42 sujetos con probable EA y 22 con probable DFTvC, todos mayores de 60 años. Se utilizaron instrumentos del Uniform Data Set validados en español: Multilingual Naming Test (MINT), historia de Craft-21 y Figura compleja de Benson, entre otros. Resultados: Se observó un mayor promedio de edad entre los pacientes con EA. La capacidad denominativa fue mucho menor en los pacientes con DFTvC que en aquellos con EA, medida según el MINT y el coeficiente de denominación sustantivos/verbos. Todos los pacientes con DFTvC, el 73,81% de aquellos con EAy solo el 31,25% de los controles no lograron reconocer la Figura compleja de Benson. Todas las diferencias fueron estadísticamente significativas (p< 0,001). Resultados: Este estudio confirma el perfil amnésico de los pacientes con EA y revela la disminución de la capacidad denominativa de los pacientes con DFTvC, un área del lenguaje que se afecta típica y tempranamente con las funciones ejecutivas, según recientes hallazgos. Conclusiones: Los pacientes con EA rinden peor en las tareas de memoria episódica verbal y visual, mientras que los pacientes con DFTvC rinden peor en tareas de denominación. Estos hallazgos abren la posibilidad de explorar los mecanismos de participación prefrontal en la memoria episódica, típicamente atribuida al hipocampo.

ABSTRACT Introduction: Although the absence of memory impairment was considered among the Alzheimer's disease diagnostic criteria to differentiate Alzheimer's disease (AD) from Behavioural Variant of Frontotemporal dementia Frontotemporal Dementia (bvFTD), current and growingevidence indicates that a significant Neuropsychological assessment percentage of cases of bvFTD present with episodic memory deficits. In order to compare Memory the performance profile of the naming capacity and episodic memory in patients with AD and bvFTD the present study was designed. Methods: Cross-sectional and analytical study with control group (32 people). The study included 42 people with probable AD and 22 with probable bvFTD, all over 60 years old. Uniform Data Set instruments validated in Spanish were used: Multilingual Naming Test (MINT), Craft-21 history and Benson's complex figure, among others. Results: A higher average age was observed among the patients with AD. The naming capacity was much lower in patients with bvFTD compared to patients with AD, measured according to the MINT and the nouns/verbs naming coefficient. All patients with bvFTD, 73.81% of those with AD and only 31.25% of the control group failed to recognise Benson's complex figure. All differences were statistically significant (p < 0.001). Results:This study confirms the amnesic profile of patients with AD and reveals the decrease in naming capacity in patients with bvFTD, an area of language that is typically affected early on with executive functions, according to recent findings. Conclusions: Patients with AD perform worse in verbal and visual episodic memory tasks, while patients with bvFTD perform worse in naming tasks. These findings open the possibility of exploring the mechanisms of prefrontal participation in episodic memory, typically attributed to the hippocampus.

Chronic feeding with 3% dried raw blueberries (V. corymbosum) reduces apomorphine-induced rotations and striatal dopaminergic loss in hemiparkinsonian rats.

Blueberries (BB) are rich in antioxidant polyphenols, and their intake could prevent Parkinson's disease (PD). Here we assessed whether rats chronically fed dried raw BB develop resistance to dopaminergic denervation and motor disorders caused by unilateral intrastriatal injection of 6-hydroxydopamine (6-OHDA), a dopaminergic neurotoxin acting mainly by inducing oxidative stress. Male rats were fed either with LabDiet® alone or supplemented with 3% lyophilized raw BB for 2 weeks before and 3 weeks after injecting 6-OHDA (day 0) or vehicle (mock lesion) into the right striatum. The cylinder test was performed on days -14, -7, -1, +7, +14, and +21; the percentage of ipsilateral forepaw (IF) use asymmetry was determined by counting the wall contacts made with either forepaw or with both. Apomorphine (0.25 mg/kg, s.c.)-induced rotation was performed on days -1, +7, +14, and +21. Full contralateral rotations were counted in 3-min periods, every 15 min, up to 90 min. Striatal slices were immunostained for tyrosine hydroxylase (TH) and the ionized calcium-binding protein-1 adapter (Iba1) [immunoreactive area or microglia count in right striatum expressed as % of the left striatum]. Antioxidants in BB methanolic extracts neutralized the free radical 2,2-diphenyl-1-picrylhydrazyl in a concentration-dependent manner. Anthocyanins have been reported as the most abundant polyphenols in BB. Using the pH differential method, the total anthocyanin content (malvidin-3-glucoside equivalents) in raw BB averaged 21.04 mg/g dry weight. The range of anthocyanin intake by rats throughout the study varied from 37.7 to 72.2 mg/kg body weight. The time and food type factors, as well as their interaction were significant according to two-way RM-ANOVA in both the apomorphine-induced rotations and the cylinder test. Compared with LabDiet® alone, chronic supplementation with 3% dried raw BB decreased apomorphine-induced rotations on days +14 and +21 (p < 0.001) and produced a 46% reduction in total rotations post-surgery (p < 0.05), but only caused a partial, non-significant, decrease of IF asymmetry. BB supplementation reduced TH loss in the striatum (p < 0.05) but did not attenuate the increase of Iba1+ microglia. The consumption of 3% dried raw blueberries attenuates dopaminergic denervation and partially reverses motor disorders in the 6-OHDA-induced PD model in rats. The phytochemicals of raw blueberries that contribute to the observed neuroprotective effect are yet to be identified.

Patrones de distribución y estructura de la vegetación en el gradiente de humedales costeros El Castaño, Chiapas, México

Introducción: Las características de los humedales costeros son resultado de las interacciones hidrogeomorfológicas entre el continente y el océano, que causan un gradiente ambiental, que resulta en diferentes tipos de vegetación como manglares, popales, tulares, selvas y palmares inundables. Objetivo: Caracterizar las variables del hidroperiodo y fisicoquímicas del agua y suelo para determinar la relación que existe en el patrón de distribución de la vegetación en el Sistema de Humedales El Castaño (SHC). Metodología: Se establecieron 11 unidades de muestreo (UM) permanentes por estrato definidos: cinco en el manglar, dos en selvas inundables, dos en tular y dos en pastizal inundable. De mayo 2016 a octubre 2017 se caracterizó la vegetación y se muestreó mensualmente los niveles de inundación y parámetros fisicoquímicos del agua (superficial, intersticial y subterránea): salinidad, conductividad y pH; y el suelo: densidad aparente, porcentaje de humedad y potencial redox. Resultados: El manglar es el más cercano al mar, tiene la menor diversidad (H:1.66) y especies registradas (14), está dominado por Laguncularia racemosa y Rhizophora mangle y tiene los valores más altos de salinidad intersticial y subterránea, mayores a 10.8 ups, se mantiene inundado de 4 a 12 meses, su potencial redox es de 14.57 mV. Seguido está el manglar, tierra adentro, se ubican los remanentes de la selva inundable, (H:2.18 y 18 especies), dominada por Pachiraaquatica, la salinidad intersticial y subterránea de 4.95 ups, permanece inundada de 0 a 6 meses y el potencial redox es de 119.07 mV. El tular, después de la selva, (H:1.92 y 16 especies), dominado por Typha domingensis, salinidad intersticial y subterránea de 6.1 ups, el tiempo de inundación es de 5 a 8 meses y potencial redox es de 125.9 mV. El pastizal inundable, con menor influencia marina, es un humedal herbáceo modificado para uso ganadero, presentó los valores más altos de diversidad (H:3.44 y 50 especies), Paspalum conjugatum es la especie dominante, la salinidad intersticial y subterránea es menor a 0.5 ups, se mantiene inundado de 5 a 9 meses y el potencial redox es de 151.23 mV. Conclusiones: En cada tipo de vegetación, la estructura, composición y diversidad es diferente, con un alto recambio de especies que indica un gradiente definido por la salinidad. La vegetación en el SHC sigue los patrones de organización típica de los humedales costeros tropicales, manglares, selvas inundables y humedales herbáceos, en este caso los tulares y pastizales inundables. El factor que define la distribución de la vegetación, es salinidad y el gradiente que se observa está en función de la dinámica hidrológica que depende de entradas de agua marina y de la bajada de agua dulce del interior del continente.

Introduction: The characteristics of coastal wetlands are the result of hydrogeomorphological interactions between the continent and the ocean, which cause an environmental gradient, hat results in different vegetation types such as mangroves, freshwater marshes, swamp forests and palm swamps. Objective: To characterize the hydroperiod and physicochemical variables of water and soil and their effect on the distribution of vegetation in the Sistema de Humedales El Castaño. Methods: A total of 11 permanent sampling units (UM) were established by defined strata: five in the mangrove, two in swamp forest, two in freshwater marshes and two in the flooded pasture. From May 2016 to October 2017 the vegetation was characterized and the water levels and physicochemical parameters (superficial, interstitial and groundwater) were sampled monthly for: salinity, and pH; and the soil for: bulk density, humidity percentage, and redox potential. Results: Mangroves are the closest to the sea, have the lowest diversity (H: 1.66) and species richness (14), they are dominated by Laguncularia racemosa and Rhizophora mangle, have the highest values of interstitial and groundwater salinity, (> 10.8 ups), remain flooded for 4 to 12 months per year, and have a redox potential of 14.57 mV. Immediately, inland, there are remnants of the swamp forests (H: 2.18 and 18 species), dominated by Pachira aquatica, with 5 ups interstitial and groundwater salinity, flooded from 0 to 6 months per year, with a redox potential of 119.07 mV. These forests are followed inland by freshwater marshes (H: 1.92 and 16 species), dominated by Typha domingensis with 6.1 ups interstitial and groundwater salinity, flooded for 5 to 8 months per year and a redox potential of 125.9 mV. Finally, furthest inland is the flooded pasture, a modified herbaceous wetland for cattle grazing (H: 3.44 and 50 species) dominated by Paspalum conjugatum, where interstitial and groundwater salinity is less than 0.5 ups, it stays flooded for 5 to 9 months and the redox potential is 151.23 mV. Conclusions: In each type of vegetation, the structure, composition, and diversity are different, with a high turnover of species that indicates a gradient defined by salinity. The vegetation in the SHC follows the patterns of typical organization of the tropical coastal wetlands, mangroves, swamp forests and herbaceous wetlands, in this case the freshwater marshes and flooded pastures. The factor that define the distribution of the vegetation is the salinity and the gradient that is observed are a function of the hydrological dynamics that depends on the mixing of marine and freshwater.

Evaluation of a Clinical Decision Support System for the Prescription of Genetic Tests in the Gynecological Cancer Risk.

Clinical Decision Support System (CDSS) has been implemented to support physicians about the medical prescription of genetic testing. CDSS is based on open source software. A CDSS for prescribing these genetic tests in BRCA1 and BRCA2 and preventing gynecological cancer risks has been designed and performed in the 'Virgen del Rocío' University Hospital. Clinical evidence demonstrates that BRCA1 and BRCA2 mutations can develop gynecological cancer, but genetic testing has a high cost to the healthcare system. The developed technological architecture integrates open source tools like Mirth Connect and OpenClinica. The system allows general practitioners and gynecologists to classify patients as low risk (they do not require a specific treatment) or high risk (they should be attended by the Genetic Council), According to their genetic risk, recommending the prescription of genetic tests. The aim main of this paper is the evaluation of the developed CDSS, getting positive outcomes.

Eficacia comparativa de prucaloprida versus tegaserod en pacientes con síndrome de intestino irritable de predominio estreñimiento / Comparative efficacy of prucalopride and tegaserod in patients with predominantly constipated irritable bowel syndrome

Resumen Introducción El síndrome de intestino irritable (SII) afecta del cinco al 20% de los individuos alrededor del mundo. En México (Veracruz) se ha documentado una prevalencia de 16.9%. Su diagnóstico se basa en los criterios de Roma III y su tratamiento tiene diferentes enfoques; dentro del farmacológico están los fármacos agonistas de los receptores de la serotonina (5-HT4). La eficacia del tegaserod ha sido establecida en pacientes con SII con estreñimiento (SII-E); la prucaloprida se considera un fármaco con potencial terapéutico para ese padecimiento, ya que muestra mayor afinidad para el receptor 5-HT4 con respecto al tegaserod y acelera el tránsito colónico. Sin embargo, se requieren mayores datos de estudios clínicos controlados aleatorizados que lo comprueben. Objetivo Comparar la eficacia de la prucaloprida con la del tegaserod en el tratamiento del intestino irritable con estreñimiento, por medio de la escala de Bristol, la escala global de síntomas y síntomas asociados. Material y métodos Se establecieron dos grupos de pacientes (A y B) de forma aleatorizada: hombres y mujeres de entre 18 y 50 años de edad, con criterios de Roma III para SII-E; fueron sometidos a una misma dieta. Al grupo A se le administró prucaloprida en dosis de 2 mg vía oral cada 24 horas por dos semanas. Al grupo B se le administraron 6 mg de tegaserod cada 12 horas por dos semanas. La evolución clínica de cada paciente se valoró cada semana durante las dos semanas del periodo de estudio, incluyendo las evaluaciones de la escala adaptada y validada de Bristol y de la escala global de síntomas y síntomas asociados. Resultados Se incluyeron 22 pacientes, 21 (95.5%) del sexo femenino, con una proporción 1:21; la edad promedio fue de 37.27 años; 11 (50%) recibieron prucaloprida y el resto, tegaserod. Para evaluar la asociación entre el tratamiento otorgado y los síntomas de «plenitud rectal, esfuerzo al evacuar y urgencia al evacuar¼, se utilizó la prueba exacta de Fisher, que no fue estadísticamente significativa (p > 0.05); para «distensión abdominal, movimientos abdominales y escala de Bristol¼, se utilizó U de Mann-Whitney; no fue estadísticamente significativa (p > 0.05). Sin embargo, para «dolor abdominal¼, con la misma prueba, sí se encontró diferencia estadísticamente significativa (p < 0.05). De los tratados con prucaloprida, uno (9%) presentó diarrea, tres (27%) cefalea y uno (9%) cefalea y náuseas; con tegaserod, dos (18%) tuvieron diarrea, dos (18%) cefalea y uno (9%) cefalea y náuseas. Conclusiones Ambos, la prucaloprida y el tegaserod, mejoran en cierto grado todos los síntomas evaluados para el SII-E, pero la prucaloprida mejora de manera significativa y en menor tiempo el síntoma de «dolor abdominal¼. Se evidenció que el evento de diarrea implicó un cambio de tratamiento en ambos grupos.

Abstract Introduction Irritable bowel syndrome (IBS) affects 5-20% of all individuals around the world. In Mexico (Veracruz), a prevalence of 16.9% has been documented. Its diagnosis is based on the Rome III criteria, and its treatment has different approaches; within the pharmacological options are the serotonin receptor agonist drugs (5-HT4). The effectiveness of tegaserod has been established in patients with IBS with constipation (IBS-C), considering prucalopride as a drug with therapeutic potential for this condition, since it shows greater affinity for the 5-HT4 receptor than tegaserod, and accelerates colonic transit. However, more data from randomized controlled trials that prove this are required. Objective To compare the efficacy of prucalopride versus tegaserod in the treatment of irritable bowel with constipation, by means of the Bristol scale, the global scale of symptoms and associated symptoms. Material and methods Two groups of patients were established (A and B) in a randomized manner: men and women between 18 and 50 years of age with Rome criteria III for IBS-C; all were given the same diet. In group A, Prucalopride was administered at a dose of 2 mg orally every 24 hours for two weeks. In group B, 6 mg of tegaserod were administered every 12 hours for two weeks. The clinical evolution of each patient was assessed each week during the two weeks of the study period, including the assessments of the adapted and validated Bristol scale, and the global scale of symptoms and associated symptoms. Results Twenty-two patients were included, 21 (95.5%) female, with a 1:21 ratio; the average age was 37.27 years; 11 (50%) received prucalopride, and the rest, tegaserod. To evaluate the association between the treatment given and the symptoms of «rectal fullness, evacuation effort and evacuation urgency¼, Fisher's exact test was used, being not statistically significant (p > 0.05); for «abdominal distension, abdominal movements and Bristol scale¼, Mann-Whitney U was used, being not statistically significant (p > 0.05); however, for «abdominal pain¼, with the same test, a statistically significant difference was found (p < 0.05). Of those treated with prucalopride, one (9%) had diarrhea, three (27%) headache, and one (9%) headache and nausea; with tegaserod, two (18%) had diarrhea, two (18%) headache, and one (9%) headache and nausea. Conclusions Both, prucalopride and tegaserod improve to some degree all the symptoms evaluated for IBS-C, but prucalopride significantly and more promptly improves the symptom of «abdominal pain¼. It was evidenced that the diarrhea event implied change of treatment in both groups.

Correlation between intake of omega-3 fatty acids and depressive and anxiety symptoms during pregnancy / Correlación entre la ingesta de ácidos grasos omega-3 y los síntomas de depresión y ansiedad en el embarazo

Abstract: Introduction: Anxiety and depression during pregnancy are disabling disorders associated to complications during the pregnancy, delivery, and postpartum period, with a significant prevalence, between 9 and 20%, hence its importance. Nutritional factors, such as omega-3 fatty acids (ω-3FA) deficiency, have been related with both disorders during pregnancy, especially docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Objective: To evaluate the association between dietary intake of EPA and DHA, and anxiety symptoms (AS) and depressive symptoms (DS) in Mexican pregnant women. Method: The sample consisted of 151 women in the second trimester of pregnancy. Instruments included a Food Frequency Questionnaire, the Trait Anxiety Inventory, and the Edinburgh Postnatal Depression Scale. Results: A daily intake of DHA and EPA of 70 mg/d and 30 mg/d, respectively, was found. The prevalence of AS was 44.4%, and 17.9% for DS. We also found the correlation negatively moderate between dietary intake of DHA and EPA and AS (p = .003, p = .017) and DS (p = .001, p = .020) in the group of women who had a severely insufficient intake of ω-3FA. Discussion and conclusion: The statistical significance shows a negative correlation between variables and the dietary intake of ω-3FA explains in a very small percentage the variability of AS and DS, according to their coefficient of determination. These results suggest the need for an investigation of this relationship through interventional studies.

Resumen: Introducción: La prevalencia de ansiedad y depresión en el embarazo oscilaentre 9 y 20%. Poseen una gran importancia al ser trastornos incapacitantes asociados a complicaciones durante el embarazo, parto y postparto. Factores nutricionales, como la deficiencia de ácidos grasos omega-3 (AGω-3), se han relacionado con ambos trastornos durante el embarazo, especialmente el ácido docosahexaenoico (DHA) y el ácido eicosapentaenoico (EPA). Objetivo: Evaluar la asociación entre la ingesta dietética de EPA y DHA y los síntomas de ansiedad (SA) y depresión (DS) en mujeres embarazadas mexicanas. Método: Se entrevistó a 151 gestantes fueron entrevistadas en el segundo trimestre de embarazo. Los instrumentos de medición utilizados fueron: un Cuestionario de Frecuencia de Consumo de Alimentos, el Inventario de Ansiedad-Rasgo y la Escala de Depresión Postnatal de Edimburgo. Resultados: Se encontró una correlación negativa moderada entre la ingesta de DHA y EPA y los SA (p = .003, p = .017) y SD (p = .001, p = .020) en el grupo de mujeres con ingesta gravemente insuficiente. Se encontró una ingesta dietética diaria de DHA y EPA de 70 mg y 30 mg, respectivamente. La prevalencia de SA fue 44.4% y de SD, 17.9%. Discusión y conclusión: Aunque la significancia estadística mostró una correlación negativa entre variables, de acuerdo con el coeficiente de determinación, la ingesta dietética de AGω-3 explica en un escaso porcentaje la variabilidad de los SA y SD. Estos resultados sugieren la necesidad de investigar dicha relación por medio de estudios de intervención.

Flora bacteriana de secreciones bronquiales en pacientes mayores de 60 años con neumonía adquirida en la comunidad en los servicios de hospitalización del Hospital General del Instituto Salvadoreño del Seguro Social de enero a diciembre 2017 / Bacterial flora of bronchial secretions in patients older than 60 years with community-acquired pneumonia in the hospitalization services of the General Hospital of the "Instituto Salvadoreño del Seguro Social" from January to December 2017

La neumonía es una infección del parénquima pulmonar generando respuesta inflamatoria que se manifiesta a través de signos y síntomas como tos, disnea, fiebre; también hay aparecimiento de consolidación pulmonar en estudios de imagen más frecuentemente causados por bacterias. El índice más alto se observa en los adultos mayores de 60 años, existen condiciones en la cuales pueden predisponer a infecciones debido a que modifican algunas respuestas inmunológicas innatas, como la diabetes, las enfermedades reumatológicas. Las guías de manejo recomiendan el uso de doble antibiótico en el caso de las neumonías comunitarias, sin embargo, también establece realizar el manejo en base a la prevalencia de los agentes. Se realizó una investigación de tipo descriptivo, retrospectivo para documentar a los agentes más frecuentes aislados en neumonías comunitarias en pacientes mayores de 60 años así como también las comorbilidades presentes en estos pacientes, se revisaron 340 muestras positivas, encontrando únicamente 39 casos correspondientes a neumonía comunitaria demostrando que Kleibsiella pneumonia y Pseudomona eroginosa más aislados compartiendo sensibilidad con quinolonas y cefepime, además se documenta que la diabetes es la enfermedad más prevalente en los mayores de 60 años y que 100 % de ellos padece de una enfermedad que afecta al sistema inmune. Debe considerase protocolizar el manejo de las neumonías comunitarias y darle seguimiento de acuerdo a la evolución clínica debido al resultado microbiológico

Validación y precisión de la escala de deterioro global (GDS) para establecer severidad de demencia en una población de Lima / Validation and diagnostic accuracy of the global deterioration scale (GDS) to establish severity of dementia in a population of Lima

Resumen Objetivo : validar y evaluar el rendimiento de la Global Deteriorarion Scale (GDS) en una población que acude a una unidad especializada de Lima. Pacientes y métodos: investigación de tipo transversal con un diseño descriptivo comparativo. El estudio incluyó 215 individuos seleccionados de forma abierta, que acudieron a la unidad de diagnóstico de deterioro cognitivo y prevención de demencia. Se estudiaron tres grupos: 60 controles, 40 con diagnóstico de deterioro cognitivo leve y 115 con demencia. Los individuos fueron sometidos a evaluaciones sucesivas: cribado, diagnóstico y estadiaje de demencia y tipo de demencia. La validez y fiabilidad de la clasificación de severidad fue demostrada mediante la concordancia entre la medición del Global Deteriorarion Scale con el Clinical Dementia Rating (CDR). El rendimiento de Global Deteriorarion Scale se valoró mediante la obtención de los valores de sensibilidad y especificidad. Resultados : los promedios de edad fueron de 69, 70, y 74 años para los controles, los pacientes con deterioro cognitivo leve y los pacientes con demencia, respectivamente. La Global Deteriorarion Scale tuvo una buena correlación con Clinical Dementia Rating (r de Spearman =0,97; P=0,0001). La sensibilidad de la escala para establecer estadio de demencia fue de 79 %, con especificidad del 100 % para cualquier categoría de demencia según los criterios diagnósticos estándares y según Clinical Dementia Rating. Conclusiones : se encontró una correlación casi perfecta entre Global Deteriorarion Scale y Clinical Dementia Rating; sin embargo, la Global Deteriorarion Scale presenta una sensibilidad moderada para establecer el estadio de demencia con respecto a Clinical Dementia Rating, mostrando además ser utilidad en el diagnóstico de deterioro cognitivo leve.

Abstract Objective: To validate and evaluate diagnostic accuracy of the Global Deteriorarion Scale (GDS) in a population of a specialized unit of Lima. Patients and Methods: This research is a comparative cross-sectional descriptive design. The study included 215 individuals selected openly, who attending in the diagnostic unit of cognitive impairment and dementia prevention. Three groups were studied: 60 controls, 40 individuals diagnosed with mild cognitive impairment (MCI) and 115 with dementia diagnosis. They were assessments in three phases: screening, diagnosis and staging of dementia, and type of dementia. The validity and reliability of the classification of severity was demonstrated by measuring the correlation between the GDS with the CDR (Clinical Dementia Rating). The diagnostic accuracy of GDS was evaluated by obtaining the values of sensitivity and specificity. Results: The average age was 69, 70, and 74 years for controls, patients with MCI and patients with dementia respectively. GDS had a good correlation with CDR (Spearman r = 0.97, P = 0.0001). The sensitivity of the GDS to set stage of dementia for any category of dementia was 79 % and specificity of 100 % according to standard diagnostic criteria and according to CDR. Conclusions: We demonstrated an almost perfect correlation between GDS and CDR, however GDS has a moderate sensitivity to set the stage dementia regarding CDR also proving to be useful in the diagnosis of MCI.

Learning Healthcare System for the Prescription of Genetic Testing in the Gynecological Cancer Risk.

Clinical evidence demonstrates that BRCA 1 and BRCA2 mutations can develop a gynecological cancer but genetic testing has a high cost to the healthcare system. Besides, several studies in the literature indicate that performing these genetic tests to the population is not cost-efficient. Currently, our physicians do not have a system to provide them the support for prescribing genetic tests. A Decision Support System for prescribing these genetic tests in BRCA1 and BRCA2 and preventing gynecological cancer risks has been designed, developed and deployed in the Virgen del Rocío University Hospital (VRUH). The technological architecture integrates a set of open source tools like Mirth Connect, OpenClinica, OpenCDS, and tranSMART in addition to several interoperability standards. The system allows general practitioners and gynecologists to classify patients as low risk (they do not require a specific treatment) or high risk (they should be attended by the Genetic Council). On the other hand, by means of this system we are also able to standardize criteria among professionals to prescribe these genetic tests. Finally, this system will also contribute to improve the assistance for this kind of patients.

Rendimiento en pruebas cognitivas breves, de adultos mayores con demencia en estadios avanzados, residentes de una comunidad urbana de Lima, Perú / Performance of cognitive brief test in elderly patients with dementia in advanced stage living in an urban community of Lima, Peru

RESUMEN Objetivos. Evaluar el rendimiento de la prueba de dibujo de reloj en versión de Manos (PDR-M) y Mini Mental State Examination (MMSE) en su versión peruana, para detectar demencia de cualquier tipo en adultos mayores residentes de una comunidad urbana de Lima, Perú. Materiales y métodos. Análisis secundario de base de datos, de tipo observacional, analítico y transversal; con diseño de prueba diagnóstica, teniendo como prueba estándar a las evaluaciones clínica y neuropsicológica en conjunto. Se evaluó el rendimiento de las pruebas individualmente, así como de forma combinada. Resultados. El rendimiento de MMSE para la evaluación de pacientes con demencia de cualquier tipo presentó sensibilidad de 64,1%, especificidad de 84,1%, VPP de 24,4%, VPN de 96,7%, LR (+) de 4,03 y LR (-) de 0,43. La PDR-M presentó sensibilidad de 89,3%, especificidad de 98,1%, VPP de 79,3%, VPN de 99,1%, LR (+) de 47,79 y LR (-) de 0,11. Cuando se aplicaron ambas pruebas, y al menos una de ellas fue positiva, presentaron sensibilidad de 98,1%, especificidad de 84,1%, VPP de 33,1%, VPN de 99,8%, LR (+) de 6,17 y LR (-) de 0,02. Al realizar el análisis, por separado, de demencia tipo alzhéimer y no alzhéimer, los valores de los parámetros no se diferencian sustancialmente de los obtenidos para demencias de cualquier tipo. Conclusiones. La combinación de MMSE y PDR-M demuestran un buen rendimiento para detectar demencia en estadios moderado y severo en población residente de una comunidad urbana de Lima.

ABSTRACT Objectives. Evaluate the performance of clock drawing test- Manos versión (PDR-M) and Mini Mental State Examination -Peruvian version (MMSE) to detect dementia in a sample based on urban community of Lima, Peru. Materials and methods. This study is a secondary analysis database, observational, analytical and cross-sectional, the gold standard was the clinical and the neuropsychological evaluations together. Performance testing individually and in combination were evaluated.. Data were obtained from prevalence study conducted in 2008 in Cercado de Lima. Results. MMSE performance for evaluation of patients with dementia of any kind showed sensitivity of 64,1%, specificity of 84,1%, PPV of 24.4%, NPV of 96.7%, PLR of 4,03 and NLR of 0,43. PDR-M showed sensitivity of 89,3%, specificity of 98,1%, PPV of 79.3%, NPV of 99.1%, PLR of 47,79 and NLR of 0,11. When both tests were applied, and at least one of them was positive, they showed sensitivity 98.1%, specificity 84.1%, PPV of 33.1%, NPV of 99.8%, PLR of 6,17 and NLR of 0,02. When performing separate analysis of Alzheimer-type dementia and non- Alzheimer dementia, the values of the parameters do not differ substantially from those obtained for dementia of any kind. Conclussions. The combination of MMSE and PDR-M show good discriminative ability to detect moderate and severe dementia in population living in urban community in Lima.

Pronóstico en cirugía de epilepsia: ¿puede influir la reserva cognitiva? / Prognosis in EpilepsyÆs surgery: Can Cognitive Reserve influence it?

Hasta un tercio de individuos diagnosticados de epilepsia continúan teniendo crisis a pesar del tratamiento antiepiléptico apropiado. Estos pacientes pueden ser referidos para evaluación pre-quirúrgica y la cirugía es considerada un tratamiento efectivo para epilepsia relacionada a localización refractaria. Los factores que predicen un mejor resultado de la cirugía son contradictorios, y las recomendaciones incluyen evaluación detallada del rendimiento cognitivo antes y después de la cirugía; sin embargo no se considera la evaluación de la reserva cognitiva (RC). La incorporación de un instrumento que valore la RC de los pacientes permitiría incrementar la fuerza predictiva de la evaluación neuropsicológica respecto al pronóstico post-quirúrgico y aportaría a la investigación de los factores neuroprotectores en aquellos pacientes con un perfil de rendimiento cognitivo post-quirúrgico superior a la etapa pre-quirúrgica, y además permitiría conocer cómo la actividad educacional, ocupacional, y de tiempo libre de los pacientes se ven afectadas por la epilepsia y su variación después de la cirugía.

Up to one-third of individuals diagnosed as having epilepsy continue to have seizures despite appropriate antiepileptic drug treatment. Patients with refractory localization-related epilepsy can be referred for presurgical evaluation, and resective surgery is considered an effective treatment for such cases. Predictive factors of a better outcome for epilepsyÆs surgery are contradictory, and recomendations include a detailed assessment of cognitive performance before and after surgery; this process, however does not consider the evaluation of Cognitive Reserve (CR). The use of an instrument that assesses the CR of patient-candidates would increase the predictive power of neuropsychological assessment regarding post-surgical prognosis and outcome; in turn, it could contribute to research of neuroprotective factors in patients with a superior pre- and post-surgical profile of cognitive performance, and also allow knowing how the patientÆs educational and occupational activity, and use of leisure time are affected by epilepsy and its post-surgical variations.

Efecto del consumo de Physalis peruviana L. (aguaymanto) sobre el perfil lipídico de pacientes con hipercolesterolemia / Effect of consumption of Physalis peruviana L. (goldenberry) on lipid profile in hypercholesterolemic patients

La hipercolesterolemia es un factor de riesgo cardiovascular. Physalis peruviana L. (aguaymanto) tiene alto contenido en fibra dietética y fitoesteroles, que disminuyen el nivel de colesterol y triglicéridos en sangre en ratas. Objetivo. Determinar el efecto del aguaymanto en el perfil lipídico de pacientes con hipercolesterolemia. Método. Ensayo clínico aleatorizado controlado simple ciego, en 28 pacientes hipercolesterolémicos de la ciudad de Trujillo, entre 20 y 65 años de edad, divididos al azar en dos grupos: experimental (GE) y control (GC). Durante ocho semanas, el GE recibió jugo de aguaymanto (100 g) y el GC, placebo; ambos siguieron una dieta baja en grasas. Se determinó el perfil lipídico al inicio y a las cuatro y ocho semanas de tratamiento. Se aplicó la prueba t de Student para muestras independientes y relacionadas. Resultados. El GE y el GC no tuvieron diferencia significativa en peso e ingesta calórica durante el tratamiento. El GE inició con un promedio de colesterol de 231,71 mg/dL y cLDL 154,21 mg/dL; a las ocho semanas, el colesterol fue 208,71 mg/ dL y cLDL 131,4 mg/dL. El GC inició con colesterol de 230,21 mg/dL y cLDL 145,49 mg/dL; a las ocho semanas el colesterol fue 226,29 mg/dL y cLDL 146,54 mg/dL. La disminución de niveles de colesterol total y cLDL al término del tratamiento en el GE fue 9,93% y 14,79%, respectivamente (p < 0,05). Conclusión. El consumo de aguaymanto reduce los niveles séricos de colesterol total y cLDL en pacientes hipercolesterolémicos...

Hypercholesterolemia is a risk factor for cardiovascular disease. Physalis peruviana L. (goldenberry) has high­amount dietary fiber and phytosterols that reduces cholesterol and triglycerides levels in blood in rats. Objective. To determine the effect of P. Peruviana L. on lipid profile in hypercholesterolemic patients. Methods. Single­ blind randomized controlled trial was performed, in 28 hypercholesterolemic patients of Trujillo, between 20­65 years old; they were randomly divided in two groups: experimental (EG) and control (CG). For 8 weeks, EG received goldenberry juice (100 g) and CG, placebo; both groups followed a low fat diet. Lipid profile was determined at begin, after four weeks and eight 8 weeks of treatment. The Student t test was applied for independent and related samples. Results. EG and CG didnÆt have significant difference in weight and caloric intake during treatment. EG began average cholesterol about 231,71 mg/dL, cLDL 154,21 mg/dL; at 8 weeks cholesterol were 208,71 mg/dL, cLDL 131,4 mg/dL. CG began average cholesterol about 230,21mg/dL, cLDL 145,49 mg/dL; at 8 weeks cholesterol were 226,29 mg/dL, cLDL 146,54 mg/dL. Decreased blood levels of total cholesteroland cLDL levels in the conclusion del treatment in EG were 9,93% y 14,79% respectively, being significant (p < 0,05). Conclusion. The consumption of goldenberry juice significantly reduces serum total cholesterol and cLDL levels in hypercholesterolemic patients...

Utilidad de la batería ejecutiva y cognición social de INECO en la evaluación de funciones ejecutivas de una serie de pacientes peruanos con demencia fronto-temporal, variante conductual / Utility of the INECO's executive and social cognition battery in the evaluation of executive functions in Peruvians patients with behavioral variant fronto-temporal dementia

Los síntomas característicos de la demencia fronto-temporal, variante conductual reflejan disfunción del cortex prefrontal ventromedial, y no existe consenso respecto a las pruebas neuropsicológicas más sensibles y específicos para evaluarlos. Objetivos: El objetivo de este estudio fue detectar alteraciones específicas de funciones ejecutivas y de cognición social en pacientes con demencia fronto-temporal variante conductual. Material y Métodos: Evaluamos la batería ejecutiva y cognición social del Instituto de Neurología Cognitiva (INECO), la cual incluye pruebas de teoría de la mente (test de la mirada y test de metida de pata), tareas del hotel, tests de diligencias multiples-versión del hospital y el Iowa Gambling Test para toma de decisiones. Los pacientes fueron divididos en dos grupos según su desempeño en el Addenbrooke´s Cognitive Examination. Resultados: Pacientes del grupo de Addenbrooke´s Cognitive Examination Bajo mostró resultados significativamente menores, respecto a los controles en muchas de las tareas de la batería ejecutiva estándar y en la batería ejecutiva y cognición social de INECO. Pero, el grupo de Addenbrooke´s Cognitive Examination Alto no difirió de los controles en muchas de las tareas de la batería ejecutiva estándar, mientras que encontramos diferencias significativas en los pacientes con demencia fronto-temporal con Addenbrooke´s Cognitive Examination Alto y los controles en la mayoría de las tareas de la batería ejecutiva y cognición social. Conclusiones: La batería ejecutiva y cognición social de INECO es más sensible para detectar alteraciones ejecutivas y de cognición social en estadios precoces de demencia fronto-temporal, variante conductual que las tareas empleadas en la batería ejecutiva estándar...

Behavioral variant frontotemporal dementia (bvFTD) is characterized by early and substantial ventromedial prefrontal cortex (VMPFC) dysfunction and there is no consensus regarding which tests are most sensitive and specific to assess it. Objectives: To detect specific executive and social cognitive deficits in patients with early behavioural variant frontotemporal dementia. Material and Methods: In this study we assessed with theINECO´s Executive and Social Cognition Battery, which included Theory of Mind tests (Mind in the Eyes, Faux Pas), the Hotel Task, Multiple Errands Task-hospital version and the Iowa Gambling Task for complex decision-making. Patients were divided into two groups according to their AddenbrookeÆs Cognitive Examination scores. Results: We found that low AddenbrookeÆs Cognitive Examination patients differed from controls onmost tasks of the standard battery and the Executive and Social Cognition Battery. But high AddenbrookeÆs Cognitive Examination patients did not differ from controls on most traditional neuropsychological tests, while significant differences were found between this high-functioning behavioural variant of frontotemporal dementia group and controls on most measures of Executive and Social Cognition Battery. Conclusions: The INECO´s Executive and Social Cognition Battery used are more sensitive in detecting executive and social cognitive impairment deficits in early behavioural variant of frontotemporal dementia than the classical cognitive measures...

CD151-α3ß1 integrin complexes are prognostic markers of glioblastoma and cooperate with EGFR to drive tumor cell motility and invasion.

Glioblastoma, one of the most aggressive forms of brain cancer, is featured by high tumor cell motility and invasiveness, which not only fuel tumor infiltration, but also enable escape from surgical or other clinical interventions. Thus, better understanding of how these malignant traits are controlled will be key to the discovery of novel biomarkers and therapies against this deadly disease. Tetraspanin CD151 and its associated α3ß1 integrin have been implicated in facilitating tumor progression across multiple cancer types. How these adhesion molecules are involved in the progression of glioblastoma, however, remains largely unclear. Here, we examined an in-house tissue microarray-based cohort of 96 patient biopsies and TCGA dataset to evaluate the clinical significance of CD151 and α3ß1 integrin. Functional and signaling analyses were also conducted to understand how these molecules promote the aggressiveness of glioblastoma at molecular and cellular levels. Results from our analyses showed that CD151 and α3 integrin were significantly elevated in glioblastomas at both protein and mRNA levels, and exhibited strong inverse correlation with patient survival (p < 0.006). These adhesion molecules also formed tight protein complexes and synergized with EGF/EGFR to accelerate tumor cell motility and invasion. Furthermore, disruption of such complexes enhanced the survival of tumor-bearing mice in a xenograft model, and impaired activation of FAK and small GTPases. Also, knockdown- or pharmacological agent-based attenuation of EGFR, FAK or Graf (ARHGAP26)/small GTPase-mediated pathways markedly mitigated the aggressiveness of glioblastoma cells. Collectively, our findings provide clinical, molecular and cellular evidence of CD151-α3ß1 integrin complexes as promising prognostic biomarkers and therapeutic targets for glioblastoma.

Neurotensin-polyplex-mediated brain-derived neurotrophic factor gene delivery into nigral dopamine neurons prevents nigrostriatal degeneration in a rat model of early Parkinson's disease.

BACKGROUND: The neurotrophin Brain-Derived Neurotrophic Factor (BDNF) influences nigral dopaminergic neurons via autocrine and paracrine mechanisms. The reduction of BDNF expression in Parkinson's disease substantia nigra (SN) might contribute to the death of dopaminergic neurons because inhibiting BDNF expression in the SN causes parkinsonism in the rat. This study aimed to demonstrate that increasing BDNF expression in dopaminergic neurons of rats with one week of 6-hydroxydopamine lesion recovers from parkinsonism. The plasmids phDAT-BDNF-flag and phDAT-EGFP, coding for enhanced green fluorescent protein, were transfected using neurotensin (NTS)-polyplex, which enables delivery of genes into the dopaminergic neurons via neurotensin-receptor type 1 (NTSR1) internalization. RESULTS: Two weeks after transfections, RT-PCR and immunofluorescence techniques showed that the residual dopaminergic neurons retain NTSR1 expression and susceptibility to be transfected by the NTS-polyplex. phDAT-BDNF-flag transfection did not increase dopaminergic neurons, but caused 7-fold increase in dopamine fibers within the SN and 5-fold increase in innervation and dopamine levels in the striatum. These neurotrophic effects were accompanied by a significant improvement in motor behavior. CONCLUSIONS: NTS-polyplex-mediated BDNF overexpression in dopaminergic neurons has proven to be effective to remit hemiparkinsonism in the rat. This BDNF gene therapy might be helpful in the early stage of Parkinson's disease.

Agregación costera de tortugas marinas en aguas del Pacífico Sur de Costa Rica / Coastal aggregation of marine turtles in waters of the South Pacific of Costa Rica

Resumen El Pacífico Sur de Costa Rica ha sido identificado como un sitio importante para la reproducción de cuatro especies de tortugas marinas. Las amenazas que éstas sufren han originado iniciativas de conservación y estudio en la zona, especialmente en playas de anidación. Sin embargo, información sobre su presencia en el agua (donde pasan la mayor parte de su vida) es escasa. Por esta razón, este estudio analiza la información recolectada como parte de un proyecto de monitoreo de tortugas marinas de la Fundación Keto, en la zona comprendida entre el Parque Nacional Marino Ballena y la Reserva Biológica Isla del Caño. Entre los años 2009 y 2011, se registraron 447 avistamientos de tortugas (la mayoría fuera de las áreas de conservación) pertenecientes a tres especies: Lepidochelys olivacea, Chelonia mydas, y Eretmochelys imbricata. Se registraron avistamientos durante todos los meses del año, siendo L. olivacea la especie con más individuos observados. Se identificaron dos áreas (a profundidades menores a 10m) importantes para la presencia de E. imbricata. Este es el primer aporte científico que documenta la presencia exacta, considerable y continua en el tiempo de tres especies de tortugas marinas frente a las costas del Cantón de Osa, Puntarenas, Costa Rica.

Abstract The southern Pacific coast of Costa Rica has been identified as an important place for the reproduction of four species of marine turtles. This presence, coupled with threats to the survival of the species, has encouraged the establishment of conservation initiatives and the study of these animals in the region, especially in nesting areas. Nonetheless, information on their presence in the water (where they spend most of their life) is scarce. For this reason, this study analyses data from a three years of a marine turtle monitoring program by Fundación Keto in the area between the Marino Ballena National Park and the Caño Island Biological Reserve, and presents the temporal and spatial distribution of the observed individuals. During this period, a total of 447 turtle (sightings per sampling effort=0.36 individuals-hr-1), of three different species were observed: Lepidochelys olivacea, Chelonia Mydas, and Eretmochelys imbricata. Sightings have been recorded during all months of the year, with L. olivacea as the species most commonly observed, especially outside of protected areas; this species presented a clear mating period in the months of July and August. E. imbricata was the species observed closer to the shore, and at a shallower site, possibly indicating an important foraging area for juvenile individuals. This is the first study to address the consistent and permanent presence of three species of marine turtles in the waters off the coast of Cantón de Osa in the southern Pacific coast of Costa Rica. Rev. Biol. Trop. 63 (Suppl. 1): 1-8. Epub 2015 April 01.