Optimization of Radiation Protection in Pediatric Interventional Radiology in Latin America and the Caribbean: Development, Advancements, Challenges and Achievements of the OPRIPALC Program.

This article presents the development, advancements, challenges and achievements of the "Optimization of Protection in Pediatric Interventional Radiology in Latin America and the Caribbean" (OPRIPALC) program. This international initiative is led by the World Health Organization, the Pan American Health Organization and the International Atomic Energy Agency. The main objectives of OPRIPALC are to foster a culture of radiological protection in pediatric interventions, enhance these procedures' quality, and define optimization strategies such as the use of diagnostic reference levels (DRLs). Currently, 33 centers from 12 countries participate actively in the program. Significant progress has been made towards the proposed objectives, overcoming the challenges posed by the COVID-19 pandemic. Through many virtual meetings for coordination, planning, training and follow-up, a comprehensive set of DRLs for both diagnostic and therapeutic procedures, categorized by weight and age, have been established and are in use. A consensus document on good practices is in the final stage of development. The program's continuation into at least a second phase is essential to address pending issues, including the integration of automatic dose management systems, the levels of occupational radiation doses, their correlation with pediatric patient doses, and strategies to reduce them.

Morgagni Hernia Repair in Adults: A Single-Center Experience in Spanish Population.

Introduction: Morgagni hernia (MH) is a rare congenital disorder, especially in adults, accounting for 2%-4% of all congenital diaphragmatic hernias. Materials and Methods: Retrospective review of all patients who underwent surgical repair of MH at our center from 1991 to 2022. A descriptive analysis was performed. Results: Eighteen patients presented with MH, of whom 11 (61.11%) were female, with a median age of 67.60 (IQR 50.25-84.50) years old. Six (33.33%) were asymptomatic and 12 (66.67%) presented with symptoms, being dyspnea (4; 33.33%) the most common. On the group of symptomatic patients, the computed tomography scan (8; 66.67%) was the most frequent diagnostic test. Whereas in the asymptomatic group, 5 patients (83.33%) were diagnosed intraoperatively, during surgery for other reasons. MH was mostly located on the right (16; 88.89%). Hernia contents included omentum and colon (10; 55.56%), omentum (5; 27.78%), and stomach (3; 16.67%). All patients underwent surgical repair, needing in 3 cases (16.67%) emergency surgery. Surgical approaches included 10 laparoscopies (55.56%), 7 laparotomies (38.89%), and 1 thoracotomy (5.55%). Repair was generally performed whether by primary closure in 8 patients (44.4%) or by mesh implantation in 10 (55.56%). The median hospital stay was 6 days (IQR 3-10). Three patients presented complications (17.65%): urinary tract infection (1 patient), intra-abdominal collection (1 patient), and the last 1 presented with renal failure and pneumonia. The median follow-up was 74 months (IQR 4.5-130). No recurrence was described. Conclusions: MH is a rare condition in the adult population. In our series most patients presented with symptoms. The gold standard treatment is surgical repair, being the laparoscopic approach the most frequent. The complications rate was relatively low and no recurrence was described in our study.

Detección de fibrosis en imágenes de cine de resonancia cardíaca mediante el uso de técnicas de inteligencia artificial / Fibrosis detection on MR-Cine images by using artificial intelligence techniques

RESUMEN Introducción: Las técnicas de inteligencia artificial han demostrado tener un gran potencial en el área de la cardiología, especialmente para identificar patrones imperceptibles para el ser humano. En este sentido, dichas técnicas parecen ser las adecuadas para identificar patrones en la textura del miocardio con el objetivo de identificar y cuantificar la fibrosis. Objetivos: Proponer un nuevo método de inteligencia artificial para identificar fibrosis en imágenes cine de resonancia cardíaca. Materiales y métodos: Se realizó un estudio retrospectivo observacional en 75 sujetos del Sanatorio San Carlos de Bariloche. El método propuesto analiza la textura del miocardio en las imágenes cine CMR (resonancia magnética cardíaca) mediante el uso de una red neuronal convolucional que determinar el daño local del tejido miocárdico. Resultados: Se observó una precisión del 89% para cuantificar el daño tisular local en el conjunto de datos de validación y de un 70% para el conjunto de prueba. Además, el análisis cualitativo realizado muestra una alta correlación espacial en la localización de la lesión. Conclusiones: El método propuesto permite identificar espacialmente la fibrosis únicamente utilizando la información de los estudios de cine de resonancia magnética nuclear, mostrando el potencial de la técnica propuesta para cuantificar la viabilidad miocárdica en un futuro o estudiar la etiología de las lesiones.

ABSTRACT Background: Artificial intelligence techniques have demonstrated great potential in cardiology, especially to detect imperceptible patterns for the human eye. In this sense, these techniques seem to be adequate to identify patterns in the myocardial texture which could lead to characterize and quantify fibrosis. Purpose: The aim of this study was to postulate a new artificial intelligence method to identify fibrosis in cine cardiac magnetic resonance (CMR) imaging. Methods: A retrospective observational study was carried out in a population of 75 subjects from a clinical center of San Carlos de Bariloche. The proposed method analyzes the myocardial texture in cine CMR images using a convolutional neural network to determine local myocardial tissue damage. Results: An accuracy of 89% for quantifying local tissue damage was observed for the validation data set and 70% for the test set. In addition, the qualitative analysis showed a high spatial correlation in lesion location. Conclusions: The postulated method enables to spatially identify fibrosis using only the information from cine nuclear magnetic resonance studies, demonstrating the potential of this technique to quantify myocardial viability in the future or to study the etiology of lesions.

The Male Mouse Meiotic Cilium Emanates from the Mother Centriole at Zygotene Prior to Centrosome Duplication.

Cilia are hair-like projections of the plasma membrane with an inner microtubule skeleton known as axoneme. Motile cilia and flagella beat to displace extracellular fluids, playing important roles in the airways and reproductive system. On the contrary, primary cilia function as cell-type-dependent sensory organelles, detecting chemical, mechanical, or optical signals from the extracellular environment. Cilia dysfunction is associated with genetic diseases called ciliopathies and with some types of cancer. Cilia have been recently identified in zebrafish gametogenesis as an important regulator of bouquet conformation and recombination. However, there is little information about the structure and functions of cilia in mammalian meiosis. Here we describe the presence of cilia in male mouse meiotic cells. These solitary cilia formed transiently in 20% of zygotene spermatocytes and reached considerable lengths (up to 15-23 µm). CEP164 and CETN3 localization studies indicated that these cilia emanate from the mother centriole prior to centrosome duplication. In addition, the study of telomeric TFR2 suggested that cilia are not directly related to the bouquet conformation during early male mouse meiosis. Instead, based on TEX14 labeling of intercellular bridges in spermatocyte cysts, we suggest that mouse meiotic cilia may have sensory roles affecting cyst function during prophase I.

Características de la mortalidad por tumores malignos en la provincia de Matanzas. 1990-2019 / Characteristics of mortality due to malignant tumors in the province of Matanzas. 1990-2019

RESUMEN Introducción: la mortalidad por tumores malignos se caracteriza por un incremento sostenido en el tiempo. En casi la totalidad de la provincia de Matanzas se ha observado esta tendencia en los últimos 30 años, con mayor o menor intensidad. Objetivo : describir algunas características de la mortalidad por cáncer en la provincia de Matanzas. Materiales y métodos: estudio observacional descriptivo retrospectivo de la mortalidad por tumores malignos durante 30 años (1990-2019). Se estimaron tasas crudas y ajustadas de mortalidad, globalmente, por períodos y por sexo. Se obtuvieron porcentajes y se determinó la significación estadística mediante el estadígrafo X2 y el valor de p < 0,05. Resultados: se detectaron diferencias estadísticas significativas entre sexos en cada uno de los períodos. Las tasas crudas y específicas de mortalidad experimentaron una tendencia sostenida al incremento. Cada 0,3 días (aproximadamente cada 8 horas) ocurrió una defunción por cáncer, con diferencias entre las localizaciones. Conclusiones: la tendencia al incremento sostenido de las tasas de mortalidad cruda y ajustada por edad se debe al aumento de las defunciones, pudiendo ser consecuencia, en parte, del envejecimiento poblacional y de un posible incremento de la morbilidad. El sexo masculino apareció como el más expuesto. La frecuencia de la mortalidad por cáncer fue diferente según localizaciones (AU).

ABSCRACT Introduction: Steady increase in time characterized the mortality by malignant tumors in the world as in Cuba. It was observed similar trend in the province of Matanzas in the last 30 years, almost in all body sites, showing higher or less intensity. Objective: To describe some characteristics of mortality by malignant tumors in the province of Matanzas Materials and methods: It is a descriptive observational and retrospective study of the mortality by malignant tumors for 30 years: 1990-2019. Crude and adjusted mortality rates were estimated, globally, by periods and sex. Percentages were estimated and statistical significance was determined through X2 test and p value < 0,05. Results: Statistical significant differences were detected among sexes in all periods. Crude and specific mortality rates showed an increasing steady trend. Every 0.3 days (around 8 hours) one decease took place due to malignant tumors, with differences among sites of the disease. Conclusions: The increasing steady trend of the crude & adjusted mortality rates by age could be, partly, results of the population ageing. Male sex appeared to be the most exposed. Mortality frequency by malignant tumors was different according to sites of the tumor (AU).

Prevalencia de diabéticos controlados con hemoglobina glicosilada en dos áreas de salud. Cárdenas, 2019 / Prevalence of diabetics controlled by glycosylated hemoglobin in two health areas. Cardenas, 2019

RESUMEN Introducción: la diabetes mellitus es un trastorno metabólico caracterizado por hiperglucemia crónica con alteraciones en carbohidratos, grasas y proteínas. Debido al aumento de la morbimortalidad por diabetes, esta constituye un problema de salud en el mundo, en Cuba y en el contexto matancero. Objetivo: determinar la prevalencia de diabéticos controlados con la hemoglobina glicosilada (HbA1c), los factores asociados, y las barreras para una intervención posterior. Materiales y métodos: estudio epidemiológico, transversal, analítico a una cohorte de 601 diabéticos tipo 2 mayores de 18 años, en dos policlínicos, estudiados anteriormente. Se encuestaron y procesaron en el programa Epi-Info 7. Se obtuvieron frecuencias y proporciones de variables, prevalencia de diabéticos controlados con la hemoglobina HbA1c, los factores asociados, las comorbilidades con el OR, y las diferencias de variables entre los dos policlínicos, con el Chi2 y p < 0,05 %. Resultados: la prevalencia de diabéticos controlados fue de un 69,3 %. Las variables demográficas, comorbilidades y factores del estilo de vida no tuvieron diferencias estadísticamente significativas. Todas las variables (presencia y ausencia del factor) presentaron un control por encima del 64 %. El peso saludable, sobrepeso, enfermedades del corazón y respiratorias crónicas, ingestión de bebidas azucaradas y alimentación inadecuada, presentaron diferencias estadísticamente significativas entre los dos policlínicos. Conclusiones: No existieron diferencias entre las variables de diabéticos controlados y no controlados. Se identificaron las barreras para mejorar el control de los pacientes para una postintervención y mejorar su calidad de vida, pues un 30 % de los diabéticos no controlados presentaron algunos de los factores de riesgo estudiados (AU).

ABSTRACT Introduction: diabetes Mellitus is a metabolic disorder characterized by chronic hyperglycemia with alterations in carbohydrates, fats and proteins. Due to the increase of the morbidity and mortality rates, this is a health problem in the world, in Cuba and the province of Matanzas. Objective: to determine the prevalence of diabetics controlled with glycosylated hemoglobin (HbA1c), associated factors, and barriers to further intervention. Materials and method: an epidemiological, cross-sectional, analytical study was carried out in a cohort of 601 previously studied, type 2 diabetics over 18 years of age, in two polyclinics. The patients were surveyed and data processed in the Epi-Info 7 program. Frequencies and proportions of variables, prevalence of diabetics controlled by hemoglobin HbA1c, associated factors, comorbidities with odds ratio, as well as differences of variables between the two polyclinics were calculated by using Chi2 and p value <0.05 %. Results: the prevalence of controlled diabetics was 69.3 %. There were no statistically significant differences between demographic variables, co-morbidities and associated life style risk factors. All variables (presence and absence of the factor) showed control above 64 %. Healthy weight, overweight, heart and chronic respiratory diseases, sweet beverages intake and inadequate diet revealed statistically significant differences between the two polyclinics. Conclusions: there were no differences between the variables controlled and non-controlled diabetics. Barriers to improve patients control were identified for the sake of performing a subsequent intervention and improving their life quality, because 30 % of uncontrolled diabetic patients had some of the studied risk factors (AU).

Optimización de la protección en radiología y cardiología intervencionista pediatrica en América Latina y el Caribe (OPRIPALC) / Optimization of protection in pediatric interventional cardiology and radiology in Latin America and the Caribbean (OPRIPALC)

El objetivo del presente artículo ha sido describir el programa "Optimización de la Protección en Radiología Intervencionista Pediátrica en América Latina y el Caribe" (OPRIPALC) que nace el año 2018 como respuesta conjunta de la Organización Panamericana de la Salud y la Organización Mundial de la Salud, en cooperación con el Organismo Internacional de Energía Atómica, para colaborar con sus Estados miembros en asegurar que las exposiciones a la radiación de los pacientes pediátricos sean las mínimas necesarias durante los procedimientos intervencionistas. Actualmente, hay 18 centros de los siguientes 10 países que participan: Argentina, Brasil, Chile, Colombia, Costa Rica, Cuba, Ecuador, México, Perú y Uruguay. Para el desarrollo del programa se plantean una serie de objetivos, productos, actividades y resultados esperados. La puesta en marcha de la WEB de OPRIPALC ha significado un instrumento muy válido para seguir la información actualizada del programa. Un programa actualizado de formación en radioprotección para los profesionales implicados en el programa, se está realizando por medio de "webinars". Se deberá seguir actuando en la aplicación del programa de control de calidad básico para los equipos de rayos X participantes y validar los valores de los Niveles de Referencia para Diagnóstico (NRDs). Se propone formar un equipo de trabajo entre los Físicos Médicos y Tecnólogos Médicos participantes de OPRIPALC para implicarse en las pruebas de control básicas que todos los centros debieran realizar. Se han presentado algunos resultados iniciales de OPRIPALC en eventos científicos internacionales. Se está avanzando en proponer unos primeros valores sobre NRDs en procedimientos de intervencionismo cardiológico pediátrico por bandas de edad y peso. OPRIPALC es una de las pocas iniciativas de carácter regional para obtener valores de NRDs en procedimientos intervencionistas pediátricos. Se espera que tanto los valores de referencia como la metodología empleada en OPRIPALC, puedan ser utilizados en otras regiones del mundo.

The objective of this article has been to describe the program "Optimization of Protection in Pediatric Interventional Radiology in Latin America and the Caribbean" (OPRIPALC) that was born in 2018 as a joint response of the Pan American Health Organization and the World Organization of the Health, in cooperation with the International Atomic Energy Agency, to collaborate with its member states in ensuring that radiation exposures of pediatric patients are the minimum necessary during interventional procedures. Currently, there are 18 centers from the following 10 countries participating: Argentina, Brazil, Chile, Colombia, Costa Rica, Cuba, Ecuador, Mexico, Peru and Uruguay. For the development of the program, a series of objectives, products, activities and expected results are proposed. The launch of the OPRIPALC WEBSITE has been a very valid instrument for following up-to-date information on the program. An updated training program in radiation protection for the professionals involved in the program is being carried out through webinars. It should continue acting in the application of the basic quality control program for the participating X-ray equipment and validate the values of the Diagnostic Reference Levels (DRLs). It is proposed to form a work team among the OPRIPALC participating medical physicists to get involved in the basic control tests that all centers should carry out. Some initial results of OPRIPALC have been presented at international scientific events. Progress is being made in proposing first values on DRLs in pediatric cardiac intervention procedures by age and weight bands. OPRIPALC is one of the few regional initiatives to obtain DRLs values in pediatric interventional procedures. It is expected that both the reference values and the methodology used in OPRIPALC can be used in other regions of the world.

Epigenetic Dysregulation of Mammalian Male Meiosis Caused by Interference of Recombination and Synapsis.

Meiosis involves a series of specific chromosome events, namely homologous synapsis, recombination, and segregation. Disruption of either recombination or synapsis in mammals results in the interruption of meiosis progression during the first meiotic prophase. This is usually accompanied by a defective transcriptional inactivation of the X and Y chromosomes, which triggers a meiosis breakdown in many mutant models. However, epigenetic changes and transcriptional regulation are also expected to affect autosomes. In this work, we studied the dynamics of epigenetic markers related to chromatin silencing, transcriptional regulation, and meiotic sex chromosome inactivation throughout meiosis in knockout mice for genes encoding for recombination proteins SPO11, DMC1, HOP2 and MLH1, and the synaptonemal complex proteins SYCP1 and SYCP3. These models are defective in recombination and/or synapsis and promote apoptosis at different stages of progression. Our results indicate that impairment of recombination and synapsis alter the dynamics and localization pattern of epigenetic marks, as well as the transcriptional regulation of both autosomes and sex chromosomes throughout prophase-I progression. We also observed that the morphological progression of spermatocytes throughout meiosis and the dynamics of epigenetic marks are processes that can be desynchronized upon synapsis or recombination alteration. Moreover, we detected an overlap of early and late epigenetic signatures in most mutants, indicating that the normal epigenetic transitions are disrupted. This can alter the transcriptional shift that occurs in spermatocytes in mid prophase-I and suggest that the epigenetic regulation of sex chromosomes, but also of autosomes, is an important factor in the impairment of meiosis progression in mammals.

Meiotic Behavior of Achiasmate Sex Chromosomes in the African Pygmy Mouse Mus mattheyi Offers New Insights into the Evolution of Sex Chromosome Pairing and Segregation in Mammals.

X and Y chromosomes in mammals are different in size and gene content due to an evolutionary process of differentiation and degeneration of the Y chromosome. Nevertheless, these chromosomes usually share a small region of homology, the pseudoautosomal region (PAR), which allows them to perform a partial synapsis and undergo reciprocal recombination during meiosis, which ensures their segregation. However, in some mammalian species the PAR has been lost, which challenges the pairing and segregation of sex chromosomes in meiosis. The African pygmy mouse Mus mattheyi shows completely differentiated sex chromosomes, representing an uncommon evolutionary situation among mouse species. We have performed a detailed analysis of the location of proteins involved in synaptonemal complex assembly (SYCP3), recombination (RPA, RAD51 and MLH1) and sex chromosome inactivation (γH2AX) in this species. We found that neither synapsis nor chiasmata are found between sex chromosomes and their pairing is notably delayed compared to autosomes. Interestingly, the Y chromosome only incorporates RPA and RAD51 in a reduced fraction of spermatocytes, indicating a particular DNA repair dynamic on this chromosome. The analysis of segregation revealed that sex chromosomes are associated until metaphase-I just by a chromatin contact. Unexpectedly, both sex chromosomes remain labelled with γH2AX during first meiotic division. This chromatin contact is probably enough to maintain sex chromosome association up to anaphase-I and, therefore, could be relevant to ensure their reductional segregation. The results presented suggest that the regulation of both DNA repair and epigenetic modifications in the sex chromosomes can have a great impact on the divergence of sex chromosomes and their proper transmission, widening our understanding on the relationship between meiosis and the evolution of sex chromosomes in mammals.

The Role of Pulsed Electromagnetic Fields on the Radical Pair Mechanism.

In recent decades, the use of pulsed electromagnetic fields (PEMF) in therapeutics has been one of the main fields of activity in the bioelectromagnetics arena. Nevertheless, progress in this area has been hindered by the lack of consensus on a biophysical mechanism of interaction that can satisfactorily explain how low-level, non-thermal electromagnetic fields would be able to sufficiently affect chemistry as to elicit biological effects in living organisms. This specifically applies in cases where the induced electric fields are too small to generate a biological response of any consequence. A growing body of experimental observations that would explain the nature of these effects speaks strongly about the involvement of a theory known as the radical pair mechanism (RPM). This mechanism explains how a pair of reactive oxygen species with distinct chemical fate can be influenced by a low-level external magnetic field through Zeeman and hyperfine interactions. So far, a study of the effects of complex spatiotemporal signals within the context of the RPM has not been performed. Here, we present a computational investigation of such effects by utilizing a generic PEMF test signal and RPM models of different complexity. Surprisingly, our results show how substantially different chemical results can be obtained within ranges that depend on the specific orientation of the PEMF test signal with respect to the background static magnetic field, its waveform, and both of their amplitudes. These results provide a basis for explaining the distinctive biological relevance of PEMF signals on radical pair chemical reactions. © 2021 Bioelectromagnetics Society.

The Inter-Agency Committee on Radiation Safety-30 years of international coordination of radiation protection and safety matters.

The Inter-Agency Committee on Radiation Safety (IACRS) was constituted in 1990, as a forum for collaboration and coordination between international bodies with regards to radiation safety. It consists today of representatives of eight intergovernmental member organizations (the European Commision, Food and Agriculture Organization, International Atomic Energy Agency (IAEA), International Labour Office, Organisation for Economic Co-operation and Development/ Nuclear Energy Agency (OECD/NEA), Pan American Health Organization, United Nations Scientific Committee on the Effects of Atomic Radiation and the World Health Organization) and five observer non-governmental organizations (International Commission on Radiological Protection, International Commission on Radiation Units & Measurements, International Electrotechnical Commission, International Radiation Protection Association and International Organization for Standardization). The IACRS provides a platform for interaction between these relevant international bodies to contribute to a common understanding of the scientific basis and legal framework for the application of the system of radiation protection, towards global harmonisation of radiation safety standards. The IACRS played a key role in the development of the International Basic Safety Standards (BSS) in 1996 and in its revision in 2014. Further, an IACRS specific Task Group-chaired by the IAEA-fosters the implementation of the BSS in a consistent and coherent manner in all Member States of the United Nations. The IACRS operates via a standing secretariat jointly provided by the IAEA and OECD/NEA and is chaired by one of its member organizations on a rotating basis for periods of about 18 months. This approach has proved to be effective and was the foundation for ensuring continuity of the work of the committee and at the same time allowing a rotating leadership for all member organizations. Currently, the IACRS is chaired by the WHO. The International Radiation Safety Framework under which the IACRS works is structured around four main areas: (a) science; (b) principles; (c) standards; and (d) practice. This paper presents briefly the mandates, roles and functions of the various international bodies that are relevant to the four above mentioned areas of work, discusses how these bodies coordinate their actions and complement each other to enhance radiation protection and safety worldwide and describes their contribution to the achievement of the Sustainable Development Goals. The paper also provides an overview of the main accomplishments of the IACRS since its inception 30 years ago, and an outlook on key challenges for its future activities.

BAP1/ASXL complex modulation regulates epithelial-mesenchymal transition during trophoblast differentiation and invasion.

Normal function of the placenta depends on the earliest developmental stages when trophoblast cells differentiate and invade into the endometrium to establish the definitive maternal-fetal interface. Previously, we identified the ubiquitously expressed tumour suppressor BRCA1-associated protein 1 (BAP1) as a central factor of a novel molecular node controlling early mouse placentation. However, functional insights into how BAP1 regulates trophoblast biology are still missing. Using CRISPR/Cas9 knockout and overexpression technology in mouse trophoblast stem cells, here we demonstrate that the downregulation of BAP1 protein is essential to trigger epithelial-mesenchymal transition (EMT) during trophoblast differentiation associated with a gain of invasiveness. Moreover, we show that the function of BAP1 in suppressing EMT progression is dependent on the binding of BAP1 to additional sex comb-like (ASXL1/2) proteins to form the polycomb repressive deubiquitinase (PR-DUB) complex. Finally, both endogenous expression patterns and BAP1 overexpression experiments in human trophoblast stem cells suggest that the molecular function of BAP1 in regulating trophoblast differentiation and EMT progression is conserved in mice and humans. Our results reveal that the physiological modulation of BAP1 determines the invasive properties of the trophoblast, delineating a new role of the BAP1 PR-DUB complex in regulating early placentation.

Percepción universitaria sobre el cuidado responsable de animales de compañía en Costa Rica / College Student Perception on the Companion Animal Responsible Care in Costa Rica

Resumen El estudio tuvo como objetivo analizar el conocimiento que tienen los universitarios sobre el manejo responsable de mascotas en sus hogares. Se realizó un estudio transversal a la población universitaria, cuyo tamaño muestral fue estimado en 369 personas, aunque se encuestaron a 393 estudiantes. El 99 % de los sujetos reporto tener mascotas, y el perro fue el animal más común dentro de los hogares. El método de desparasitación más comúnmente utilizado fue el de uso interno 59,6 %. Las mascotas son desparasitadas más comúnmente cada 3 meses. Se encontró que es más probable que los hombres en posesión de una mascota la lleven al veterinario con respecto a las mujeres y el 65,3 % de los encuestados reporta que sus mascotas duermen dentro del hogar. Este es el primer estudio en Costa Rica que muestra la forma en que los poseedores de mascotas conviven y cuidan de ellas. La mayoría de los sujetos no conoce el desparasitante que aplica en sus mascotas. Es necesario reforzar la educación en los propietarios para que conozcan más sobre los productos que utilizan en sus mascotas y quién los está recomendando, así como las implicaciones de una correcta higiene en ellas.

Abstract This study aims to analyze the knowledge by college students on the responsible management of pets at home. A cross-sectional study was conducted on the college population with an estimated sample of 369 persons, even though 393 were surveyed. Out of them, 99% reported to have a pet and the dog was the most common in their homes. The home de-worming was the most commonly used method (59.6%) to that end. Pets are de-wormed quarterly in most cases. It was found that men are more likely to bring the pet to the doctor as compared to women and 65.3% of the surveyed sample states that their pets sleep inside the house. This is the first studied conducted in Costa Rica showing how pet owners live with and care them. Most of the subjects do not know the de-worming drug being administered to their pets. There is a need to strengthen the education among pet owners so that they got to know more about the products being used in their pets, who recommends the product, and the implications of the correct hygiene.

PLK1 regulates centrosome migration and spindle dynamics in male mouse meiosis.

Cell division requires the regulation of karyokinesis and cytokinesis, which includes an essential role of the achromatic spindle. Although the functions of centrosomes are well characterised in somatic cells, their role during vertebrate spermatogenesis remains elusive. We have studied the dynamics of the meiotic centrosomes in male mouse during both meiotic divisions. Results show that meiotic centrosomes duplicate twice: first duplication occurs in the leptotene/zygotene transition, while the second occurs in interkinesis. The maturation of duplicated centrosomes during the early stages of prophase I and II are followed by their separation and migration to opposite poles to form bipolar spindles I and II. The study of the genetic mouse model Plk1(Δ/Δ) indicates a central role of Polo-like kinase 1 in pericentriolar matrix assembly, in centrosome maturation and migration, and in the formation of the bipolar spindles during spermatogenesis. In addition, in vitro inhibition of Polo-like kinase 1 and Aurora A in organotypic cultures of seminiferous tubules points out to a prominent role of both kinases in the regulation of the formation of meiotic bipolar spindles.

Initial Single-center Experience of PIPAC in Patients With Unresectable Peritoneal Metastasis. / Experiencia inicial del tratamiento de la carcinomatosis peritoneal irresecable con PIPAC.

INTRODUCTION: Peritoneal carcinomatosis remains a condition with poor prognosis and limited therapeutic options. Pressurized Intrapertioneal Aerosol Chemotherapy (PIPAC) has been developed as a new tool for delivering intraperitoneal chemotherapy with low morbidity. The aim of this study was to evaluate the initial experience of PIPAC in patients with peritoneal carcinomatosis at our hospital. METHODS: A prospective study between January 2019 and February 2020 was carried at a tertiary public hospital. Primary tumor, ascites volume, PCI, chemotherapy regimen, operative time, morbidity, length of hospital stay and mortality were recorded for analysis. RESULTS: We analyzed 9 PIPAC procedures performed in 5patients. Median PCI was 27.6 (24-35). Median surgical time was 93minutes (70-125). Only one adverse event occurred out of 9 procedures (Clavien-DindoII). Median length of hospital stay was 2days (1-4). Mortality was 0%. CONCLUSION: PIPAC seems to be a feasible and safe procedure to treat peritoneal carcinomatosis, with low morbidity and short hospital stay.

Laparoscopic duodenojejunostomy as a treatment for Wilkie's syndrome. Analysis of a four cases series.

We present 4 cases of Wilkie's syndrome (WS) diagnosis in our Hospital between 2014-2019. WS is an infrequent disease, whose diagnosis can be challenging for patients suffering recurrent digestive symptoms. Our patients refered a history of chronic postprandial abdominal pain associated with vomiting, intestinal transit disorders or an uncontrolled weight loss. Abdominopelvic angio-CT was part of the research in all the cases, objectifying a decrease in the angle between Superior Mesenteric Artery (SAM) and Aorta below 25°. In case of chronic or refractory cases, the surgical treatment may be an option. Laparoscopic duodenojejunostomy constitutes the treatment of choice due its low rate of complications and acceptable results.

[Quality of mammography and breast cancer screening in ArgentinaQualidade da mamografia e prevenção do câncer de mama na Argentina]. / Calidad de la mamografía y tamizaje del cáncer de mama en Argentina.

This paper presents results from the mammography quality plan of the National Breast Cancer Program at Argentina's National Cancer Institute, which focused on improving mammography quality in the public health-care sector and on using mammography to implement breast cancer screening. Plan implementation started in 2011, based on the premise that poor quality mammography impedes early diagnosis of breast cancer. At the time, there was little awareness in Argentina of the importance of quality control, and constant changes in lines of authority in the health system tended to hinder organized implementation of the program. The plan consisted of quality review and control of mammography facilities, training of technical and medical human resources, and implementation of an accreditation system for mammography services by the National Cancer Institute. Perception by involved personnel of the importance of quality improved; an overview was obtained of the state of mammography at the national level regarding quality, technology, quantity of equipment, and opportunities for implementation of screening; technical and medical personnel were trained using different methods; and standardization of mammography reading was promoted in the participating provinces.

Management of Esophageal Perforation: 28-Year Experience in a Major Referral Center.

Esophageal perforation constitutes a surgical emergency. Despite its gravity, no single strategy has been described as sufficient to deal with most situations to date. The aim of this study was to assess the etiology, management, and outcome of esophageal perforation over a 28-year period, to characterize optimal treatment options in this severe disease. A retrospective clinical review of all patients treated for esophageal perforation at Ramón y Cajal Hospital between January 1987 and December 2015 was performed (n = 57). Iatrogenic injury was the most frequent cause of esophageal perforation (n = 32). Abdominal esophagus was the main location (23 patients; 40.4%). Eight patients (14%) were managed with antibiotics and parenteral nutrition. In seven patients (12.3%), an endoscopic stent was implanted. Surgical therapy was performed in 38 patients (66.7%). Morbidity and 90-day mortality rates were 61.4 and 28 per cent, respectively. Five patients were reoperated (8.8%). Median hospital stay was 23.5 days. The mortality rate was higher among patients with spontaneous and tumoral perforation (54.5 and 100%; P = 0.009), delayed diagnosis (>24 hours; P = 0.0001), and abdominal/thoracic location (37.5%; P = 0.05). No statistical differences were found between surgical and conservative/endoscopic management (31% vs 20%; P = 0.205) although hospital staying was longer in surgical group (36.30 days vs 15.63 days; P = 0.029). Esophageal perforation was associated with high morbidity and mortality rates. Global outcomes depend on etiology, site of perforation, and delay in diagnosis. An individualized approach for each patient should be chosen to prevent septic complications of this potentially fatal disease.