Insights on the epigenetic mechanisms underlying pulmonary arterial hypertension

Pulmonary arterial hypertension (PAH), characterized by localized increased arterial blood pressure in the lungs, is a slow developing long-term disease that can be fatal. PAH is characterized by inflammation, vascular tone imbalance, pathological pulmonary vascular remodeling, and right-sided heart failure. Current treatments for PAH are palliative and development of new therapies is necessary. Recent and relevant studies have demonstrated that epigenetic processes may exert key influences on the pathogenesis of PAH and may be promising therapeutic targets in the prevention and/or cure of this condition. The aim of the present mini-review is to summarize the occurrence of epigenetic-based mechanisms in the context of PAH physiopathology, focusing on the roles of DNA methylation, histone post-translational modifications and non-coding RNAs. We also discuss the potential of epigenetic-based therapies for PAH.

Malla para la reparación del prolapso vaginal apical y anterior: resultados subjetivos y complicaciones / Vaginal mesh for repair of apical and anterior vaginal prolapse: subjective outcomes and complications

Resumen Antecedentes: la aplicación de mallas con fijación al ligamento sacroespinoso para corregir el prolapso apical de órganos pélvicos tiene tasas de éxito objetivo de 92%, con 2-12% de eventos adversos. Objetivo: evaluar los resultados clínicos posteriores a la aplicación de la malla UpholdTM en pacientes con prolapso apical, con o sin útero. Materiales y métodos: estudio retrospectivo y descriptivo efectuado en pacientes atendidas en la Clínica de Urología Ginecológica del Instituto Nacionalo de Perinatología Isidro Espinosa de los Reyes entre los meses de noviembre de 2013 a marzo de 2017 con prolapso de órganos pélvicos de la cúpula a quienes se aplicaron mallas que se fijaron al ligamento sacroespinoso. A las pacientes con incontinencia urinaria de esfuerzo se les colocó una cinta mediouretral. Resultados: se estudiaron 22 pacientes de las que 72% (n = 16) tenían histerectomía previa. El estadio del prolapso de órganos pélvicos fue II en 18% (n = 4), III en 41% (n = 9) y IV en 41% (n = 9). El compartimento anterior se encontró afectado en 41% (n = 9) y en 59% (n = 13) el apical. El 54% (n = 12) de las pacientes tenía incontinencia urinaria de esfuerzo. A 9% (n = 2) de las pacientes solo se les colocó la malla UpholdTM, a 45% (n = 10) se les practicó una cirugía concomitante para corrección del prolapso de órganos pélvicos (colpoplastia posterior [n = 5], colpoperineoplastia [ n = 4] y 1 culdoplastia) y para incontinencia urinaria de esfuerzo a 68% (n = 15) se les colocó una cinta mediouretral. El 9% (n = 2) tuvieron lesión vesical, 40% (n = 9) retención urinaria, 4.5% (n = 1) exposición y 4.5% (n = 1) extrusión. El éxito subjetivo y objetivo fue de 100%. Conclusiones: la colocación de la malla Uphold con fines de corrección del prolapso apical tiene buenos resultados, con mínimos efectos adversos. El procedimiento antiincontinencia concomitante incrementa la retención urinaria.

Abstract Introduction: The use of mesh with fixation to sacoespinous ligament (SEL) for correction of pelvic organ prolapse has a success rate of 92% and adverse events are reported in 2-12%. The aim of this study was to evaluate the clinical results after the application of Uphold mesh in women with apical prolapse with or without uterus. Methods: A retrospective and descriptive study, 22 patients with E ≥ II voult pelvic organ prolapse who underwent vault fixation or hysteropexy to SEL and mediourethral tape (CMU) in those with stress urinary incontinence (SUI) from November-2013 to March-2017. Results: 72.7% (n = 16) had previous hysterectomy. The pelvic organ prolapse stage was grade II in 18% (n = 4), III in 41% (n = 9) and IV in 41% (n = 9), the anterior compartment was affected in 40.9% and 59% (n = 13) for apical. 54.5% (n = 12) had SUI. In 9% (n = 2) were placed exclusively Uphold, concomitant surgery was performed for correction of posterior compartment pelvic organ prolapse in 45% (n=10) and at 68% (n = 15) CMU was placed. 9% (n = 2) had bladder injury, 40% (n = 9) urinary retention of patients with CMU application, 4.5% (n = 1) exposure and 4.5% (n = 1) extrusion. Subjective and objective success was 100%. Conclusions: The placement of Uphold has successful results in the correction of apical prolapse. The concomitant anti-incontinence procedure increases the presence of urinary retention.

Neoplasia intraepitelial cervical durante el embarazo, experiencia institucional / Cervical intraepithelial neoplasia during pregnancy, Institutional Experience

Resumen OBJETIVO: describir el tipo de atención médica, tratamiento y seguimiento de pacientes con neoplasia intraepitelial cervical (NIC 3) y carcinoma in situ durante el embarazo, su evolución y condiciones del recién nacido. MATERIALES Y MÉTODOS: estudio retrospectivo de pacientes atendidas en el Instituto Nacional de Perinatología entre los meses de enero de 2009 y diciembre de 2014. Se incluyeron pacientes con diagnóstico de NIC 3 durante el embarazo, con expediente completo y atendidas en el servicio de Obstetricia desde su ingreso para control prenatal hasta la terminación del embarazo y tratamiento oncológico definitivo. RESULTADOS: se identificaron 6 casos de pacientes embarazadas con diagnóstico de NIC 3 posterior a la toma de citología cervical. A todas se les realizó colposcopia y biopsia cervical, sin complicaciones secundarias al procedimiento. El diagnóstico histopatológico fue: carcinoma epidermoide in situ en 3 pacientes y en otras 3 neoplasia intraepitelial cervical. Todas las pacientes recibieron atención multidisciplinaria, sin complicaciones obstétricas ni neonatales. El seguimiento promedio fue de 2 años. CONCLUSIONES: el diagnóstico oportuno de las lesiones precursoras de cáncer cervicouterino es indispensable y no se relaciona con inconvenientes perinatales derivados del tipo de acceso.

Abstract OBJECTIVE: Describe the approach, management and monitoring of patients with cervical intraepithelial neoplasia (NIC) 3 and in situ carcinoma during pregnancy, its evolution and perinatal outcomes. MATERIALS AND METHODS: We made a retrospective study of cases from January 2009 to December 2014 in women of the National Institute of Perinatology . We included patients who were diagnosed with cervical intraepithelial neoplasia 3 during pregnancy, with complete file and that received medical consultation of the oncology and obstetrics service since their admission to the hospital for prenatal control until de resolution of pregnancy and oncological definitive treatment. RESULTS: During the study period, 6 cases of pregnant patients where diagnosed with CIN 3, after cervical cytology was taken, a cervical biopsy was performed without complications secondary to this procedure; the histopathological diagnosis was: In situ epidermoid carcinoma in 3 patients and Cervical Intraepithelial Neoplasia in the other 3. All patients were treated with a Multidisciplinary approach. None of the patients presented obstetric or neonatal complications; At the end of the puerperium, follow-up was continued,the mean follow-up after the definitive treatment was 2 years. CONCLUSIONS: The timely diagnosis of precursor lesions of CACU is indispensable, in turn, is not related to adverse perinatal outcomes derived from the approach and timely screening.

Cáncer de ovario durante el embarazo: experiencia institucional y revisión de la bibliografía / Ovarian cancer in the pregnancy: An institutional experience and literature review

RESUMEN ANTECEDENTES: la incidencia de cáncer de ovario durante el embarazo es de 1:10,000-100,000 casos. La cirugía y quimioterapia pueden indicarse después del primer trimestre. El tratamiento de estas pacientes debe ser multidisciplinario. OBJETIVO: reportar la experiencia institucional relacionada con el diagnóstico, tratamiento, vigilancia y resultados perinatales de pacientes embarazadas con cáncer de ovario. MATERIAL Y MÉTODOS: estudio retrospectivo, observacional y descriptivo efectuado en pacientes embarazadas, con cáncer de ovario, atendidas en el Instituto Nacional de Perinatología de 2009 a 2014. Del expediente clínico se obtuvieron los datos demográficos, antecedentes ginecoobstétricos, síntomas, semanas de gestación al momento de establecer el diagnóstico de malignidad, tipo histológico y estadificación de la neoplasia según los criterios de la FIGO 2014. Los resultados se expresan en medidas de tendencia central. RESULTADOS: se registraron 5 pacientes con edad promedio de 24.6 ± 8.9 años. A todas se les realizó cirugía conservadora durante el embarazo, entre las 22.8 ± 6.4 semanas, sin observar complicaciones relacionadas; se encontraron 3 pacientes en estadio I, 1 en IIIA2 y 1 en IVB. Se obtuvieron 4 neonatos vivos y sanos, con edad gestacional promedio de 38 ± 1.1 semanas y peso de 2,845 ± 700 g. La evolución y estancia hospitalaria posterior al nacimiento fue satisfactoria. CONCLUSIÓN: el diagnóstico, tratamiento y vigilancia de pacientes con cáncer de ovario durante el embarazo deben realizarse de manera multidisciplinaria, considerando el estadio de la enfermedad, edad gestacional y deseo genésico, con la finalidad de ofrecer las mejores alternativas. Se requieren estudios de seguimiento a largo plazo de los niños expuestos a quimioterapia durante el embarazo, para evaluar los efectos de la misma durante su desarrollo.

ABSTRACT BACKGROUND: The incidence of ovarian cancer diagnosed during pregnancy is 1: 10,000-100,000 pregnant women. Surgery and use of chemotherapy during pregnancy is feasible after the first trimester. The management of this patients should be performed by a multidisciplinary team. OBJECTIVE: To describe the treatment and perinatal outcomes of patients diagnosed with ovarian cancer during pregnancy. MATERIAL AND METHODS: Retrospective, observational and descriptive study included 5 patients with ovarian cancer associated with pregnancy treated at the Instituto Nacional de Perinatología Isidro Espinosa de los Reyes of 2009-2014. Demographic data, gynecological findings, symptoms, weeks of gestation at the time of diagnosis of malignancy, histological type and staging of neoplasia (FIGO 2014) were obtained from the clinical file. The results were expressed in measures of central tendency. RESULTS: The mean age of patients was 24.6 ± 8.9 years. All were performed conservative surgery during pregnancy (median 22.8 ± 6.4 weeks) without observing complications related to this. Three patients were in stage I, 1 in IIIA2 an 1 in IVB. 4 newborn and healthy, gestational age 38 ± 1.1 weeks, weight of 2,845 ± 700 g neonates were obtained. The evolution and post-natal hospital stay was satisfactory. CONCLUSION: The diagnosis, treatment and monitoring of ovarian cancer during pregnancy should be done in a multidisciplinary manner, considering the stage of the disease, gestational age and patient decision of the patient, in order to offer the best alternatives. It requires studies of long term follow up of children exposed to chemotherapy during pregnancy to evaluate the effects of it during development.

Efecto de una dieta personalizada en mujeres embarazadas con sobrepeso u obesidad / Personalized diet effect in pregnant obese or overweight women

Objectives: To determine if the implementation of a personalized diet for three months improves the nutritional status of pregnant women with overweight and obesity of the UMF No. 56. Methodology: Prospective longitudinal study in 53 overweight or obese pregnant women to whom which were given a specific diet, according to its particular characteristics; were evaluated the characteristics of the right diet, 24 hours recall, frequency of food consumption, weight and biochemical indicators. The real, ideal and projected weight of the patients was compared. McNemar test and Kuskal-Wallis was applied with confidence interval of 95%. Results: the BMI pre-gestational average was 28.5 kg / m2. At the end ofthe study pregnant women improved the characteristics of the right diet: the complete one (9.4% vs 60.4%), the percentage of adequacy of lipids (7.5% vs 45.3%) and increased in active physical activity (22.6% vs 54.7%). Ideal gestational weight wasn't reached, but there was a weight control reflected in a projected weight higher than real in each intervention. No significant changes in the biochemical indicator (p> 0.05). Conclusions: The implementation of a personalized diet improved the nutritional status of overweight or obese pregnant women in their eating patterns and gestational weight control.

Objetivo: Determinar si la implementación de una dieta personalizada durante tres meses, mejora el estado nutricional de mujeres embarazadas con sobrepeso y obesidad de la UMF No. 56. Metodología: Estudio prospectivo longitudinal en 53 embarazadas con sobrepeso u obesidad a las que se les proporcionó una dieta específica, de acuerdo a sus características particulares; se evaluaron las características de la dieta correcta, la R24H, la frecuencia de consumo de alimentos, el peso corporal e indicadores bioquímicos. Se comparó el peso real, peso proyectado y peso ideal de las pacientes. Se aplicó prueba de McNemar y Kuskal-Wallis con nivel de confianza de 95%. Resultados: el promedio del IMC pregestacional fue 28.5 kg/m2. Al finalizar el estudio las gestantes mejoraron las características de la dieta correcta: la completa (9.4% a 60.4%), el porcentaje recomendable de adecuación de lípidos (7.5% a 45.3%) y aumentaron la actividad física activa (22.6% a 54.7%). No se alcanzó el peso ideal gestacional, pero se logró control de peso, reflejado en peso proyectado mayor al real en cada intervención. Sin cambios significativos en el indicador bioquímico (p>0.05). Conclusiones: La implementación de la dieta personalizada mejoró el estado nutricional de mujeres embarazadas con sobrepeso u obesidad en sus patrones de alimentación y en el control de peso gestacional.

Determinantes sociales de salud en los agricultores del resguardo indígena Zenú / Social determinants of health in indigenous farmers of shelter Zenú

Objetivo: Analizar los determinantes sociales de salud presentes entre los indígenas agricultores del Resguardo Zenú de San Andrés de Sotavento. Metodología: Estudio descriptivo de corte, con enfoque cuantitativo, participaron 64 indígenas agricultores de las comunidades Celeste Imperio y Santa Elena del Municipio de San Andrés de Sotavento en el año 2012, se seleccionaron bajo la técnica del muestreo aleatorio simple. La recolección de la información se efectuó a través de encuestas estructuradas diligenciadas mediante entrevista. Resultados: El rango de edad de la población sujeto osciló entre 18 a 70 años, existe 41% de analfabetismo absoluto, las familias son extensas con orientación endogámica, las condiciones de vida son precarias, hay ausencia de actividad recreativa y actividad física programada, 97% percibe menos de un salario mínimo mensual legal vigente producto del trabajo comunitario, 95.3% pertenece al regimen de salud subsidiado, todos carecen de afiliación a riesgos laborales y pensión, 77% admitió que tuvo algún accidente laboral en el último año, así mismo, 70% manifestó morbilidad sentida relacionada con la actividad laboral. Conclusiones: Los determinantes de carácter social que influyen negativamente en la salud identificados fueron: sociopolítico, circunstancias materiales, factores biológicos, conductuales y laborales; los cuales se reflejan en deficiencias en su calidad de vida, morbilidad sentida, accidentalidad laboral, fragilidades en el Sistema de Protección Social, altos índices de analfabetismo absoluto, pobreza y características que indiscutiblemente reafirman la relación perversa e interdependiente entre analfabetismo, pobreza y salud. Sin embargo, la cohesión social se identificó como determinante social de influencia positiva para la salud (94%).

Objective: To analyze the social determinants of health present among indigenous farmers of Zenú reservation of San Andrés de Sotavento. Methodology: Descriptive cutting with a quantitative approach, 64 indigenous farmers of communities Celeste Imperio and Santa Elena of the municipality of San Andrés de Sotavento participated in 2012; they were selected by simple random sampling technique. The data collection was conducted through structured surveys filled by interview. Results: The age range of the target population oscillated from 18 to 70 years, there is 41% of total illiteracy, families are large with inbred orientation, living conditions are poor, there are no recreational activity or physical activity programs, 97 % earn less than the monthly legal minimum wage of community work product, 95.3% belongs to the subsidized health regime, all lack of affiliation to occupational hazards and pension, 77% admitted that they had some accident in the last year also 70 % said they felt morbidity related to work activity. Conclusions: The identified social determinants that negatively affect health were: sociopolitical, material circumstances, biological, behavioral and occupational factors; which are reflected in deficiencies in their quality of life, perceived morbidity, occupational accidents, weaknesses in the social protection system, high levels of absolute illiteracy, poverty and characteristics that undoubtedly reinforce the perverse and interdependent relationship between illiteracy, poverty and health. However, social cohesion was identified as a positive influence of health (94%).

Extratos vegetais no controle da antracnose e na conservação da qualidade em frutos de mamoeiro / Plant extracts in controlling anthracnose and quality conservation in papayas fruit

RESUMO O presente trabalho teve como objetivo avaliar a ação antifúngica dos extratos de Allamanda blanchetti A.DC. e Momordica charantia L. no controle de Colletotrichumgloesporioides e qualidade pós-colheita em frutos de mamoeiro da cultivar Sunrise solo. Os experimentos foram conduzidos nos Laboratório de Fitopatologia e Laboratório de Produtos de Origem Animal, CCA-UFPB, Campus.II, Areia-PB. Os frutos foram colhidos no estádio 1 de maturação, em seguida, sanitizados com hipoclorito de sódio a 1% por três minutos e pulverizados com os extratos etanólicos de A. blanchetti e M. charantia nas concentrações: 0, 10, 100, 500 e 1000 µg.mL-1. Os frutos foram distribuídos em bandejas de polipropileno expandido em temperatura ambiente (23±2 °C) e umidade relativa em torno de 70%. Após doze dias de armazenamento, os frutos foram avaliados quanto à incidência natural de C. gloesporioides, severidade, atividade da enzima peroxidase, sólidos solúveis, acidez titulável, relação SS/AT, perda de massa e aparência externa dos frutos. Foi realizada análise de regressão polinomial testando modelos até o terceiro grau para as concentrações dos extratos utilizando análise de variância pelo teste F enquanto as médias foram comparadas pelo teste de Tukey a 5% de probabilidade, através do programa SAS® 9.2. Não se observou diferença estatística quando avaliou-se a incidência natural de C. gloesporioides em frutos de mamoeiro utilizando os extratos de A. blanchetti e M. charantia. Já na avaliação da severidade da antracnose, verificou-se diferença para o tratamento com o extrato de A. blanchetti, que apresentou as menores escalas de notas em relação ao tratamento com a M. charantia. Observou-se atividade da peroxidase (POD) em frutos de mamoeiro nos extratos de A. blanchetti e M. charantia. Os frutos tratados com A. blanchetti apresentaram teor de acidez, com máximo de 0,12 g de ácido cítrico.100 g-1 e no de M. charantiaapresentou aumento para 0,15 g de ácido cítrico.100 g-1. A relação SS/AT diminuiu com o aumento das concentrações dos dois extratos. Os frutos tratados com A. blanchetti apresentaram maior perda de massa durante todo o armazenamento, sendo maior que 10% aos nove dias. Já a perda de massa dos frutos tratados com M. charantia apresentou comportamento linear, sendo superior a 12% aos 12 dias de armazenamento. A cor evoluiu de 1 (verde) para 6 (casca alaranjada) e a aparência dos frutos diminuiu com o decorrer do tempo de 5 (excelente) para 3 (regular) em todas concentrações dos extratos de A. blanchetti e M. charantia. Os extratos de A. blanchetti e M. charantia não reduziram a incidência natural, porém, só o extrato de A. blanchetti foi responsável por reduzir a severidade da antracnose. Ocorreu a atividade da enzima peroxidase em todos os tratamentos avaliados e conservaram a qualidade pós-colheita em frutos até os nove dias de armazenamento.

ABSTRACT This study aimed to evaluate the antifungal effect of the extracts Allamandablanchetti A.DC. and Momordica charantia L. in the control of Colletotrichum gloesporioides in papaya fruits of the Sunrise Solo cultivation, as well as their post-harvest quality. The trials were conducted in the Laboratory of Plant Pathology and Animal Products Laboratory, CCA-UFPB, Campus II, Areia-PB. The fruits were harvested at maturity stage 1, then sanitized with sodium hypochlorite 1% for three minutes and sprayed with ethanol extracts of A. blanchetti and M.charantia at concentrations of 0, 10, 100, 500 and 1000 μg.mL-1.The fruits were distributed in polypropylene trays expanded at room temperature (23±2 °C) and relative humidity around 70%. After twelve days of storage, the fruits were evaluated for natural incidence of C. gloesporioides, severity, peroxidase enzyme activity, soluble solids, titratable acidity, SS/TA ratio, weight loss and external appearance of the fruit. Polynomial regression testing models to the third degree were employed for the extracts of concentrations, using analysis of variance by F test. The averages were compared by Tukey test at 5% probability, through the SAS® 9.2 program. There was no statistical difference observed when we evaluated the natural incidence of C. gloesporioides in the papaya fruit, using extracts from A. blanchetti and M. charantia. In the assessment of the severity of the anthracnose, there was no statistical difference for the treatment with the extract of A. blanchetti, which had smaller scales of notes when compared with the treatment using the M. charantia. It was observed peroxidase activity (POD) in the papaya fruits treated with the extracts of A. blanchetti and M. charantia. The fruits treated with A. blanchetti presented a maximum dose of acidity of 0.12 g g-1 of citric acid.100 g-1. In the fruits treated with M. charantia this increase was of 0.15g of citric acid.100 g-1. The SS/TA ratio decreased with increasing concentrations of the two extracts. The fruits treated with A. blanchettipresented higher weight loss of approximately 10%, since the M. charantia was over 12%. The color evolved from 1 (green) to 6 (Orange Peel) and the appearance of the fruit got worse according to the time, from 5 (excellent) to 3 (regular) in all the concentrations of the extracts of A. blanchetti and M. charantia. The A. blanchetti and M. charantia extracts did not reduce the natural incidence, however, only the A. blanchetti extract was able to decrease the severity of the anthracnose. The peroxidase enzyme presented activity in all treatments and kept the postharvest quality of the fruits in the nine days of storage.

A suggested local regions in the Southern Gulf of Mexico using a diatom database (1979-2002) and oceanic hidrographic features.

A diatom data-base of 255 species obtained from 14 oceanographic cruises (14801 entries of 647 sampling sites) together with the analysis of oceanic features were used to establish four local regions in the southern Gulf of Mexico. In addition, common species for each region were designated. This study is based on the application of cluster analysis and the species frequency data. Material for this undertaking consisted of water and net samples obtained between June 1979 and December 2002. Results show that the most frequent species (> 40%) were: Asterionellopsis glacialis, Bacteriastrum delicatulum, B. hyalinum, Chaetoceros affinis, C. coarctatus, C. compresus, C. curvisetus, C. danicus, C. decipiens, C. diversus, C. lorenzianus, C. pelagicus, C. peruvianus, Coscinodiscus radiatus,Cylindrotheca closterium, Guinardia flaccida, Hemiaulus hauckii, H. membranaceus, H. sinensis, Leptocylindrus danicus, Neocalyptrella robusta, Nitzschia bicapitata, Pleurosigma diverse-striatum, Proboscia alata, Pseudo-nitzschia pungens, Pseudosolenia calcar-avis, Rhizosolenia imbricata,R. setigera, Skeletonema costatum, Thalassionema bacillare, T. frauenfeldii, T. nitzschioides and Thalassiosira eccentrica. The species composition for each region and season are discussed. It is concluded that sampling site assemblages are related to oceanographic conditions. A total list of species composition is given, forty-seven species taxa being new records for this area.

Germinación in vitro de híbridos de Vanilla planifolia y V. pompona / In vitro germination of Vanilla planifolia and V. pompona hybrids

El cultivo de la vainilla se lleva a cabo ampliamente por medio de propagación clonal, de manera asexual por cortes de tallos y la producción de frutos se realiza por autopolinización. Esta práctica inhibe la variación genética y la emergencia de nuevos individuos por recombinación sexual. Por lo anterior, se considera necesario realizar cruzas por propagación sexual entre especies para obtener nuevos individuos con características deseables para el cultivo. En el presente trabajo se obtuvieron híbridos de dos especies de vainilla como parte de un programa de mejoramiento genético. En general, las semillas híbridas obtenidas que presentaron mayor porcentaje de germinación fueron las cruzas interespecíficas interespecíficos de V. planifolia y V. pompona (85%), seguido de la cruza inversa V. planifolia y V. pompona (57,9%). Las semillas producto de V. pompona autopolinizada obtuvieron valores muy bajos de germinación (10,8%), mientras que las obtenidas de V. planifolia autopolinizada no presentaron germinación. El medio de cultivo más eficiente en todos los tratamientos fue el Murashige & Skoog (MS) adicionado con 400 mg/L-1 de glutamina y 80 mg/L-1 de sulfato de adenina.

The cultivation of vanilla is extensive clonal asexual propagation by cuttings and fruit production by artificial self-pollination. This feature tends to inhibit the genetic variation and the emergence of new individuals by sexual recombination. Therefore, sexual propagation between species it is considered necessary to obtain new individuals with desirable characteristics for cultivation. In this paper we were able to obtain hybrids of two species of vanilla. In general, the hybrids seeds obtained whit the higher germination percentage were interspecific crosses of V. planifolia and V. pompona (85%), followed by reverse cross V. planifolia and V. pompona (57.9%). Seeds obtained of V. pompona self-pollination were very low germination (10.8%) while those obtained from V. planifolia self-pollination showed no germination in any media culture. The most efficient medium for all treatments was the Murashige & Skoog (MS) supplemented whit 400 mg/L-1glutamine and 80 mg/L-1 of adenine sulfate.

Extension model of lactation curves to evaluate the effect of the recombinant bovine somatotropin on milk yield in Holstein cows / Modelo de extensão de curvas de lactação para avaliar o efeito da somatotropina bovina recombinante sobre a produção de leite em vacas Holstein

An extension model of lactation curves was used to determine the effect of recombinant bovine somatotropin (bST-r) on milk yield in Holstein dairy cattle. This model use the fitted values obtained by the Wood model, and was tested on the records of 66 cows. The milk yield predicted with the extension model and the observed yield were compared and no significant differences were observed (P>0.05). Once the extension model was validated, the milk yield tests of 199 cows were used. The cows received bST-r 500mg by subcutaneous injections. The injections were applied after 100 days in milk at 14-day intervals (seven injections). The observed milk yield was compared with the yield expected by the extension model. An increase of 5.3 percent was observed in milk yield in response to the bST-r. This increase is lower than that reported in the literature in response to the growth hormone in dairy cattle. It is concluded that extension model used in the present work is reliable for extending the lactation curve in Holstein cows, and the increase in milk yield in response to the application of bST-r, determined in the same animal using the extension model, was lower than that reported by other authors.

Um modelo de extensão de curvas de lactância foi utilizado para determinar o efeito da somatotropina bovina recombinante (bST-r) sobre a produção de leite em vacas Holstein. Este modelo, que utiliza os valores ajustados obtidos pelo modelo de Wood, foi testato nos registros de 66 vacas. A produção de leite predita com o modelo de extensão e a produção observada foram comparadas e não se observaram diferenças significativas (P>0,05). Uma vez validado o modelo de extensão, utilizaram-se os controles de produção de leite (de cada 15 dias) de 199 vacas. As vacas receberam injeções de 500mg de bST-r via subcutânea. As injeções fora aplicadas a partir dos 100 dias de lactação a intervalos de 14 dias (sete injeções). A produção de leite observada foi comparada com a produção esperada com o modelo de extensão. Observou-se um incremento de 5,3 por cento na produção de leite em resposta à bST-r. Este incremento foi menor que o relatado na literatura em resposta ao hormônio do crescimento em vacas leiteiras. O modelo de extensão usado é confiável para estender a curva de lactação na vaca Holstein, e o aumento do rendimento de leite em resposta à aplicação de bST-r, determinado no mesmo animal usando o modelo de extensão, foi inferior ao observado por outros autores.

Intervención del profesional de enfermería durante la contingencia de influenza A H1N1, en el Instituto Nacional de Enfermedades Respiratorias / Intervention of the professional nursing during the contingency of influenza AH1N1 in the National Institute of respiratory diseases

El INER es una institución normativa en las afecciones respiratorias, quien a lo largo de su historia ha enfrentado desafíos ante situaciones emergentes de salud, como lo son la tuberculosis y el VIH. Actualmente afronta un nuevo reto de salud respiratoria, la epidemia de influenza A H1N1, la cual se presentó de forma inesperada en México en la primavera del 2009, provocando la implementación de medidas sanitarias urgentes, al rebasarse la capacidad de atención médica en el Instituto. Por ello, fue necesario organizar todos sus recursos humanos, físicos y materiales. Instaurar el Comité de Influenza Institucional y en apoyo y coordinación con el Comité de Control de Infecciones, tomar decisiones urgentes enfocadas a la prevención, manejo y control de la enfermedad. Se implementó el Triage en los servicios de concentración para la atención integral del paciente con sospecha y/o confirmación de influenza (Consulta Urgencias, Urgencias Observación, Unidades de Terapia Intensiva e Intermedia y clínico 5). Con todo ello y gracias a la intervención y el trabajo en equipo que realizó el profesional de enfermería del Instituto, se logró controlar la propagación de la epidemia y una vez más lograr conciencia en el personal de salud (médicos y enfermeras), para afrontar manera exitosa, nuevos retos en la salud respiratoria.

INER is a respiratory-illness treating institution which has faced diverse health challenges including tuberculosis and VIH; yet, at present, it is facing a new one: the unexpected 2009 A H1N1 influenza outbreak in Mexico. This massive incident provoked the implementation of urgent sanitary measurements including: the organization of human, physical and material resources; the establishment of-Infection Committee coordinated measurement towards illness prevention, control and management; and the establishment of the TRIAGE on concentration services towards patients with confirmed or dubious influenza (Urgencies, Consult, Urgencies Observation, Intensive Therapy Unit, Intermediate Therapy Unit and Clinical 5). Thanks to these measurements and the INER's nursing personnel team work, we were able to control the outbreak propagation, but also to create consciousness among doctors and nurses to successfully face the new respiratory-illnesses challenges.

Gastropods and bivalves of commercial interest from the continental shelf of Jalisco and Colima, México

The distribution and abundance with respect to depth and type of substratum of 20 species of gastropods and four species of bivalves of economic importance were examined in the continental shelf of Jalisco and Colima, MÚxico. These species were taken with net trawls at depths from 24 to 83 m in August, 1988. Most individuals and species of gastropods were collected in stations with sandy silt substratum. Bivalves were collected in sandy silt and medium sand substrata. The six most abundant species represented 81.2 of all gastropods and bivalves collected. These species are: Cantharus pallidus, Fusinus dupetittouarsi, Ficus ventricosa, Hexaplex brassica, Harpa conoidalis and Arca pacifica.

Precorte de papila de vater. Evaluacion prospectiva de frecuencia de uso, eficacia, complicaciones y mortalidad. Estudio cooperativo del Noroeste de la Provincia de Buenos Aires / Precut Vaters papilla. Prospective evaluation of frequency of use, effectiveness, complication and mortality. Cooperative study in thenorthwest of the province of Buenos Aires

1) INTRODUCTION: Precut papillotomy, has been considered a potentially dangerous procedure. In spite of this, numerous national and foreign referral centers have reported good results with the use of this technique that increases the cannulation rate and permits additional therapeutic procedures. 2) OBJECTIVES: We evaluated the procedure in terms of frequency of use, effectiveness, complications and mortality. 3) PATIENT AND METHODS: Between January 1, 1996 and December 31, 1999, 419 ERCP were performed in our centers. We used precut papillotomy in 51 patients. Inclusion criteria for precut papillotomy protocol were: 1 precut papillotomy indication. 1-1 failure to cannulate the papilla, 1-2 appropriate indication, 1-3 Expert endoscopist, 2 complete follow up, 3 informed consent. The experimental design of the study was prospective. When the patients entered into the protocol, they underwent a needle-knife sphincterotomy according to Huibregise's technique. The follow up was done during 30 days, with a clinical examination, laboratory test and ultrasonography all of them weekly, to determine the possible complications according to Cotton's criteria and the mortality. 4) RESULTS: 4-1) Precut frequency: 51 patients (pts.) (12.1 percent). 4-2) Follow up: 49 pts. (96.1 percent) fulfilled the weekly controls; 2 pts. (3.9 percent) did not come for the controls. 4-3) Sex and Age: Women 29 pts. (56.9 percent). Age 62.5 +/- 1.74 years. Men: 22 pts. (43.1 percent) Age +/- 3.35 years. 4-4) Indications: Jaundice, diagnosis and treatment: 44 pts. (86.3 percent), post-cholecystectomy pain; 4 pts. (7.8 percent), and idiopathic abdominal pain: 3 pts. (5.9 percent). 4-5) Effectiveness: First attempt 35 pts. (71.4 percent), second attempt: 10 pts (20.4 percent). Definite effectiveness: 45 pts. (98.1 percent), failure: 4 pts. (8.1 percent). 4-6) Complementary treatment: in 43 pts. we performed the following procedures: papillotomy and stone extraction: 26 pts. (53 percent), papillotomy and prosthesis: 9 pts. (18.4 percent), Prosthesis: 8 pts. (16.3 percent, only pre-cut papillotomy: 6 pts. (12.2 percent). 4-7 Final diagnoses: Coledocholithiasis 41 pts. (83.6 percent); Malignant obstruction of biliary duct: 4 pts. (8.2 percent), Pancreatic Cancer: 1 pts. (2 percent); Ampullary Cancer 1 pts. (2 percent). Oddi sphyncter dysfunction: 1 pts. (2 percent). 4-8...

Rotura hepática en el embarazo: aporte de un caso y revisión de la bibliografía / Hepatic rupture in pregnancy: report of a case and review of the bibliography

A hepatic rupture case in a pregnancy is reported. A bibliographic revision during the last fifteen years has been carried out in which: epidemiology, risk factors, etiopatogenia, clinic, complementary exams, presage and treatment.

Síndrome de Marfan / Marfan syndrome

El síndrome de Marfan es un desorden sistémico hereditario del tejido conectivo. Se manifiesta principalmente con alteraciones en los sistemas musculoesqueléticos, cardiovascular, ocular, respiratorio, cutáneo y sistema nervioso. Se describen tres casos de síndrome de Marfan con manifestaciones mucocutáneas y se realiza una revisión de la literatura

Prótesis endoesofágica en el tratamiento paliativo de la estenosis esofágica de origen maligno: estudio cooperativo del Noroeste de la Provincia del Buenos Aires / Endoesophageal protesis as a palliative treatment for malignant esophageal stenosis: comparative study of the Northwest of the Buenos Aires Province

Objetivo: Mostrar la experiencia en prótesis rígidas para el tratamiento paliativo de las estenosis malignas esofágicas. Material y Método: Desde noviembre de 1995 hasta enero de 1997 ingresaron al protocolo de prótesis rígidas en forma prospectiva no randomizada 14 pacientes, cuya edad fue de 51 a 83 años (71.5 + 2.3); 11 de sexo masculino y 3 de sexo feminino. Los criterios de inclusión fueron 11 pacientes con cáncer de esófago en estadio IV, 2 pacientes con cáncer de estómago con invasión a esófago y estadio IV y 1 paciente con metástasis en mediastino de cáncer de mama. Se utilizó prótesis rígida modelo Wilson-Cook. La técnica de inserción fue "el método sobre el dilatador". Resultados: Procedimiento exitoso: 14 (100 por ciento), Mortalidad: no se registró, Complicaciones: en 6 pacientes (42.8 por ciento), 2 (14.3 por ciento) tempranas: migraciones y 4 (28.5 por ciento) tardías: 3 taponamiento por alimentos y una migración, Tiempo de Internación: 24 horas (100 por ciento), Mejoría de la Disfagia: 14 (100 por ciento), Seguimento: 13 (92.8 por ciento), Sobrevida: 18 a 266 días (92 + 83.6). Conclusiones: En nuestra casuística hemos observado: 1º Alto porcentaje de éxitos en la colocación; 2º Ausencia de mortalidad; 3º Bajo porcentaje de complicaciones y dentro de ellas menores; 4º Mínimo tiempo de internación; 5º Rápida y efectiva mejoría de la disfagia; 6º Adecuado seguimiento; 7º Tiempo de sobrevida similar a otros métodos paliativos, pero con menor morbimortalidad y costo, y mejor calidad de vida.

Fístula lagrimal congénita / Congenital lacrimal fistula

Presentamos una paciente que consulta por una fístula lagrimal congénita, entidad que es infrecuente y raramente diagnosticada en la consulta dermatológica. Los pacientes pueden ser asintomáticos o presentar lagrimeo desde el orificio de la fístula. Con respecto al tratamiento se recomienda la dacriocistorrinostomía con disección de los canalículos comunes; excisión de la fístula e intubación canicular en todos los pacientes sintomáticos, para facilitar el drenaje desde la misma y para prevenir así la obstrucción de los canalículos comunes

Eritema necrolítico migratorio: presentación de un caso y revisión de la literatura / Necrolytic migratory erythema: case and literature review

El eritema necrolítico migratorio es una erupción cutánea característica, con hallazgos histopatológicos específicos que se relacionan frecuentemente con un tumor pancreático, el glucagonoma. Los pacientes con este síndrome son generalmente mal diagnosticados. Se presenta un paciente de 54 años de edad con una erupción cutánea recurrente, pérdida de peso, glositis e hiperglucemia de cuatro meses de duración. Esta importante, pero rara enfermedad, puede ser diagnosticada tempranamente, basándonos en el cuadro cutáneo

Farmacodermias en pacientes H.I.V / Farmacodermal in H.I.V patients

La incidencia de reacciones adversas a drogas en pacientes HIV positivos es elevada. Las drogas más frecuentemente involucradas so: sulfonamidas y amoxilina-cluvanato. Diferentes tipos de reacciones son vistas, entre ellas:eritema polimorfo y la necrólisis epidérmica tóxica, que pueden llegar a comprometer la vida del paciente.Los mecanismos que provocan estas reacciones son desconocidos,sin embargo las las evidencias sugieren que la afectación podría deberse a la capacidad disminuida para la detoxificación de metabolitos intermediarios de las drogas con capacidad reactiva. Otras reacciones menos severas sondescriptas como erupciones máculo-pápuloerimatosas generalizadas asociadas a la administración de trimetoprima-sulfametoxazol;hiperpigmentación de uñas asociada a zidovudina y menos frecuentemente,erupción exantemática severa en aproximadamente el 1 por ciento de los pacientes que reciben zidovudina.La observación de de dos pacientes con eritema polimorfo como reacción adversa al cotrimoxazol y amnoxilina-clovanato y otros pacientes con otras reacciones a diferentes drogas motivan esta publicación