The genus Gautieria (Gomphales) in Europe and the Mediterranean Basin: a morphological and phylogenetic taxonomic revision.

Type material and additional collections of 11 taxa of Gautieria described in Europe and North Africa have been studied, namely G. dubia, G. graveolens, G. morchelliformis var. globispora, G. morchelliformis var. magnicellaris, G. morchelliformis var. morchelliformis, G. morchelliformis var. stenospora, G. otthii, G. pseudovestita, G. retirugosa, G. trabutii and G. villosa. At the same time, morphological and genetic studies on recent and herbarium collections from several European countries have been carried out. This enabled clarification of sections within Gautieria and differentiation of 28 taxa, of which 21 are new to science. However, the deeper relationships and nomenclature changes related to the phylogenetic position of the genus Gautieria within Gomphaceae will not be addressed in this study because they would require a more complete molecular analysis together with that of related genera, e.g., Gomphus, Turbinellus, and the four subgenera of Ramaria. In addition, a lectotype for G. villosa var. villosa and reference specimens for G. graveolens and G. morchelliformis var. morchelliformis are selected, and the new combination G. morchelliformis var. dubia is proposed. Detailed descriptions, macro- and microphotographs and distribution maps of all taxa are provided, as well as extensive information on their ecology, chorology and phylogeny. A key is included to facilitate identification of taxa. Citation: Vidal JM, Cseh P, Merényi Z, et al. 2023. The genus Gautieria (Gomphales) in Europe and the Mediterranean Basin: a morphological and phylogenetic taxonomic revision. Persoonia 50: 48 -122. https://doi.org/10.3767/persoonia.2023.50.03.

Tissue talks: immunophenotype of cells infiltrating the graft explains histological findings and the benefits of belatacept at 10 years.

Previously, we found a substantial number of regulatory T cells (Tregs ) and fewer senescent and T helper type 17 (Th17) and a decrease in interstitial fibrosis (IF) in 12-month graft biopsies in belatacept versus cyclosporin (CNI)-treated patients [Belatacept Evaluation of Nephroprotection and Efficacy as First-line Immunosuppression Trial (BENEFIT) study]. Seven years after kidney transplantation (KT), mean estimated glomerular filtration rate (eGFR), patient and graft survival were significantly higher with belatacept versus CNI treatment. The aim of this study was to determine whether the immunophenotypes of inflammatory and regulatory cell subsets infiltrating the grafts contribute to the BENEFIT's clinical findings a decade after KT. Twenty-three adult patients with functionally stable KT treated with belatacept and 10 treated with CNI were enrolled. Biopsies were analyzed by histomorphometry and immunohistochemistry for proliferation, senescence, apoptosis, inflammatory and regulatory cell markers in a blinded manner. Significantly lower percentages of inflammatory/fibrogenic cells [interleukin (IL)-22+ /Th17/Th2/M1 macrophages] were observed in patients treated with belatacept than in patients treated with CNI. By contrast, remarkably higher percentages of regulatory cells [Tregs /Bregs / plasmacytoid dendritic regulatory cells (pDCregs )/M2] were found in belatacept-treated patients than in CNI-treated patients. Conspicuously lower percentages of apoptosis and senescence and higher proliferation markers were found in belatacept-treated patients than in CNI-treated patients. Consequently, there was significantly more inflammation in the microvascular compartments as well as increased tubular atrophy and IF in CNI-treated patients. These findings strongly suggest that regulatory mechanisms, along with the absence of deleterious effects of CNI, contribute to the long-term graft histology and function stability in patients treated with belatacept.

[Cardiovascular Preparticipation Screening of young population. Position statement of Chilean Scientific Societies]. / Evaluación Preparticipativa Cardiovascular Pediátrica. Declaración de posición de la Sociedad Chilena de Pediatría (SOCHIPE), Sociedad Chilena de Medicina del Deporte (SOCHMEDEP) y Sociedad Chilena de Cardiología y Cirugía Cardiovascular (SOCHICAR).

The Preparticipation Physical Evaluation (PPE), defined as "the health supervision of individuals, prior to the practice of physical activity and/or sports, which seeks to optimize their safe participation in sports and provide an opportunity to identify current and future risks to their health and quality of life", inclu des the Cardiovascular assessment, which aims to screen cardiovascular pathologies with the risk of worsening or sudden death during exercise. Although there is broad international consensus that the use of Pediatric Cardiovascular PPE in young athletes is useful, there is no consensus on whether this should be used in the entire pediatric population or on which is the best strategy to apply. This article presents the position of the scientific societies related to sport, physical activity and child health on the Pediatric Cardiovascular PPE.

Evaluación preparticipativa cardiovascular pediátrica: declaración de posición de la Sociedad Chilena de Pediatría (SOCHIPE), Sociedad Chilena de Medicina del Deporte (SOCHMEDEP) y Sociedad Chilena de Cardiología y Cirugía Cardiovascular (SOCHICAR) / Cardiovascular preparticipation screening of young population: position statement of Chilean Scientific Societies

La Evaluación Preparticipativa (EPP) definida como "la supervisión de salud de individuos, previo a la práctica de la actividad física y/o deporte, que busca optimizar su participación deportiva segura y brindar una oportunidad para identificar los riesgos actuales y futuros de su salud y su calidad de vida" contempla la EPP Cardiovascular (EPPC), que tiene por objetivo la pesquiza de patologías cardio vasculares con riesgo de agravarse o presentar muerte súbita durante la práctica de ejercicio. Si bien existe amplio consenso internacional respecto a que la realización de la EPPC en jovenes deportistas es de utilidad, no existe consenso respecto a si esta debe ser realizada a toda la población pediátrica ni tampoco sobre cuál es la mejor estrategia a aplicar. En el presente trabajo se presenta la posición de las sociedades cientificas relacionadas al deporte, actividad fisica y salud infantil sobre la Evaluación Preparticipativa Cardiovascular Pediátrica.

The Preparticipation Physical Evaluation (PPE), defined as "the health supervision of individuals, prior to the practice of physical activity and/or sports, which seeks to optimize their safe participation in sports and provide an opportunity to identify current and future risks to their health and quality of life", inclu des the Cardiovascular assessment, which aims to screen cardiovascular pathologies with the risk of worsening or sudden death during exercise. Although there is broad international consensus that the use of Pediatric Cardiovascular PPE in young athletes is useful, there is no consensus on whether this should be used in the entire pediatric population or on which is the best strategy to apply. This article presents the position of the scientific societies related to sport, physical activity and child health on the Pediatric Cardiovascular PPE.

An assessment of commonly employed satellite-based remote sensors for mapping mangrove species in Mexico using an NDVI-based classification scheme.

Optimizing the classification accuracy of a mangrove forest is of utmost importance for conservation practitioners. Mangrove forest mapping using satellite-based remote sensing techniques is by far the most common method of classification currently used given the logistical difficulties of field endeavors in these forested wetlands. However, there is now an abundance of options from which to choose in regards to satellite sensors, which has led to substantially different estimations of mangrove forest location and extent with particular concern for degraded systems. The objective of this study was to assess the accuracy of mangrove forest classification using different remotely sensed data sources (i.e., Landsat-8, SPOT-5, Sentinel-2, and WorldView-2) for a system located along the Pacific coast of Mexico. Specifically, we examined a stressed semiarid mangrove forest which offers a variety of conditions such as dead areas, degraded stands, healthy mangroves, and very dense mangrove island formations. The results indicated that Landsat-8 (30 m per pixel) had  the lowest overall accuracy at 64% and that WorldView-2 (1.6 m per pixel) had the highest at 93%. Moreover, the SPOT-5 and the Sentinel-2 classifications (10 m per pixel) were very similar having accuracies of 75 and 78%, respectively. In comparison to WorldView-2, the other sensors overestimated the extent of Laguncularia racemosa and underestimated the extent of Rhizophora mangle. When considering such type of sensors, the higher spatial resolution can be particularly important in mapping small mangrove islands that often occur in degraded mangrove systems.

Assessing the influence of artificially constructed channels in the growth of afforested black mangrove (Avicennia germinans) within an arid coastal region.

Hypersaline conditions are common in sub-tropical latitudes where freshwater availability is seasonal. Hence, hydroperiod plays a crucial role in providing a suitable area for the establishment of new mangrove seedlings. The purpose of this study was to assess the function of hydrological change and irradiance in the growth of afforested black mangrove (Avicennia germinans) along the upper saltpan area by creating six channels of 1 m wide by 0.3 deep and 30 m length. All channels were constructed perpendicular to the main coastline of the Urias lagoon, Pacific coast of Mexico. Seedlings of black mangrove were planted along four of the channels. After ten months, the pore-water salinity concentration within the six channels was reduced by half. Results indicate that there were no significant differences (P > 0.05) in mangrove survival among the channels. However, the optimal growth of black mangroves was near the channels edge. The growth of mangrove seedlings planted under 50% of solar attenuation was 10 times higher as compared to mangroves under direct sunlight. This study shows the feasibility of using channels to enhance tidal flow and decrease hypersaline conditions for future afforestation endeavors in arid coastlines.

[Prevalence of genital anomalies in young football players]. / Prevalencia de anomalías genitales en futbolistas jóvenes.

The purpose of genital examination (GE) during the Pre-participation Physical Examination (PPE) is to identify the state of maturity, and rule out any genital pathology. To describe genital anomalies (GA) and estimate the awareness of GE in young football players. A descriptive, cross-sectional study was conducted in 280 elite football players from the results of PPE over two seasons. There was a detection rate of 5.4% GA, with varicocele being 3.2%, and of which only 13% were aware of their condition. Although this study shows a low incidence of genital abnormality in the study population, only 13% were aware of the GE prior to assessment. These findings demonstrate a low incidence of GA in this population. While GE is recommended during PPE, it is not a routine practice performed by family doctors or sports medicine specialists. This article attempts to raise awareness of the importance of GE in PPE as a preventive health strategy.

Nutrient removal in a closed silvofishery system using three mangrove species (Avicennia germinans, Laguncularia racemosa, and Rhizophora mangle).

The removal of ammonium (NH4(+)), nitrite (NO2(-)), nitrate (NO3(-)), and phosphate (PO4(-3)) in a closed silvofishery system was examined using three mangrove species (i.e., Avicennia germinans, Laguncularia racemosa, and Rhizophora mangle). Specifically, six closed tanks were installed for this experiment with a population of 60 Dormitator latifrons fishes per tank. We planted 40 seedlings in each of three experimental tanks separated by species, while the remaining tanks were used as control. During 15 weeks, nutrient concentrations among the three mangrove systems presented no significant differences (P>0.05). However, nutrient removal variability was minimum during the last 2-5 weeks. Mangroves presented an average efficiency of 63% for the removal of NH4(+) and NO2(-). Contrary, the average removal potential of NO3(-) and PO4(-3) was 50%. Results from this study suggest that the three mangrove species could be used in a closed silvofishery systems for the biological removal of NH4(+), NO2(-), NO3(-), and PO4(-3).

Subjective pain response to two anesthetic systems in dental surgery: traditional syringe vs. a computer controlled delivery system.

The present study was conducted to evaluate human pain perception at different phases of dental surgery using a computer controlled device, the Single Tooth Anesthesia System (STA System), versus the traditional syringe technique. One hundred healthy patients participated in this single-blind split-mouth design study. Individuals provided pain ratings at needle insertion, delivery of anesthetic solution and tooth extraction via a numeric visual rating scale or NVRS. The anterior middle superior alveolar, or AMSA, injection was compared with traditional syringe injections in maxillary quadrants. NVRS scores for AMSA were significantly lower for the STA System when compared to traditional syringe technique at needle insertion, delivery of anesthetic solution (p less than 0.0001) and also during tooth extractions (p=0.0002). A higher percentage of patients (23 percent) required a second injection after the traditional syringe technique. Subjects reported having less clinical pain with AMSA injection at every step of the dental surgery. The STA System combines an anesthetic pathway and controlled flow rate resulting in virtually imperceptible needle insertion and injection, and a rapid onset of profound anesthesia. NVRS scoring system facilitated patient comprehension in assessing pain value and intensity experienced. The two anesthetic delivery techniques were therapeutically equivalent for maxillary injections but AMSA/computer controlled protocol significantly minimizes subjective pain perception at needle insertion, anesthetic delivery and during tooth extraction.

Platelet-rich plasma improves wound healing in multiple myeloma bisphosphonate-associated osteonecrosis of the jaw patients.

Bisphosphonates are drugs used to treat various metabolic and malignant bone diseases. In the past 10 years intravenous bisphosphonates have been associated with increased risk of osteonecrosis of the jaw (ONJ). The aim of the present study is to evaluate platelet-rich plasma (PRP) wound healing benefits in multiple myeloma (MM) patients who developed ONJ after surgical tooth extraction. The study included 7 patients, 2 males and 5 females. All individuals had been taking zoledronate or pamidronate followed by zoledronate for an average of 5 years. Four subjects had only standard surgical debridement and sequestrectomy to treat the ONJ and three had additional autologous PRP. The patients were followed-up for 3 months. The use of PRP to enhance wound healing and reduce bone exposure seems to be a good treatment protocol in ONJ MM subjects.

Uso de la toxina botulínica a (Botox) en hiperactividad del detrusor / Use of toxin botulínica - to (Botox) in hyperactivity of the detrusor

La toxina botulínica (BTX) es una neurotoxina que inhibe la liberación de acetilcolina en la unión neuromuscular, provocando relajación del músculo. En urología ha sido utilizada en disinergia vecesicoesfintenaria e hiperactividad del detrusor con buenos resultados. El objetivo de este trabajo es evaluar la eficacia y seguridad de Botox en el tratamiento de la hiperactividad del detrusor. Realizamos una revisión retrospectiva de resultados obtenidos en pacientes sometidos a inyección intradetrusor de BTX por hiperactividad del detrusor entre diciembre de 2007 y julio de 2009.Se realizaron 20 tratamientos en 18 pacientes (4hombres y 14 mujeres).La edad promedio de los pacientes fue 60.4 años. Todos los pacientes tenían demostración urodinámica de hiperactividad del detrusor con un promedio de amplitud de las contracciones de 50 cm. de agua. El 100 por ciento había recibido diversos tratamientos previos con antimuscarínicos. Tres casos eran de causa neurogénica. La dosis de inyección varió de 100 a 300 UI. A las dos semanas del tratamiento 14 pacientes tuvieron remisión completa de los síntomas. El tiempo de efectividad fue variable de 1 a 14 meses (4 pacientes con menos de 2 meses de seguimiento) En un paciente de origen neurogénico fue necesaria una segunda inyección para lograr la desaparición completa de síntomas. La inyección de BTX es un procedimiento simple y de bajo riesgo con buenos resultados en el tiempo y debe ser considerado como una importante herramienta en Hipercactividad del Detrusor.

Introduction: Botulinum toxin is a neurotoxin that inhibits the release of acetylcholine causing muscle relaxion. Is has used en Urology showing adequate safety and efficacy for neurogenic and idiopathic detrusor overactivity. We decided evaluate our outcomes in the treatment of detrusor hyperactivity. This is a board approved retrospective study.We research our database for patients treated with BTX-A for overactive detrusor between. December 2007 and July 2009.We identified 18 patients (14 women and 4 males) with a mean age 60.2 years in whom detrusor overactivity was confirmed on urodynamics and who were refractory to or intolerant of antimuscarinics and treated with intravesical BTX-A. After weeks from treatment 147 (77.8 percent) patients reported improvement of symptoms. There were no treatment ralated complications. According our result, BTX-A treatment a simple and low-risk procedure with adecuate safety and efficacy in the onset of overactive detrusor.

Examination of periodontal pathogens in stenotic valve specimens and in whole blood samples in patients affected by aortic valve stenosis and chronic periodontitis.

Periodontitis may be a risk factor for atherosclerosis and coronary heart disease. The influence of periodontal pathogens in cardiovascular diseases needs further investigation. Therefore, the aims of this clinical study are: to test the presence of periodontal bacteria DNA in aortic valves and to assess the concomitant presence of the same periodontal bacteria DNA in whole blood samples in patients affected by aortic valve stenosis and chronic periodontitis. Nineteen consecutive patients (12 males and 7 females, age: 49-85 years) were enrolled in this study after having been subjected to a complete periodontal evaluation to confirm the diagnosis of chronic periodontitis. All patients were scheduled for aortic valve replacement surgery. After clinical and microbial periodontal examination, the aortic valve tissue specimens were obtained by excision during valve replacement surgery and the patients were subjected to the whole blood sampling before the surgery. The polymerase chain reaction technology was used to detect the putative periodontal pathogens Tannerella forshytia, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Fusobacterium nucleatum, Campylobacter rectus, Eikenella corrodens and Treponema denticola. Neither the 19 aortic valve specimens nor the blood samples were positive for the genoma of the selected periodontal pathogens. The selected periodontal pathogens did not colonize the aortic valve of patients affected by stenosis and bacterial genoma was not present in whole blood samples. A high blood pressure at the aortic valve may prevent the adhesion and proliferation of bacterial colonies.

Evaluating the condition of a mangrove forest of the Mexican Pacific based on an estimated leaf area index mapping approach.

Given the alarming global rates of mangrove forest loss it is important that resource managers have access to updated information regarding both the extent and condition of their mangrove forests. Mexican mangroves in particular have been identified as experiencing an exceptional high annual rate of loss. However, conflicting studies, using remote sensing techniques, of the current state of many of these forests may be hindering all efforts to conserve and manage what remains. Focusing on one such system, the Teacapán-Agua Brava-Las Haciendas estuarine-mangrove complex of the Mexican Pacific, an attempt was made to develop a rapid method of mapping the current condition of the mangroves based on estimated LAI. Specifically, using an AccuPAR LP-80 Ceptometer, 300 indirect in situ LAI measurements were taken at various sites within the black mangrove (Avicennia germinans) dominated forests of the northern section of this system. From this sample, 225 measurements were then used to develop linear regression models based on their relationship with corresponding values derived from QuickBird very high resolution optical satellite data. Specifically, regression analyses of the in situ LAI with both the normalized difference vegetation index (NDVI) and the simple ration (SR) vegetation index revealed significant positive relationships [LAI versus NDVI (R (2) = 0.63); LAI versus SR (R (2) = 0.68)]. Moreover, using the remaining sample, further examination of standard errors and of an F test of the residual variances indicated little difference between the two models. Based on the NDVI model, a map of estimated mangrove LAI was then created. Excluding the dead mangrove areas (i.e. LAI = 0), which represented 40% of the total 30.4 km(2) of mangrove area identified in the scene, a mean estimated LAI value of 2.71 was recorded. By grouping the healthy fringe mangrove with the healthy riverine mangrove and by grouping the dwarf mangrove together with the poor condition mangrove, mean estimated LAI values of 4.66 and 2.39 were calculated, respectively. Given that the former healthy group only represents 8% of the total mangrove area examined, it is concluded that this mangrove system, considered one of the most important of the Pacific coast of the Americas, is currently experiencing a considerable state of degradation. Furthermore, based on the results of this investigation it is suggested that this approach could provide resource managers and scientists alike with a very rapid and effective method for monitoring the state of remaining mangrove forests of the Mexican Pacific and, possibly, other areas of the tropics.

Siete años de experiencia en cirugía "Tension Free Vaginal Tape" (TVT) / Seven years of experience in tension free vaginal tape (TVT) procedure

Desde la introducción del “tension free vaginal tape” (TVT) para el tratamiento de la IOE se ha popularizado como técnica quirúrgica relativamente estándar y comparable. El TVT a 7 años ha mostrado buenos resultados y pocas complicaciones en la serie histórica. El TVT además ha modificado los conceptos en que se basan la mayoría de las técnicas quirúrgicas para la IOE. Nuestro objetivo es mostrar los resultados quirúrgicos a corto y largo plazo de la técnica TVT, para lo cual realizamos una revisión retrospectiva de los registros de las pacientes operadas con la técnica TVT consignando resultados terapéuticos y complicaciones. En el período agosto 2000 a agosto del 2007 hemos operado 129 pacientes con esta técnica. El seguimiento promedio fue de 45,7 meses. El promedio de edad fue de 56 años. En 71 (55 por ciento) pacientes existía el antecedente de cirugía ginecológica o de incontinencia previa. Complicaciones intraoperatorias y post-operatorias inmediatas fueron sangramiento severo en 1 (0,8 por ciento)paciente, perforación vesical en 5 (3,9 por ciento), retención de orina en 11 (8,5 por ciento) y urgencia de Novo en 13 (10 por ciento) pacientes. Cinco pacientes debieron ser sometidas a uretrolisis por síntomas obstructivos bajos u obstrucción. Tuvimos 3 pacientes con erosión, una con cierre espontáneo y dos en que debió ser retirada la malla. De las 113 pacientes con más de 12 meses de seguimiento 13 (11,5 ciento) persisten con IOE y 100 (88,1 por ciento) se encuentran continentes. En nuestra experiencia la cirugía TVT ha reproducido con éxito los resultados originales, siendo una técnica poco invasiva recomendable para resolver.

The minimally invasive TVT procedure and similar techniques of sling placement with reported cure rate for stress incontinence from 84 percent to 95 percent, have replaced most of stress urinary incontinence procedures. The aim of the present study is to evaluate TVT outcome in our hospital. We performed a retrospective review of the hospital database between August 2000 and August 2007. 129 patients were identified with TVT surgery as treatment for stress urinary incontinence. The mean age was 56years old. 71 patients (55 percent) had a previous SUI or prolapsed surgery. Mean follow up was 45.7 months. 113 patients had a follow up longer than 12 months with a success rate of 88.5 percent (100 patients). Immediate complications were defined as bleeding, bladder perforation and postoperative urinary retention and occurred in 1 patients (0.77 percent), 5 patients (3.9 percent), 6 patients (4,65 percent) respectively. We had de novo urgency in 13 patients (10 percent). Three patients (2.3 percent) had vaginal erosion, in 2 cases we removed the mesh. Five patients (3.9 percent) had postoperative voiding disfunction that requiered urethrolysis. Subjetive complete cure rate was 88,1percent for the 113 women available for follow-up. According to our data, TVT shows good outcome in the treatment of SUI. TVT is a safe, effective, and minimally invasive option.

Descripción histológica de las glándulas anexas del aparato digestivo de avestruz (Struthio camelus var. domesticus) / Histologic description of the annexed glands from the ostrich digestive system (Struthio camelus var. domesticus)

En la última década, la crianza del avestruz en Chile ha ido aumentando sustancialmente, por lo cual se ha hecho necesario incrementar los estudios para mejorar la producción de esta especie. La literatura señala sólo estudios sobre la fisiología y anatomía de esta especie. Nuestro objetivo es aportar al conocimiento de la histología normal de las glándulas anexas al aparato digestivo. Esta investigación se realizó con 6 avestruces clínicamente sanas, de las que se obtuvieron muestras representativas del hígado, pro ventrículo y páncreas. Se realizaron cortes histológicos, los que fueron teñidos y montados para su análisis comparativo bajo microscopio de luz, entre avestruz y gallina. La histología de las glándulas anexas del aparato digestivo es semejante a la descrita en la gallina. Sin embargo, en el hígado los cordones de hepatocitos se disponen en forma radial, tanto alrededor de la vena central como de los espacios porta, característica no observada en otras especies. Con respecto al pro ventrículo, en la mucosa se observan glándulas tubulares simples o ramificadas, semejantes a las glándulas fúndicas de los mamíferos. En la submucosa se observan glándulas túbuloalveolares compuestas con células parietales. El páncreas no presenta diferencias destacables.

In the last decade the upbringing of the ostrich in Chile has increased substantially, for this reason it is necessary to increase the studies to improve the production of this species. The literature only points out studies on the physiology and anatomy of this species. The purpose of this work is to contribute to the knowledge of the normal histology from the annexed glands to the digestive system. This study was carried out clinically using 6 healthy ostriches, of which representative samples of the liver, proventricle and pancreas. Histological sections were realized, mounted and stained for their comparative analysis under low light microscope to describe with those cited in the hen. The histology of the annexed glands from the digestive system is similar to the described in the hen. However, in the liver the arrangement hepatic cords so is in the central vein such as the portal spaces is radial, characteristic not observed in other species. In relation to the histology of the proventricle, the tubular glands are quite, similar to the fundic glands of the mammals. In the submucosa compound tubulosacular glands are observed, with parietal cells. The pancreas doesn't present prominent differences.

Descripción histológica de los diferentes segmentos del aparato digestivo de avestruz (Struthio camelus var. domesticus) / Histologic description of the different segments from the ostrich digestive system (Struthio camelus var. domesticus)

Struthio camelus domesticus (Swart, 1987) es descrita como reflejo del híbrido natural de avestruces de granja en Sudáfrica, la que actualmente se conoce como avestruz de cuello negro o African Black. Esta ave fue desarrollada mediante programas de mejoramiento genético, con el objetivo de aumentar el valor comercial de la especie. Se caracteriza por ser de menor talla y más fértil que las otras subespecies, estructura del plumaje bien desarrollada, carácter dócil, y de fácil crianza en granjas, ya que es tremendamente curiosa y amigable con los humanos (Deeming, 2001; Camiruaga, 2004). En relación a las características anatómicas generales del tracto digestivo, Camiruaga & Simonetti, (2003) señalan que el avestruz presenta semejanzas y diferencias, tanto con otras aves, como con los rumiantes y otros herbívoros (equinos). Del análisis comparativo con la gallina, presenta ciertas diferencias anatómicas, una de ellas es no presentar buche, órgano almacenador de alimento que existe en otras aves. El proventrículo y el estómago muscular (molleja), en el avestruz, pueden cumplir dicha función (Angel, 1996). No presentan vesícula biliar, por lo que el vaciamiento de la bilis se realiza directamente al intestino delgado. Además, el intestino grueso del avestruz, a diferencia de otras especies, representa el 50 % del largo total del tubo digestivo y el intestino delgado corresponde sólo al 35,5%. (Camiruaga, 2004). En el presente trabajo se analizó la histología normal de los diferentes segmentos del tubo digestivo del avestruz: esófago, proventrículo, estómago muscular (molleja o ventrículo), intestino delgado (duodeno, yeyuno e íleon) e intestino grueso (ciego, colon y recto), y se analizó comparativamente con especies a las que se le asocia morfológicamente, como las aves domésticas, rumiantes, seudo rumiantes (camélidos) y algunos otros herbívoros.

Reparación de cistocele con malla de polipropileno sin tensión / Cystocele reparation with free of tension polypropylene net

La reparación quirúrgica del cistocele presenta altas tasas de recidiva con las técnicas tradicionales (colporrafia anterior con plicatura de la fascia). Con el objeto de disminuir la recidiva se ha comenzado a usar en los últimos años material protésico en la reparación del cistocele. Distintos autores han desarrollado técnicas simples para la corrección quirúrgica del cistocele con malla de polipropileno. Nuestro objetivo es mostrar una nueva técnica quirúrgica para el cistocele y evaluar sus resultados y complicaciones a mediano y corto plazo de esta casuística inicial. La técnica consiste en incindir longitudinalmente la mucosa vaginal en su parte media y separar por disección la vejiga de la mucosa vaginal, luego se realizan dos túneles laterales mediante disección roma con tijeras (como en el TVT) hasta perforar la fascia endopélvica, se realiza una plicatura tradicional y se refuerza con malla de polipropileno, la que tiene una parte central que hará las veces de la fascia pubocervical y dos ramas de 1 cm por 5 cm que se colocan en los túneles, abandonando sus extremos en el espacio paravesical, cerrando luego la pared vaginal. Se revisan las primeras 7 pacientes operadas con esta técnica en nuestro Servicio. Todas las pacientes presentaban cistocele gr. II o III de la ICS, en 6 existía IOE (3 IOE pura y 3 IOM asociada), a las cuales además se colocó TVT a través de una segunda incisión. El seguimiento va de 1 a 10 meses. No hubo complicaciones intraoperatorias ni posoperatorias inmediatas significativas. Todas se encuentran continentes, sin urgencia y sin recidiva del cistocele.

Efficacy of oral rofecoxib versus intravenous ketoprofen as an adjuvant to PCA morphine after urologic surgery.

BACKGROUND: Adjunctive use of nonsteroidal anti-inflammatory drugs has become increasingly popular in the perioperative period because of their opioid-sparing effects. This randomized, controlled, double-dummy study was designed to evaluate the cost-effectiveness of using oral rofecoxib as an alternative to intravenous ketoprofen for pain management in patients undergoing urologic surgery. METHODS: Seventy patients were randomly assigned to receive either a placebo (Control) or rofecoxib 50 mg po (Rofecoxib) 1 h prior to surgery. After a standardized spinal anesthetic, patients in the Control group received ketoprofen 100 mg IV q 8 h for 24 h, while the Rofecoxib group received an equivolume of saline at 8-h intervals for 24 h. Both groups were allowed to self-administer morphine (1 mg IV boluses) using a PCA delivery system. The need for 'rescue' analgesic medication, as well as pain scores [using an 11-point verbal rating scale (VRS) (0 = none to 10-severe)], were recorded at 1, 2, 6, 12, and 24-h intervals after surgery. In addition, the incidences of side-effects were recorded at the end of the study period. RESULTS: Total amount of morphine required in the initial 24-h postoperative period was nonsignificantly reduced in the Rofecoxib group (29 +/- 2 vs. 37 +/- 4 mg). More importantly, the percentage of patients reporting moderate-to-severe pain (VRS score > or =4) during the study period was lower in the Rofecoxib group (12 vs. 22%, P < 0.05). The daily cost of rofecoxib (USD 1.14 for 50-mg dose) was also significantly less than ketoprofen (USD 3.06 for three 100-mg doses). CONCLUSION: Premedication with oral rofecoxib (50 mg) is a cost-effective alternative to the parenteral nonselective NSAID, ketoprofen (100 mg q 8 h), when used as an adjuvant to PCA morphine for pain management after urologic surgery.

Estudio de prevalencia de incontinencia urinaria en mujeres de Isla de Pascua / Prevalence study urinary incontinence in women in the Rapa Nui

La Incontinencia Urinaria (IU) es un problema que afecta significativamente la calidad de vida de laspersonas. Conocer la prevalencia de la IU es importante para planificar estrategias de salud en laspacientes y su tratamiento. El objetivo de este estudio es conocer la realidad de este problema en unaregión aislada de nuestro país con un acceso limitado al sistema de salud.Se confeccionó encuesta que incluyó preguntas en relación a la edad, presencia de IU, tipo de IU y gradode molestia, además, conocimiento del problema y consulta profesional. Ésta fue contestada anónimamentepor mujeres mayores de 30 años, que asistieron al Hospital y Centro del Adulto Mayor de Rapa Nui,durante el operativo de salud del Hospital FACH, en el mes de junio del año 2003.Doscientas treinta y seis mujeres entre 30 y 84 años contestaron la encuesta, que corresponde al 26,3 porciento de la población femenina en este rango de edad, con una edad promedio de 47,2 años. Ciento ochenta y dos(77,1 porciento) refieren episodios de IU, de éstas, 119 (50,4 porciento) manifiestan tener IU que afecta su calidad de vida. Sólo el 39 porciento sabe que este problema tiene tratamiento y 26,8 porciento de los pacientes ha consultado.Estos resultados muestran que en esta población existe una alta prevalencia de IU, que afecta a todos losgrupos etarios y que existe poca información sobre este problema...

Denervación testicular laparoscópica: una alternativa eficaz en el manejo del dolor testicular crónico / Laparoscopic testicular denervation: an reasonable alternative in the handling of the chronic testicular pain

El dolor testicular crónico (DTC) es subdiagnosticado y puede llegar a constituir un trastorno en la vida diaria de los pacientes que lo padecen. Para estos casos se ha planteado la denervación testicular con buenos resultados. Mediante cirugía laparoscópica ofrecemos una alternativa mínimamente invasiva para realizar una denervación testicular uni o bilateral, con una mínima morbilidad y una alta eficacia.Nos propusimos evaluar los resultados clínicos, luego de la denervación testicular por mini laparoscopía. Se efectúa un estudio descriptivo en 7 pacientes con DTC, quienes fueron sometidos a una denervación testicular laparoscópica entre 2000 y 2003.Todos ellos presentaron alivio total del dolor testicular. Un paciente diabético presentó una infección de la herida operatoria. La denervación testicular, efectuada por una mini laparoscopía, es un método efectivo en el control del DTC.