RESUMEN
Linear dermatoses are unusual entities whose distribution reflects cutaneous mosaicism, even when they occur in adult life. Adult blaschkitis (AB) and lichen striatus (LS) always follow this peculiar distribution. Although usually referred to as distinct entities, the clinical and histopathological presentation of lichen striatus in adults may be similar to those of adult blaschkitis. Moreover, some cases with overlapping features between lichen striatus and linear lichen planus have been published, making precise diagnosis very difficult. Recently, the concept of a wide spectrum of blaschkolinear dermatoses with AB and LS located somewhere within it has been proposed but it has not gained general recognition. We report three cases of dermatoses following the lines of Blaschko in adults (two women and one male, ages 35, 50 and 56, respectively). They involved the upper extremity in two cases and the lower in the third. Clinically, they were interpreted as linear lichen planus or blaschkitis but, histopathologically, they showed features consistent with lichen striatus. Lesions subsided with topic steroids and/or tacrolimus ointment, they are an example of the significant overlapping between these three entities, demonstrating that they may exist on a spectrum both clinically and histopathologically and clinico-pathologic correlation is essential to achieve an accurate final diagnosis. A detailed review of previously published cases has also been made.
Asunto(s)
Enfermedades de la Piel/patología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
We estimated jaguar density and tenure, and investigated ranging behavior, using camera traps across the Maya Forest Corridor, a human-influenced landscape in central Belize that forms the only remaining connection for jaguar populations inhabiting two regional forest blocks: the Selva Maya and the Maya Mountain Massif. Jaguars were ubiquitous across the study area. Similar to the neighboring Selva Maya, mean density ranged from 1.5 to 3.1 jaguars per 100 km2, estimated by spatial capture-recapture models. Cameras detected almost twice as many males as females, probably reflecting detection bias, and males ranged more widely than females within the camera grid. Both sexes crossed two major rivers, while highway crossings were rare and male-biased, raising concern that the highway could prevent female movement if traffic increases. Jaguars were more transient where the landscape was fragmented with settlements and agriculture than in contiguous forest. Compared with jaguars in the protected forests of the Maya Mountains, jaguars in central Belize displayed a lower potential for investment in intraspecific communication, indicative of a lower quality landscape; however, we did detect mating behavior and juveniles. Tenure of individuals was shorter than in the protected forests, with a higher turnover rate for males than females. At least three-quarters of reported jaguar deaths caused by people were male jaguars, and the majority was retaliation for livestock predation. Jaguars seem relatively tolerant to the human-influenced landscape of central Belize. However, intensification of game hunting and lethal control of predators would threaten population persistence, while increased highway traffic and clear-cutting riparian forest would severely limit the corridor function. Our results show that the viability of the corridor, and thus the long-term survival of jaguar populations in this region, will depend on appropriate land-use planning, nonlethal control of livestock predators, enforcement of game hunting regulations, and wildlife-friendly features in future road developments.
Utilizando trampas-cámara, se estimó la densidad, permanencia y desplazamiento de jaguares a través del Corredor del Bosque Maya, un paisaje dominado por humanos en la zona central de Belice y que actualmente representa la única posibilidad de conectividad para las poblaciones de jaguares que habitan en dos grandes bloques boscosos regionales: La Selva Maya y El Macizo de las Montañas Mayas. Los jaguares estuvieron presentes en toda el área de estudio. De igual forma que en la vecina Selva Maya, la densidad media varió de 1.5 a 3.1 jaguares por cada 100 km2, estimada con modelos espaciales de captura-recaptura. Las cámaras detectaron casi el doble de machos que hembras, probablemente reflejando un sesgo de detección; y los machos se desplazaron más ampliamente que las hembras a lo largo de la cuadrícula de las cámaras. Jaguares de ambos sexos cruzaron dos ríos principales, mientras que el cruce de carreteras no fue común y estuvo sesgado hacia los machos, generando la preocupación de que las carreteras puedan impedir el movimiento de hembras si el tráfico vehicular aumenta. Los jaguares fueron más transitorios en paisajes fragmentados por asentamientos humanos y agricultura que en áreas de bosque continuo. Comparando con los jaguares de los bosques protegidos de las Montañas Mayas, los jaguares de la zona central de Belice mostraron menor potencial para invertir en comunicación intraespecífica, indicador de un paisaje de menor calidad; sin embargo, se detectó comportamiento de apareamientos y la presencia de juveniles. La permanencia de individuos fue más corta que en los bosques protegidos, con una tasa de recambio más alta para machos que para hembras. Al menos las tres cuartas partes de las muertes reportadas de jaguares causadas por humanos correspondieron a jaguares machos, la mayoría como retaliación por la muerte de ganado. Los jaguares parecen relativamente tolerantes del paisaje dominado por humanos en la zona central de Belice. Sin embargo, el aumento de la cacería de especies presa y el control letal de predadores amenazaría la persistencia de la población, mientras que el aumento del tráfico vehicular y la deforestación de bosques de galería reducirían severamente la funcionalidad del corredor. Nuestros resultados muestran que la viabilidad del corredor y por lo tanto la sobrevivencia de jaguares a largo plazo en esta región dependerá de la planificación apropiada del uso del suelo, de un control no letal de predadores de ganado, una mejor regulación de la cacería, y de una infraestructura amigable con la vida silvestre en las futuras carreteras.
RESUMEN
The Male Warrior Hypothesis (MWH) establishes that men's psychology has been shaped by inter-group competition to acquire and protect reproductive resources. In this context, sex-specific selective pressures would have favored cooperation with the members of one's group in combination with hostility towards outsiders. We investigate the role of developmental testosterone, as measured indirectly through static markers of prenatal testosterone (2D:4D digit ratio) and pubertal testosterone (body musculature and facial masculinity), on both cooperation and aggressive behavior in the context of intergroup conflict among men. Supporting the MWH, our results show that the intergroup conflict scenario promotes cooperation within group members and aggression toward outgroup members. Regarding the hormonal underpinnings of this phenomenon, we find that body musculature is positively associated with aggression and cooperation, but only for cooperation when context (inter-group competition) is taken into account. Finally, we did not find evidence that the formidability of the group affected individual rates of aggression or cooperation, controlling for individual characteristics.
Asunto(s)
Agresión/psicología , Conducta Competitiva , Procesos de Grupo , Hostilidad , Psicología Social , Testosterona/metabolismo , Adulto , Conflicto Psicológico , Humanos , Masculino , Testosterona/análisis , Guerra , Adulto JovenRESUMEN
The Pan American Health Organization (PAHO) has conducted a study of Streptococcus pneumoniae in six Latin-American countries: Argentina, Brazil, Chile, Colombia, Mexico, and Uruguay. Sterile site isolates from children aged < or =5 years showing clinical symptoms of pneumonia (as defined by the clinical criteria of WHO), meningitis, sepsis or bacteremia (without infectious foci), arthritis, and peritonitis were the source of most of the invasive pneumococcal isolates collected between the end of 1993 and 1996 in the six participating countries. Partial characterization of these isolates (antibiotic resistance and serotyping) have already been described (Microbial Drug Resistance 3:(2):131-163, 1997). In the next phase of the study, 326 S. pneumoniae isolates with reduced penicillin susceptibility were transferred to the Laboratory of Microbiology at The Rockefeller University for molecular characterization, and a summary and overview of the findings is described in this article. Some of the most interesting findings were as follows: (1) There was a surprisingly high representation of two internationally spread clones, which made up >80% of the strains with penicillin MIC of 1 microg/ml or higher; most of these isolates were recovered in large cities, supporting the likelihood that the source of these clones is through international travel. (2) The frequency of resistance to trimethoprim/sulfamethoxazole was extremely high (present in 85% of all isolates with decreased penicillin susceptibility). (3) None of these isolates was resistant to ofloxacin, and macrolide resistance was rare (present in 6.4% of the isolates). (4) There was an apparent inverse relationship between level of penicillin resistance and genetic diversity. (5) There were striking differences in the "microbiologic profiles" of the six different Latin-American countries.
Asunto(s)
Epidemiología Molecular , Penicilinas/farmacología , Streptococcus pneumoniae/efectos de los fármacos , Niño , Dermatoglifia del ADN , Humanos , América Latina/epidemiología , Pruebas de Sensibilidad Microbiana , Resistencia a las Penicilinas/genética , Especificidad de la Especie , Streptococcus pneumoniae/clasificación , Streptococcus pneumoniae/genéticaRESUMEN
Chagasic patients with advanced heart disease have fluid retention-dependent symptoms. Since fluid retention is mostly dependent on the renin-angiotensin-aldosterone system, chagasic patients with congestion related symptoms should have activation of the renin-angiotensin-aldosterone system. The purpose of this investigation was to determine the plasma renin activity baseline values of chagasic patients with and without congestive heart failure. Twenty-eight patients with positive serology for Chagas' disease were studied. Nineteen patients were asymptomatic (functional class I New York Heart Association) and nine were symptomatic (functional classes II-IV). Cardiac catheterization and ventricular cineangiography were performed on 20 patients. The symptomatic patients had significantly higher plasma renin activity levels (4.11 +/- 1.03 ng/ml/h) than the asymptomatic patients (1.08 +/- 0.11 ng/ml/h, P < 0.001) and the normal sedentary controls (1.65 +/- 0.22 ng/ml/h, P < 0.05, mean +/- S.E.). The plasma renin activity baseline values of the asymptomatic and symptomatic patients correlated directly with the baseline heart rate (r = 0.77, P < 0.0001). The symptomatic patients had larger ventricular volumes, moderately depressed ejection fractions and increased left ventricular end-diastolic pressures. The plasma renin activity baseline values also correlated directly with the left ventricular diastolic pressures (r = 0.70, P < 0.0006) and with the left ventricular diastolic (r = 0.66, P < 0.001) and systolic volumes (r = 0.67, P < 0.001). These results indicate that chagasic patients with fluid retention-dependent symptoms and hemodynamic evidence of left ventricular systolic dysfunction have activation of the renin-angiotensin-aldosterone system.
Asunto(s)
Enfermedad de Chagas/sangre , Insuficiencia Cardíaca/etiología , Renina/sangre , Adulto , Análisis de Varianza , Cateterismo Cardíaco , Cardiomiopatía Chagásica/sangre , Cardiomiopatía Chagásica/fisiopatología , Enfermedad de Chagas/fisiopatología , Cineangiografía , Electrocardiografía , Femenino , Insuficiencia Cardíaca/sangre , Hemodinámica/fisiología , Humanos , Masculino , Persona de Mediana Edad , Renina/biosíntesis , Disfunción Ventricular Izquierda/sangre , Disfunción Ventricular Izquierda/etiologíaRESUMEN
NASA's newly restructured Mars Exploration Program (MEP) is finally on the way to Mars with the successful April 7 launch of the 2001 Mars Odyssey Orbiter. In addition, the announcement by the Bush Administration that the exploration of Mars will be a priority within NASA's Office of Space Science further cements the first decade of the new millennium as one of the major thrusts to understand the "new" Mars. Over the course of the past year and a half, an integrated team of managers, scientists, and engineers has crafted a revamped MEP to respond to the scientific as well as management and resource challenges associated with deep space exploration of the Red Planet. This article describes the new program from the perspective of its guiding philosophies, major events, and scientific strategy. It is intended to serve as a roadmap to the next 10-15 years of Mars exploration from the NASA viewpoint. [For further details, see the Mars Exploration Program web site (URL): http://mars.jpl.nasa.gov]. The new MEP will certainly evolve in response to discoveries, to successes, and potentially to setbacks as well. However, the design of the restructured strategy is attentive to risks, and a major attempt to instill resiliency in the program has been adopted. Mars beckons, and the next decade of exploration should provide the impetus for a follow-on decade in which multiple sample returns and other major program directions are executed. Ultimately the vision to consider the first human scientific expeditions to the Red Planet will be enabled. By the end of the first decade of this program, we may know where and how to look for the elusive clues associated with a possible martian biological record, if any was every preserved, even if only as "chemical fossils."
Asunto(s)
Marte , Vuelo Espacial , United States National Aeronautics and Space Administration , Estados UnidosRESUMEN
To determine the factors responsible for the dramatic fall in cholesterol levels after coronary artery bypass surgery (CABG), the authors reviewed, in a retrospective study, the cholesterol levels of 36 patients who underwent CABG surgery during 1987 and compared their levels with those of a control group of 30 patients who underwent cholecystectomies during the same time. In a prospective study, the authors measured the lipids and the hematocrit levels of 15 patients undergoing CABG surgery before the initiation of cardiopulmonary bypass, after 5 minutes of extracorporeal circulation (ECC), and at the end of ECC. In the CABG group, the plasma cholesterol level fell from 211 +/- 63 mg/dl (mean +/- SE) to 70 +/- 48 mg/dl (p less than 0.01), a 77% decrease within 24 hours of surgery. In the cholecystectomy group, the plasma cholesterol fell from 192.3 +/- 8.9 mg/dl to 158 +/- 76 mg/dl (p less than 0.01), an 18% decrease within 24 hours of surgery. To estimate the contribution of hemodilution or blood loss to the fall in cholesterol, changes in hematocrit were recorded. In the CABG group, hematocrit fell from 39.5 +/- 0.7% to 23.5 +/- 0.7% 24 hours after surgery (41% decrease) (p less than 0.01), whereas in the cholecystectomy group hematocrit fell from 39.4 +/- 0.8% to 37.1 +/- 0.9% on the first postoperative day (6% decrease). There was a positive correlation between the fall in cholesterol and the fall in hematocrit in the CABG group (correlation coefficient 0.472), suggesting that hemodilution was a major factor in the decrease in cholesterol levels.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Colesterol/sangre , Puente de Arteria Coronaria , Adulto , Anciano , Anciano de 80 o más Años , Circulación Extracorporea , Femenino , Hematócrito , Hemodilución , Humanos , Lipoproteínas/sangre , Masculino , Persona de Mediana Edad , Triglicéridos/sangreRESUMEN
According to the neurogenic theory of Chagas' heart disease, the cardiac parasympathetic abnormalities of chagasic cardiac patients are due to a selective destruction of the cardiac parasympathetic neurons. Trypanosoma cruzi would selectively destroy the cardiac vagal neurons, during the acute stage of the disease. However, these cardiac parasympathetic abnormalities are found mainly in chagasic patients who are in very advanced stages of the disease. Furthermore, the extent of cardiac parasympathetic involvement correlates with the degree of left ventricular dilation. Cardiac parasympathetic abnormalities, and a reciprocal sympathetic hyperactivity are also present in non-chagasic cardiac patients. Modern medical treatment, with sympatholytic drugs, prevents ventricular dilatation and prolongs life in these non-chagasic cardiac patients. Consequently, if chagasic cardiac patients have ventricular dilatation-related parasympathetic abnormalities; it is of the utmost importance to ask: first, do they also have a progressive activation of their neurohumoral systems?; and second, would they benefit from sympatholytic drugs?.
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Sistema Nervioso Autónomo/fisiopatología , Cardiomiopatía Chagásica/fisiopatología , Cardiomiopatía Chagásica/tratamiento farmacológico , Cardiomiopatía Chagásica/etiología , Cardiopatías/fisiopatología , Humanos , Modelos Biológicos , Sistema Nervioso Parasimpático/fisiopatología , Simpaticolíticos/uso terapéuticoRESUMEN
We investigated the HIV prevalence rate in 106 female prostitutes residing in Huixtla, State of Chiapas, which is a small town in the southeastern part of Mexico, from February of 1989 to January of 1990. We used an immunoenzymatic method (Serodia). The mean age was 35 years ranging from 17 to 43. Sixty six women (62%) were from Central America, and the remainder had been born in Mexico. The HIV antibody was not detected in the women, but 39 (37%) had a sexually transmitted disease: the more frequent were condolomatosis, candidiasis, trichomoniasis, gonorrhea, and syphilis.
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Infecciones por VIH/epidemiología , Trabajo Sexual , Enfermedades de Transmisión Sexual/epidemiología , Adolescente , Adulto , Femenino , Humanos , México/epidemiología , Prevalencia , Salud UrbanaAsunto(s)
Coinfección/microbiología , Enfermedades de la Uña/etiología , Onicomicosis/complicaciones , Trastornos de la Pigmentación/etiología , Infecciones por Pseudomonas/complicaciones , Pseudomonas aeruginosa , Adulto , Humanos , Masculino , Enfermedades de la Uña/microbiología , Trastornos de la Pigmentación/microbiologíaRESUMEN
No disponible
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Humanos , Femenino , Adulto , Nevo Pigmentado/diagnóstico , Nevo Pigmentado/cirugía , Electrocirugia/métodos , Síndrome , Nevo Pigmentado/patología , Diagnóstico DiferencialAsunto(s)
Condiloma Acuminado , Linfangioma , Aminoquinolinas , Femenino , Humanos , Imiquimod , VulvaRESUMEN
No disponible
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Humanos , Masculino , Adulto , Uñas/patología , Onicomicosis/complicaciones , Onicomicosis/microbiología , Pseudomonas aeruginosa/aislamiento & purificación , Onicomicosis/patología , Dermoscopía/métodos , Onicomicosis/tratamiento farmacológico , Hiperqueratosis Epidermolítica/tratamiento farmacológicoRESUMEN
Botulinum neurotoxin is widely used to treat a variety of movement disorders, especially dystonia and spasticity. There botúlica different preparations of botulinum type A, that because biologics are difficult to compare. AbobotulinumtoxinA (Dysport ®) has recently been introduced in Chile for treating dystonia and spasticity. The aim of this paper is to provide a review by experts on the existing evidence and propose a practical guide to the use of the drug. Methods and Results: A group of Chilean experts met on 6 and 7 July 2012 to review AbobotulinumtoxinA doses along with injection protocols for dystonia, spasticity and other movement disorders. We worked in two groups, one composed of neurologists who reviewed the on dystonias and other by physiatrists who reviewed the indications for spasticity. Conclusions: Finally, there is a proposal in terms of dose, injection points and recommendations for dystonia and spasticity...
La neurotoxina botulínica es ampliamente usada para tratar una variedad de trastornos del movimiento, especialmente la distonía y la espasticidad. Existen diferentes preparados de toxina botúlica tipo A, que por ser productos biológicos resultan difícilmente comparables. La abobotulinumtoxinA (Dysport®) ha sido introducida en Chile recientemente para el tratamiento de la distonía y la espasticidad. El objetivo de este trabajo es entregar una revisión hecha por expertos sobre la evidencia existente y plantear una guía práctica para el uso del medicamento. Métodos y Resultados: Un grupo de expertos chilenos se reunieron el 6 y 7 julio de 2012 para revisar las dosis abobotulinumtoxin A, junto con los protocolos de inyección para la distonía, la espasticidad y otros trastornos del movimiento. Se trabajó en dos grupos, uno compuesto por neurólogos que revisaron las indicaciones en distonías y otro por fisiatras que revisaron las indicaciones para espasticidad. Conclusiones: Finalmente, se realiza una propuesta en cuanto a dosis, puntos a inyectar y recomendaciones para la distonia y espasticidad...
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Humanos , Distonía/tratamiento farmacológico , Espasticidad Muscular/tratamiento farmacológico , Fármacos Neuromusculares/administración & dosificación , Toxinas Botulínicas Tipo A/administración & dosificación , Chile , Consenso , Medicina Basada en la Evidencia , Fármacos Neuromusculares/efectos adversos , Guías de Práctica Clínica como Asunto , Toxinas Botulínicas Tipo A/efectos adversosRESUMEN
En la valoración visual del paciente pediátrico es indispensable determinar el alineamiento ocular, para poder así descartar estrabismos que generan además de ambliopía, pérdida de la visión binocular. La endotropiase considera como el tipo más frecuente de estrabismo en los niños, responsable de más del 50% de las desviaciones, cuyo manejo puede ser quirúrgico o con prescripción óptica de acuerdo a su origen. Las exodesviaciónes son poco frecuentes antes de los 6 meses, generalmente inician de manera intermitente y se vuelven constantes, están asociadas a insuficiencia de convergencia y correspondencia sensorial anómala; dependiendo de su magnitud y permanencia se tratan con ortóptica o con cirugía.
In the visual assessment of pediatric patients is essential to determine the ocular alignment, and to generate further ruled strabismus amblyopia, binocular vision loss. The esotropia is considered the most common type of strabismus in children, accountingfor more than 50% of the deviations, whose management may be surgical or optical prescription according to their origin. Exotropias and endotropias in children. The exotropia are rare before six months, usually starting intermittently and become constant, are associated with convergence insufficiency and abnormal sensory correspondence, depending on their size and permanence, are treated with orthoptics or surgery.
Asunto(s)
Esotropía , Exotropía , EstrabismoRESUMEN
Due to the broad behaviour variability of the tricuspid atresia by the defects to which it is associated, the authors propose another classification, based on the position of the great vessels and the characteristics of the pulmonary flow, in addition to the extent of the intracardiac septal defects (atrial septal defect and ventricular septal defect) and the presence of patent ductus arterious. Eleven patients with tricuspid atresia with situs solitus and heart normo-placed are studied for diagnosis confirmation by catheterism or autopsy. Electrocardiograms are studied and observed in two patients with transposition of the great vessels and pulmonary oligohemia, a more evident right auricular enlargement (P of greater voltage in DII and AP heading right in the front plane), the AQRS deviated to the right, up and backwards, with less evidence of the left ventricular power than in other varieties of tricuspid atresia. These characteristics gave a diagnosis useful for this variation. On those patients without transposition and pulmonary flow increase, it is observed that growing appearance of the left auricle is more evident and so is the power of the free wall of the right ventricle (high R in right precordial deviations), the AQRS heads left as in most of the cases, but forward and upwards also. This electrocardiographic information is considered to have great importance to establish a diagnosis of the variations of tricuspid atresia due to associated malformations. Common varieties have already been extensively described by other authors and are not subject to special study. Bibliography on this matter is reviewed.
Asunto(s)
Defectos de los Tabiques Cardíacos/diagnóstico , Válvula Tricúspide/anomalías , Anomalías Múltiples/diagnóstico , Preescolar , Electrocardiografía , Femenino , Humanos , Lactante , Recién Nacido , MasculinoRESUMEN
BACKGROUND: Salmonella enteritidis infections have increased worldwide in the last years. Isolation of this pathogen was remarkably rare in Chile until 1994, when the still ongoing outbreak emerged. AIM: To assess the main epidemiological characteristics of the Salmonella enteritidis epidemic in Chile. MATERIALS AND METHODS: Cases of clinical infections by Salmonella enteritidis were recorded from bacteriological and demographic notifications obtained at The National Reference Laboratory for Enterobacteria. Infection rates were calculated using the total Chilean population and the population of the different Health Services along the country. RESULTS: Until 1993, 13.67 Salmonella enteritidis strains per year were received at the Reference Laboratory. The figures increased to 478 and 432 in 1994 and 1995, respectively. National rates were 3.41 and 3.04 notifications/100,000 inhabitants in 1994 and 1995 respectively. Northern regions were the most affected and 90% of observed cases during 1994 came from Arica and Antofagasta. At the present time, 20% of cases are observed in Santiago, located in the mid-portion of the country. The outbreak has mainly affected children and young adults (70% of cases). Strains have been isolated from stool cultures, suggesting gastrointestinal infections as the main clinical presentation. More than 98% of strains are susceptible to chloramphenicol, ampicillin, tetracycline, sulfa-trimetroprim, cefotaxime or ciprofloxacin. CONCLUSIONS: The obtained data clearly indicate the existence of an epidemic outbreak of Salmonella enteritidis infections, with a geographic progression from North to South.
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Infecciones por Salmonella/epidemiología , Salmonella enteritidis/aislamiento & purificación , Chile/epidemiología , Brotes de Enfermedades , Humanos , PrevalenciaRESUMEN
Este artículo resume una propuesta organizacional para la atención de salud rural, realizada a solicitud del Servicio de Salud Llanquihue Chiloé Palena, por los autores entre enero y abril del 2007. Realiza un análisis esencialmente cualitativo de la situación rural en el área del Servicio de Salud y un diagnóstico centrado en una hipótesis unitaria: la salud rural ha extraviado el espíritu que la animó en las décadas precedentes. Del diagnóstico se desprende la identidad territorial y el conocimiento local como pilares indispensables para recuperar ese espíritu. La propuesta se centra en la construcción de equipos territoriales, autónomos y públicos.
This paper is a summary of an organizational proposal for rural health. Between January and April 2007 we prepared a document requested by Llanquihue Chiloé Palena Health Service. We did a research and qualitative diagnosis of rural health situation in Health Service area. Our analysis is based in a unitary hypothesis: rural health has loosed its spirit. From the diagnosis we recognized territorial identity and local knowledge as essentials tools for the spirit recovery. The proposal is then focused in the construction of public, autonomic and territorial health teams.