Two new species of the genus Givarbela Clench, 1957 (Lepidoptera: Cossidae: Hypoptinae) from South Neotropics.

Givarbela steinbachi was described as a new genus and species by Clench (1957), based on 21 specimens from central Bolivia (Prov. del Sara; Buena Vista and Rio Japacani). He indicated that Givarbela (Figs 1‒8) belongs to the Langsdorfia-Givira group of genera but differs from them by the following combination of characters: "R2 stalked with R3-R4, R5 free; the long palpi; absence of fore tibial epiphysis; absence of median cell-vein on fore wing and the open cell-end there; stalked M2-M3 on hind wing; absence of all but traces of a single hind wing anal vein; short hind wing cell; deeply excised hind wing costa" (Clench 1957).

Gastric Electric Stimulation for Refractory Gastroparesis.

OBJECTIVE: To outline the use and utility of gastric electric stimulation (GES) as a therapeutic intervention for gastroparesis. METHODS: Review of the literature. RESULTS: Gastroparesis is characterized by delayed gastric emptying, with symptoms of nausea, vomiting, early satiety, postprandial fullness, and abdominal pain. Some patients with gastroparesis do not respond to medical intervention, and for these patients surgical intervention may be warranted. GES utilizes high-frequency gastric neurostimulation to facilitate gastric emptying and reduce symptoms of gastroparesis. It is indicated for patients with idiopathic and diabetic gastroparesis who have nausea and vomiting as their primary symptoms and who have not responded to medical therapy. GES has also been used in postsurgical and pediatric gastroparesis patients. Optimizing the outcome of this surgical treatment through proper patient selection and meticulous surgical technique is essential as there are inherent risks to the procedure. Nonblinded studies of GES for medically refractory gastroparesis have demonstrated therapeutic symptomatic benefit, whereas randomized controlled trials have not. New interventions such as pyloromyotomy and pyloroplasty are reasonable alternatives or addendums to GES. CONCLUSION: GES may be considered among the therapies available for treating patients with refractory symptoms of gastroparesis. More studies, specifically those comparing GES, pyloromyotomy, GES combined with pyloromyotomy, and placebo, are needed to help guide therapy selection for refractory gastroparesis.

Biomass fuel smoke exposure was associated with adverse cardiac remodeling and left ventricular dysfunction in Peru.

While household air pollution from biomass fuel combustion has been linked to cardiovascular disease, the effects on cardiac structure and function have not been well described. We sought to determine the association between biomass fuel smoke exposure and cardiac structure and function by transthoracic echocardiography. We identified a random sample of urban and rural residents living in the high-altitude region of Puno, Peru. Daily biomass fuel use was self-reported. Participants underwent transthoracic echocardiography. Multivariable linear regression was used to examine the relationship of biomass fuel use with echocardiographic measures of cardiac structure and function, adjusting for age, sex, height, body mass index, diabetes, physical activity, and tobacco use. One hundred and eighty-seven participants (80 biomass fuel users and 107 non-users) were included in this analysis (mean age 59 years, 58% women). After adjustment, daily exposure to biomass fuel smoke was associated with increased left ventricular internal diastolic diameter (P=.004), left atrial diameter (P=.03), left atrial area (four-chamber) (P=.004) and (two-chamber) (P=.03), septal E' (P=.006), and lateral E' (P=.04). Exposure to biomass fuel smoke was also associated with worse global longitudinal strain in the two-chamber view (P=.01). Daily biomass fuel use was associated with increased left ventricular size and decreased left ventricular systolic function by global longitudinal strain.

Taxonomic notes on the genera Brypoctia Schoorl, 1990 and Schreiteriana Fletcher & Nye, 1982 (Lepidoptera, Cossidae).

Currently, the Cossidae of South America are rather poorly studied. Data on the distribution and taxonomy of Neotropical carpenter moths are lacking. An exception is the clarification of the taxonomic position of the genus Miacora Dyar, 1905 (Yakovlev 2014), Neotropical Cossidae checklist (Donahue 1995), and a preliminary list of Cossidae  of Argentina (Penco & Yakovlev 2015). The majority of Neotropical Cossidae genera have not been studied and the taxonomic position of some genera remains completely unresolved. Additionally, images of genitalia of the Neotropical genera have not been published, including the genera Brypoctia Schoorl, 1990 and Schreiteriana Fletcher & Nye, 1982 (Cossidae: Zeuzerinae). The taxonomic position of the second genus was questioned by Schoorl (1990).

Vitamina D: ¿qué es lo que debe saber un traumatólogo? / Vitamin D: what should an orthopaedist know?

La única patología asociada al déficit de vitamina D fue durante el siglo XX el raquitismo. Nuevas consecuencias asociadas a esta deficiencia han surgido destacando la osteomalacia, mayor riesgo de fracturas, mayor incidencia de caídas en los adultos mayores y una peor coordinación neuromuscular. El propósito de la presente revisión es proporcionar una actualización dirigida a especialistas en ortopedia y traumatología, respecto a definiciones, beneficios, patologías relevantes y guías de manejo que el especialista debe conocer respecto a este problema.

The only condition related to vitamin D deficiency during the 20th century was rickets. New conditions associated with this deficiency have been increasingly reported including: osteomalacia, increased fracture risk, greater incidence of falls among the elderly population, and a worse neuromuscular coordination. The main purpose of this review is to present an update regarding the useful aspects for the orthopaedic community related to vitamin D deficiency, including definitions, benefits, significant diseases, and management guidelines that the specialist must know.

Chronic exposure to biomass fuel smoke and markers of endothelial inflammation.

Indoor smoke exposure may affect cardiovascular disease (CVD) risk via lung-mediated inflammation, oxidative stress, and endothelial inflammation. We sought to explore the association between indoor smoke exposure from burning biomass fuels and a selected group of markers for endothelial inflammation. We compared serum concentrations of amyloid A protein, E-selectin, soluble intercellular adhesion molecule 1 (ICAM-1) and VCAM-1, von Willebrand factor (vWF), and high-sensitivity C-reactive protein (hs-CRP) in 228 biomass-exposed vs. 228 non-exposed participants living in Puno, Peru. Average age was 56 years (s.d. = 13), average BMI was 26.5 kg/m(2) (s.d. = 4.4), 48% were male, 59.4% completed high school, and 2% reported a physician diagnosis of CVD. In unadjusted analysis, serum levels of soluble ICAM-1 (330 vs. 302 ng/ml; P < 0.001), soluble VCAM-1 (403 vs. 362 ng/ml; P < 0.001), and E-selectin (54.2 vs. 52.7 ng/ml; P = 0.05) were increased in biomass-exposed vs. non-exposed participants, respectively, whereas serum levels of vWF (1148 vs. 1311 mU/ml; P < 0.001) and hs-CRP (2.56 vs. 3.12 mg/l; P < 0.001) were decreased, respectively. In adjusted analyses, chronic exposure to biomass fuels remained positively associated with serum levels of soluble ICAM-1 (P = 0.03) and VCAM-1 (P = 0.05) and E-selectin (P = 0.05), and remained negatively associated with serum levels of vWF (P = 0.02) and hs-CRP (P < 0.001). Daily exposure to biomass fuel smoke was associated with important differences in specific biomarkers of endothelial inflammation and may help explain accelerated atherosclerosis among those who are chronically exposed.

Hepatotoxicidad y pancreatitis por sales de oro: reporte de caso / Hepatotoxicity and pancreatitis by gold salts: case report

Se reporta el caso de una paciente de 37 años, natural y procedente de Lima, portadora de Artritis Reumatoide quien estuvo en tratamiento con prednisona, metotrexate y cloroquina. Esta terapia fue remplazada por sales de oro un mes antes de su ingreso, presentando luego de la aplicación de la tercera dosis dolor abdominal, diarrea, prurito e ictericia, asociado a astenia y sensación de alza térmica no cuantificada. Los exámenes auxiliares mostraron incremento de las transaminasas, bilirrubinas, fosfatasa alcalina, eosinofilia e inversión de la relación albúmina globulina, con incremento predominante de la inmunoglobulina G, así como de amilasa y lipasa. El estudio Anatomopatológico demostró: colestasis, balonamiento de hepatocitos y necrosis unifocal, a predominio de la zona 3 del lobulillo hepático, lo cual se encontró consistente con reacción tóxica.

The case of a patient, 37 years old, born and resident of Lima, suffering rheumatoid arthritis who underwent treatment with Prednisone, Methotrexate, and Chloroquine is reported. This therapy was substituted for gold salts one month before her admission. After the third dose she presented symptoms of abdominal pain and diarrhea, itching, and jaundice, associated with asthenia and a feverish sensation. Liver biochemistry demonstrated elevated transaminase, bilirubin, alkaline phosphatase, eosinophilia, inversion of the rate albumin / globulin, higher titer of immunoglobulin G, as well as an elevation of amylase and lipase. The anatomopathological study showed cholestasis, hepatocyte ballooning, spotty necrosis, predominantly in zone 3 of the acinus. These findings where found consistent with a toxic reaction.

[Effects of nutritional intervention on anthropometric variables, intake, serum lipids concentrations and plasma lipids and lipoproteins in dyslipidemic children]. / Efectos de la intervención nutricional sobre las variables antropométricas, la ingesta y las concentraciones de lipidos y lipoproteínas del plasma en niños con dislipidemia.

The purpose of this study was to evaluate the effect of the individualized nutritional intervention on: 1) Anthropometric variables; 2) Changes in lipid intake variables; 3) Changes in plasma lipids concentrations. The relationship between the initial and final difference in plasma lipid concentrations and the quality of the intake was analyzed. The nutritional intervention was provided in a four-month period to a 27 dyslipidemic children. The results indicate that individualized nutritional intervention favors weight loss and reduction of fat indicators in overweight children with adequate proteic and caloric reserves, not affecting the normal growing process. Those children with normal weight and caloric reserves maintained them without affecting growth. The nutritional intervention also had a beneficial effect on those variables related to dietary intake. The reduction of the saturated fat and cholesterol intake in dyslipidemic children resulted in a significant decrease in total plasma concentration of cholesterol and LDL-C lipoproteins (11% and 17%, respectively). These results show the importance of nutritional intervention in dyslipidemic children since it seems an efficient way for prevention, control and treatment of lipid metabolic disorders over lipemic reducing drugs.

nef/long terminal repeat quasispecies from HIV type 1-infected Mexican patients with different progression patterns and their pathogenesis in hu-PBL-SCID mice.

To examine the genetic features of the long terminal repeat (LTR) derived from six HIV-1-infected individuals enrolled in the Mexico City Cohort, we cloned and sequenced a 505-bp fragment of the proviral LTR from their peripheral blood mononuclear cells (PBMCs). All patients harbored HIV-1 LTR quasispecies corresponding to the B subtype. Three patients with high CD4+ T cell counts (>500/mm3) presented LTR sequences with point mutations in the TAR bulge. The LTR sequence from a patient classified as a long-term nonprogressor (LTNP) presented the most frequent naturally occurring length polymorphism (MFNLP) and two substitutions in the TAR region that were predicted to result in two alternative secondary RNA structures. A novel 18-bp deletion, which eliminates part of the putative binding site for the nuclear factor of activated T cells (NFAT-1), was identified in the overlapping nef/LTR sequence derived from a patient progressing to AIDS. This deletion coincides with the ability of this virus to consistently replicate at low levels in vivo (viral load <500 RNA copies/ml) and in vitro (unsuccessful virus isolation). On one occasion, when virus isolation was successful, the 18-bp deletion was no longer evident and LTR sequences with intact NFAT-1-binding sites were observed. Inoculation of hu-PBL-SCID mice with viruses from several Mexican patients resulted in differential CD4+ T cell depletion patterns 15 days postinfection, which agree with the in vivo CD4+ T cell count data from each patient.

Estudio clínico de eficacia y tolerancia con sultamicilina fipexiam en procesos infecciosos de tratamiento ambulatorio / Clinic study of efficacy and toleration with sultamicilina fipeham in infectious process of ambulatory treatment

Se realizó un estudio abierto, multicéntrico, no comparativo donde se avaluó la eficacia y tolerancia de la combinación Ampicilina/Sulbatam por vía oral-Sultamicilina-(Fipexiam), en adultos y niños con infecciones del tracto respiratorio superior e inferior y con infeciones de piel y partes blandas, y adultos con Enfermedad Inflamatoria Pélvica (EIP). El estudio reunió los investigadores de 73 Centros. Se trataron un total de 195 pacientes obteniéndose una efectividad global de 93.3 por ciento. De estos pacientes 84 presentaron Otitis media aguda, resultando curas clínicas en el 89.2 por ciento, 67 presentaron procesos orofaríngeos con curación en el 94 por ciento; en los casos con infecciones de piel y partes blandas, así como en las mujeres tratadas con (EIP) la curación clínica fue de 100 por ciento. Se reportaron efectos adversos en 10.9 por ciento, siendo las molestias gastrointestinales más resaltantes con 8.7 por ciento de los casos reportados, siendo menores a lo reportado por la literatura médica

Diarrea crónica: Aspectos clínicos / Chronic diarrea: clinical aspect

Reportamos un estudio retrospectivo acerca del síndrome de diarrea crónica, realizado en 50 historias clínicas correspondientes a pacientes hospitalizados en el Hospital E. Rebagliati M. durante el período de abril de 1983; a marzo de 1988; con la finalidad de evaluar la clínica del síndrome, los agentes causales del mismo y la metodología diagnóstica utilizada. El criterio de selección consideró aquellos pacientes con diagnóstico de ingreso de "diarrea crónica de causas a determinar". Siete fueron excluídos por presentar estudios incompletos mientras que 2 fueron casos de diarrea aguda infecciosa. Cuarenta y un pacientes fueron casos definitivos de diarrea crónica y fueron divididos en dos categorias : la primera como Diarrea Crónica Orgánica (58.53 por ciento) y la restante comop Diarrea Crónica Funcional (41.46 por ciento). Sobre el universo de 41 pacientes con diagnóstico de diarrea crónica nuestros resultados revelan que : (1) el síndrome afecta principalmente a la población económicamente activa y el tiempo de enfermedad es mayor de 3 semanas en todos los casos; (2) la anemia, fiebre, baja ponderal, evacuaciones nocturnas y deposiciones con sangre, orientan a la organicidad; mientras que los disturbios psiquiatricos, las evacuacines diurnas, el dolor abdominal, la recurrencia de la enfermedad y la ausencia de patología orgánica detectable, suguieren el caracter funcional del síndrome; (3)la causa más frecuente de diarrea crónica es el síndrome de intestino irritable seguido de las enfermedades infecciosas, con la parasitosis en primer término y (4) siendo la afección colónica predominante y las enfermedades infecciosas preponderantes, la metodología diagnóstica orientada hacia aquellas, tendrá un buen rendimiento diagnóstico