Use of mouthguards in Latin American field hockey athletes during the ODESUR 2022 Games.

BACKGROUND/AIMS: Athletes are susceptible to oral injuries. To reduce the incidence and severity of oral trauma, a custom-made mouthguard, a device positioned in the mouth to prevent damage to teeth and surrounding structures, is recommended. In field hockey, according to the international rules of this sport, using mouthguards is not mandatory, but it is recommended to wear them at all times while practicing this discipline. We aimed to determine characteristics and differences regarding mouthguard usage among field hockey players from different countries participating in the XII ODESUR Games. METHODS: We conducted a cross-sectional study that included 78 voluntary hockey athletes that met the inclusion criteria. The questionnaire used was validated by Panam Sports, collecting information on the type of mouthguard (custom-made or prefabricated), and the time of use of the mouthguard (range of 5 years). RESULTS: Of the total number of athletes, 96% used mouthguards, of which 64% were custom-made type, and 32% were prefabricated (p < .001). Custom-made mouthguards were used by 100%, 89%, and 64% of athletes in Argentina, Chile, and Peru, respectively, while only 40% of athletes in Paraguay and Uruguay used them. It has also been observed that more than 50% of the individuals have not controlled and replaced their intraoral devices for more than 10 years. CONCLUSIONS: Our results reveal a problem with a public health dimension and thus invite the standardization of guidelines with an educational approach to promoting and adopting good sports practices. This report is the first on using mouthguards in high-performance athletes during an international multisport event.

[Pembrolizumab-induced gastritis with PDL1 histological expression]. / Gastritis inducida por pembrolizumab con expresión histológica de PDL1.

Immune-mediated gastritis is a rare adverse effect in patients treated with immune checkpoint inhibitors. We present a patient with a diagnosis of cervical carcinoma under treatment with pembrolizumab who was admitted with nausea, vomiting and weight loss; an endoscopy revealed a ulcerated lesion covered by mucus in the antrum and gastric body. The biopsy revealed extensive denudation of the gastric mucosa with fibrin leukocyte reaction. Into the lamina propria, an increased lymphocytic and polymorphonuclear inflammatory infiltrate was observed. Immunohistochemistry confirmed positivity for PDL1 (clone SP2630) and combined positive score of 35%, with a relative contribution of epithelial cells of 25% and inflammatory cells of 10%. After three weeks with 30 mg meprednisone, a new endoscopy revealed a stomach with clear mucus content; fundus and body without lesions, and an antrum with congestive mucosa and multiple superficial ulcers covered by fibrin. Diagnostic and therapeutic aspects of immune-mediated gastritis are described.

La gastritis inmunomediada es un efecto adverso raro en pacientes bajo tratamiento con inhibidores del punto de control inmunitario; se presenta el caso de una paciente con carcinoma de cuello uterino bajo tratamiento con pembrolizumab que ingresa con náuseas, vómitos y pérdida de peso. La endoscopía demostró una lesión ulcerada cubierta por moco en antro y cuerpo gástrico. La biopsia reveló una extensa denudación de la mucosa gástrica con material fibrinoleucocitario. La lámina propia presentó incremento del infiltrado inflamatorio linfocitario y polimorfonuclear. La inmunohistoquímica confirmó positividad para PDL1 (clon SP2630) y un score positivo combinado (CPS) del 35%, con una contribución relativa de células epiteliales de 25% y de células inflamatorias de 10%. Luego de tres semanas de tratamiento con 30 mg de meprednisona, la endoscopía constató un estómago con contenido mucoso claro; fundus y cuerpo sin lesiones, antro con mucosa congestiva y múltiples úlceras extensas y superficiales cubiertas por fibrina. Se describen los aspectos diagnósticos y terapéuticos de la gastritis inmunomediada.

Gastritis inducida por pembrolizumab con expresión histológica de PDL1 / Pembrolizumab-induced gastritis with PDL1 histological expression

Resumen La gastritis inmunomediada es un efecto adverso raro en pacientes bajo tratamiento con inhibidores del punto de control inmunitario; se presenta el caso de una pa ciente con carcinoma de cuello uterino bajo tratamiento con pembrolizumab que ingresa con náuseas, vómitos y pérdida de peso. La endoscopía demostró una lesión ulcerada cubierta por moco en antro y cuerpo gástrico. La biopsia reveló una extensa denudación de la muco sa gástrica con material fibrinoleucocitario. La lámina propia presentó incremento del infiltrado inflamatorio linfocitario y polimorfonuclear. La inmunohistoquímica confirmó positividad para PDL1 (clon SP2630) y un score positivo combinado (CPS) del 35%, con una contribución relativa de células epiteliales de 25% y de células infla matorias de 10%. Luego de tres semanas de tratamiento con 30 mg de meprednisona, la endoscopía constató un estómago con contenido mucoso claro; fundus y cuerpo sin lesiones, antro con mucosa congestiva y múltiples úlceras extensas y superficiales cubiertas por fibrina. Se describen los aspectos diagnósticos y terapéuticos de la gastritis inmunomediada.

Abstract Immune-mediated gastritis is a rare adverse effect in patients treated with immune checkpoint inhibitors. We present a patient with a diagnosis of cervical carcinoma under treatment with pembrolizumab who was admitted with nausea, vomiting and weight loss; an endoscopy revealed a ulcerated lesion covered by mucus in the antrum and gastric body. The biopsy revealed extensive denudation of the gastric mucosa with fibrin leukocyte reaction. Into the lamina propria, an increased lymphocytic and polymorphonuclear inflammatory infiltrate was ob served. Immunohistochemistry confirmed positivity for PDL1 (clone SP2630) and combined positive score of 35%, with a relative contribution of epithelial cells of 25% and inflammatory cells of 10%. After three weeks with 30 mg meprednisone, a new endoscopy revealed a stomach with clear mucus content; fundus and body without lesions, and an antrum with congestive mucosa and multiple su perficial ulcers covered by fibrin. Diagnostic and therapeu tic aspects of immune-mediated gastritis are described.

Genomic Characterization and Genetic Profiles of Salmonella Gallinarum Strains Isolated from Layers with Fowl Typhoid in Colombia.

Salmonella Gallinarum (SG) is the causative agent of fowl typhoid (FT), a disease that is harmful to the poultry industry. Despite sanitation and prophylactic measures, this pathogen is associated with frequent disease outbreaks in developing countries, causing high morbidity and mortality. We characterized the complete genome sequence of Colombian SG strains and then performed a comparative genome analysis with other SG strains found in different regions worldwide. Eight field strains of SG plus a 9R-derived vaccine were subjected to whole-genome sequencing (WGS) and bioinformatics analysis, and the results were used for subsequent molecular typing; virulome, resistome, and mobilome characterization; and a comparative genome study. We identified 26 chromosome-located resistance genes that mostly encode efflux pumps, and point mutations were found in gyrase genes (gyrA and gyrB), with the gyrB mutation S464T frequently found in the Colombian strains. Moreover, we detected 135 virulence genes, mainly in 15 different Salmonella pathogenicity islands (SPIs). We generated an SPI profile for SG, including C63PI, CS54, ssaD, SPI-1, SPI-2, SPI-3, SPI-4, SPI-5, SPI-6, SPI-9, SPI-10, SPI-11, SPI-12, SPI-13, and SPI-14. Regarding mobile genetic elements, we found the plasmids Col(pHAD28) and IncFII(S) in most of the strains and 13 different prophage sequences, indicating a frequently obtained profile that included the complete phage Gifsy_2 and incomplete phage sequences resembling Escher_500465_2, Shigel_SfIV, Entero_mEp237, and Salmon_SJ46. This study presents, for the first time, the genomic content of Colombian SG strains and a profile of the genetic elements frequently found in SG, which can be further studied to clarify the pathogenicity and evolutionary characteristics of this serotype.

Hypertrophic cardiomyopathy in a patient with secondary hypoparathyroidism: A case report.

Parathyroid hormone (PTH) has direct and indirect actions on cardiovascular cells. The effects of chronic hypoparathyroidism on cardiac morphology, function, and conduction are still unclear. Low PTH states are associated with multiple manifestations in the heart, acute or chronic. Acute hypocalcemic cardiomyopathy is a transient dilated cardiomyopathy with reduced ejection fraction and diffuse left ventricular hypokinesia. Chronic hypoparathyroidism-associated cardiomyopathy is a rare disease that may cause reduced myocardial tension, cardiac cavity enlargement, arrhythmias, and congestive heart failure. Here, we describe a 73-year-old woman with chronic hypoparathyroidism and hypocalcemia, who developed a hypertrophic cardiomyopathy, and not a dilated hypocalcemia-associated cardiomyopathy, which would be usually the case.

Estrategia educativa para elevar el conocimiento sobre hipertensión arterial en la población, de 20 años en adelante / Educational strategy to raise knowledge about arterial hypertension in the population aged 20 and over

En el mundo las enfermedades cardiovasculares son responsables de casi un tercio del total de las muertes por año. Cada vez son más las personas que padecen hipertensión arterial (HTA), desconociendo muchos su condición. Objetivo: Diseñar una estrategia educativa para elevar el conocimiento sobre hipertensión arterial en la población de 20 años y más en el consultorio 2 de Medicina Familiar y Comunitaria; Centro de Salud Luchadores del Norte, año 2021.Materiales métodos: Se realizó una investigación descriptiva, observacional, prospectiva y transversal con la población de adultos del Centro de Salud Luchadores Norte, para elaborar el diseño de una estrategia educativa que eleve el conocimiento sobre esta enfermedad; se midieron variables sociodemográficas, de estilos de vida y de conocimiento. Resultados: El grupo de edad más frecuente de 50 a 59 años 26,2%; sexo masculino 66,4%; escolaridad nivel básico 41,1%; estado civil unión libre 52,3%; etnia mestizo 58,9% y ocupación empleado privado 29,0%; no realizan actividad física 65,4%; consumo excesivo de sal 67,3%; grasa 58,9%; gaseosas y energizantes 52,8%; no conocen de la enfermedad 62,6%; técnica charla 39,3%; frecuencia una vez cada 15 días 43,9%; horario de mañana 57,0%; duración 30 minutos 52,3%; lugar centro de salud 50,5% y tamaño del grupo de 6 a 10 (42,1%). Conclusión: La bibliografía concuerda mayoritariamente con los resultados de la investigación, en consumo de sal elevado, grasas, gaseosas y bebidas energizantes; el conocimiento sobre la enfermedad es escaso en los hipertensos, concordando con las citas de referencia; concluyendo, que coexisten estilos de vida no saludables con desconocimiento; favoreciendo las complicaciones de la enfermedad, una intervención educativa elevaría conocimiento y cambia actitudes evitando consecuencias y daños irreversibles(AU)

In the world, cardiovascular diseases are responsible for almost a third of all deaths per year. More and more people suffer from high blood pressure (HBP), many unaware of their condition. Objective: To design an educational strategy to raise awareness about arterial hypertension in the population aged 20 and over in Family and Community Medicine office 2; Luchadores del Norte Health Center, year 2021. Materials and methods: A descriptive, observational, prospective and cross-sectional investigation was carried out with the adult population of the Luchadores Norte Health Center, to develop the design of an educational strategy that raises knowledge about this illness; sociodemographic, lifestyle and knowledge variables were measured. Results: The most frequent age group was 50 to 59 years old, 26.2%; male sex 66.4%; basic level schooling 41.1%; marital status free union 52.3%; mestizo ethnic group 58.9% and occupation private employee 29.0%; do not perform physical activity 65.4%; excessive consumption of salt 67.3%; fat 58.9%; soft drinks and energy drinks 52.8%; 62.6% do not know about the disease; talk technique 39.3%; frequency once every 15 days 43.9%; morning hours 57.0%; duration 30 minutes 52.3%; health center location 50.5% and group size from 6 to 10 (42.1%). Conclusion: The bibliography mostly agrees with the results of the investigation, in consumption of high salt, fat, soft drinks and energy drinks; knowledge about the disease is scarce in hypertensive patients, in agreement with the reference citations; concluding that unhealthy lifestyles coexist with ignorance; favoring the complications of the disease, an educational intervention would increase knowledge and change attitudes, avoiding consequences and irreversible damage(AU)

Does Roux-en-Y Gastric Bypass Really Cure Gastroesophageal Reflux Disease? Analysis of Objective Data.

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is considered the treatment of choice for obesity with gastroesophageal reflux disease (GERD). There are few reports showing objective data based on esophageal function tests (EFTs). The aim of our study was to evaluate the influence of LRYGB on GERD. Methods: Candidates for laparoscopic sleeve gastrectomy (LSG) underwent preoperative esophageal manometry (EM) and 24-hour pH monitoring. Based on the negative influence of LSG on GERD, patients with abnormal pH were offered LRYGB. Those patients repeated EFTs, esophagogastroduodenoscopy, and symptom questionnaire 1 year after surgery. Results: Two hundred fifty LSG candidates underwent preoperative EFTs; 38% were redirected to LRYGB due to abnormal pH and 13 (18%) completed EFTs postoperatively. In ten women, age: 40 ± 7 years, body mass index: 41 ± 1 kg/m2. EM: lower esophageal sphincter (LES) length increased from 2.6 to 2.9 cm (P = not statistically significant [NS]), and LES pressure decreased from 15 to 14.2 mmHg (P = NS). Preoperatively, LES was normotensive in 12 (92%) patients and postoperatively in 11 (85%) (P = NS). DeMeester score decreased from 35.7 to 11 (P < .001). Postoperatively, 9 (69%) patients resolved their GERD, 3 (23%) improved, and 1 (8%) remained the same (P < .001). Symptoms decreased significantly after surgery. Two patients (15%) had Grade A esophagitis. One of them was able to resolve it, while the other 1 remained the same. Conclusions: Our preliminary data showed that after LRYGB, LES pressure remained the same and DeMeester score decreased, while 69% of patients resolved their GERD. Therefore, LRYGB seems to be an excellent option for obesity and GERD.

Efectos de la rehabilitación cardiaca en el paciente cardiovascular con ansiedad y depresión / Effects of cardiac rehabilitation on the cardiovascular patient with anxiety

Resumen Objetivo: determinar el efecto de un programa de rehabilitación en los puntajes de ansiedad y depresión de pacientes con enfermedad cardiovascular. Materiales y métodos: se analizó la información de una cohorte retrospectiva de pacientes con enfermedad cardiovascular, admitidos a un programa de rehabilitación cardiaca. La ansiedad y depresión fueron medidas con la escala HADS (Hospital Anxiety and Depression Scale) y se categorizaron según el tratamiento de base recibido (médico o quirúrgico). Se comparó el cambio en los puntajes de ansiedad y depresión al ingreso y al final de la rehabilitación cardiaca mediante la prueba de Wilcoxon para muestras pareadas y la prueba de McNemar para evaluar el cambio de los porcentajes en cada subescala. Resultados: se incluyeron 1.221 pacientes. La mediana de edad fue 61 años, 68,30% eran hombres. Al ingreso, la mediana del puntaje de ansiedad y depresión fue 3, de los cuales 141 pacientes presentaron un trastorno de ansiedad (11,55%) y 67 un trastorno depresivo (5,49%). Al final de la rehabilitación cardiaca se obtuvo una mejoría en los puntajes de ansiedad y depresión tanto en pacientes en tratamiento médico (promedio -1,87 puntos 95% IC -2,14 a -1,60 p<0,01 y -1,46 puntos 95% IC -1,72 a -1,21 p<0,01 respectivamente) como quirúrgico (promedio -1,48 puntos 95% IC -1,78 a -1,18 p<0,01 y -1,83 puntos 95% IC -2,12 a -1,57 p<0,01). Conclusiones: los puntajes de ansiedad y depresión, en pacientes con enfermedad cardiovascular en tratamiento médico o quirúrgico, mejoraron luego de un programa integral de rehabilitación cardíaca.

Abstract Objective: To determine the effects of a rehabilitation program on the anxiety and depression scores of patients with cardiovascular disease. Materials and methods: An analysis was performed on the information collected from a retrospective cohort of patients with cardiovascular disease, admitted to a cardiac rehabilitation program. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS), and were classified according to the baseline treatment (medical or surgical) received. A comparison was made between the anxiety and depression scores on admission and at the end of the cardiac rehabilitation program using Wilcoxon test for paired samples and the McNemar test to evaluate the change in the percentages in each sub-scale. Results: A total of 1,221 patients were included. The median age was 61 years, and 68.3% were males. On admission, the median score was 3 on the anxiety and depression scale, with 141 (11.55%) patients having an anxiety disorder, and 67 (5.49%) with depressive disorder. An improvement was observed in the anxiety and depression scores at the end of the end of the cardiac rehabilitation, both in patients on medical treatment (mean difference minus 1.87 points, 95% CI; -2.14 to -1.60: P<.01, and -1.46 points, 95% CI; -1.72 to -1.21: P<.01, for anxiety and depression, respectively) and on surgical treatment (mean difference -1.48 points, 95% CI; -1.78 to -1.18, P<.01 and -1.83 points, 95% CI -2.12 to -1.57, P<.01, respectively). Conclusions: The anxiety and depression scores in patients with cardiovascular disease on medical or surgical treatment improved after an integrated cardiac rehabilitation program.

Campylobacter jejuni isolated from poultry meat in Brazil: in silico analysis and genomic features of two strains with different phenotypes of antimicrobial susceptibility.

Campylobacter jejuni is the most common bacterial cause of foodborne diarrheal disease worldwide and is among the antimicrobial resistant "priority pathogens" that pose greatest threat to public health. The genomes of two C. jejuni isolated from poultry meat sold on the retail market in Southern Brazil phenotypically characterized as multidrug-resistant (CJ100) and susceptible (CJ104) were sequenced and analyzed by bioinformatic tools. The isolates CJ100 and CJ104 showed distinct multilocus sequence types (MLST). Comparative genomic analysis revealed a large number of single nucleotide polymorphisms, rearrangements, and inversions in both genomes, in addition to virulence factors, genomic islands, prophage sequences, and insertion sequences. A circular 103-kilobase megaplasmid carrying virulence factors was identified in the genome of CJ100, in addition to resistance mechanisms to aminoglycosides, beta-lactams, macrolides, quinolones, and tetracyclines. The molecular characterization of distinct phenotypes of foodborne C. jejuni and the discovery of a novel virulence megaplasmid provide useful data for pan-genome and large-scale studies to monitor the virulent C. jejuni in poultry meat is warranted.

TargeTALE: A Web Resource to Identify TALEs in Xanthomonas Genomes and Their Respective Targets.

The Xanthomonas genus, comprises more than 30 species of gram-negative bacteria, most of which are pathogens of plants with high economic value, such as rice, common bean, and maize. Transcription activator-like effectors (TALEs), which act by regulating the host gene expression, are some of the major virulence factors of these bacteria. We present a novel tool to identify TALE genes in the genome of Xanthomonas strains and their respective targets. The analysis of the results obtained by TargeTALE in a proof-of-concept validation demonstrate that, at optimum setting, approximately 93% of the predicted target genes with available expression data were confirmed as upregulated during the infection, indicating that the tool might be useful for researchers in the field.

Whole-genome sequencing of Leptospira interrogans from southern Brazil: genetic features of a highly virulent strain

BACKGROUND Leptospirosis is the most widespread zoonotic disease. It is caused by infection with pathogenic Leptospira species, of which over 300 serovars have been described. The accurate identification of the causative Leptospira spp. is required to ascertain the pathogenic status of the local isolates. OBJECTIVES This study aimed to obtain the complete genome sequence of a virulent Leptospira interrogans strain isolated from southern Brazil and to describe its genetic features. METHODS The whole genome was sequenced by next-generation sequencing (Ion Torrent). The genome was assembled, scaffolded, annotated, and manually reviewed. Mutations were identified based on a variant calling analysis using the genome of L. interrogans strain Fiocruz L1-130 as a reference. FINDINGS The entire genome had an average GC content of 35%. The variant calling analysis identified 119 single nucleotide polymorphisms (SNPs), from which 30 led to a missense mutation. The structural analyses identified potential evidence of genomic inversions, translocations, and deletions in both the chromosomes. MAIN CONCLUSIONS The genome properties provide comprehensive information about the local isolates of Leptospira spp., and thereby, could facilitate the identification of new targets for the development of diagnostic kits and vaccines.

Whole-genome sequencing of Leptospira interrogans from southern Brazil: genetic features of a highly virulent strain.

BACKGROUND Leptospirosis is the most widespread zoonotic disease. It is caused by infection with pathogenic Leptospira species, of which over 300 serovars have been described. The accurate identification of the causative Leptospira spp. is required to ascertain the pathogenic status of the local isolates. OBJECTIVES This study aimed to obtain the complete genome sequence of a virulent Leptospira interrogans strain isolated from southern Brazil and to describe its genetic features. METHODS The whole genome was sequenced by next-generation sequencing (Ion Torrent). The genome was assembled, scaffolded, annotated, and manually reviewed. Mutations were identified based on a variant calling analysis using the genome of L. interrogans strain Fiocruz L1-130 as a reference. FINDINGS The entire genome had an average GC content of 35%. The variant calling analysis identified 119 single nucleotide polymorphisms (SNPs), from which 30 led to a missense mutation. The structural analyses identified potential evidence of genomic inversions, translocations, and deletions in both the chromosomes. MAIN CONCLUSIONS The genome properties provide comprehensive information about the local isolates of Leptospira spp., and thereby, could facilitate the identification of new targets for the development of diagnostic kits and vaccines.

Assessing Mongolian gerbil emotional behavior: effects of two shock intensities and response-independent shocks during an extended inhibitory-avoidance task.

Despite step-down inhibitory avoidance procedures that have been widely implemented in rats and mice to study learning and emotion phenomena, performance of other species in these tasks has received less attention. The case of the Mongolian gerbil is of relevance considering the discrepancies in the parameters of the step-down protocols implemented, especially the wide range of foot-shock intensities (i.e., 0.4-4.0 mA), and the lack of information on long-term performance, extinction effects, and behavioral patterning during these tasks. Experiment 1 aimed to (a) characterize gerbils' acquisition, extinction, and steady-state performance during a multisession (i.e., extended) step-down protocol adapted for implementation in a commercially-available behavioral package (Video Fear Conditioning System-MED Associates Fairfax, VT, USA), and (b) compare gerbils' performance in this task with two shock intensities - 0.5 vs. 1.0 mA-considered in the low-to-mid range. Results indicated that the 1.0 mA protocol produced more reliable and clear evidence of avoidance learning, extinction, and reacquisition in terms of increments in freezing and on-platform time as well as suppression of platform descent. Experiment 2 aimed to (a) assess whether an alternate protocol consisting of a random delivery of foot shocks could replicate the effects of Experiment 1 and (b) characterize gerbils' exploratory behavior during the step-down task (jumping, digging, rearing, and probing). Random shocks did not reproduce the effects observed with the first protocol. The data also indicated that a change from random to response-dependent shocks affects (a) the length of each visit to the platform, but not the frequency of platform descends or freezing time, and (b) the patterns of exploratory behavior, namely, suppression of digging and rearing, as well as increments in probing and jumping. Overall, the study demonstrated the feasibility of the extended step-down protocol for studying steady performance, extinction, and reacquisition of avoidance behavior in gerbils, which could be easily implemented in a commercially available system. The observation that 1.0 mA shocks produced a clear and consistent avoidance behavior suggests that implementation of higher intensities is unnecessary for reproducing aversive-conditioning effects in this species. The observed patterning of freezing, platform descents, and exploratory responses produced by the change from random to periodic shocks may relate to the active defensive system of the gerbil. Of special interest is the probing behavior, which could be interpreted as risk assessment and has not been reported in other rodent species exposed to step-down and similar tasks.

Barrett's esophagus after Roux-en-Y gastric bypass: does regression occur?

INTRODUCTION: Barrett's esophagus (BE) is recognized as a premalignant lesion for esophageal adenocarcinoma. BE appears as a consequence of gastroesophageal reflux disease (GERD), which is increased among obese population. Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the best treatment option for obesity combined with GERD. However, data on evolution of BE after LRYGB are scarce. METHODS AND PROCEDURES: Patients were studied with esophagogastroduodenoscopy (EGD) and gastric biopsy preoperatively. If BE was suspected, esophageal biopsy was performed. If BE was confirmed, LRYGB was indicated with yearly surveillance EGD with biopsies. LRYGB patients who had BE with at least 1-year follow-up were included. RESULTS: Between 10/07 and 1/16, 2144 patients underwent laparoscopic bariatric surgery at our institution. There were 1681 (78 %) LRYGB, 399 (19 %) laparoscopic sleeve gastrectomies, and 64 (3 %) revisions. Nineteen patients (0.9 %) had BE preoperatively, and they all underwent LRYGB; 11 of them (58 %) were eligible for this study. There were 6 women and 5 men, mean age 49 ± 11 years, initial BMI 44 ± 6 kg/m2. Mean follow-up was 41 ± 31 months; there were 9 short-segment BE (SSBE) and 2 long-segment BE (LSBE). On pre- and post-op EGD, BE length was 2.1 ± 1.6 and 1.2 ± 1.2 cm, respectively (p = NS). Post-op EGD was compatible with BE in all cases, although esophageal biopsy showed remission in 4 (36 %) cases: three short-segment BE (SSBE) and one long-segment BE (LSBE). One patient was indefinite for dysplasia and remained the same after the operation. CONCLUSION: Our preliminary data showed that LRYGB is a suitable treatment option for obese patients with BE, demonstrated by 36 % regression rate of this premalignant disease. Although BE persisted in the remaining patients, no progression to dysplasia was observed. A larger number of patients and longer follow-up are needed for more definitive conclusions.

Terapia con anticuerpos monoclonales en Cardiología y Medicina Interna / Monoclonal antibody therapy in Cardiology and Internal Medicine

La terapia biológica basada en anticuerpos monoclonales, constituyen una nueva herramienta terapéutica, que de la mano del desarrollo de la biología molecular permiten intervenir puntos claves en la etiopatogenia de la enfermedad, permitiendo una terapia personalizada. Se han desarrollado nuevos anticuerpos monoclonales que intervienen en las enfermedades cardiovasculares, por lo que el entendimiento de los principios terapéuticos, los tipos y el mecanismo de acción de estos fármacos es esencial para un uso adecuado. En este artículo se discutirá el perfil de los anticuerpos monoclonales en la enfermedad cardiovascular, como los inhibidores de la PCSK-9 y el antídoto del Dabigatran, pasando por las moléculas ya conocidas como el abciximab, el antídoto de la digoxina y la terapia inmunomoduladora en el trasplante cardiaco. Del mismo modo, se evalúa una posible aplicación de los anticuerpos monoclonales usados en reumatología que podrían tener un papel importante en el manejo de las enfermedades cardiovasculares.

The monoclonal antibodies (mAb) constitute a new therapeutic tool in cardiovascular medicine, based in the development of the molecular biology in this area. The understanding of therapeutic principles, types and mechanism of action of these drugs is essential for proper use and management of adverse reactions. We discuss the profile of the PCSK-9 inhibitors, the Dabigatran antidote, the abciximab, the digoxin antidote, the therapy in heart transplantation, and a possible cardiovascular use of monoclonal antibodies used in rheumatology.

Endoscopic balloon dilation of anastomotic strictures occurring after laparoscopic gastric bypass for morbid obesity.

BACKGROUND: Gastrojejunal anastomotic stenosis of laparoscopic Roux-en-Y gastric bypass (LRYGB) for morbid obesity occurs in 3-25% of cases. The aim of this report was to evaluate the utility of endoscopic balloon dilation for the therapy of anastomotic strictures after LRYGB. PATIENTS AND METHODS: 111 consecutive patients were treated with endoscopic dilation under sedation with propofol. Dilations were performed with through-the-scope over-the-wire balloons, with sizes ranging from 6 to 18 mm. The outcomes of the procedure were analyzed. RESULTS: 200 endoscopic balloon dilations were performed in 111 patients. Repeated dilations were necessary in patients with complex stenosis. In 75% of the patients it was possible to dilate to 12 mm during the first session. Only in 2% of the cases was it impossible to introduce the endoscope through the stenosed anastomosis after dilation. On follow-up a repeat dilation was necessary in 26% of the cases. Minor complications occurred in 2.7% of patients (2 concealed perforations and 1 hematoma of the esophagus). These were treated conservatively. None of the patients required operation. CONCLUSIONS: Endoscopic balloon dilation is a safe and effective therapy for anastomotic strictures occurring after LRYGB.

Efecto de la aplicación de fertilizantes foliares y fitorreguladores en la calidad de la flor de la celosia (Celosia plumosa) en maceta

Con el fin de probar alternativas del uso de fertilizantes para mejorar la calidad de la flor de la Celosía plumosa y estudiar sus efectos, se probaron fertilizantes foliares (Biol y Nitrofoska) y un fitorregulador (Pro-Gibb), en diferentes concentraciones. En diseño experimental de bloques completamente al azar, con nueve tratamientos más un tratamiento testigo y con tres repeticiones, los datos fueron evaluados en la etapa madura después de tres periodos de aplicación, los resultados indican que por la aplicación de ácido giberelico incrementa el rendimiento y la calidad de la Celosía plumosa.

Factores de riesgo para infecciones urinarias bajas en embarazadas mayo 1999 - marzo 2000 / Risk factors for uinary infections in pregnancy may 1999 - march 2000

Los cambios anatomofisiológicos propios de la gestación condicionan el aumento de la frecuencia de las infecciones urinarias bajas. Existen múltiples factores de riesgo para adquirir estas infecciones además de la condición de gravidez. Entre estos se encuentran edad de la paciente, número de gestas, vida sexual activa y edad gestacional. Es por ello que en este estudio se investiga la relación entre el embarazo y dichos factores. Se diseño un estudio descriptivo, de casos y controles. El universo lo constituyó 206 embarazadas que asistieron al control prenatal del Hospital Universitario de Caracas entre mayo de 1999 y marzo de 2000. Para ello se utilizaron modelos de encuesta de grupos seleccionados y revisión de las historias clínicas. Dicho estudio reveló un mayor porcentaje de infecciones urinarias durante el embarazo en el grupo etario de 20 y 25 años (31 por ciento), en el segundo trimestre de embarazo (41,8 por ciento), en las multigestas (51,7 por ciento) y aunque hay similitud con la literatura mundial no se puede hablar de una relación causa efecto ya que las P obtenidas fueron mayor de 0,05. A pesar de que porcentualmente la frecuencia de mantenimiento de relaciones sexuales se vio asociada al desarrollo de la infección la P (0,11) no demuestra significación estadística. Se concluyó que la clínica y el examen de orina simple patológico no son parámetros estadísticamente significativos para el diagnóstico de infecciones urinarias

Tromboflebitis séptica de la vena porta asociada a hipertensión portal reversible / Septic thrombophlebitis of the portal vein associated with reversible portal hypertension

Septic thrombophlebitis of the portal vein is an unusual and serious complication of abdominal infection. We present a patient with thrombophlebitis of the portal vein of unknown origin, suffering from fever, abdominal pain, jaundice, abnormal liver test function and bacteremia related to Bacteroides fragilis. Ultrasonography, with doppler of the portal vein, was performed which showed thrombosis of the portal vein together with signs of portal hypertension. The patient underwent six weeks of antibiotic treatment. The evolution was favourable, the infection was overcome and the portal vein was de-obstructed as a consequence of which the signs of portal hypertension disappeared.

Tromboflebitis séptica de la vena porta asociada a hipertensión portal reversible / Septic thrombophlebitis of the portal vein associated with reversible portal hypertension

Septic thrombophlebitis of the portal vein is an unusual and serious complication of abdominal infection. We present a patient with thrombophlebitis of the portal vein of unknown origin, suffering from fever, abdominal pain, jaundice, abnormal liver test function and bacteremia related to Bacteroides fragilis. Ultrasonography, with doppler of the portal vein, was performed which showed thrombosis of the portal vein together with signs of portal hypertension. The patient underwent six weeks of antibiotic treatment. The evolution was favourable, the infection was overcome and the portal vein was de-obstructed as a consequence of which the signs of portal hypertension disappeared. (Au)