A realistic combined exposure scenario: effect of microplastics and atrazine on Piaractus mesopotamicus.

Microplastics, considered emerging environmental contaminants resulting from plastic degradation, are discovered in diverse aquatic ecosystems and can be unintentionally ingested by fish. Therefore, it is essential to characterize their interaction with other contaminants, such as agrochemicals, in aquatic environments. This study aimed to assess histological, enzymatic, and genotoxic biomarkers in juvenile pacú (Piaractus mesopotamicus) exposed to polyethylene (PE) microplastic particles and the herbicide atrazine, individually or combined, for 15 days. Four treatments were used: a negative control (CON), PE in the fish diet (0.1% w/w, FPE), atrazine through water (100 µg L-1, ATZ), and the mixture (ATZ+FPE). Results confirmed histological alterations in gills (edema and lamellar fusion) and liver (necrotic areas and congestion) of fish exposed to ATZ and ATZ+FPE. The number of goblet cells increased in the posterior intestine of fish under ATZ+FPE compared to CON and FPE. Enzyme activities (CAT, GST, AChE, and BChE) significantly increased in ATZ+FPE compared to CON. However, no genotoxic effect was demonstrated. These findings provide insights into the complex impacts of simultaneous exposure to atrazine and microplastics, emphasizing the need for continued research to guide effective environmental management strategies against these contaminants that represent a risk to aquatic organisms.

Propiedades Psicométricas de la Escala Conners-3 (SR-S) en Estudiantes Chilenos

Antecedentes En Chile, la prevalencia del Trastorno por Déficit de Atención con Hiperactividad (TDAH) se estima en un 10%. Frente a esta realidad, las políticas públicas promueven la detección oportuna de esta condición, suscitándose sin embargo problemas de sobre y sub-diagnóstico atribuibles a la falta de escalas actualizadas. Objetivo El propósito de este estudio fue evaluar las propiedades psicométricas de la escala Conners-3 en su forma abreviada de auto-reporte en niños y adolescentes chilenos. Método Se aplicó el Conners-3, y una medida de validez convergente (BRIEF-2), a una muestra no probabilística (n = 265) de estudiantes de enseñanza básica y media (8-18 años). Se efectuó un análisis de la correlación ítem-test e inter-escalar, seguido de un análisis factorial confirmatorio (AFC), finalizando con un análisis de consistencia interna. Resultados Todos los ítems presentaron una correlación ítem-escala aceptable. La estructura interna de cinco factores del AFC coincide con la original, las cuales además presentaron una consistencia interna aceptable y evidencia de validez convergente así como divergente. Conclusiones La escala Conners-3 presenta propiedades psicométricas aceptables para ser usada en la fase de detección del TDAH, recomendándose su uso como parte de una evaluación integral que incorpore otros métodos de evaluación.

Background In Chile, it is estimated that the prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD) is at 10%. Faced with this reality, public policies promote the timely detection of this condition; however, this situation generates over and underdiagnosis problems attributable to the lack of updated scales. Objective The purpose of this study was to assess the psychometric properties of the Conners-3 Rating Scale in its self-report short form in Chilean children and adolescents. Method The Conners-3 Self-report Scale and a convergent validity measure (BRIEF-2) were applied to a non-probability sample (n = 265) of elementary and high school students (8 to 18 years old). A confirmatory factor analysis (CFA) was carried out, in addition to an internal consistency analysis and an item-total and inter-scale correlation analysis. Results All the items presented an acceptable item-scale correlation. The five-factor internal structure of the CFA coincides with the original. Scales also presented an acceptable internal consistency and evidence of convergent validity. Conclusions the Conners-3 Self-report Scale presents acceptable psychometric properties for use in the detection phase of ADHD; furthermore, its use is suggested as part of a comprehensive assessment that incorporates other assessment methods.

Workplace bullying and sexual harassment among general surgery residents in Colombia / Acoso laboral y sexual en residentes de cirugía general en Colombia

INTRODUCTION: Workplace bullying and sexual harassment are concerns among general surgery residents in Colombia. OBJETIVE: To explore the prevalence and impact of workplace bullying and sexual harassment incidents among general surgery residents in Colombia. MATERIALS AND METHODS: This nationwide study was conducted in 2020. Residents selfrated their exposure to workplace bullying and to sexual harassment in the forms of gender harassment, unwanted sexual attention, and sexual coercion. We analyzed demographic variables, perpetrator's characteristics, and differences between victims and non-victims. RESULTS: The study included 302 residents. It found that 49% of general surgery residents in Colombia suffered from workplace bullying and 14.9% experienced sexual harassment. The main forms of sexual harassment were gender harassment (47%) and unwanted sexual attention (47%). Women reported significantly higher rates of being sexually harassed. Surgeons were the main perpetrators of sexual harassment. CONCLUSIONS: Workplace bullying and sexual harassment are frequent events in general surgery residency in Colombia. These findings suggest the need for interventions to improve the educational culture of surgical departments and decrease the prevalence of these behaviors.

Introducción: El acoso laboral y el acoso sexual son preocupaciones en la formación quirúrgica. Objetivo: Exploramos la magnitud de estos problemas entre los residentes de cirugía general en Colombia. Materiales y métodos: se realizó un estudio nacional en junio de 2020. Los residentes autoevaluaron su exposición a la intimidación y el acoso sexual en forma de acoso de género, atención sexual no deseada y coerción sexual. Se analizaron variables demográficas y perpetradores entre víctimas y no víctimas. Resultados: Se incluyeron un total de 302 residentes. Las tasas de acoso laboral y sexual fueron del 49% y 14,9%, respectivamente. Las principales formas de acoso sexual correspondieron al acoso de género (47%) y la atención sexual no deseada (47%). El acoso sexual fue significativamente mayor entre las mujeres. Los cirujanos fueron los principales perpetradores. Conclusiones: El acoso laboral y el acoso sexual son frecuentes en la formación quirúrgica en Colombia. Estos hallazgos conducen a intervenciones para mejorar la cultura educativa de los departamentos quirúrgicos para disminuir la prevalencia de estos comportamientos.

Workplace bullying and sexual harassment among general surgery residents in Colombia / Acoso laboral y sexual en residentes de cirugía general en Colombia

Introduction. Workplace bullying and sexual harassment are concerns among general surgery residents in Colombia. Objective. To explore the prevalence and impact of workplace bullying and sexual harassment incidents among general surgery residents in Colombia. Materials and methods. This nationwide study was conducted in 2020. Residents selfrated their exposure to workplace bullying and to sexual harassment in the forms of gender harassment, unwanted sexual attention, and sexual coercion. We analyzed demographic variables, perpetrator's characteristics, and differences between victims and non-victims. Results. The study included 302 residents. It found that 49% of general surgery residents in Colombia suffered from workplace bullying and 14.9% experienced sexual harassment. The main forms of sexual harassment were gender harassment (47%) and unwanted sexual attention (47%). Women reported significantly higher rates of being sexually harassed. Surgeons were the main perpetrators of sexual harassment. Conclusions. Workplace bullying and sexual harassment are frequent events in general surgery residency in Colombia. These findings suggest the need for interventions to improve the educational culture of surgical departments and decrease the prevalence of these behaviors.

Introducción. El acoso laboral y el acoso sexual son preocupaciones en la formación quirúrgica. Objetivo. Exploramos la magnitud de estos problemas entre los residentes de cirugía general en Colombia. Materiales y métodos. Se realizó un estudio nacional en junio de 2020. Los residentes autoevaluaron su exposición a la intimidación y el acoso sexual en forma de acoso de género, atención sexual no deseada y coerción sexual. Se analizaron variables demográficas y perpetradores entre víctimas y no víctimas. Resultados. Se incluyeron un total de 302 residentes. Las tasas de acoso laboral y sexual fueron del 49% y 14,9%, respectivamente. Las principales formas de acoso sexual correspondieron al acoso de género (47%) y la atención sexual no deseada (47%). El acoso sexual fue significativamente mayor entre las mujeres. Los cirujanos fueron los principales perpetradores. Conclusiones. El acoso laboral y el acoso sexual son frecuentes en la formación quirúrgica en Colombia. Estos hallazgos conducen a intervenciones para mejorar la cultura educativa de los departamentos quirúrgicos para disminuir la prevalencia de estos comportamientos.

Transgastric laparoscopic polypectomy in giant gastric polyps not susceptible of endoscopic management: novel surgical technique and case series.

BACKGROUND: The identification of gastric polyps incidentally in endoscopies of the upper digestive tract has increased its incidence, varying between 0.5% and 23%. 10% of these polyps have symptoms, 40% are hyperplastic. We allow ourselves to propose a laparoscopic technique for the management of giant hyperplastic polyps associated with a pyloric syndrome, not susceptible to endoscopic resection. METHOD: A series of patients approached by laparoscopic transgastric polypectomy due to the giant gastric polyps associated with pyloric syndrome, in Bogotá, Colombia, from January 2015 to December 2018. RESULTS: Seven patients, 85% female, with an average age of 51 years, who were admitted for pyloric syndrome and were taken to laparoscopic management, with an average surgical time of 42 min, intraoperative bleeding 7-8 cc, tolerance to the oral route 24 hours, no conversion, without mortality. CONCLUSIONS: Transgastric polypectomy for the management of benign giant gastric polyps that cannot be resected endoscopically turns out to be a feasible method, with a low rate of complications and without mortality.

ANTECEDENTES: La identificación de pólipos gástricos de manera incidental en endoscopias de vías digestivas altas ha aumentado su incidencia, que varía entre el 0.5% y el 23%. El 10% de estos pólipos presentan síntomas y el 40% son hiperplásicos. Nos permitimos proponer una técnica laparoscópica para el manejo de los pólipos hiperplásicos gigantes asociados a síndrome pilórico no susceptibles de resección endoscópica. MÉTODO: Serie de pacientes llevados a polipectomía transgástrica laparoscópica por hallazgo de pólipos gástricos gigantes asociados a síndrome pilórico, en Bogotá, Colombia, de enero de 2015 a diciembre de 2018. RESULTADOS: Un total de siete pacientes, el 85% de sexo femenino, con edad promedio de 51 años, ingresaron por síndrome pilórico y fueron llevados a manejo laparoscópico, con un tiempo quirúrgico promedio de 42 minutos, sangrado intraoperatorio de 7-8 cc, tolerancia a la vía oral a las 24 horas, no conversión, sin mortalidad. CONCLUSIONES: La polipectomía transgástrica para el manejo de pólipos gástricos gigantes benignos que no pueden ser resecados por vía endoscópica resulta ser un método factible, con una baja tasa de complicaciones y sin mortalidad.

Prevention of exposure to zoonoses in rural Latin America: Social ecological factors in a diverse regional context.

Zoonotic diseases have serious impacts on human health and well-being, but they are often overlooked in rural Latin America. The design of effective preventive interventions is complex and requires an integrative approach from evidence-based information analyzed through robust theoretical frameworks. We conducted a systematized literature review and qualitative framework-guided thematic analysis to identify social ecological factors affecting the prevention and exposure to zoonotic diseases. Although resources for research are limited in Latin America, we found several studies with relevant results. We extracted and interpreted 8 themes as factors affecting the prevention, transmission, and exposure to zoonosis. These themes included knowledge and misconceptions, low risk perception, gaps in knowledge and communication, psychological effect of diseases, culture and traditions, inequality, disarticulated prevention programs, and organizational responsibility. Alongside this, we compiled and present the recommendations for actions to reduce the impact of zoonoses in these populations. The factors and recommendations here presented can be adapted to inform the design and improvement of preventive programs, focused on One Health and aiming to reduce the impact of zoonotic diseases in rural settings.

Pain Assessment and Management in Pediatric Intensive Care Units Around the World, an International, Multicenter Study.

The adequate assessment and management of pain remains a challenging task in the Pediatric Intensive Care Unit (PICU). Our goal is to describe how pain is assessed and managed in PICUs around the world and to examine how human and material resources impact achievement of this goal. An international multicenter cross-sectional observational study was designed with the participation of 34 PICUs located in urban, suburban, and rural areas of 18 countries. We evaluated how PICUs around the world assessed and managed pain according to the Initiative for Pediatric Palliative Care recommendations, and how human and material resources impacted achievement of this goal. Data was collected for this study from 2016 to 2018 using questionnaires completed by medical doctors and nurses. In this paper, we focus on the indicators related to how pain is managed and assessed. The average achievement of the goal of pain relief across all centers was 72.2% (SD: 21.1). We found a statistically significant trend of more effective pain management scores, routine assessment, proper documentation, and involvement of pain management experts by increasing country income. While there are efforts being made worldwide to improve the knowledge in pain assessment and management, there is a lack of resources to do so appropriately in low-middle-income countries. There is a mismatch between the existing guidelines and policies, which are mainly designed in high income countries, and the resources available in lower resourced environments.

Characterization of Geiger-Müller radiation detectors response at the University of Costa Rica's Cyclotron Facilities / Caracterización de la respuesta de detectores de radiación Geiger-Müller en el Ciclotrón de la Universidad de Costa Rica

To ensure a reliable verification of a radiation detector, the right parameters for this response verification must be determined and a specific characterization on the detectors of interest must be performed. These were the main pillars of this study, where four Geiger-Müller at the University of Costa Rica's Cyclotron Facilities' main laboratories were studied and characterized using a 137Cs source. First, a verification of the inverse-square law was performed to corroborate the correct measurement by the detectors as the distance from a 137Cs source to the detectors was varied using a new design for a positioner support to ensure repeatability. This verification yielded a potential fit curve with and equation D=670635 x-1.961 (error percentage of 1.95%) and an R2 value of 0.9836. Then, using combinations of copper plates of widths 1.0 mm and 2.0 mm as attenuators between the source and the detectors, the mass attenuation coefficient for copper was obtained only as a reference value for future calibrations of the detectors. The result for this value was 0.040 cm2 /g. The results obtained in this study and the method developed to achieve these results will serve as a base for calibrations of the detectors at these facilities, which will ensure the safety of the patients and personnel in this building.

Para asegurar respuesta correcta de un detector de radiación, se deben determinar los parámetros correctos para esta verificación y debe realizarse una caracterización específica de los detectores de interés. Estos fueron los pilares principales de este estudio, donde se estudiaron y caracterizaron 4 detectores Geiger-Müller en los laboratorios principales del Ciclotrón de la Universidad de Costa Rica utilizando una fuente radiactiva de 137Cs. Primero, se realizó una verificación de la ley del inverso-cuadrado para corroborar la medición correcta de los detectores según se varía la distancia entre la fuente de 137Cs al detector utilizando un diseño nuevo de un soporte posicionador para la fuente que asegura la repetibilidad entre experimentos. Esta verificación resultó en una curva de ajuste potencial de ecuación D=670635x-1,961 (porcentaje de error de 1,95%) y un valor de R2 de 0,9836. Luego, utilizando combinaciones de placas de cobre de espesores 1,0 mm y 2,0 mm como atenuadores entre la fuente y los detectores, se obtuvo el coeficiente de atenuación másico para el cobre como un valor de referencia para futuras calibraciones de los detectores. Este resultado fue de 0,040 cm2/g. Los resultados obtenidos en esta investigación y el método desarrollado para lograr estos resultados servirán como una base para una futura confirmación metrológica calibraciones de los detectores en estos laboratorios, lo cual colaborará con la seguridad y protección radiológica de pacientes y trabajadores en este edificio.

[Acute kidney injury caused by rhabdomyolysis as a SARS-CoV-2 infection manifestation. Report of one case]. / Insuficiencia renal aguda secundaria a rabdomiolisis como manifestación de infección por SARS-CoV-2.

SARS-CoV-2 infection has a wide spectrum of clinical manifestations secondary to the impairment of different organs, including kidney. Rhabdomyolysis is produced by disintegration of striated muscle and the liberation of its contents to the extracellular fluid and bloodstream. This may produce hydro electrolytic disorders and acute kidney injury. We report a 35-year-old female with a history of SARS-CoV-2 infection who was hospitalized because of respiratory failure and developed renal failure. The etiologic study showed elevated total creatine kinase levels and a magnetic resonance imaging confirmed rhabdomyolysis. The patient required supportive treatment with vasoactive drugs, mechanic ventilation and kidney replacement therapy. She had a favorable evolution with resolution of respiratory failure and improvement of kidney function.

Anterolateral thigh versus radial forearm flap for cervical esophageal reconstruction in cancer patients: A retrospective cohort study in Colombia.

OBJETIVO: Este estudio tuvo como objetivo describir los resultados clínicos del colgajo anterolateral de muslo y radial de antebrazo, para la reconstrucción hipofaríngea y esofágica en un hospital de cuarto nivel en Bogotá, Colombia. MÉTODOS: Estudio retrospectivo inlcuyo 38 pacientes a los que se les realizó reconstrucción funcional esofágica con colgajo de antebrazo radial o anterolateral de muslo (ALT) entre febrero de 2010 y diciembre de 2017. RESULTADOS: Edad media fue de 51 años. El 80% genero femeninp. Los defectos laringoesofágicos estuvieron presentes en el 80%. Se requirió reconstrucción circunferencial total en el 60% de los pacientes. Se realizaron injertos braquio-radiales en el 26% y colgajos anterolaterales de muslo en el 74%. La tasa global de complicaciones tempranas fue del 30%, de las cuales el 20% fueron fístulas (braquio-radial, 2,8%; colgajo libre de ALT, 8,3%). Las complicaciones tardías (20%) incluyeron estenosis y obstrucción de la luz del injerto distal. Solo el 10% de los pacientes no pudieron tolerar la alimentación oral y el 50% de este paciente necesitó gastrostomía permanente. En cuanto al seguimiento oncológico durante el postoperatorio de 24 meses, no se observó recidiva tumoral. CONCLUSIÓN: Los resultados funcionales de la reconstrucción con colgajo braquio-radial y ALT fueron satisfactorios. Nuestros hallazgos sugieren que la ALT tiene una menor incidencia de complicaciones posoperatorias que el colgajo radial de antebrazo. La elección del tipo de colgajo dependerá del tamaño y la ubicación del defecto. Los defectos pequeños y parcialmente cubiertos se benefician del uso de un colgajo radial, y para reconstrucciones faríngeas más grandes y circunferenciales con posibles requisitos de radioterapia, se benefician de un colgajo ALT. OBJECTIVE: This study aimed to describe clinical outcomes of anterolateral thigh (ALT) and radial forearm flap in hypopharyngeal and esophageal reconstruction in a fourth level hospital in Bogotá, Colombia. METHODS: This retrospective study included 38 patients who esophageal functional reconstruction using radial forearm or ALT flap at our center between February 2010 and December 2017. RESULTS: Mean age was 51 years. About 80% of the included patients were females. Laryngoesophageal defects were present in 80%. Total circumferential reconstruction was required in 60% of patients. Brachial-radial grafts were performed in 26% and anterolateral thigh flaps in 74%. Overall, early complication rate was 30%, which 20% were fistulae (brachial-radial, 2.8%; ALT free flap, 8.3%). Late complications (20%) included stenosis and distal graft lumen obstruction. Only 10% of patients were unable to tolerate oral feeding and 50% of this patient needed permanent gastrostomy. Regarding oncological follow-up during the 24-month post-operative, no tumor recurrence was observed. CONCLUSIONS: Functional outcomes of reconstruction with brachial-radial and ALT flap were satisfying. Our findings suggest that ALT has a lower incidence of post-operative complications than radial forearm flap. The choice of the type of flap will depend on the size and location of the defect. Small and partially covered defects benefit from the use of a radial flap, and for larger and circumferential pharyngeal reconstructions with possible radiotherapy requirements, they benefit from an ALT flap.

Insuficiencia renal aguda secundaria a rabdomiolisis como manifestación de infección por SARS-CoV-2 / Acute kidney injury caused by rhabdomyolysis as a SARS-CoV-2 infection manifestation: report of one case

SARS-CoV-2 infection has a wide spectrum of clinical manifestations secondary to the impairment of different organs, including kidney. Rhabdomyolysis is produced by disintegration of striated muscle and the liberation of its contents to the extracellular fluid and bloodstream. This may produce hydro electrolytic disorders and acute kidney injury. We report a 35-year-old female with a history of SARS-CoV-2 infection who was hospitalized because of respiratory failure and developed renal failure. The etiologic study showed elevated total creatine kinase levels and a magnetic resonance imaging confirmed rhabdomyolysis. The patient required supportive treatment with vasoactive drugs, mechanic ventilation and kidney replacement therapy. She had a favorable evolution with resolution of respiratory failure and improvement of kidney function.

Apoptotic Effects of N-(2-Hydroxyphenyl)-2-Propylpentanamide on U87-MG and U-2 OS Cells and Antiangiogenic Properties.

BACKGROUND AND OBJECTIVE: Histone Deacetylases (HDACs) are important therapeutic targets for many types of human cancers. A derivative of valproic acid, N-(2-hydroxyphenyl)-2-propylpentanamide (HOAAVPA), has antiproliferative properties on some cancer cell lines and inhibits the HDAC1 isoform. MATERIALS AND METHODS: In this work, HO-AAVPA was tested as an antiproliferative agent in U87-MG (human glioblastoma) and U-2 OS cells (human osteosarcoma), which are types of cancer that are difficult to treat, and its antiangiogenic properties were explored. RESULTS: HO-AAVPA had antiproliferative effects at 48h with an IC50=0.655mM in U87-MG cells and an IC50=0.453mM in U-2 OS cells. Additionally, in the colony formation assay, HO-AAVPA decreased the number of colonies by approximately 99% in both cell lines and induced apoptosis by 31.3% in the U-2 OS cell line and by 78.2% in the U87-MG cell line. Additionally, HO-AAVPA reduced the number of vessels in Chorioallantoic Membranes (CAMs) by approximately 67.74% and IL-6 levels in both cell lines suggesting that the biochemical mechanism on cancer cell of HO-AAVPA is different compared to VPA. CONCLUSION: HO-AAVPA has antiproliferative effects on glioblastoma and osteosarcoma and antiangiogenic properties.

Long-term trends of fishery landings and target fish populations in the lower La Plata basin

The La Plata basin is the second largest basin of South America and has supported important river fisheries for more than a century. In this paper, we evaluate for the first time the historical trends of landings of 21 fish taxa and the recent population trends of 27 species of commercial fishes in the lower La Plata basin (Argentina). We compiled three kinds of data sets: Total fishery landings (between 1934 and 1986) and exports (1994‒2019), fisheries monitoring programs of Chaco and Santa Fe provinces in the Paraná River (2009‒2019), and surveys of fish populations in the Upper (Corrientes, 1993‒2020) and Middle (EBIPES, 2005‒2020) Paraná River. The analysis of the historical landings showed more species declining in the lower portion of the basin than in the upper basin. Regarding recent population trends, Pimelodus spp., Hoplias spp., Salminus brasiliensis, Luciopimelodus pati, and Ageneiosus spp. declined in more than one region, while Megaleporinus spp., Pterodoras granulosus, and Oxydoras kneri showed stable to positive trends, with the other species varying in their trends between regions. These tendencies could be associated to a combination of factors such as overfishing and environmental changes that would require an ecosystem approach for their adequate management.(AU)

La Cuenca del Plata es la segunda más grande de Sudamérica y ha soportado importantes pesquerías fluviales desde hace más de un siglo. En este trabajo, evaluamos por primera vez las tendencias históricas en los desembarques pesqueros de 21 taxones de peces y las tendencias poblacionales recientes de 27 especies de peces comerciales de la baja Cuenca del Plata (Argentina). Compilamos tres tipos de datos: desembarques pesqueros totales (1934‒1986) y exportaciones (1994‒2019), programas de monitoreo de pesca comercial de las provincias de Chaco y Santa Fe en el río Paraná (2009‒2019), y relevamientos de peces en el río Paraná Alto (Corrientes, 1993‒2020) y Medio (EBIPES, 2005‒2020). El análisis de los desembarques históricos mostró más disminuciones en la porción baja de la cuenca que en la porción alta. En cuanto a las tendencias poblacionales recientes, Pimelodus spp., Hoplias spp., Salminus brasiliensis, Luciopimelodus pati y Ageneiosus spp. declinaron en más de un sector, mientras que Megaleporinus spp., Pterodoras granulosus y Oxydoras kneri mostraron tendencias estables a positivas, con las otras especies variando en sus tendencias entre regiones. Estas tendencias podrían asociarse a una combinación de factores como la sobrepesca y los cambios ambientales que requerirían una aproximación ecosistémica para su adecuado manejo.(AU)

Long-term trends of fishery landings and target fish populations in the lower La Plata basin

The La Plata basin is the second largest basin of South America and has supported important river fisheries for more than a century. In this paper, we evaluate for the first time the historical trends of landings of 21 fish taxa and the recent population trends of 27 species of commercial fishes in the lower La Plata basin (Argentina). We compiled three kinds of data sets: Total fishery landings (between 1934 and 1986) and exports (1994‒2019), fisheries monitoring programs of Chaco and Santa Fe provinces in the Paraná River (2009‒2019), and surveys of fish populations in the Upper (Corrientes, 1993‒2020) and Middle (EBIPES, 2005‒2020) Paraná River. The analysis of the historical landings showed more species declining in the lower portion of the basin than in the upper basin. Regarding recent population trends, Pimelodus spp., Hoplias spp., Salminus brasiliensis, Luciopimelodus pati, and Ageneiosus spp. declined in more than one region, while Megaleporinus spp., Pterodoras granulosus, and Oxydoras kneri showed stable to positive trends, with the other species varying in their trends between regions. These tendencies could be associated to a combination of factors such as overfishing and environmental changes that would require an ecosystem approach for their adequate management.(AU)

La Cuenca del Plata es la segunda más grande de Sudamérica y ha soportado importantes pesquerías fluviales desde hace más de un siglo. En este trabajo, evaluamos por primera vez las tendencias históricas en los desembarques pesqueros de 21 taxones de peces y las tendencias poblacionales recientes de 27 especies de peces comerciales de la baja Cuenca del Plata (Argentina). Compilamos tres tipos de datos: desembarques pesqueros totales (1934‒1986) y exportaciones (1994‒2019), programas de monitoreo de pesca comercial de las provincias de Chaco y Santa Fe en el río Paraná (2009‒2019), y relevamientos de peces en el río Paraná Alto (Corrientes, 1993‒2020) y Medio (EBIPES, 2005‒2020). El análisis de los desembarques históricos mostró más disminuciones en la porción baja de la cuenca que en la porción alta. En cuanto a las tendencias poblacionales recientes, Pimelodus spp., Hoplias spp., Salminus brasiliensis, Luciopimelodus pati y Ageneiosus spp. declinaron en más de un sector, mientras que Megaleporinus spp., Pterodoras granulosus y Oxydoras kneri mostraron tendencias estables a positivas, con las otras especies variando en sus tendencias entre regiones. Estas tendencias podrían asociarse a una combinación de factores como la sobrepesca y los cambios ambientales que requerirían una aproximación ecosistémica para su adecuado manejo.(AU)

Localization and distribution of CCK-8, NPY, Leu-ENK-, and Ghrelin- in the digestive tract of Prochilodus lineatus (Valenciennes, 1836).

This study describes the histological characteristics and distribution of gastrointestinal tract endocrine cells (ECs) of Prochilodus lineatus (detritivorous fish) using immunohistochemical procedures. The digestive tract of P. lineatus was divided into seven portions: stomach (cardial and pyloric), pyloric caeca, and intestine (anterior, glandular, middle and posterior). A pool of specific antisera against cholecystokinin (CCK-8), -neuropeptide Y (NPY), -ghrelin (Ghre) and -leu-enkephalin (Leu-ENK) to identify ECs were used. According to the morphological characteristics of ECs, two different types were identified and classified as open or closed-type. The number of ECs varied throughout the gastrointestinal tract, though a high abundance was found in the anterior intestine and pyloric caeca. A large number of ECs immunoreactive to CCK-8 and NPY were recorded in the anterior, glandular and middle intestine. ECs immunopositive to Leu-ENK were distributed in the stomach and pyloric caeca. For Ghre, immunopositive ECs were restricted to the glandular intestine. The results of the present study indicate that P. lineatus presents an ECs distribution pattern with species-specific particularities. However, CCK showed a distribution similar to that of omnivores, which is possibly related to local signaling functions in order to achieve the correct digestion of the various organisms found in the detritus.

Impact of social media on the continuous education of the general surgeon, a new experience, @Cirbosque: A Latin American example.

Social media has gained widespread recognition for its importance in the medical field. Such platforms play an important role for learning and teaching, because knowledge can be transmitted instantly and massively, and specialists in different world-wide locations can discuss experiences instantaneously. The present article presents our experience of using social media to facilitate surgical learning while encouraging leadership and global mentoring. This retrospective descriptive study was initiated at the time of the creation of our social media handle on Twitter, February 22, 2019. Since that time, we have posted 10,587 academic tweets; the monthly growth rate has been 9% (393 new followers per month). Currently, we have 4,213 followers, 11,241,000 impressions, 121,105 visits, and 121,105 mentions. We have reviewed 59 topics of interest in general surgery and 132 clinical cases in trauma, as well as in hepatobiliary, gastrointestinal, thoracic, and acute-care surgery. We have made 13 image challenges using illustrations of diagnostic and intraoperative images. Although the evidence is uncertain to promote education performed entirely through social media, we show that @Cirbosque has been effective, and the impact of this initiative on Twitter is appreciated by many surgeons worldwide, including renowned teachers in each of the topics addressed. Furthermore, the number of participants in the discussions increased each day, as did all impact indicators according to Twitter Analytics. Thus, we conclude that the educational message of @Cirbosque is having a positive effect and reaching thousands of people worldwide, suggesting that others can develop similar outreach programs in education and communication.

Uso de mallas de polipropileno en el reparo de la hernia inguinal con herida sucia o contaminada / Use of polypropylene meshes in the repair of inguinal hernia with dirty or contaminated wound

Introducción. La hernioplastia con malla de polipropileno es la técnica de elección para el reparo de las hernias inguinales. Actualmente, existe controversia sobre esta técnica en pacientes con heridas sucias o contaminadas; sin embargo, la evidencia en la literatura médica ha demostrado que su uso puede ser seguro. Los autores presentan su experiencia con las mallas de polipropileno en la cirugía contaminada para cierre de hernias inguinales.Método. Se realizó un estudio observacional retrospectivo en el que se incluyeron los pacientes mayores de 18 años atendidos entre enero de 2017 y diciembre de 2018 por presentar hernias inguinales, que requirieron tratamiento quirúrgico de urgencias, y que presentaban heridas sucias o contaminadas. Los criterios evaluados fueron: infección de la herida quirúrgica, morbilidad y mortalidad, necesidad de remoción de la malla y recurrencia de la hernia.Resultados. Diez pacientes fueron sometidos a cirugía de urgencias, requiriendo resección intestinal por necrosis: nueve de ellos, por hernias estranguladas y, uno, por apendicitis perforada. En uno de los diez pacientes, se consideró sucia la herida por presentar necrosis intestinal y perforación. Los nueve restantes presentaban necrosis intestinal sin perforación, por lo cual se consideraron heridas contaminadas. La infección de la herida ocurrió en 1/10 pacientes con infección del sitio operatorio superficial; la eliminación de la malla no fue necesaria en ningún paciente durante todo el período de estudio. No se observaron recidivas y no hubo mortalidad.Conclusión. El uso de malla de polipropileno para la corrección de hernias inguinales, en pacientes con heridas sucias o contaminadas, es efectivo y seguro, con una morbilidad aceptable y buenos resultados a corto plazo

Introduction: Polypropylene mesh hernioplasty is the technique of choice for the repair of inguinal hernias. Currently, there is controversy about this technique in patients with dirty or contaminated wounds. However, evidence in the medical literature has shown its use can be safe. The authors present their experience in the use of polypropylene meshes in contaminated surgery to close inguinal hernias.Methods: A retrospective observational study was conducted in patients older than 18 year-old between January 2017 and December 2018. Were included those with inguinal hernias, requiring emergency surgical treatment, and presented contaminated or dirty wounds. The inclusion criteria were infection of the surgical wound, the need for removal of the mesh removal and recurrence of the hernia.Results: Ten patients underwent emergency surgery, requiring bowel resection for necrosis: nine of them for strangulated hernias and, one for perforated appendicitis. In one of the ten patients, the wound was considered dirty due to intestinal necrosis and perforation. The remaining nine had intestinal necrosis without perforation, so they were considered contaminated wounds. Wound infection occurred in 1/10 patients (10%) with superficial operative site infection; mesh removal was not necessary in any patient during the entire study period. No recurrence was observed and there was no mortality.Conclusion: The use of polypropylene mesh for the correction of inguinal hernias in patients with contaminated and dirty wounds is effective and safe, with acceptable morbidity and good short-term results

Educación quirúrgica en Colombia en la era del COVID­19 / Surgical education in Colombia in the era of COVID­19

La enfermedad por Coronavirus-2 en poco tiempo ha logrado encender las alarmas de los sistemas de salud a nivel mundial. Además de las implicaciones económicas, sanitarias, políticas, culturales y sociales, está claro que ha cambiado la vida de los seres humanos incluyendo como se desarrollan los programas de postgrado en medicina.Múltiples comunidades científicas alrededor del mundo han manifestado la necesidad de diferir los pro-cedimientos quirúrgicos electivos y priorizar la atención de los pacientes por encima de la academia, lo que podría disminuir la exposición de residentes de cirugía general a actos quirúrgicos esenciales para su aprendizaje.Como respuesta a ello, los autores presentan este artículo en donde se discute el papel de la educación virtual y la simulación como posibles respuestas a la dificultad educativa que representa la pandemia del COVID-19

Coronavirus-2 disease in a short time has managed to turn on the alarms of systems healthcare worldwide. In addition to the economic, health, political, cultural, and social implications, it has changed the lives of human beings including how medical graduate programs are developed. Multiple scientific communities around the world have expressed the need to defer elective surgical procedures and prioritize patient care over teaching, which could decrease the exposure of general surgery residents to surgical opportunities essential to their learning. In response to this, the authors present this article where the role of virtual education and simulation are discussed as possible responses to the educational difficulty represented by the COVID-19 pandemic

Distribution and bioaccumulation of 12 trace elements in water, sediment and tissues of the main fishery from different environments of the La Plata basin (South America): Risk assessment for human consumption.

The concentration of Ag, As, Cd, Cu, Cr, Hg, Ni, Pb, Se, U, V, and Zn was analyzed in water, sediment, and different organs of Prochilodus lineatus (muscle, liver and gill) in three most commercially important catch areas along La Plata Basin, namely High Paraná River (HPR), Middle Paraná River (MPR) and Río de la Plata Estuary (RPE). The concentration of As, Cu and Zn (RPE) and Se (HPR) in water and As (RPE), Ni (HPR and MPR), Cu and Cr (all sites) in sediments exceeded the limits considered as hazardous for aquatic life. With the exception of Se (sediment-liver) and Pb (sediment-liver and sediment-gill), it was not observed a significant correlation between the element concentration in tissues and that found in water and sediment. No correlation was found between the size fish and element concentrations. Liver appeared to be the main storage tissue of trace elements and was classified as a macroconcentrator of Ag, Cu, Hg and Zn. Levels of trace elements in muscle of streaked prochilod were below recommended maximum levels established by national and international guidelines. According to Target Hazard Quotient (THQ), the consumption of muscle of P. lineatus from three sampling sites did not present toxicological risk for general and fishermen populations. Multivariate analyses suggest that the three groups studied remain with an important degree of geographical segregation, indicating that regulations should be revised according to the presence of contaminants in the different fishing areas.

A step forward in the quest for a mobile EEG-designed epoch for psychophysiological studies.

The aim of this study was to compare a reconfigurable mobile electroencephalography (EEG) system (M-EMOTIV) based on the Emotiv Epoc® (which has the ability to record up to 14 electrode sites in the 10/20 International System) and a commercial, clinical-grade EEG system (Neuronic MEDICID-05®), and then validate the rationale and accuracy of recordings obtained with the prototype proposed. In this approach, an Emotiv Epoc® was modified to enable it to record in the parieto-central area. All subjects (15 healthy individuals) performed a visual oddball task while connected to both devices to obtain electrophysiological data and behavioral responses for comparative analysis. A Pearson's correlation analysis revealed a good between-devices correlation with respect to electrophysiological measures. The present study not only corroborates previous reports on the ability of the Emotiv Epoc® to suitably record EEG data but presents an alternative device that allows the study of a wide range of psychophysiological experiments with simultaneous behavioral and mobile EEG recordings.