Abordaje de síntomas de diarrea y estreñimiento por el farmacéutico comunitario en periodo de pandemia por la COVID-19: estudio observacional, transversal y multicéntrico / Community pharmacist management of diarrhoea and constipation symptoms during a COVID-19 pandemic: an observational, cross-sectional, multicentre study

Introducción: el papel del farmacéutico comunitario ha adquirido mayor relevancia en el contexto de las restricciones derivadas por la pandemia de COVID-19. Objetivo del estudio: identificar el resultado de la indicación farmacéutica ante la consulta por diarrea o estreñimiento durante este período.Material y métodos: estudio observacional, transversal, multicéntrico y nacional. Se invitó a participar a los farmacéuticos comunitarios registrados en la base de datos Medynet. Los seleccionados se estratificaron por comunidades autónomas y población rural o urbana. La población de estudio fueron los pacientes que acudieron a las farmacias comunitarias desde enero a junio de 2021 por estreñimiento o diarrea. Resultados: un total de 121 farmacéuticos de un máximo establecido de 120 reclutaron a 849 pacientes (49,7 % consultaron por diarrea y un 50,3 % por estreñimiento). Un 83,5 % de farmacéuticos consideraba haber atendido un mayor número de consultas por síntomas digestivos, pero sin llegar a ser el doble que antes de la pandemia. En los pacientes con diarrea, dieta (76,9 %) y suero oral (64,2 %) fueron las indicaciones más frecuentes, mientras que en los pacientes con estreñimiento destacaron el aumento de la ingesta de agua (86,9 %), la dieta (84,1 %) y la indicación de algún medicamento de prescripción libre (68,1 %). 4 de cada 5 consultas farmacéuticas por diarrea o estreñimiento fueron resueltas en la farmacia comunitaria sin precisar derivación al médico.Conclusión: el presente estudio refuerza el papel destacado del farmacéutico comunitario como profesional de primera línea, realizando indicaciones farmacéuticas personalizadas a pacientes con diarrea o estreñimiento, contribuyendo de forma sustancial a la eficiencia y sostenibilidad del sistema sanitario durante la pandemia de COVID-19. (AU)

Bioprospection of Native Antagonistic Rhizobacteria From the Peruvian Coastal Ecosystems Associated with Phaseolus vulgaris.

Phaseolus vulgaris is originally from the American continent. It is renowned as one of the preferred legume choice in the Peruvian market, due to its high content of nutrients. The Peruvian coast valleys are key-production areas for local varieties of the common bean crops. Soil-borne plant pathogens, however, favored by soil and environmental conditions, may reduce crop production. The aim of this study was to conduct a bio prospection of the antagonistic native bacteria of the north, south and central part of the coastal areas related to the common bean. A collection of 26 strains isolated from the rhizosphere of common bean plants showed high potential to control the growth of Sclerotinia, Fusarium and Rhizoctonia due to the production of both volatile and non-volatile organic compounds. Most of the strains were able to suppress fungal growth due to the presence of non-volatile organic compounds, such as hydrolytic enzymes, siderophores and antifungal lipopeptide production. Bacillus IcBac2.1 strain showed a remarkable ability to halt the majority of phytopathogens producing antifungal lipopeptides. The crude lipopeptides were soluble in polar solvents and remained stable at high temperatures and low pH. Strains were also able to inhibit fungal growth through volatile organic compounds. Alcaligenes TvPs2.4 and Pseudomonas TvPs1.6 showed the highest inhibition strength against the tested phytopathogens. Each strain produced 21 volatile organic compounds detected by SPME/GC-MS analysis. The compounds with the highest concentration were dimethyl disulfide and D-limonene. The 16S rRNA gene sequence confirmed that the strains were closely related to Bacillus, Paenibacillus, Achromobacter, Pseudomonas, Serratia and Alcaligenes.

Tratamiento exitoso de lipodermatoesclerosis aguda con doxiciclina: reporte de diez casos / Successful treatment of acute lipodermatosclerosis with doxycycline: report of ten cases

Resumen La doxiciclina, una tetraciclina semisintética de segunda generación, ampliamente usada para el tratamiento de patologías dermatológicas por sus propiedades antimicrobianas, ha demostrado en varios estudios experimentales sus acciones como un potente fármaco antiinflamatorio, aprobado por estas características por la FDA como una terapia complementaria en la periodontitis del adulto, así como en el tratamiento de la forma papulopustulosa de la rosácea. Se describen además en la literatura otras indicaciones para procesos inflamatorios, tales como, calcinosis cutis, vasculitis livedoide, patologías ampollares, entre otras. Se presenta una serie de 10 pacientes con lipodermatoesclerosis que presentaron una respuesta eficaz a su patología al recibir tratamiento con doxiciclina durante 3 meses, destacando de esta forma su eficacia terapéutica, accesibilidad y baja asociación a efectos adversos.

Abstract Doxycycline, a second generation semi-synthetic tetracycline, widely used for the treatment of dermatological diseases for its antimicrobial effects, has shown in many clinical studies its actions as a powerful anti-inflammatory drug. Approved by the FDA as a complementary therapy in adult periodontitis, and of the papulopustular form of rosacea. In addition, other indications for inflammatory processes are described in the literature, such as calcinosis cutis, livedoid vasculitis, blistering pathologies, among others. We present a series of 10 patients with lipodermatosclerosis who presented an effective response to their pathology when receiving treatment with doxycycline for 3 months. Its therapeutic efficacy, accessibility and low association with adverse effects are highlighted.

Laparoscopic Liver Resection: A South American Experience with 2887 Cases.

BACKGROUND: Laparoscopic liver resections (LLR) have been increasingly performed in recent years. Most of the available evidence, however, comes from specialized centers in Asia, Europe and USA. Data from South America are limited and based on single-center experiences. To date, no multicenter studies evaluated the results of LLR in South America. The aim of this study was to evaluate the experience and results with LLR in South American centers. METHODS: From February to November 2019, a survey about LLR was conducted in 61 hepatobiliary centers in South America, composed by 20 questions concerning demographic characteristics, surgical data, and perioperative results. RESULTS: Fifty-one (83.6%) centers from seven different countries answered the survey. A total of 2887 LLR were performed, as follows: Argentina (928), Brazil (1326), Chile (322), Colombia (210), Paraguay (9), Peru (75), and Uruguay (8). The first program began in 1997; however, the majority (60.7%) started after 2010. The percentage of LLR over open resections was 28.4% (4.4-84%). Of the total, 76.5% were minor hepatectomies and 23.5% major, including 266 right hepatectomies and 343 left hepatectomies. The conversion rate was 9.7%, overall morbidity 13%, and mortality 0.7%. CONCLUSIONS: This is the largest study assessing the dissemination and results of LLR in South America. It showed an increasing number of centers performing LLR with the promising perioperative results, aligned with other worldwide excellence centers.

The increased cost of ventral hernia recurrence: a cost analysis.

PURPOSE: Over 300,000 ventral hernia repairs (VHRs) are performed each year in the US. We sought to assess the economic burden related to ventral hernia recurrences with a focused comparison of those with the initial open versus laparoscopic surgery. METHODS: The Premier Alliance database from 2009 to 2014 was utilized to obtain patient demographics and comorbid indices, including the Charlson comorbidity index (CCI). Total hospital cost and resource expenses during index laparoscopic and open VHRs and subsequent recurrent repairs were also obtained. The sample was separated into laparoscopic and open repair groups from the initial operation. Adjusted and propensity score matched cost outcome data were then compared amongst groups. RESULTS: One thousand and seventy-seven patients were used for the analysis with a recurrence rate of 3.78 %. For the combined sample, costs were significantly higher during recurrent hernia repair hospitalization ($21,726 versus $19,484, p < 0.0001). However, for index laparoscopic repairs, both the adjusted total hospital cost and department level costs were similar during the index and the recurrent visit. The costs and resource utilization did not go up due to recurrence, even though these patients had greater severity during the recurrent visit (CCI score 0.92 versus 1.06; p = 0.0092). Using a matched sample, the total hospital recurrence cost was higher for the initial open group compared to laparoscopic group ($14,520 versus $12,649; p = 0.0454). CONCLUSIONS: Based on our analysis, need for recurrent VHR adds substantially to total hospital costs and resource utilization. Following initial laparoscopic repair, however, the total cost of recurrent repair is not significantly increased, as it is following initial open repair. When comparing the initial laparoscopic repair versus open, the cost of recurrence was higher for the prior open repair group.

Selection by mating competitiveness improves the performance of Anastrepha ludens males of the genetic sexing strain Tapachula-7.

The sexual performance of Anastrepha ludens males of the Tapachula-7 genetic sexing strain, produced via selection based on mating success, was compared with that of males produced without selection in competition with wild males. Mating competition, development time, survival, mass-rearing quality parameters and pheromone production were compared. The results showed that selection based on mating competitiveness significantly improved the sexual performance of offspring. Development time, survival of larvae, pupae and adults, and weights of larvae and pupae increased with each selection cycle. Differences in the relative quantity of the pheromone compounds (Z)-3-nonenol and anastrephin were observed when comparing the parental males with the F4 and wild males. The implications of this colony management method on the sterile insect technique are discussed.

Antipredator behavior of the new mass-reared unisexual strain of the Mexican Fruit Fly.

Tephritid pests controlled through the sterile insect technique (SIT) are mass-reared and subsequently released in affected areas. Several quality parameters are currently used to test adults, but none take into account interactions with a predator. When sterile males are released in the field, they will need to avoid predators until they reach sexual maturity and survive long enough to mate with wild females. Spiders are one of the most common predators that flies may encounter in release sites. In this study, we evaluated the antipredator behavior of a mass-reared sterile unisexual strain ('Tapachula-7') of the Mexican fruit fly Anastrepha ludens (Diptera: Tephritidae) against their spider predators. We sampled spiders in citrus trees to determine which families could be more common. We established the baseline activity rates of sterile Tapachula-7 (Tap-7) flies in comparison with wild flies. We also tested the behavior of the fertile and sterile bisexual strain and wild flies against hunting spiders (Family Salticidae) and orb building spiders (Family Tetragnathidae). We recorded 18 spider families, with Salticidae being the most dominant. Tap-7 flies diminished their activity in comparison with wild males at 1800 h but showed similar activity levels earlier in the day. When exposed to orb-web spiders (Leucauge venusta), Tap-7, fertile and sterile males from the bisexual strain had similar rates of survival, but Tap-7 males showed lower survival than wild males. Against hunting spiders (Phidippus audax), wild males had higher probability of defensive wing displays, but there was no difference in spider attack rates. In general, sterile Tap -7 males performed as well as males from the bisexual strain, although they had lower survival than wild males. This could be due to either mass-rearing and/or irradiation effects. We recommend the use of the defensive wing display behavior as a quality parameter and propose a rapid and effective method to evaluate fly activity. The efficiency of SIT will be improved if released sterile males have the same antipredator repertoire as their wild counterparts.

Towards a full integration of vertically aligned silicon nanowires in MEMS using silane as a precursor.

Silicon nanowires present outstanding properties for electronics, energy, and environmental monitoring applications. However, their integration into microelectromechanical systems (MEMS) is a major issue so far due to low compatibility with mainstream technology, which complicates patterning and controlled morphology. This work addresses the growth of 〈111〉 aligned silicon nanowire arrays fully integrated into standard MEMS processing by means of the chemical vapor deposition-vapor liquid solid method (CVD-VLS) using silane as a precursor. A reinterpretation of the galvanic displacement method is presented for selectively depositing gold nanoparticles of controlled size and shape. Moreover, a comprehensive analysis of the effects of synthesis temperature and pressure on the growth rate and alignment of nanowires is presented for the most common silicon precursor, i.e., silane. Compared with previously reported protocols, the redefined galvanic displacement together with a silane-based CVD-VLS growth methodology provides a more standard and low-temperature (<650 °C) synthesis scheme and a compatible route to reliably grow Si nanowires in MEMS for advanced applications.

Loss of Tribbles pseudokinase-3 promotes Akt-driven tumorigenesis via FOXO inactivation.

Tribbles pseudokinase-3 (TRIB3) has been proposed to act as an inhibitor of AKT although the precise molecular basis of this activity and whether the loss of TRIB3 contributes to cancer initiation and progression remain to be clarified. In this study, by using a wide array of in vitro and in vivo approaches, including a Trib3 knockout mouse, we demonstrate that TRIB3 has a tumor-suppressing role. We also find that the mechanism by which TRIB3 loss enhances tumorigenesis relies on the dysregulation of the phosphorylation of AKT by the mTORC2 complex, which leads to an enhanced phosphorylation of AKT on Ser473 and the subsequent hyperphosphorylation and inactivation of the transcription factor FOXO3. These observations support the notion that loss of TRIB3 is associated with a more aggressive phenotype in various types of tumors by enhancing the activity of the mTORC2/AKT/FOXO axis.

Estrés postraumático en escolares a 8 meses del 27F / Post-traumatic stress disorder in children eight months after february 27, 2010

Introduction: there are several epidemiological studies regarding the incidence of post-traumatic stress disorder (PTSD) in children exposed to natural disasters. Objective: to describe the prevalence of PTSD in a school-age population in a coastal town from the Maule Region, 8 months after the earthquake/tsunami in february 2010, and to compare differences among PTSD groups of symptom (re-experiencing, avoidance and activation) according to demographic variables such as age, grade, gender and family type. Methodology: the Child PTSD Symptom Scale (CPSS), validated in Chile in 2009, was used in 89 children between 3rd and 6th grade, corresponding to 94.7 percent of the children enrolled in the local school in such classes. Data are analyzed by gender, age, grade and type of family. 89 surveys were applied, 59.6 percent were male and 40.4 percent female aged 8-13. Results: 40.4 percent of children had symptoms consistent with PTSD, with higher incidence in women and younger children; the most significant association among women was age. Both groups (women and young children) presented the highest scores on all group of symptoms. There were no differences by type of family. Conclusions: the incidence of PTSD measured by CPSS scale in the study population was 40.4 percent, considered to be among the highest percentages reported in the international literature.

Introducción: existen diversos datos epidemiológicos respecto a la incidencia de Trastorno por Estrés Pos-traumático (TEPT) en niños expuestos a desastres naturales. Objetivo: describir la prevalencia de TEPT en una población infantil escolarizada de una localidad costera de la Región del Maule después de 8 meses de ocurrido el terremoto/maremoto de febrero/2010, y comparar las diferencias entre grupos de síntomas del TEPT (reexperimentación, evitación y activación) según variables demográficas, como edad, curso, sexo y tipo de familia. Metodología: se aplicó la escala Child PTSD Symptom Scale (CPSS) validada en Chile el año 2009, a 89 niños de 3° a 6° básico lo que corresponde al 94,7 por ciento de los niños matriculados en la escuela de la localidad en dichos cursos. Se analizan los datos según sexo, edad, curso y tipo de familia. Se aplicaron 89 encuestas, 59,6 por ciento eran varones y 40,4 por ciento mujeres de 8 a 13 años de edad. Resultados: el 40,4 por ciento del total de niños tuvo una evaluación compatible con TEPT, con mayor incidencia en mujeres y niños de menor edad, siendo la edad un factor de asociación significativa en las mujeres. Ambos grupos (mujeres y niños más pequeños) presentaron mayores puntajes en todos los grupos sintomáticos. No se encontraron diferencias según el tipo de familia. Conclusiones: la incidencia de TEPT medida a través de la escala CPSS en la población estudiada fue de 40.4 por ciento, encontrándose entre las más altas reportadas en la bibliografía internacional.

Intervención de salud mental en niños expuestos a desastre natural / Mental health intervention in children exposed to natural disasters

Introduction: this study is part of the mental health intervention, conducted by a child psychiatry team for children exposed to the february 2010 earthquake/tsunami in a community of the VII Region that was strongly affected by the natural disaster. Objective: to describe the intervention and evaluate the effectiveness of the strategies implemented for both children and teachers. Methodology: interventions are described and classified in three categories. (1) Case report and child care consulting, referred by their teacher. (2) Psychoeducational workshops for teachers of the intervened school. (3) Self-Care day aimed at professionals of the same school. The evaluation is done through an anonymous survey designed to measure the effectiveness of the intervention. Results: 33 children were evaluated and treated, the most common diagnoses were adaptive disorders (8/33) and ADHD (11/33), and only 3 patients met the criteria for post-traumatic stress disorder (PTSD). Intervention implementation included psychoeducation for parents (100 percent), coordination with schools and local health network (100 percent), counseling (70 percent) and drug prescription (45 percent). Only 45 percent of the cases evaluated had symptoms triggered or exacerbated by the earthquake/tsunami. Regarding teacher evaluation (N: 11), 100 percent described the intervention as "very good". 90 percent considered it appropriate to the needs at the moment and as a contribution to their educational work. Conclusions: after events of this nature, many interventions take place to support the affected population. It is important to have more scientific information about the effectiveness of such interventions to prevent the development of post-traumatic psychopathology.

Introducción: este trabajo forma parte de la intervención de salud mental, realizada por un equipo de psiquiatría infantil para niños expuestos al terremoto/maremoto de febrero de 2010, en una comunidad de la VII Región fuertemente afectada por el desastre natural. Objetivos: describir la intervención realizada y evaluar la efectividad de las estrategias implementadas tanto a niños como a profesores. Metodología: se describe las intervenciones realizadas, clasificadas en 3 categorías: 1) Consultoria de casos clínicos y atención de niños derivados por sus profesores. 2) Talleres psicoeducativos a profesores de la escuela intervenida. 3) Jornada de autocuidado, dirigida a los profesionales de la misma escuela. La evaluación se realiza a través de encuesta anónima a los profesores diseñada para cuantificar la efectividad de la intervención. Resultados: se evaluaron y trataron 33 niños, los diagnósticos más frecuentes fueron Trastornos adaptativos (8/33) y Déficit atencional (11/33); sólo 3 casos cumplían criterios de Trastorno por Estrés Postraumático(TEPT). Las intervenciones utilizadas incluyeron psicoeducación a padres (100 por ciento), coordinación con colegios y red de salud municipal (100 por ciento), apoyo psicológico (70 por ciento) y farmacológico (45 por ciento). Sólo en el 45 por ciento de los casos evaluados la sintomatología se había desencadenado o agravado con el terremoto/maremoto. En relación a la evaluación de profesores (n: 11), 100 por ciento consideró la intervención como "muy buena". Un 90 por ciento la consideró adecuada a las necesidades y constituyó un aporte a su quehacer educativo. Conclusiones: tras eventos como éste, se realizan variadas intervenciones de apoyo a la población afectada. Es importante contar con mayor información científica acerca de la efectividad de dichas intervenciones para prevenir el desarrollo de psicopatología postraumática.

Prediction models of donor arrest and graft utilization in liver transplantation from maastricht-3 donors after circulatory death.

Shortage of organs for transplantation has led to the renewed interest in donation after circulatory-determination of death (DCDD). We conducted a retrospective analysis (2001-2009) and a subsequent prospective validation (2010) of liver Maastricht-Category-3-DCDD and donation-after-brain-death (DBD) offers to our program. Accepted and declined offers were compared. Accepted DCDD offers were divided into donors who went on to cardiac arrest and those who did not. Donors who arrested were divided into those producing grafts that were transplanted or remained unused. Descriptive comparisons and regression analyses were performed to assess predictor models of donor cardiac arrest and graft utilization. Variables from the multivariate analysis were prospectively validated. Of 1579 DCDD offers, 621 were accepted, and of these, 400 experienced cardiac arrest after withdrawal of support. Of these, 173 livers were transplanted. In the DCDD group, donor age < 40 years, use of inotropes and absence of gag/cough reflexes were predictors of cardiac arrest. Donor age >50 years, BMI >30, warm ischemia time >25 minutes, ITU stay >7 days and ALT ≥ 4× normal rates were risk factors for not using the graft. These variables had excellent sensitivity and specificity for the prediction of cardiac arrest (AUROC = 0.835) and graft use (AUROC = 0.748) in the 2010 prospective validation. These models can feasibly predict cardiac arrest in potential DCDDs and graft usability, helping to avoid unnecessary recoveries and healthcare expenditure.

Two-step activation of FOXO3 by AMPK generates a coherent feed-forward loop determining excitotoxic cell fate.

Cerebral ischemia and excitotoxic injury induce transient or permanent bioenergetic failure, and may result in neuronal apoptosis or necrosis. We have previously shown that ATP depletion and activation of AMP-activated protein kinase (AMPK) during excitotoxic injury induces neuronal apoptosis by transcription of the pro-apoptotic BH3-only protein, Bim. AMPK, however, also exerts pro-survival functions in neurons. The molecular switches that determine these differential outcomes are not well understood. Using an approach combining biochemistry, single-cell imaging and computational modeling, we here demonstrate that excitotoxic injury activated the bim promoter in a FOXO3-dependent manner. The activation of AMPK reduced AKT activation, and led to dephosphorylation and nuclear translocation of FOXO3. Subsequent mutation studies indicated that bim gene activation during excitotoxic injury required direct FOXO3 phosphorylation by AMPK in the nucleus as a second activation step. Inhibition of this phosphorylation prevented Bim expression and protected neurons against excitotoxic and oxygen/glucose deprivation-induced injury. Systems analysis and computational modeling revealed that these two activation steps defined a coherent feed-forward loop; a network motif capable of filtering any effects of short-term AMPK activation on bim gene induction. This may prevent unwanted AMPK-mediated Bim expression and apoptosis during transient or physiological bioenergetic stress.

Regulation of the phosphatase calcineurin by insulin-like growth factor I unveils a key role of astrocytes in Alzheimer's pathology.

Whether insulin-like growth factor I (IGF-I) signaling in Alzheimer's disease (AD) is beneficial or detrimental remains controversial. We now show that a competitive regulation by IGF-I of the phosphatase calcineurin in reactive, but not in quiescent astrocytes drives Alzheimer's pathology. Calcineurin de-phosphorylates the transcription factor Foxo3 in response to tumor necrosis factor-α (TNFα), an inflammatory cytokine increased in AD, activating nuclear factor-κB (NFκB) inflammatory signaling in astrocytes. In turn, IGF-I inactivates and displaces Foxo3 from calcineurin in TNFα-stimulated astrocytes by recruiting the transcription factor peroxisome proliferator-activated receptor-γ, and NFκB signaling is inhibited. This antagonistic mechanism reversibly drives the course of the disease in AD mice, even at advanced stages. As hallmarks of this calcineurin/Foxo3/NFκB pathway are present in human AD brains, treatment with IGF-I may be beneficial by antagonizing it.

Silicon-based microfabricated microbial fuel cell toxicity sensor.

Microbial fuel cells (MFCs) have been used for several years as biosensors for measuring environmental parameters such as biochemical oxygen demand and water toxicity. The present study is focused on the detection of toxic matter using a novel silicon-based MFC. Like other existing toxicity sensors based on MFCs, this device is capable of detecting the variation on the current produced by the cell when toxic compounds are present in the medium. The MFC approach presented in this work aims to obtain a simple, compact and planar device for its further application as a biosensor in the design and fabrication of equipment for toxicity monitoring. It consists on a proton exchange membrane placed between two microfabricated silicon plates that act as current collectors. An array of square 80 µm × 80 µm vertical channels, 300 µm deep, have been defined trough the plates over an area of 6 mm × 6 mm. The final testing assembly incorporates two perspex pieces positioned onto the plates as reservoirs with a working volume of 144 µL per compartment. The operation of the microdevice as a direct electron transfer MFC has been validated by comparing its performance against a larger scale MFC, run under the same conditions. The device has been tested as a toxicity sensor by setting it at a fixed current while monitoring changes in the output power. A drop in the power production is observed when a toxic compound is added to the anode compartment. The compact design of the device makes it suitable for its incorporation into measurement equipment either as an individual device or as an array of sensors for high throughput processing.

A new generation of X ray irradiators for insect sterilization.

Recent fears of terrorism have provoked an increase in delays and denials of transboundary shipments of radioisotopes. This represents a serious constraint to sterile insect technique (SIT) programs around the world as they rely on the use of ionizing radiation from radioisotopes for insect sterilization. To validate a novel X ray irradiator, a series of studies on Ceratitis capitata (Wiedemann) and Anastrepha fraterculus (Wiedemann) (Diptera: Tephritidae) were carried out, comparing the relative biological effectiveness (RBE) between X rays and traditional gamma radiation from 60Co. Male C. capitata pupae and pupae of both sexes of A. fraterculus, both 24-48 h before adult emergence, were irradiated with doses ranging from 15 to 120 Gy and 10-70 Gy, respectively. Estimated mean doses of 91.2 Gy of X and 124.9 Gy of gamma radiation induced 99% sterility in C. capitata males. Irradiated A. fraterculus were 99% sterile at approximately 40-60 Gy for both radiation treatments. Standard quality control parameters and mating indices were not significantly affected by the two types of radiation. The RBE did not differ significantly between the tested X and gamma radiation, and X rays are as biologically effective for SIT purposes as gamma rays are. This work confirms the suitability of this new generation of X ray irradiators for pest control programs that integrate the SIT.

Tricobezoar gástrico e intestinal en adolescente femenina de 15 años: a propósito de un caso clínico IVSS "Dr. Tulio Carnevali Salvatierra" Mérida-Venezuela / Gastric and intestinal trichobezoar female teenager about 15 years: a purpose of case clinical in IVSS Dr. Tulio Carnevali Salvatierra

Los tricobezoar son recolecciones de material ingerido (pelos, fibras) que se acumulasn en estómago e intestino. Se originan de la tricotilomanía más tricofagia, cuando el tricobezoar se acumula en duodeno recibe el nombre de Sídrome de Rapunzel, más frecuente en el sexo femenino. Adolescente de 15 años, quien presentó dolor abdominal de aparición insidiosa acompañada de naúseas y vómitos incontables que se irradian a hipocondrio y fosa iliaca izquierda, su evolución fue torpida presentando signos de irritación peritoneal. Se realiza laparatomía exploradora hallándose tumor de contenido de pelo a nivel del Ángulo de Treitz, y cámara gástrica. Siendo egresada y referida al servicio de psiquiatría infanto-juvenil.