Effect of an Albumin Infusion Treatment Protocol on Delayed Cerebral Ischemia and Relevant Outcomes in Patients with Subarachnoid Hemorrhage.

BACKGROUND: An institutional management protocol for patients with subarachnoid hemorrhage (SAH) based on initial cardiac assessment, permissiveness of negative fluid balances, and use of a continuous albumin infusion as the main fluid therapy for the first 5 days of the intensive care unit (ICU) stay was implemented at our hospital in 2014. It aimed at achieving and maintaining euvolemia and hemodynamic stability to prevent ischemic events and complications in the ICU by reducing periods of hypovolemia or hemodynamic instability. This study aimed at assessing the effect of the implemented management protocol on the incidence of delayed cerebral ischemia (DCI), mortality, and other relevant outcomes in patients with SAH during ICU stay. METHODS: We conducted a quasi-experimental study with historical controls based on electronic medical records of adults with SAH admitted to the ICU at a tertiary care university hospital in Cali, Colombia. The patients treated between 2011 and 2014 were the control group, and those treated between 2014 and 2018 were the intervention group. We collected baseline clinical characteristics, cointerventions, occurrence of DCI, vital status after 6 months, neurological status after 6 months, hydroelectrolytic imbalances, and other SAH complication. Multivariable and sensitivity analyses that controlled for confounding and considered the presence of competing risks were used to adequately estimate the effects of the management protocol. The study was approved by our institutional ethics review board before study start. RESULTS: One hundred eighty-nine patients were included for analysis. The management protocol was associated with a reduced incidence of DCI (hazard ratio 0.52 [95% confidence interval 0.33-0.83] from multivariable subdistribution hazards model) and hyponatremia (relative risk 0.55 [95% confidence interval 0.37-0.80]). The management protocol was not associated with higher hospital or long-term mortality, nor with a higher occurrence of other unfavorable outcomes (pulmonary edema, rebleeding, hydrocephalus, hypernatremia, pneumonia). The intervention group also had lower daily and cumulative administered fluids compared with historic controls (p < 0.0001). CONCLUSIONS: A management protocol based on hemodynamically oriented fluid therapy in combination with a continuous albumin infusion as the main fluid during the first 5 days of the ICU stay appears beneficial for patients with SAH because it was associated with reduced incidence of DCI and hyponatremia. Proposed mechanisms include improved hemodynamic stability that allows euvolemia and reduces the risk of ischemia, among others.

Eventos tromboembólicos sintomáticos después de artroscopia de rodilla / Symptomatic thromboembolic events after knee arthroscopy

Introducción: La artroscopia de rodilla es usualmente un procedimiento seguro con pocas complicaciones. El objetivo de este estudio es calcular la incidencia de eventos tromboembólicos sintomáticos: trombosis venosa profunda y tromboembolismo pulmonar, asociados a artroscopia de rodilla y los posibles factores de riesgo relacionados. Materiales and Métodos: Cohorte retrospectiva que incluyó todos los pacientes llevados a artroscopia de rodilla entre Enero 2011 y Diciembre 2015 en un hospital universitario. El seguimiento fue de 30 días después de la cirugía. Se registraron datos demográficos, los eventos de interés, el tipo de cirugía y los posibles factores de riesgo. Resultados: 1,097 artroscopias de rodilla se hicieron en los 5 años. El 100% tuvieron seguimiento de 10 días mínimo, 90.5% alcanzaron el seguimiento de 30 días. El tiempo promedio de seguimiento fue 15.1 meses. El porcentaje de eventos tromboembólicos fue de 1.4% (n = 14). Se encontraron dos factores de riesgo asociados: eventos tromboembólicos previos (p = 0.013) y uso de anticoagulantes previo a la cirugía (p=0.001). La edad promedio fue mayor en los pacientes con eventos tromboembólicos comparado con los que no tuvieron eventos (58 vs 46 años), p = 0.009. Discusión: La incidencia de eventos tromboembólicos sintomáticos tras artroscopia de rodilla es bajo. El uso rutinaio de profilaxis tromboembólica no se recomienda. En los pacientes con historia de eventos tromboembólicos previos o que estpan anticoagulados en el momento de la cirugía, si se recomienda. Además, en los pacientes mayores de 50 años, debería considerarse su uso. Nivel de Evidencia: III, Estudio de Cohorte Restrospectiva.

Introduction: Knee arthroscopy is usually a safe procedure with few complications. The objective of this study is to calculate the incidence of symptomatic thromboembolic events: deep vein thrombosis and pulmonary thromboembolism, associated with knee arthroscopy and the possible related risk factors. Materials and Methods: Retrospective cohort that included all patients undergoing knee arthroscopy between January 2011 and December 2015 at a university hospital. Follow-up was 30 days after surgery. Demographic data, events of interest, type of surgery and possible risk factors were recorded. Results: 1,097 knee arthroscopies were performed in the 5 years. 100% had follow-up of at least 10 days, 90.5% reached follow-up of 30 days. The average follow-up time was 15.1 months. The percentage of thromboembolic events was 1.4% (n = 14). Two associated risk factors were found: previous thromboembolic events (p = 0.013) and use of anticoagulants prior to surgery (p = 0.001). The average age was higher in patients with thromboembolic events compared to those without events (58 vs 46 years), p = 0.009. Discussion: The incidence of symptomatic thromboembolic events after knee arthroscopy is low. The routine use of thromboembolic prophylaxis is not recommended. In patients with a history of previous thromboembolic events or who are on anticoagulation at the time of surgery, if recommended. Furthermore, its use should be considered in patients over 50 years of age. Level of Evidence: III, Retrospective Cohort Study.

Validación de la versión en español para Colombia de la escala ASES / Validation of the Spanish version for Colombia of the ASES (American Shoulder and Elbow Surgeons) score

Introducción: La escala de ASES (American Shoulder and Elbow Surgeons) es una herramienta de medición funcional para evaluar problemas alrededor del hombro. Desarrollada en inglés, se utiliza desde 1993 en su idioma original. Está conformada por datos demográficos, una sección de evaluación médica y otra sección autodiligenciada por el paciente. El objetivo de este estudio es la traducción al español de Colombia de la escala ASES y su validación. Materiales y métodos: Estudio de traducción al español y validación de la escala de ASES. Se incluyeron pacientes con patología en el hombro entre diciembre de 2015 y marzo de 2016. Los pacientes respondieron la escala en dos ocasiones, con diferencia de 7-14 días entre una y otra. Se calculó el alfa de Cronbach (AC) y el coeficiente de correlación intraclase (CCI) para determinar la consistencia interna y la confiabilidad test-retest. Se utilizó el gráfico de Bland-Altman para determinar el error de medición. Resultados: Sesenta y cinco pacientes con patología de hombro fueron incluidos en el estudio, la lesión del manguito rotador (27%) fue la patología más frecuente. El alfa de Cronbach fue de 0.76 y el coeficiente de correlación intraclase fue de 0.74. El gráfico de Bland-Altman determinó la ausencia de error sistemático. Conclusiones: La versión en español para Colombia de la escala de ASES es una herramienta válida y confiable para evaluar calidad de vida en pacientes con patología en el hombro y puede ser aplicada en pacientes de habla hispana en Colombia.

Introduction: The ASES (American Shoulder and Elbow Surgeons) score, is a measurement tool developed in English for evaluating function around the shoulder. It has been used since 1993 in its original language. It is made up of demographic data, a medical evaluation section and another section self-completed by the patient. The aim if the study was to translate the ASES score to Colombian Spanish and validate it. Materials and methods: This is a translation and validation study of Spanish of the ASES score. Patients with shoulder problems were included between December 2015 and March 2016. Patients answered the score twice, during the first consultation and again 7-14 days after. Statistical analysis was performed with Stata 13.0. Cronbach's alpha (AC) and intraclass correlation coefficient (ICC) were calculated to determine internal consistency and test-retest reliability. The Bland-Altman plot was used to determine the measurement error. Results: Sixty-five patients were included in the study. The first cause of consultation was rotator cuff tear (27%). Cronbach's alpha was 0.76 and the intraclass correlation coefficient was 0.74. The Bland-Altman showed absence of systematic error. Conclusion: The Colombian Spanish version of the ASES score is a valid and reliable tool to assess the quality of life in patients with shoulder pathology and can be used in Colombia on Spanish speaking patients.

Broad Kinase Inhibition Mitigates Early Neuronal Dysfunction in Tauopathy.

Tauopathies are a group of more than twenty known disorders that involve progressive neurodegeneration, cognitive decline and pathological tau accumulation. Current therapeutic strategies provide only limited, late-stage symptomatic treatment. This is partly due to lack of understanding of the molecular mechanisms linking tau and cellular dysfunction, especially during the early stages of disease progression. In this study, we treated early stage tau transgenic mice with a multi-target kinase inhibitor to identify novel substrates that contribute to cognitive impairment and exhibit therapeutic potential. Drug treatment significantly ameliorated brain atrophy and cognitive function as determined by behavioral testing and a sensitive imaging technique called manganese-enhanced magnetic resonance imaging (MEMRI) with quantitative R1 mapping. Surprisingly, these benefits occurred despite unchanged hyperphosphorylated tau levels. To elucidate the mechanism behind these improved cognitive outcomes, we performed quantitative proteomics to determine the altered protein network during this early stage in tauopathy and compare this model with the human Alzheimer's disease (AD) proteome. We identified a cluster of preserved pathways shared with human tauopathy with striking potential for broad multi-target kinase intervention. We further report high confidence candidate proteins as novel therapeutically relevant targets for the treatment of tauopathy. Proteomics data are available via ProteomeXchange with identifier PXD023562.

Encuadres Mediáticos del Perdón y la Reconciliación en el Contexto del Conflicto Armado Colombiano / Media Framings of Forgiveness and Reconciliation in the Context of the Colombian Armed Conflict / Enquadramentos Midiáticos do Perdão e da Reconciliação no Contexto do Conflito Armado Colombiano

Resumen Debido a su duración e intensidad, el conflicto armado colombiano puede ser analizado como un conflicto intratable. La intratabilidad involucra el desarrollo del ethos del conflicto (EDC), un conjunto de creencias sociales compartidas por la mayoría de los miembros de la sociedad, de manera que es usualmente exhibido en el discurso mediático. Este estudio describe, a través de la lexicometría unidimensional y multidimensional, cómo el EDC permeó el discurso de cuatro de los principales medios de comunicación en Colombia (El Tiempo, El Espectador, Noticias Caracol, Noticias RCN); específicamente, cómo el EDC caracterizó el encuadre del perdón y la reconciliación durante el proceso de paz entre el Gobierno colombiano y las FARC-EP (2012-2017). Los resultados sugieren que el EDC en Colombia se transformó con los diálogos de paz, probablemente promoviendo una orientación hacia la paz. Sin embargo, simultáneamente, algunas de las creencias del EDC que contribuyen a la intratabilidad también fueron presentadas en el discurso mediático.

Abstract Given its duration and intensity, the Colombian armed conflict can be analyzed as an intractable conflict. Intractability involves the development of an ethos of conflict (EOC), a set of social beliefs shared by most members of society, which is usually exhibited in media discourse. Using unidimensional and multidimensional lexicometry, this study describes how the EOC permeated the discourse of four of Colombia's main means of communication (El Tiempo, El Espectador, Noticias Caracol, Noticias RON), and, specifically, how the EOC characterized the framing of forgiveness and reconciliation during the peace process between the Colombian Government and the FARC-EP (2012-2017). The results suggest that the EOC in Colombia was transformed with the peace dialogues, probably fostering an orientation toward peace. Nevertheless, some of the beliefs of the EOC that contribute to intractability were also simultaneously present in media discourse.

Resumo Devido à sua duração e intensidade, o conflito armado colombiano pode ser analisado como um conflito intratável. A intratabilidade envolve o desenvolvimento do ethos do conflito (EDC), um conjunto de crenças sociais partilhado pela maioria dos membros da sociedade, de maneira que é usualmente exibido no discurso midiático. Este estudo descreve, por meio da lexicometria uni e multidimensional, como o EDC permeou o discurso de quatro dos principais meios de comunicação na Colômbia (El Tiempo, El Espectador, Noticias Caracol, Noticias RON); especificamente, como o EDC caracterizou o enquadramento do perdão e da reconciliação durante o processo de paz entre o governo colombiano e as Forças Armadas Revolucionárias da Colômbia (FARC-EP - 2012-2017). Os resultados indicam que o EDC na Colômbia se transformou com os diálogos de paz, provavelmente promovendo uma orientação para a paz. Contudo, de forma simultânea, algumas das crenças do ED C que contribuem para a intratabilidade também foram apresentadas no discurso midiático.

Tau-mediated dysregulation of RNA: Evidence for a common molecular mechanism of toxicity in frontotemporal dementia and other tauopathies.

Frontotemporal dementias (FTDs) encompass several disorders commonly characterized by progressive frontotemporal lobar degeneration and dementia. Pathologically, TDP-43, FUS, dipeptide repeats, and tau constitute the protein aggregates in FTD, which in turn coincide with heterogeneity in clinical variants. The underlying molecular etiology explaining the formation of each type of protein aggregate remains unclear; however, dysregulated RNA metabolism rises as a common pathogenic factor. Alongside with TDP-43 and FUS, which bind to and regulate RNA dynamics, emerging data suggest that tau may also regulate RNA metabolism and translation. The complex mechanisms that drive translational selectivity in turn regulate the broad clinical presentation of FTDs. Here, we focus on the enigmatic relationship between tau and RNA and review the mechanisms of tau-mediated dysregulation of RNA in tauopathies such as FTD.

Control de daño y estabilización temprana definitiva en el tratamiento del paciente politraumatizado / Damage control and definitive early stabilization in the treatment of polytrauma patient

Introducción En este estudio se busca evaluar los desenlaces de los pacientes con traumatismo múltiple, fractura de pelvis o de huesos largos, que recibieron tratamiento con estabilización definitiva de sus fracturas en las primeras 48 horas y después de 48 horas del episodio traumático. Materiales y métodos Estudio de tipo cohorte retrospectiva que incluye a todos los pacientes politraumatizados con fracturas de pelvis o de huesos largos, que ingresaron en una institución de salud de nivel IV entre enero de 2012 y junio de 2016. Se evaluaron mortalidad, infección, tiempo de hospitalización y complicaciones. Además, se calculó el índice de gravedad del traumatismo (ISS) y el nuevo índice (NISS) de cada paciente. Resultados Ingresaron 220 pacientes, con predominio masculino (82%). La nueva escala del índice de gravedad del traumatismo (NISS) registró una mediana 4,5 puntos mayor a la mediana de la escala de ISS tradicional (34 frente a 29,5; p = 0,016). Los pacientes con fijación temprana definitiva tuvieron menor tiempo de hospitalización (p = 0,008) y menos complicaciones (p = 0,022). Discusión La escala tradicional del ISS podría subestimar la gravedad del traumatismo en los pacientes politraumatizados al no permitir que un mismo sistema registre más de una afectación independiente de cuán comprometido haya estado. El control del daño se puede reservar para los pacientes más graves, que no se compensan tras la reanimación inicial, con valores de ISS y NISS por encima de 36 y 40 puntos, respectivamente. Nivel de evidencia clínica Nivel II.

Background The aim of this study is to evaluate patients with multiple trauma and pelvis or long bones fractures that were treated with definite fixation of their fractures in the first 48 hours of trauma and after 48 hours. Methods Retrospective cohort study that includes all polytraumatized patients with pelvis or long bones fracture, that were admitted to a first level trauma center between January 2012 and June 2016. Outcomes evaluated were mortality, infection, hospital stay length and complications. Injury severity score (ISS) and new injury severity score (NISS) were calculated for every patient. Results A total of 220 patients were included, with male predominance (82%). The new injury severity score had a median that was 4.5 points higher than traditional ISS (34 vs 29.5, p=0.016). Patients with early total care had shorter hospital stay lengths (p=0.008) and lower rate of complications (p=0.022). Discussion The traditional injury severity score might underestimate the severity of trauma because each system can only be registered once independently of how affected it is. Damage control can be reserved for the most seriously injured patients, that do not respond properly to initial reanimation, with ISS values higher than 36 points and NISS values greater than 40 points. Evidence level IV.

Analysis of combat casualties admitted to the emergency department during the negotiation of the comprehensive Colombian process of peace / Análisis de los soldados heridos en combate admitidos al departamento de emergencias durante la negociación del proceso de paz en Colombia

Abstract Aim: Our objective was to describe the variations in casualties admitted to the emergency department during the period of the negotiation of the comprehensive peace agreement in Colombia between 2011 and 2016. Methods: A retrospective study of all hostile military casualties managed at a regional Level I trauma center from January 2011 to December 2016. Patients were subsequently divided into two groups: those seen before the declaration of the process of peace truce (November 2012) and those after (negotiation period). Variables were compared with respect to periods Results: A total of 448 hostile casualties were registered. There was a gradual decline in the number of admissions to the emergency department during the negotiation period. The number of soldiers suffering blast and rifle injuries also decreased over this period. In 2012 there were nearly 150 hostile casualties' admissions to the ER. This number decreased to 84, 63, 32 and 6 in 2013, 2014, 2015 and 2016 respectively. Both, the proportion of patients with an ISS ≥9 and admitted to the intensive care unit were significantly higher in the period before peace negotiation. From August to December/2016 no admissions of war casualties were registered. Conclusion: We describe a series of soldiers wounded in combat that were admitted to the emergency department before and during the negotiation of the Colombian process of peace. Overall, we found a trend toward a decrease in the number of casualties admitted to the emergency department possibly in part, as a result of the period of peace negotiation.

Resumen Objetivo: Describir las variaciones en los soldados heridos en combate admitidos al departamento de emergencias durante el periodo de negociación del proceso de paz colombiano entre el 2011 y el 2016. Métodos: Estudio retrospectivo de todos los soldados heridos en combate que fueron manejados en un centro de trauma desde Enero del 2011 a Diciembre del 2016. Los pacientes se dividieron en dos grupos: aquellos que ingresaron al departamento de emergencias antes de la tregua del proceso de paz (Noviembre 2012) y aquellos que ingresaron durante la negociación. Los grupos se compararon con respecto a los periodos de tiempo. Resultados: Un total de 448 soldados heridos en combate fueron incluidos. Hubo una disminución gradual en el número de admisiones durante el periodo de negociación. Además, el número de soldados que sufrieron heridas por explosiones y fusiles disminuyó durante este periodo. En el 2012 se registraron 150 soldados heridos en combate. Este número disminuyó a 84, 63, 32 y 6 en los años 2013, 2014, 2015 y 2016 respectivamente. La proporción de pacientes con un ISS ≥9 y la proporción de admitidos a la unidad de cuidado intensivo fueron significativamente mayores en el periodo antes de la negociación. Desde Agosto a Diciembre/2016 no se registraron admisiones. Conclusión: Este estudio describe una disminución gradual en el número de soldados heridos en combate admitidos al departamento de emergencia en un periodo de 6 años. Este fenómeno pudo deberse al periodo de negociación del proceso de paz.

Experience in the use of non-pneumatic anti-shock garment (NASG) in the management of postpartum haemorrhage with hypovolemic shock in the Fundación Valle Del Lili, Cali, Colombia.

BACKGROUND: The aim of this case series is to describe the experience of using the non-pneumatic anti-shock garment (NASG) in the management of severe Postpartum hemorrhage (PPH) and shock, and the value of implementing this concept in high-complexity obstetric hospitals. METHODS: Descriptive case series of 77 women that received NASG in the management of PPH with severe hypovolemic shock from June 2014 to December 2015. Vital signs, shock index (SI), the lactic acid value and the base deficit were compared before and after NASG application. RESULTS: Fifty-six (77%) women had an SI > 1.1 at the time shock management was initiated; 96% had uterine atony. All women received standard does of uterotonics. The average time between the birth and NASG applications was 20 min. Forty-eight percent of women recovered haemodynamic variables in the first hour and 100% within the first 6 h; 100% had a SI < 1.0 in the first hour. The NASG was not removed until definitive control of bleeding was achieved, with an average time of use of 24 h. There were no mortalities. CONCLUSIONS: In this case series of women in severe shock, the NASG was an effective management device for the control of severe hypovolemic shock. It should be considered a first-line option for shock management.

Analysis of combat casualties admitted to the emergency department during the negotiation of the comprehensive Colombian process of peace.

AIM: Our objective was to describe the variations in casualties admitted to the emergency department during the period of the negotiation of the comprehensive peace agreement in Colombia between 2011 and 2016. METHODS: A retrospective study of all hostile military casualties managed at a regional Level I trauma center from January 2011 to December 2016. Patients were subsequently divided into two groups: those seen before the declaration of the process of peace truce (November 2012) and those after (negotiation period). Variables were compared with respect to periods. RESULTS: A total of 448 hostile casualties were registered. There was a gradual decline in the number of admissions to the emergency department during the negotiation period. The number of soldiers suffering blast and rifle injuries also decreased over this period. In 2012 there were nearly 150 hostile casualties' admissions to the ER. This number decreased to 84, 63, 32 and 6 in 2013, 2014, 2015 and 2016 respectively. Both, the proportion of patients with an ISS ≥9 and admitted to the intensive care unit were significantly higher in the period before peace negotiation. From August to December/2016 no admissions of war casualties were registered. CONCLUSION: We describe a series of soldiers wounded in combat that were admitted to the emergency department before and during the negotiation of the Colombian process of peace. Overall, we found a trend toward a decrease in the number of casualties admitted to the emergency department possibly in part, as a result of the period of peace negotiation.

OBJETIVO: Describir las variaciones en los soldados heridos en combate admitidos al departamento de emergencias durante el periodo de negociación del proceso de paz colombiano entre el 2011 y el 2016. MÉTODOS: Estudio retrospectivo de todos los soldados heridos en combate que fueron manejados en un centro de trauma desde Enero del 2011 a Diciembre del 2016. Los pacientes se dividieron en dos grupos: aquellos que ingresaron al departamento de emergencias antes de la tregua del proceso de paz (Noviembre 2012) y aquellos que ingresaron durante la negociación. Los grupos se compararon con respecto a los periodos de tiempo. RESULTADOS: Un total de 448 soldados heridos en combate fueron incluidos. Hubo una disminución gradual en el número de admisiones durante el periodo de negociación. Además, el número de soldados que sufrieron heridas por explosiones y fusiles disminuyó durante este periodo. En el 2012 se registraron 150 soldados heridos en combate. Este número disminuyó a 84, 63, 32 y 6 en los años 2013, 2014, 2015 y 2016 respectivamente. La proporción de pacientes con un ISS ≥9 y la proporción de admitidos a la unidad de cuidado intensivo fueron significativamente mayores en el periodo antes de la negociación. Desde Agosto a Diciembre/2016 no se registraron admisiones. CONCLUSIÓN: Este estudio describe una disminución gradual en el número de soldados heridos en combate admitidos al departamento de emergencia en un periodo de 6 años. Este fenómeno pudo deberse al periodo de negociación del proceso de paz.

Consideraciones importantes acerca de la producción in vitro de embriones equinos / Important considerations about in vitroproduction of equine embryos / Considerações importantes sobre a produção in vitro de embriões eqüinos

La producción in vitro de embriones (PIVE) en equinos es una técnica que genera incrementos en la eficienciareproductiva de especímenes de alto valor genético y comercial. A pesar de todos los estudios que se hanrealizado, la PIVE es una técnica con acceso y un éxito limitado, debido principalmente a las dificultades paraalcanzar tasas de fertilización eficientes mediante fertilización in vitro convencional, al igual que por las altasnecesidades en recursos técnicos y económicos para la fertilización mediante inyección intracitoplasmáticade espermatozoides (ICSI), entre otras limitaciones existentes para el desarrollo embrionario in vitro. En elmundo, se han evaluado múltiples alternativas para el mejoramiento de la PIVE en equinos, desde el uso dediferentes medios, fluidos, células, y moléculas, hasta la utilización de métodos alternativos para mejorar lastasas de fertilización como la ICSI en asociación de sustancias como el polivinilalcohol. Esta revisión exploralos avances investigativos y las expectativas futuras de aplicación de la técnica de PIVE en equinos.

The in vitro embryo production (PIVE) in horses is a technique that generates increases in reproductive efficiencyof high genetic and commercial value animals. Despite all the studies that has been made, PIVE is still atechnique with limited access and success, mainly due to difficulties to achieve efficient rates of fertilizationthrough conventional in vitro fertilization, as well as by the high needs in technical and economic resources for fertilization using intracytoplasmic sperm injection (ICSI), among other limitations on in vitro embryonic development. In the world there have been evaluated multiple alternatives for improving the PIVE in horses: from the use of different means, fluids, cells and molecules, to the use of alternative methods to improve therates of fertilization through ICSI with the use of substances such as polyvinylalcohol. This review explores the research progress and future expectations for the application of the PIVE technique in horses.

A produção de embriões eqüinos in vitro (PIVE) é uma técnica que aumenta eficiência reprodutiva em espéciesde alto valor genético e comercial. Apesar de todos os estudos realizados, a PIVE é uma técnica de acesso eêxito limitados, principalmente devido à dificuldade de se alcançar taxas de fertilização eficientes diante dafertilização in vitro convencional, grande necessidade de recursos financeiros e técnicos para a fertilizaçãopor injeção intracitoplasmática de espermatozóide (ICSI), entre outras limitações para o desenvolvimentoembrionário in vitro. Em todo mundo foram avaliadas várias alternativas para a melhoria da PIVE em eqüinos,desde a utilização de diferentes meios, fluidos, células e moléculas até a utilização de métodos alternativos paramelhorar as taxas de fertilização como a ICSI em associação com outras substâncias como o álcool polivinílico.Essa revisão aborda o progresso da pesquisa e as perspectivas futuras de aplicação da técnica PIVE em eqüinos.

Vaginitis por Gardnerella vaginalis en un servicio médico universitario / Vaginitis due to Gardnerella vaginalis in an academic medical service

En 363 mujeres atendidas en un servicio médico universitario, se practicó búsqueda de agentes causales de vaginitis y de los criterios que sustentan el diagnóstico de vaginitis por Gardnerella vaginalis; se complementó el estudio con cultivos selectivos para este microorganismo y se establecieron la sensibilidad y especificidad de los criterios aludidos y de otros adicionales frente al cultivo positivo; setenta y nueve (21,8%) de las pacientes tenían vaginitis por Gardnerella con 94.9% de las mismas con cultivo positivo;otras cuarenta y cuatro pacientes (12.1%) tenían candidiasis, tricomoniasis o infecciones mixtas; no se halló asociación entre vaginitis por Gardnerella y anticoncepción; más del 90% de las pacientes con esta forma de vaginitis tenían en el Gram de la secreción vaginal microorganismos compatibles con Gardnerella, el pH estaba por encima de 4.50, se observaban células guía y había desprendimiento de olor a aminas al alcalinizarla; igualmente se notaba ausencia de reacción leucocitaria, de lactobacilos y de corynebacterias