Hernia obturatriz izquierda, obstrucción intestinal y hernia inguinal bilateral: Reporte de caso / Left obturator hernia, intestinal obstruction and bilateral inguinal hernia: a case report

RESUMEN La hernia obturatriz tiene una incidencia de menos del 1% de todas las hernias de la pared abdominal, se presentan predominantemente en mujeres de edad avanzada y se caracteriza por la protrusión de las vísceras intraabdominales hacia el agujero obturador. El diagnóstico preoperatorio suele ser difícil debido a la falta de manifestaciones externas obvias, síntomas y signos inespecíficos y falta de sospecha clínica. El retraso en el diagnóstico y en el tratamiento de esta afección generalmente conduce a una alta tasa de mortalidad. Reportamos el caso de una paciente con hernia obturatriz complicada y hernia inguinal bilateral, la cual fue resuelto por cirugía mínimamente invasiva, no hubo complicaciones en la evolución postoperatoria, siendo su estancia hospitalaria siete días.

SUMMARY Obturator hernia has an incidence of less than 1% of all abdominal wall hernias, it is predominantly observed in elder women and it is characterized by protrusion of intra-abdominal viscera into the shutter hole. The preoperative diagnosis is difficult due to the lack of external manifestations, nonspecific symptoms and lack of clinical suspicion. Delaying diagnosis and treatment is associated with high mortality. We report the case of a female patient with a complicated obturator hernia with concomitant bilateral inguinal hernias that underwent minimally invasive surgery with no complications and a seven day stay in hospital.

Traditional Mushroom Consumption Associated to Lower Levels of Triglycerides and Blood Pressure in an Indigenous Peasant Community from Oaxaca, Mexico.

Traditional consumption of edible mushrooms is supported by ethnomycological studies worldwide. However, the potential impact of mushroom consumption on the nutritional and health status of remote rural communities has not yet been studied. We carried out these initial standard studies in the indigenous peasant community of Benito Juarez, Oaxaca, Mexico. Participant adults (45) were grouped as follows: optimal body mass index (BMI: 17.8%), overweight (48.9%), obesity type I (24.5%), obesity type II (4.4%), and obesity type III (4.4%). A high proportion of women (90.3%) and men (64.3%) had a high risk of cardiovascular disease (WHI: waist/hip index). Most women (93.6%) and men (57.1%) showed abdominal obesity. In biochemical parameters, subjects had hypertriglyceridemia (75.6%), hypercholesterolemia (26.7%), hyperglycemia (53.3%), and hypertension (46.7%). There was an excessive intake in the diet of energy, proteins, carbohydrates, sugar, and lipids, as well as a deficiency in the consumption of several vitamins and minerals. A high frequency of mushroom consumption (> 3 times per week) was significantly correlated to lower energy, lipids, saturated fatty acids (SFA), and sodium intake, as well as to higher intake of cobalamin and zinc. The levels of triglycerides and diastolic blood pressure were significantly lower in adults consuming edible mushrooms every day. Total cholesterol also tended to be lower. These associations allow to promote healthier diets in remote indigenous communities by keeping or increasing the consumption of edible mushrooms, either wild or cultivated. Edible mushrooms can play a more important role in community nutrition and health, considering their unique functional and medicinal properties.

In and out of refugia: historical patterns of diversity and demography in the North American Caesar's mushroom species complex.

Some of the effects of past climate dynamics on plant and animal diversity make-up have been relatively well studied, but to less extent in fungi. Pleistocene refugia are thought to harbour high biological diversity (i.e. phylogenetic lineages and genetic diversity), mainly as a product of increased reproductive isolation and allele conservation. In addition, high extinction rates and genetic erosion are expected in previously glaciated regions. Some of the consequences of past climate dynamics might involve changes in range and population size that can result in divergence and incipient or cryptic speciation. Many of these dynamic processes and patterns can be inferred through phylogenetic and coalescent methods. In this study, we first delimit species within a group of closely related edible ectomycorrhizal Amanita from North America (the American Caesar's mushrooms species complex) using multilocus coalescent-based approaches; and then address questions related to effects of Pleistocene climate change on the diversity and genetics of the group. Our study includes extensive geographical sampling throughout the distribution range, and DNA sequences from three nuclear protein-coding genes. Results reveal cryptic diversity and high speciation rates in refugia. Population sizes and expansions seem to be larger at midrange latitudes (Mexican highlands and SE USA). Range shifts are proportional to population size expansions, which were overall more common during the Pleistocene. This study documents responses to past climate change in fungi and also highlights the applicability of the multispecies coalescent in comparative phylogeographical analyses and diversity assessments that include ancestral species.

Case report: three farmworkers who gave birth to infants with birth defects closely grouped in time and place-Florida and North Carolina, 2004-2005.

CONTEXT: There is little evidence linking adverse reproductive effects to exposure to specific pesticides during pregnancy. CASE PRESENTATION: In February 2005, three infants with congenital anomalies were identified in Collier County, Florida, who were born within 8 weeks of one another and whose mothers worked for the same tomato grower. The mothers worked on the grower's Florida farms in 2004 before transferring to its North Carolina farms. All three worked during the period of organogenesis in fields recently treated with several pesticides. The Florida and North Carolina farms were inspected by regulatory agencies, and in each state a large number of violations were identified and record fines were levied. DISCUSSION: Despite the suggestive evidence, a causal link could not be established between pesticide exposures and the birth defects in the three infants. Nonetheless, the prenatal pesticide exposures experienced by the mothers of the three infants is cause for concern. Farmworkers need greater protections against pesticides. These include increased efforts to publicize and comply with both the U.S. Environmental Protections Agency's Worker Protection Standard and pesticide label requirements, enhanced procedures to ensure pesticide applicator competency, and recommendations to growers to adopt work practices to reduce pesticide exposures. RELEVANCE TO PROFESSIONAL PRACTICE: The findings from this report reinforce the need to reduce pesticide exposures among farmworkers. In addition, they support the need for epidemiologic studies to examine the role of pesticide exposure in the etiology of congenital anomalies.

Aspectos epidemiológicos del trauma en Colombia / Aspects epidemiologists of the trauma in Colombia

El trauma representa la principal causa de muerte en las 3 primeras décadas de la vida y la tercera para cualquier edad luego de las enfermedades cardiovasculares y el cáncer. En Colombia el trauma constituye un problema de salud pública. Desde la década de los años 70 del siglo XX, las lesiones violentas tanto intencionales como no intencionales han ocupado los primeros lugares entre las causas de mortalidad en este país...

Tratamiento de la luxación congénita de cadera con arnés de Pavlik / Treatment of congenital dislocation of the hip treated by the Pavlik harness

El propósito de este trabajo es estudiar los resultados obtenidos con el uso de arnés de Pavlik en lactantes portadores de luxación congénita de cadera en el Servicio de Ortopedia Infantil de la Dirección General de Seguridad Social. Fueron tratados por dos de los autores entre 1980 y 1984. El follow-up osciló entre 1 y 5 años

Tratamiento de la luxación congénita de cadera con arnés de Pavlik / Treatment of congenital dislocation of the hip treated by the Pavlik harness

El propósito de este trabajo es estudiar los resultados obtenidos con el uso de arnés de Pavlik en lactantes portadores de luxación congénita de cadera en el Servicio de Ortopedia Infantil de la Dirección General de Seguridad Social. Fueron tratados por dos de los autores entre 1980 y 1984. El follow-up osciló entre 1 y 5 años