Revision of the genus Agrostis (Poaceae, Pooideae, Poeae) in Megamexico.

Agrostis is one of the most diverse genera of the Poaceae, including ca. 198 species, principally distributed in cold and temperate regions of the world, but also found in the high mountains of the tropics. We present a revision based on morphoanatomical evidence, for the biogeographic region known as Megamexico 3 (i.e., Mexico including the desert areas of southern USA and the Central America territory, to northern Nicaragua). We include taxonomic descriptions and an identification key for the found taxa, maps with the known geographical distribution of the species, and figures with the morphoanatomical characteristics, elevation and phenology. Agrostis is represented in the study zone by 20 species, of which four are endemic and three are introduced. Most records of the genus are distributed in the mountains, above 1500 m a.s.l., in open areas of temperate forests, with conifers and Quercus. Specimens with spikelets occur year round, but most records occur during the wet season, in the months of July to October. We propose a preliminary conservation assessment for each species in the study zone, according to the International Union for Conservation of Nature categories: one with Deficient Data (DD), six as Endangered (EN), two as Vulnerable (VU), and 11 as Least Concern (LC).

ResumenAgrostis es uno de los géneros más diversos de las Poaceae, con ca. 198 especies, principalmente distribuidas en regiones frías y templadas del mundo, aunque también se pueden encontrar en grandes elevaciones de los trópicos. En este trabajo se presenta una revisión basada en evidencia morfoanatómica para la región biogeográfica conocida como Megaméxico 3 (i.e., México incluyendo las áreas desérticas del sur de los EUA y el territorio de Centroamérica hasta el norte de Nicaragua). Se incluyen descripciones taxonómicas y una clave de identificación para los taxones encontrados, mapas con la distribución geográfica conocida de las especies, así como figuras con las características morfoanatómicas, elevación y fenología. Agrostis está representado en la zona de estudio por 20 especies, cuatro de las cuales son endémicas y tres son introducidas. La mayoría de los registros del género se distribuyen en regiones montañosas, por arriba de los 1500 de elevación, en áreas abiertas de bosques templados, con coníferas y Quercus. Es posible encontrar ejemplares con espiguillas durante todo el año, pero la mayoría de los registros ocurren durante la época lluviosa, durante los meses de julio a octubre. Se propone una evaluación preliminar de conservación para cada especie en la zona de estudio, de acuerdo con las categorías de la Union Internacional para la Conservación de la Naturaleza: una con Datos Deficientes (DD), seis como Amenzadas (EN), dos como Vulnerables (VU) y 11 de Preocupación Menor (LC).

[Willingness to receive the COVID-19 vaccine in the population aged 80 years and older in Colombia 2021]. / Disposición a recibir la vacuna contra COVID-19 en población de 80 y más años en Colombia 2021.

Objective: Colombia designed and adopted a vaccination plan against COVID-19 that will immunize 35 million people. The aim study was to know the willingness to accept the vaccination against COVID-19. Methods: A telephone survey of 11,721 people aged 80 and over, affiliated with a health insurer, was carried. The respondents were the affiliates or their relatives or caregivers. Results: The average age was 85.0 years (SD: 4.5), with no differences between sexes; 3,344 (28.5%) referred a previous diagnostic test for COVID-19 and 73 were positive for an incidence of 622.8 per 100,000 people (95%CI: 491-778). Regarding the attitude with the vaccination against SARS-CoV-2, 1/4 respondents refrained from giving an opinion or was neutral. When the respondent was a relative, the acceptance of the vaccine was 60.4% (95% CI: 59.5-61.3) with differences by gender: men 62.2% (95% CI: 60.8-63.6) and women of 59.2 (95% CI: 58.0-60.3), P < 0.05. When the respondent was the potential recipient of the vaccine, the acceptance of the vaccine was 61.7% (95% CI: 59.4-64.0) and also differed by gender: 70.2% in men (95% CI: 66, 9-73.5) and 55.1% in women (95% CI: 52.0-58.3), P < 0.05. Conclusion: The relatively low acceptance of vaccination against COVID-19 in Colombia poses significant challenges to achieve herd immunity that allows control of the pandemic.

Ectopic expression of the atypical HLH FaPRE1 gene determines changes in cell size and morphology.

PACLOBUTRAZOL RESISTANCE (PRE) genes code atypical HLH transcriptional regulators characterized by the absence of a DNA-binding domain but present an HLH dimerization domain. In vegetative tissues, the function of these HLH proteins has been related with cell elongation processes. In strawberry, three FaPRE genes are expressed, two of them (FaPRE2 and FaPRE3) in vegetative tissues while FaPRE1 is fruit receptacle-specific. Ubiquitous FaPRE1 accumulation produced elongated flower receptacles and plants due to the elongation of the main aerial vegetative organs, with the exception of leaves. Histological analysis clearly demonstrated that the observed phenotype was due to significant changes in the parenchymal cell's morphology. In addition, transcriptomic studies of the transgenic elongated flower receptacles allowed to identify a small group of differentially expressed genes that encode cell wall-modifying enzymes. Together, the data seem to indicate that, in the strawberry plant vegetative organs, FaPRE proteins could modulate the expression of genes related with the determination of the size and shape of the parenchymal cells.

Understanding individualistic response patterns when assessing expert operators on nuclear power plant control tasks.

We evaluated the performance of three highly practiced participants on three task types that comprised a simulated nuclear power plant control operation. Multiple subjective, physiological, and objective performance measures were collected on these three highly-practiced individuals. Results indicated ceiling effects in terms of performance accuracy, yet each individual adopted a unique response strategy across the respective sub-tasks. Their maximised accuracy was achieved at the expense of longer response times across differing sub-tasks. The measures which proved diagnostic and predictive of performance capacity were explored. The current conclusion presents us with an invidious problem in that performance and workload associations, insensitivities, and dissociations may be unique to each individual operator, and may well depend also upon the overall task in context. Such findings push our science away from seeking nomothetic assertions and toward individuated concerns. In consequence, the age of the idiographic may well be upon us. Practitioner summary: The importance and relevance of nuclear power control is self-evident. Concerns here have centred around the safety of the technology and its operators. Our work informs practitioners in this industry, and in Ergonomics in general, of the response of highly trained individuals in these safety-critical, operational domains. We show that even experts engage in personal and individual strategies, an observation critical to the assessment of this specific workplace, and potentially all others. Abbreviations: NPP: nuclear power plant; ROs: reactor operators; MCR: main control room; LOA: levels of automation; EOP: emergency operating procedure; OP: operating procedures; ISA: instantaneous self-assessment; DSSQ: Dundee stres state questionnaire.

Large increase of rotavirus diarrhoea in the hospital setting associated with emergence of G12 genotype in a highly vaccinated population in Nicaragua.

Rotaviruses (RVs) are a major cause of severe diarrhoea in young children. Nicaragua introduced routine immunization with the pentavalent RV vaccine (RV5) in 2006, which greatly reduced the incidence of diarrhoea. A remaining concern has been the possible emergence of new RV strains to which the vaccination has less effect. In this study, 837 children with diarrhoea in hospital settings were investigated for RV between May 2011 and July 2013. RVs were subsequently typed by multiplex PCR and/or sequencing. Fecal anti-RV IgA titres for a subset of RV-infected (n = 137) and noninfected children (n = 52) were determined with an in-house enzyme-linked immunosorbent assay. The RV detection rate was 8% in 2011, followed by a sharp increase to 29% in 2012 and 19% in 2013. This was associated with emergence and predominance of genotype G12 RV, from 0% in 2011 to 66% in 2012 and 82% in 2013, infecting children from 1 month to 10 years of age. Two sequenced G12 strains showed a Wa-like genome with genotype G12-P[8]-I1-R1-C1-M1-A1-N1-T1-E1-H1, similar to the globally emerging G12 strains. Fecal anti-RV IgA analysis showed that most G12-infected and noninfected children had been in contact with either vaccine or wild RV strains, but such antibodies did not prevent symptomatic G12 infection. A marked increase of RV was evident in the hospital setting associated with a nationwide emergence and predominance of RV G12 genotype in a population with high RV5 vaccine coverage.

Potential for genotoxic and reprotoxic effects of vanadium compounds due to occupational and environmental exposures: an article based on a presentation at the 8th International Symposium on Vanadium Chemistry, Biological Chemistry, and Toxicology, Washington DC, August 15-18, 2012.

Research on the biological effects of vanadium in humans has shown that acute poisoning in workers can manifest itself in a number of symptoms. There are no reports in humans about reproductive and developmental effects induced by vanadium compounds in humans; however, some studies with rats and mice indicate that vanadium can cross the placental barrier and accumulate in fetal membranes rather than the fetus itself. In this case, probably most consequences of administration of vanadium to pregnant females like reabsorptions, fetal death and reduction in size can be the result of maternal toxicity. Concerning genetic and related effects in humans exposed to different vanadium compounds, data are controversial. Data on genotoxic effects in workers exposed to vanadium indicate that they can have an increased risk to develop cancer, and DNA instability can give rise to an onset of genetic syndromes, fetal malformations, and cancer. This paper presents materials presented at the 8th International Symposium on Vanadium Chemistry, Biological Chemistry, and Toxicology in a session titled 'Relationship between occupational and environmental exposure to vanadium compounds and the reprotoxic and genotoxic effects'.

Cardiac output is not a significant source of low frequency mean arterial pressure variability.

Spontaneous mean arterial pressure (MAP) variability may be mainly due to fluctuations in cardiac output (CO) and total peripheral resistance (TPR). While high frequency (HF ∼ 0.25 Hz) oscillations in MAP are ultimately driven by respiration, the source of low frequency (LF ∼ 0.1 Hz) fluctuations has not been fully elucidated. It is known that CO buffers these oscillations, but there is no evidence on its potential role in also generating them. The main goal was to determine whether CO is a source of LF variability in MAP. Six dogs were chronically instrumented to obtain beat-to-beat measurements of CO and MAP while the dogs were fully awake and at rest. A causal dynamic model was identified to relate the fluctuations in CO to MAP. The model was then used to predict the MAP fluctuations from the CO fluctuations. The CO fluctuations were able to predict about 70% of the MAP oscillations in the HF band but showed no predictive value in the LF band. Hence, respiration induces CO fluctuations in the HF band that, in turn, cause MAP oscillations, while TPR fluctuations appear to be the dominant mediator of LF fluctuations of MAP. CO is not a significant source of these oscillations, and it may only be responsible for dampening them, likely through the baroreflex.

[Early prediction of severity in acute pancreatitis]. / Predicción precoz de severidad en pancreatitis aguda.

OBJECTIVE: To identify the score that best predicts early severity in patients with acute pancreatitis. MATERIALS AND METHODS: A prospective cohort study was performed from December 2009 to December 2011. Cases of pancreatitis were classified as mild or severe based on the organ failure criteria and/or local complications according to the Atlanta Symposium. APACHE-II, BISAP and urea were calculated using data from the first 24 hours. Ranson was calculated using data from the first 48 hours. Hemoconcentratión was assessed 24 hours from admission, after adequate hydration. To assess the predictive value of the different scores the area under the curve ROC was used. RESULTS: 329 patients with acute pancreatitis were included: 214 women (65%) and 115 males (35%). The most common etiology was biliary 245 (74.3%). Two hundred and forty were mild cases of pancreatitis (73%) and 89 were severe (27%). The areas under the curve ROC were: APACHE-II: 0.74; BISAP: 0.78; Ranson: 0.48; urea: 0.70; hemoconcentratión: 0.73. There were 10 deaths (mortality: 3%). There were no significant differences between BISAP and APACHE-II, urea or hemoconcentration, but a significant difference existed with Ranson score. CONCLUSION: BISAP is a simple score that applied early in the emergency room identifies patients with severe pancreatitis with an efficacy similar to APACHE-II, urea and hemoconcentration, and KEY WORDS: acute pancreatitis, BISAP, severity, prognostic scoring.

[Severe decompensation of hepatitis e in a patient with autoimmune hepatitis: a case report]. / Severa descompensación por virus de hepatitis e en una paciente con hepatitis autoinmune: reporte de un caso.

We report the case of a patient who initially made the diagnosis of acute hepatitis E virus with a clinical picture of jaundice with elevated liver enzymes and HEV IgM (+), but chronic evolution (More than 6 months) without being an immunosuppressed patient, forced us to exclude different causes that may produce chronic liver disease. And hypergammaglobulinemia was detected in liver biopsy: interface hepatitis, mixed inflammatory infiltrate with predominance of lymphocytes, and presence of portal-portal fibrous tracts, suggestive of severe active chronic hepatitis may be secondary to autoimmune hepatitis associated with hepatitis virus infection E. With these findings, we decided to start treatment for autoimmune hepatitis with prednisone and azathioprine, leading to a decrease in transaminases and coagulation profile to normal, which helped confirm the diagnosis of autoimmune hepatitis and decompensated manifested by acute virus infection of hepatitis E. Full report the case and a review of the literature.

[Celiac disease: descriptive study at the Anglo American clinic]. / Enfermedad celiaca: estudio descriptivo en la clínica Anglo Americana.

BACKGROUND: Celiac disease (CD) is a condition in which gluten intake develops an autoimmune response generating intestinal villous atrophy, causing malabsorption. Prevalence worldwide is approximately 1%, in our country it is not known. MATERIAL AND METHODS: Retrospective, descriptive, observational study in Anglo American Clinic between September 2004 and February 2012. We reviewed the medical charts, upper GI endoscopy reports and duodenal biopsy reports of all patients with positive anti TTG results, who were older than 18 years of age. RESULTS: We studied 39 cases, 26 (66.7%) women and 13 (33.3%) men. Mean age was 61.25 years. The symptoms were chronic diarrhea in 32 (82.1%), abdominal pain in 22 (56.4%), abdominal distention in 14 (35.9%), and others in lower frequency. Eight (20.5%) patients had anemia. Just 5 (12.8%) had upper endoscopy findings consistent with CD, and Marsh classification was: 0: 5 (12.7%), I: 1 (2.6%), II: 0 (0%), IIII A: 20 (51.3%), III B: 12 (30.8%) y III C: 1 (2.6%). CONCLUSIONS: CD should be considered as a differential diagnosis of patients with non-specific long-term gastrointestinal symptoms, extraintestinal symptoms should also be taken into account. Diagnosis should be made with anti TTG as the initial test and posteriorly with a duodenal biopsy for staging.

Predicción precoz de severidad en pancreatitis aguda / Early prediction of severity in acute pancreatitis

OBJETIVO: Identificar el indicador que mejor predice la severidad en forma temprana en pacientes con pancreatitis aguda. MATERIALES Y MÉTODOS: Se realizó un estudio de cohorte prospectiva entre diciembre del 2009 y diciembre del 2011. Se clasificó los cuadros de pancreatitis aguda en leve y severa en base a los criterios de falla orgánica o complicaciones locales según el Simposio de Atlanta. Los indicadores de APACHE-II, BISAP y urea fueron calculados usando los datos de las primeras 24 horas de admisión. El indicador de Ranson se calculó con datos de las primeras 48 horas. La hemoconcentración se calculó a las 24 horas de la admisión después de una adecuada hidratación. Para evaluar la capacidad predictiva de los diferentes indicadores se utilizó el área bajo la curva ROC. RESULTADOS: Ingresaron al estudio 329 pacientes con pancreatitis aguda: doscientos catorce mujeres (65%) y 115 varones (35%). La etiología más frecuente fue la biliar 245 (74.3%). Doscientos cuarenta fueron pancreatitis leves (73%) y 89 pancreatitis severas (27%). Las áreas bajo la curva ROC de los indicadores fueron: APACHE-II: 0.74; BISAP: 0.78; Ranson: 0.48; urea: 0.70; hematocrito a las 24 horas: 0.73. Se registraron 10 muertes (mortalidad: 3%). No se observó diferencias significativas del indicador BISAP con el indicador de APACHE-II, con la urea ni la hemoconcentración, pero sí con el puntaje de Ranson. CONCLUSIÓN: BISAP es un score sencillo que aplicado tempranamente en la emergencia identifica pacientes con cuadro clínico severo con eficacia similar al APACHE-II, urea y hemoconcentración; y mejor que Ranson.

OBJECTIVE: To identify the score that best predicts early severity in patients with acute pancreatitis. MATERIALS AND METHODS: A prospective cohort study was performed from December 2009 to December 2011. Cases of pancreatitis were classified as mild or severe based on the organ failure criteria and/or local complications according to the Atlanta Symposium. APACHE-II, BISAP and urea were calculated using data from the first 24 hours. Ranson was calculated using data from the first 48 hours. Hemoconcentratión was assessed 24 hours from admission, after adequate hydration. To assess the predictive value of the different scores the area under the curve ROC was used. RESULTS: 329 patients with acute pancreatitis were included: 214 women (65%) and 115 males (35%). The most common etiology was biliary 245 (74.3%). Two hundred and forty were mild cases of pancreatitis (73%) and 89 were severe (27%). The areas under the curve ROC were: APACHE-II: 0.74; BISAP: 0.78; Ranson: 0.48; urea: 0.70; hemoconcentratión: 0.73. There were 10 deaths (mortality: 3%). There were no significant differences between BISAP and APACHE-II, urea or hemoconcentration, but a significant difference existed with Ranson score. CONCLUSION: BISAP is a simple score that applied early in the emergency room identifies patients with severe pancreatitis with an efficacy similar to APACHE-II, urea and hemoconcentration, and better than Ranson.

Enfermedad celiaca: estudio descriptivo en la Clínica Anglo Americana / Celiac disease: descriptive study in the Anglo American clinic

INTRODUCCIÓN: La enfermedad celiaca (EC) es una condición en la que la ingesta de gluten desencadena una respuesta de autoinmunidad que genera aplanamiento de las vellosidades intestinales causando malabsorción. La prevalencia mundial es de aproximadamente 1%. En nuestro país no es conocida MATERIALES Y MÉTODOS: Estudio retrospectivo, descriptivo y observacional realizado en la Clínica Angloamericana entre Septiembre del 2004 y Febrero 2012. Se revisaron las historias clínicas, reportes endoscópicos y reportes de biopsias duodenales de los pacientes con anti Transglutaminasa tisular (TTG) positiva, mayores de 18 años. Resultados: Se estudiaron 39 casos, siendo 26 (66.7%) mujeres y 13 (33.3%) varones. La edad media de diagnóstico fue 61.25 años. Los síntomas fueron diarrea crónica en 32 (82.1%), dolor abdominal en 22 (56.4%), distensión abdominal en 14 (35.9%) y otros en menor frecuencia. Ocho (20.5%) pacientes presentaron anemia. Solo 5 (12.8%) pacientes presentaron hallazgos endoscópicos compatibles con EC. La clasificación Marsh de las biopsias duodenales fueron 0: 5 (12.7%), I: 1 (2.6%), II: 0 (0%), III A: 20 (51.3%), III B: 12 (30.8%) y III C: 1 (2.6%). CONCLUSIONES: La EC debe ser considerada como diagnóstico diferencial de pacientes con síntomas gastrointestinales inespecíficos de larga data, teniendo en cuenta también sus manifestaciones extraintestinales. Para el diagnóstico debe utilizarse la anti TTG como prueba inicial y posteriormente realizar una biopsia duodenal para estadiaje.

BACKGROUND: Celiac disease (CD) is a condition in which gluten intake develops an autoimmune response genetaring intestinal villous atrophy, causing malabsorption. Prevalence worlwide is approximately 1%, in our country it is not known. MATERIAL AND METHODS: Retrospective, descriptive, observational study in Anglo American Clinic between September 2004 and February 2012. We reviewed the medical charts, upper Gl endoscopy reports and duodenal biopsy reports of all patients with positive anti TTG results, who were older than 18 years of age. RESULTS: We studied 39 cases, 26 (66.7%) women and 13 (33.3%) men. Mean age was 61.25 years. The symptoms were chronic diarrhea in 32 (82.1%), abdominal pain in 22 (56.4%), abdominal distention in 14 (35.9%), and others in lower frequency. Eight (20.5%) patients had anemia. Just 5 (12.8%) had upper endoscopy findings consistent with CD, and Marsh classification was: 0: 5 (12.7%), l: 1 (2.6%), ll: 0 (0%), llll A: 20 (51.3%), lll B: 12 (30.8%) y lll C: 1 (2.6%). CONCLUSIONS: CD should be considered as a differential diagnosis of patients with non-specific-long-term gastrointestinal symptoms, extraintestinal symptoms should also be taken into account. Diagnosis should be made with anti TTG as the initial test and posteriorly with a duodenal biopsy for staging.

Severa descompensación por virus de hepatitis E en una paciente con hepatitis autoinmune: reporte de un caso / Severe decompensated hepatitis E virus in a patient with autoimmune hepatitis: a case report

Reportamos el caso de una paciente en quien se hizo inicialmente el diagnóstico de infección aguda por virus de hepatitis E por presentar un cuadro de ictericia con elevación de enzimas hepáticas e IgM VHE (+), pero por evolución crónica (Más de 6 meses) y sin ser una paciente inmunosuprimida; nos obligó a descartar causas diferentes que podrían producir enfermedad hepática crónica. Se detectó hipergamaglobulinemia y en biopsia hepática: hepatitis de interface, infiltrado inflamatorio mixto a predominio de linfocitos, y presencia de tractos fibrosos porta-porta, cambios sugestivos de hepatitis crónica severamente activa que podría ser secundaria a hepatitis autoinmune asociada a infección por virus de hepatitis E. Con estos hallazgos se decidió iniciar tratamiento para hepatitis autoinmune con Prednisona y Azatioprina, produciéndose una disminución de las transaminasas y perfil de coagulación hasta la normalidad, lo que ayudó a confirmar el diagnostico de hepatitis autoinmune descompensada y puesta de manifiesto por una infección aguda por virus de hepatitis E. Presentamos el caso clínico completo y una revisión de la literatura.

We report the case of a patient wo initially made the diagnosis of acute hepatitis E virus with a clinical picture of jaundice with elevated liver enzymes and HEV IgM (+), but chronic evolution (More than 6 months) without being an immunosuppresed patient, forced us to exclude different causes that may produce chronic liver disease. And hypergammaglobulinemiawas detected in liver biopsy: interface hepatitis, mixed inflammatory infiltrate with predominance of lymphocytes, and presence of portal-portal fibrous tracts, suggestive of severe active chronic hepatitis may be secondary to autoimmune hepatitis associated with hepatitis virus infection E. With these findings, we decided to start treatment for autoimmune hepatitis with prednisone and azathioprine, leading to a decrease in transaminases and coagulation profile to normal, which helped confirm the diagnosis of autoimmune hepatitis and decompesated manifested by acute virus infection of hepatitis E. Full report the case and a review of the literature.

Autonomic dysfunction in chronic inflammatory demyelinating polyradiculoneuropathy.

OBJECTIVES: Autonomic deficits in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) have not been adequately quantitated. The Composite Autonomic Severity Score (CASS) is a validated instrument for laboratory quantitation of autonomic failure derived from standard autonomic reflex tests. We characterized dysautonomia in CIDP using CASS. METHODS: Autonomic function was retrospectively analyzed in 47 patients meeting CIDP criteria. CASS ranges from 0 (normal) to 10 (pandysautonomia), reflecting summation of sudomotor (0-3), cardiovagal (0-3), and adrenergic (0-4) subscores. Severity of neurologic deficits was measured with Neuropathy Impairment Score (NIS). Degree of small fiber involvement was assessed with quantitative sensation testing. Thermoregulatory sweat test (TST) was available in 8 patients. RESULTS: Patients (25 men) were middle-aged (45.0 ± 14.9 years) with longstanding CIDP (3.5 ± 4.3 years) of moderate severity (NIS, 46.5 ± 32.7). Autonomic symptoms were uncommon, mainly gastrointestinal (9/47; 19%) and genitourinary (8/47; 17%). Autonomic deficits (CASS ≥1) were frequent (22/47; 47%) but very mild (CASS, 0.8 ± 0.9; CASS ≤3, all cases). Deficits were predominantly sudomotor (16/47; 34%) and cardiovagal (10/47; 21%) with relative adrenergic sparing (4/47; 9%). TST was abnormal in 5 of 8 patients (anhidrosis range, 2%-59%). Sudomotor impairment was predominantly distal and postganglionic. Somatic deficits (disease duration, severity, small fiber deficits) did not predict presence of autonomic deficits. CONCLUSION: Our data characterize the autonomic involvement in classic CIDP as mild, cholinergic, and predominantly sudomotor mainly as a result of lesions at the distal postganglionic axon. Extensive or severe autonomic involvement (CASS ≥4) in suspected CIDP should raise concern for an alternative diagnosis.

Combined study of daily growth variability and nitrogen-carbon isotopic signature analysis of schooling Sardina pilchardus larvae.

A combined study of Alborán Sea Sardina pilchardus larval daily growth and isotopic signature was carried out to elucidate the cause of morphometric differences observed in a single larval school whereby the standard length (L(S)) v. dry mass (M(D)) relationship differentiated a heavier-by-size larval group from a lighter larval group. The daily growth analysis revealed that this difference originated from two larval growth patterns, where a fast growing population (F) in contrast to a slow-growing larval population (S) was distinguished. The S-growing larval cohort had a significantly higher nitrogen (N) content as a result of greater somatic mass build up with time in the form of structural proteins. Alternatively, the F-growing population showed a significantly greater amount of carbon (C) content with age, indicating faster metabolic rates of C accretion compared to the S-growing group. In consequence, the C:N ratios of the F-growing larvae were significantly higher than the S-group. C:N ratios of both larval populations showed significant linear decrease with age (and size), while K showed an inverse relationship. The stable isotopes of N did not show significant differences between the S and F-growing larvae. In F-growing larvae, however, a significant linear increase in δ(15)N (by age class) was observed, indicating that as larvae undergo ontogenetic development, trophic level tends to increase. This was also made evident by the significant decrease in age of δ(15)N coefficients of variation (by age class). The higher δ(13)C values in the S-growing larvae were related to the lower growth rates observed in this group. These results suggest a broader trophic flexibility in younger larvae, but moving towards a trophic specialization and more selective diets with age. This trophic specialization shows a tendency of a greater prey size with age. These findings suggest that S-growing larvae have a more omnivorous diet than the F-growing ones.

Influence of carotene-rich vegetable meals on the prevalence of anaemia and iron deficiency in Filipino schoolchildren.

OBJECTIVE: To determine the effects of eating carotene-rich green and yellow vegetables on the prevalence of anaemia, iron deficiency and iron-deficiency anaemia in schoolchildren. SUBJECTS AND METHODS: Schoolchildren (n=104), aged 9-12 years, received standardized meals containing 4.2 mg of provitamin A carotenoids/day (mainly beta-carotene) from yellow and green leafy vegetables and at least 7 g dietary fat/day. The meals were provided three times/day, 5 days/week, for 9 weeks at school. Before and after the dietary intervention, total-body vitamin A pool size was assessed by using the deuterated-retinol-dilution method; serum retinol and beta-carotene concentrations were measured by high-performance liquid chromatography; and whole blood haemoglobin (Hb) and zinc protoporphyrin (ZnPP) concentrations were measured by using a photometer and a hematofluorometer, respectively. RESULTS: After 9 weeks, the mean total-body vitamin A pool size increased twofold (95% confidence interval (CI): -0.11, -0.07 micromol retinol; P<0.001), and serum beta-carotene concentration increased fivefold (95% CI: -0.97, -0.79 micromol/l; P<0.001). Blood Hb (95% CI: -1.02, -0.52 g per 100 ml; P<0.001) and ZnPP increased (95% CI: -11.82, -4.57 microol/mol haem; P<0.001). The prevalence of anaemia (Hb<11.5 g per 100 ml) decreased from 12.5 to 1.9% (P<0.001). There were no significant changes in the prevalence of iron deficiency or iron-deficiency anaemia. CONCLUSIONS: Ingestion of carotene-rich yellow and green leafy vegetables improves the total-body vitamin A pool size and Hb concentration, and decreases anaemia rates in Filipino schoolchildren, with no effect on iron deficiency or iron-deficiency anaemia rates.

[Esomeprazole based triple therapy for the eradication of helicobacter pylori in patients with non-ulcer dyspepsia]. / Esomeprazol en la terapia triple para la erradicacion de helicobacter pylori en pacientes dispepticos no ulcerosos.

OBJECTIVE: To assess the efficacy of esomeprazole-based triple therapy in the eradication of helicobacter pylori (HP). METHODOLOGY: A descriptive, prospective study was carried out between the months of June and August, 2008, at the Gastroenterology Service of the Cayetano Heredia National Hospital (HNCH) in which patients with non-ulcer dyspepsia infected with HP (diagnosed bya biopsy) were randomized and divided into two groups: the control group was treated with Amoxicillin (1g VO e/12h), Clarithromycin (500 mg VO e/12h) and Omeprazole (20 mg VO e/12h) and the study group received Amoxicillin (1g VO e/12h), Clarithromycin (500 mg VO e/12h) and Esomeprazole (20 mg VO e/12h); both treatments were administered over a period of ten days. Four weeks after the conclusion of the treatment, each group underwent an endoscopic control, including biopsy tests and breath tests to determine the eradication of the HP infection. RESULTS: A total of 83 patients were included, out of which 42 received triple therapy with Omeprazole (control group) and 41 received triple therapy with Esomeprazole (study group). Five patients of the control group and 7 of the study group were lost in the follow-up stage and 3 patients of the control group and 2 of the study group were excluded due to the lack of a breath test. Out of the 34 patients of the control group, HP was eradicated in 25 of them (73,5%) while out of the 32 patients of the study group, HP was eradicated in 26 (81,2%). The most important adverse effects included: diarrhea, headaches, abdominal pain and constipation. CONCLUSIONS: Treatment with Esomeprazole showed an eradication rate of 8% greater than treatment with Omeprazole and the percentage of adverse effects was similar in both groups.

Esomeprazol en la terapia triple para la erradicación de Helicobacter Pylori en pacientes dispépticos no ulcerosos / Esomeprazole based triple therapy for the eradication of Helicobacter Pylori in patients with non-ulcer dyspepsia

OBJETIVO: El presente trabajo tiene como objetivo principal, evaluar la eficacia de la terapia triple con esomeprazol en la erradicación del Helicobacter pylori (Hp). METODOLOGÍA: Se realizó un estudio descriptivo, prospectivo en el Servicio de gastroenterología del Hospital Nacional Cayetano Heredia (HNCH), donde se seleccionaron pacientes dispépticos no ulcerosos con infección por Hp (determinada mediante biopsia) entre los meses de junio a agosto del 2008, a los cuales se les dividió en dos grupos: el ¨grupo control¨ se trató conamoxicilina 1g VO c/12h, claritromicina 500 mg VO c/12h y omeprazol 20 mg VO c/12h, y el ¨grupo en estudio¨ recibió amoxicilina 1g VO c/12h, claritromicina 500 mg VO c/12h y esomeprazol 20 mg VO c/12h, ambos esquemas se dieron por 10 días. A las 4 semanas de completado el tratamiento, a cada grupo se le hizo un control endoscópico con toma de biopsias y test de aliento para determinar la erradicación del Hp. RESULTADOS: Se incluyó un total de 83 pacientes, de los cuales 42 recibieron terapia triple con omeprazol (grupo control) y 41 recibieron terapia triple con esomeprazol (grupo en estudio). Se perdieron en el seguimiento 5 pacientes del grupo control y 7 pacientes en el grupo en estudio. Por no contar con Test de aliento se excluyeron 3 pacientes en el grupo control y 2 pacientes en el grupo en estudio. De los 34 pacientes del grupo control se erradicó el Hp en 25 (73,5%), mientras que los 32 pacientes del grupo en estudio se erradicó el Hp en 26 (81,2%). Los efectos adversos más importantes incluyeron: diarrea, cefalea, dolor abdominal y estreñimiento. CONCLUSIONES: El tratamiento con esomeprazol presentó una tasa de erradicación 8% mayor que el esquema con omeprazol y el porcentaje de reacciones adversas fue similar enambos grupos.

OBJECTIVE: To assess the efficacy of esomeprazole-based triple therapy in the eradication of helicobacter pylori (HP). METHODOLOGY: A descriptive, prospective study was carried out between the months of June and August, 2008, at the Gastroenterology Service of the Cayetano Heredia National Hospital (HNCH) in which patients with non-ulcer dyspepsia infected with HP (diagnosed by a biopsy) were randomized and divided into two groups: the "control group" was treated with Amoxicillin (1g VO e/12h), Clarithromycin (500 mg VO e/12h) and Omeprazole (20 mg VO e/12h) and the "study group" received Amoxicillin (1g VO e/12h), Clarithromycin (500 mg VO e/12h) and Esomeprazole (20 mg VO e/12h); both treatments were administered over a period of ten days. Four weeks after the conclusion of the treatment, each group underwent an endoscopic control, including biopsy tests and breath tests to determine the eradication of the HP infection. RESULTS: A total of 83 patients were included, out of which 42 received triple therapy with Omeprazole (control group) and 41 received triple therapy with Esomeprazole (study group). Five patients of the control group and 7 of the study group were lost in the follow-up stage and 3 patients of the control group and 2 of the study group were excluded due to the lackof a breath test. Out of the 34 patients of the control group, HP was eradicated in 25 of them (73,5%) while out of the 32 patients of the study group, HP was eradicated in 26 (81,2%). The most important adverse effects included: diarrhea, headaches, abdominal pain and constipation. CONCLUSIONS: Treatment with Esomeprazole showed an eradication rate of 8% greater than treatment with Omeprazole and the percentage of adverse effects was similar in both groups.

[Choledochal cyst in pregnancy and puerperium: report on two cases and review of literature]. / Quiste de colédoco en la gestación y puerperio: reporte de dos casos y revisión de la literatura.

A choledochal cyst is a cystic dilation of the intrahepatic or extrahepatic biliary tract. According to the most accepted theory, it is caused by an anomalous pancreatobiliary junction. The most important complications are cholangiocarcinoma, lithiasis, and pancreatitis. Current therapy is surgical resection. Only 20% to 30% of cases are diagnosed in adult life. Two cases of choledochal cysts are reported in female adult patients, one of them in late pregnancy and the other in puerperium. Diagnosis of choledochal cyst in pregnancy and puerperium is an uncommon event, entailing particular considerations regarding symptoms and treatment.