Pulmonary and Systemic Skeletal Muscle Embolism in a Beaked Whale with a Massive Trauma of Unknown Aetiology.

An adult female Sowerby's beaked whale was found floating dead in Hermigua (La Gomera, Canary Islands, Spain) on 7 December 2016. Severe traumas of unknown aetiology were attributed, and the gross and microscopic findings are consistent with catastrophic trauma as a cause of death. Rib fractures affected the intercostals, transverse thoracis skeletal muscles, and thoracic rete mirabile. Degenerated muscle fibres were extruded to flow into vascular and lymphatic vessels travelling to several anatomic locations into the thoracic cavity, including the lungs, where they occluded the small lumen of pulmonary microvasculature. A pulmonary and systemic skeletal muscle embolism was diagnosed, constituting the first description of this kind of embolism in an animal. The only previous description has been reported in a woman after peritoneal dialysis. Skeletal pulmonary embolism should be considered a valuable diagnostic for different types of trauma in vivo in wild animals. This is especially valuable when working with decomposed carcasses, as in those cases, it is not always feasible to assess other traumatic evidence.

Perfil Psicofisiológico del Estrés en Personas que viven con Diabetes Mellitus Tipo II / Psychophysiological Profile of Stress in People Living with Type II Diabetes Mellitus

Introducción: La diabetes Mellitus Tipo II se ha convertido en un problema de salud pública. Entre las variables psicosociales asociadas al automanejo de la diabetes, según diversos estudios, donde destacan Sánchez Sosa, Del Castillo Arreola, la Asociación Americana de Diabetes, se encuentra el estrés, el cual puede medirse a través de un perfil psicofisiológico. Objetivo: Determinar el nivel de respuestas fisiológicas como componentes del perfil psicofisiológico de estrés en personas que viven con Diabetes Mellitus Tipo II de un Centro de Salud de Hidalgo. Material y métodos: Se realizó un estudio observacional descriptivo, para medir las variables se utilizó un procedimiento de registro que incluyó cinco fases. El perfil psicofisiológico incluyó el registro de la temperatura periférica (TP) y la variabilidad de la frecuencia cardiaca (VFC). Debido a la activación simpática propia de la respuesta del estrés. Resultados: Los resultados denotan que la temperatura en las fases del estresor decrementó y en las fases de descanso 1 y 2 se incrementó en promedio entre 1° y 2°F en la mayoría de los pacientes. En el caso de la VFC hubo predominio parasimpático correspondiente a la potencia Alta Frecuencia (AF) en cada una de las fases del registro, mostrando así una actividad simpática disminuida. Conclusión: Estos resultados no coinciden con los reportes encontrados de estudios previos, se cree que estos podrían tener relación con la pertenencia a los grupos GAM, así como a la posible presencia de ateroesclerosis y dislipidemias. Estudios donde han realizado reportes del perfil psicofisiológico en pacientes con diabetes, muestran reducciones en la VFC total y la temperatura, estos últimos podrían significar resultados negativos.(AU)

Introduction: Diabetes has become a public health problem. Among the psychosocial variables associated with diabetes self-management, according to various studies, which include Sánchez Sosa, Del Castillo Arreola, the American Diabetes Association, is stress, which can be measured through a psychophysiological profile. Aim: Determine the level of physiological responses as components of the psychophysiological profile of stress in people living with type II diabetes mellitus of a Health Center in Hidalgo. Material and methods: A descriptive observational study was performed, to measure the variables a registration procedure was used that included five phases. The psychophysiological profile included the registration of peripheral temperature (TP) and heart rate variability (VFC). Due to the sympathetic activation of the stress response. Results: The results indicate that the temperature in the phases of the stressor decreased and in the rest phases 1 and 2 it increased on average between 1 ° and 2 ° F in most patients. In the case of the VFC was there a parasympathetic predominance corresponding to the AF? in each of the phases of the registry, thus showing a diminished sympathetic activity. Conclusion: These results do not coincide with the reports found from previous studies, it is believed that these could be related to belonging to the GAM groups, as well as to the possible presence of atherosclerosis and dyslipidemias. Studies where they have made reports of the psychophysiological profile in patients with diabetes, show reductions in total HRV and temperature, the latter could mean negative results.(AU)

Comparison of Methods for the Histological Evaluation of Odontocete Spiral Ganglion Cells.

Cetaceans greatly depend on their hearing system to perform many vital activities. The spiral ganglion is an essential component of the auditory pathway and can even be associated with injuries caused by anthropogenic noise. However, its anatomical location, characterized by surrounding bony structures, makes the anatomical and anatomopathological study of the spiral ganglion a difficult task. In order to obtain high-quality tissue samples, a perfect balance between decalcification and the preservation of neural components must be achieved. In this study, different methodologies for spiral ganglion sample preparation and preservation were evaluated. Hydrochloric acid had the shortest decalcification time but damaged the tissue extensively. Both formic acid and EDTA decalcification solutions had a longer decalcification time but exhibited better preservation of the neurons. However, improved cell morphology and staining were observed on ears pretreated with EDTA solution. Therefore, we suggest that decalcifying methodologies based on EDTA solutions should be used to obtain the highest quality samples for studying cell morphology and antigenicity in cetacean spiral ganglion neurons.

Bazo metastásico de un adenocarcinoma de endometrio. Presentación de un caso / Splenic metastasis from endometrial adenocarcinoma. A case presentation

Introducción: La metástasis esplénica de un carcinoma endometrial es un acontecimiento clínico raro, con solo 13 casos documentados en la literatura, revisada. La evolución de esta metástasis, en una paciente atendida, en nuestra Institución, fue el motivo para publicar este trabajo. Hay otras enfermedades oncológicas que en su evolución de progresión o recaída cursan con este tipo de cuadro clínico donde el tratamiento quirúrgico es fundamental y así complementar con tratamiento de quimioterapia. Se hizo una revisión en publicaciones cubanas no se encontró reporte del tema. Objetivo: Presentar un caso con un adenocarcinoma de endometrio tipo endometroide que metastiza al bazo con histología de células claras. Presentación: Paciente de 45 años, con diagnóstico de adenocarcinoma de endometrio con estadiamiento quirúrgico pT3A Nx Mo etapa IIIA Grado 2; este estadiamiento es el anterior a 2009, llevó su tratamiento quirúrgico y radioterapia complementaria, controlada por 21 meses. En consulta de seguimiento se diagnostica metástasis al bazo, por lo que se realiza esplenectomía y es tratada con quimioterapia; fue atendida por el equipo multidisciplinario de ginecología oncológica; las investigaciones realizadas estuvieron basadas en inmuhistoquimica, imageneología y tratamiento de soporte cuando lo necesitó. Conclusiones: La metástasis esplénica por un cáncer de endometrio es rara, es el primero reportado en Cuba, los estudios inmuhistoquímicos y de imágenes son fundamentales(AU)

Introduction: Splenic metastasis from endometrial carcinoma is a rare clinical event with only 13 documented cases in the literature reviewed. The evolution of a patient with this metastasis attended in our institution was the reason that motivated us to publish this work. There are other oncological diseases that are accompanied by this clinical picture during their evolution of progression where surgical treatment complemented with chemotherapy treatment is essential. A literature review was carried out in Cuban publications, but no reports on the topic were found. Objective: The aim of this work is to present an endometroid type case endometrium adenocarcinoma which metastasizes to the spleen with clear cell histology. Case presentation: Forty-five-year-old patient with diagnosis of endometrium adenocarcinoma with surgical stage pT3a Nx Mo stage IIIA Grade 2; this quantification was defined before 2009. The patient underwent surgical treatment which was complemented with radiotherapy and then followed for 21 months. In the follow-up consultation, spleen metastasis was diagnosed; so she underwent splenectomy and was treated with chemotherapy. She was treated by the multidisciplinary gynecologic oncology team; the investigations performed were based on immuhistochemistry, imaging, and supportive treatment whenever needed. Conclusions: Splenic metastasis from endometrial cancer is rare; it is the first case reported in Cuba. Immuhistochemical and imaging studies are essential(AU)

Untangling the evolutionary history of a highly polymorphic species: introgressive hybridization and high genetic structure in the desert cichlid fish Herichtys minckleyi.

Understanding the origin of biodiversity requires knowledge on the evolutionary processes that drive divergence and speciation, as well as on the processes constraining it. Intraspecific polymorphisms can provide insight into the mechanisms that generate and maintain phenotypic, behavioural and life history diversification, and can help us understand not only the processes that lead to speciation but also the processes that prevent local fixation of morphs. The 'desert cichlid' Herichtys minckleyi is a highly polymorphic species endemic to a biodiversity hotspot in northern Mexico, the Cuatro Ciénegas valley. This species is polymorphic in body shape and trophic apparatus, and eco-morphotypes coexist in small spring-fed lagoons across the valley. We investigated the genetic structure of these polymorphisms and their phylogeographic history by analysing the entire control region of the mitochondrial DNA and 10 nuclear microsatellite markers in several populations from different sites and morphs. We found two very divergent mitochondrial lineages that most likely predate the closing of the valley and are not associated with morphotypes or sites. One of these lineages is also found in the sister species Herichthys cyanoguttatus. Data from neutral microsatellite markers suggest that most lagoons or drainages constitute their own genetic cluster with sympatric eco-morphotypes forming panmictic populations. Alternative mechanisms such as phenotypic plasticity and a few loci controlled traits provide possible explanations for the sympatric coexistence of discrete nonoverlapping eco-morphotypes with apparent lack of barriers to gene flow within multiple lagoons and drainages.

Interventional nephrology in Puerto Rico: a four year experience.

Puerto Rico is one of the most prevalent areas covered by Medicare in need of renal replacement therapy for which interventional procedures are performed. A cumulative analysis of this management is reported in patients during the period between June 2007 and August 2010. Experience accumulated with 3755 surgical patients revealed that 58% had intravascular catheters, 28% had arteriovenous fistulas, 15% had arteriovenous grafts, and 2% without vascular access. Procedures performed in these patients were: catheter introduction in 1990 cases (33%), angioplasty in 751 cases (20%), angiography in 450 cases (12%), thrombectomy in 413 cases (11%) and venous mapping in 151 cases (4%). The success rates of these procedures were evaluated by analysis of the Society of Interventional Radiology (SIR) criteria for Lifeline Vascular Access. Using SIR definition of success rate for at least one session that includes "declots", placement of catheters and angioplasty, our results revealed an average of 98.2% overall success rate greater than the standard value KDOQI/SIR (> 85% ). This study has documented for four years the success rate of Vascular Interventional Nephrology Center at Auxilio Mutuo Hospital. In order to maintain this success rate is necessary to further evaluate its effectiveness and, most importantly, the development of an educational program for vascular access in patients with chronic kidney disease prior to placement in dialysis units.

Prevalencia del síndrome de burnout en las y los trabajadores sociales del Instituto Nicaragüense de Seguridad Social. abril 2015

En esta investigación se evaluó la presencia del Síndrome de Burnout en lapoblación de Trabajadores Sociales que laboran en el Instituto Nicaragüense deSeguridad Social, específicamente en las áreas de Prestaciones económicas yclínicas médicas previsionales (IPSS); además se determinó cuáles fueron losposibles factores de riesgo que influyen en la aparición del síndrome de Burnouten esta organización. Para poder llevar a cabo el estudio se aplicó unaherramienta que constó de dos partes; la primera empleada para recoger datossocio demográficos así como información del entorno laboral y una segunda parteen donde se aplicó la adaptación al español del “Burnout Maslach Inventory”;siendo este, el instrumento diagnóstico.Los resultados indican que existe una prevalencia del Síndrome de Burnout del18% y que los factores que pueden estar influyendo en la aparición del mismo sonlas cargas laborales excesivas y puestos de trabajo no adecuados.Otro aspecto relevante encontrado fue que un 63% de la población incluida eneste estudio presenta Agotamiento o Cansancio Emocional.

Predisposing factors for acute kidney injury in Hispanic patients treated with diuretics for decompensated heart failure.

OBJECTIVE: In patients with congestive heart failure (CHF), use of loop diuretic therapy may result in acute kidney insufficiency (AKI). We assessed the factors that contributed to the development of AKI in patients with CHF treated with loop diuretics in a sample of patients who attended the Cardiovascular Center of Puerto Rico and the Caribbean (CCPRC). METHODS: Medical records of 236 patients admitted between: January 1, 2008 to December 31, 2008 with the diagnosis of CHF were reviewed. Diagnosis of CHF based on symptoms and signs was confirmed by echocardiography. Twenty six (26) patients with significant valvular disease and four (4) patients who did not receive diuretics during hospitalization were excluded. Hospital course was observed until diuretic therapy was discontinued or patient was discharged. AKI was defined as a 25% increase in serum creatinine level after the start of diuretic therapy. The study sample was categorized in two groups: patients who developed AKI and those who did not. Variables associated with AKI (p<0.05) in the bivariate logistic regression models were included in the multivariate logistic regression models. RESULTS: In the multivariate logistic regression model, only a greater dose of diuretic therapy (>80 mg/dl) and history of diabetes mellitus were significantly (p<0.05) associated with AKI. CONCLUSION: Analysis of data shows that increased doses of diuretic therapy and history of diabetes mellitus were significantly associated with AKI in patients with CHF. This study highlights the importance of monitoring the doses of diuretic therapy during hospitalization, in this group of patients.

Tratamiento con terapia floral de Bach y homeopatía a fumadores del Policlínico Norte de Morón / Treatment with Bach floral therapy and homeopathy in smoker patients from Morón North polyclinic

Se realizó un estudio de intervención antes y después de aplicar el tratamiento con terapia floral de Bach y homeopatía a un grupo de fumadores del Policlínico Norte de Morón, en el período de septiembre del 2009 a febrero del 2010 con el objetivo de determinar la efectividad de la terapia floral combinada con la homeopatía, en el tratamiento del hábito de fumar. El universo estuvo constituido por 20 fumadores. Los datos se recolectaron a través de la encuesta. La mayoría de los fumadores tenían entre 40-49 años, del sexo masculino, fumadores moderados a severos, estilo de fumar adictivo, iniciaron su hábito antes de los 16 años; el padecimiento relacionado con la adicción tabáquica, más relevante correspondió a la hipertensión arterial y un gran por ciento intentaron dejar de fumar anteriormente. Se utilizaron como esencias florales: agrimony, cherry plum, crab apple y larch y como remedio homeopático el nicotinum a la 30 CH. El 70 por ciento de los fumadores atendidos disminuyeron el consumo del cigarro considerablemente y el 30 por ciento, lo abandonó. A pesar de que no todos eliminaron por completo este nocivo hábito, se lograron buenos resultados con el empleo de la terapia floral de Bach y la homeopatía.

An intervention study was carried out before and after the treatment with bach floral therapy and homeopathy to a smoker group of Morón north polyclinic, from September 2009 to February 2010 with the aim to determine the effectiveness of floral therapy combined with the homeopathy, in the smoking habit treatment,the universe was composed by 20 smokers.data were collected through the survey. Most of the smokers were between 40-49 years, of masculine sex, moderate smokers to severe, an addictive style of smoking, they initiated their habit before 16 years; the more relevant suffering related to the tobacco addition corresponded to the arterial hypertension and a great percent tried to stop smoking previously. They were used as floral essences: agrimony, cherry plum, crab apple and larch and nicotinum to the 30 ch as homeopathic remedy. 70 percent of smokers seen decreased significantly the cigarette consumption and the 30 percent gave up it. In spite of the fact that not all of them eliminate completely this harmful habit, good results were achieved with the use of bach floral therapy and the homeopathy.

Tratamiento con terapia floral de Bach y homeopatía a fumadores del Policlínico Norte de Morón / Treatment with Bach floral therapy and homeopathy in smoker patients from Morón North polyclinic

Se realizó un estudio de intervención antes y después de aplicar el tratamiento con terapia floral de Bach y homeopatía a un grupo de fumadores del Policlínico Norte de Morón, en el período de septiembre del 2009 a febrero del 2010 con el objetivo de determinar la efectividad de la terapia floral combinada con la homeopatía, en el tratamiento del hábito de fumar. El universo estuvo constituido por 20 fumadores. Los datos se recolectaron a través de la encuesta. La mayoría de los fumadores tenían entre 40-49 años, del sexo masculino, fumadores moderados a severos, estilo de fumar adictivo, iniciaron su hábito antes de los 16 años; el padecimiento relacionado con la adicción tabáquica, más relevante correspondió a la hipertensión arterial y un gran por ciento intentaron dejar de fumar anteriormente. Se utilizaron como esencias florales: agrimony, cherry plum, crab apple y larch y como remedio homeopático el nicotinum a la 30 CH. El 70 por ciento de los fumadores atendidos disminuyeron el consumo del cigarro considerablemente y el 30 por ciento, lo abandonó. A pesar de que no todos eliminaron por completo este nocivo hábito, se lograron buenos resultados con el empleo de la terapia floral de Bach y la homeopatía(AU)

An intervention study was carried out before and after the treatment with bach floral therapy and homeopathy to a smoker group of Morón north polyclinic, from September 2009 to February 2010 with the aim to determine the effectiveness of floral therapy combined with the homeopathy, in the smoking habit treatment,the universe was composed by 20 smokers.data were collected through the survey. Most of the smokers were between 40-49 years, of masculine sex, moderate smokers to severe, an addictive style of smoking, they initiated their habit before 16 years; the more relevant suffering related to the tobacco addition corresponded to the arterial hypertension and a great percent tried to stop smoking previously. They were used as floral essences: agrimony, cherry plum, crab apple and larch and nicotinum to the 30 ch as homeopathic remedy. 70 percent of smokers seen decreased significantly the cigarette consumption and the 30 percent gave up it. In spite of the fact that not all of them eliminate completely this harmful habit, good results were achieved with the use of bach floral therapy and the homeopathy(AU)

Prevalencia de chasquido en la ATM y su relación con el tipo de oclusión dental, en un grupo de jóvenes mexicanos / The prevalence of TMJ clicking and its relationship to dental occlusion type in a group of young Mexicans

Antecedentes: El chasquido es un ruido articular de corta duración y su relevancia radica en que es uno de los principales signos de disfuncióntemporomandibular. Algunos autoresponen en controversia el papel de la oclusión dental como un factor asociado en el desarrollo de alguna alteración de la ATM. Objetivo: Por esta razón, el presente estudio tuvo como propósito evaluar la posible asociación entreambas variables. Materiales y métodos: Se encuestaron 246 alumnos de la carrera Cirujano Dentista de la FESZaragoza. Previo al levantamiento epidemiológico se intracalibró a un pasante de la carrera de Cirujano Dentista (kappa=0.84). Para diagnosticar la presencia de chasquido en la ATM se utilizó un estetoscopio y para evaluar el tipo de oclusión dental fueron aplicados los criterios propuestos por Angle. Resultados: En cuanto a la prevalencia de chasquido por edad no mostró diferencias entre los grupos etarios estudiados (X2Y=1.745,p=0.187).Tampoco hubo asociación con el género a pesar de que la prevalencia fue mayor en mujeres (X2Y=6.037, p=0.144). Asimismo, se observó que fue más frecuente la presencia de chasquido en la ATM del lado derecho que del izquierdo, sin embargo, esta diferencia no mostró significancia alguna (t=7.98, p=0.833). La prevalencia de chasquido en la ATM sólo resultó estar asociada a las maloclusiones dentales Clase II y III (X2Y=18.195, p=0.0001). Conclusiones: La prevalencia de chasquido sí estuvo asociada al tipo de oclusión, sólo en los casos de maloclusión Clase II y III.

Promoción de salud con acciones sistemáticas en la comunidad, desde la biblioteca / Systematic Actions on Health Promotion through the Library

Se realizó un estudio descriptivo de corte transversal para determinar el impacto de las acciones de promoción y educación para la salud desarrolladas por la Biblioteca en diferentes instituciones aledañas a nuestra filial en el período comprendido entre octubre 2007 y mayo 2008. Se seleccionó una muestra probabilística de 75 usuarios integrados por 22 ancianos de un círculo de abuelos, 15 estudiantes de secundaria básica, 20 de primaria, 8 de Gestión Información en Salud (GIS) y un Consultorio del Médico de la Familia, donde se seleccionaron 10 embarazadas. Como resultado se obtuvo que las acciones de educación y promoción para la salud tuvieron un gran impacto en las diferentes instituciones en orden de prioridad se destaca Círculo de Abuelos, grupo de embarazadas, estudiantes de GIS, secundaria básica y primaria...(AU)

A cross-sectional descriptive study was carried out, aimed at determining the impact of health promotion actions developed by the library in several institutions near the Faculty, from October 2007 to May 2008. The sample comprised 75 users, 22 of them were grandparents, and 15 were students from the secondary school, 20 of them were students from primary school and 10 pregnants from the Family Doctors consulting room and 8 students from the Health Statistics specialty...(AU)