A pre-Hispanic canoe or Wampo burial in Northwestern Patagonia, Argentina.

The burial of Individual 3 at the Newen Antug site, a young adult woman, with a pottery grave offering characteristic of the Late Pottery period and dated to 880 years BP, is an indirect burial in a wooden structure. The form and design comprise a wooden wampo or small canoe, or a symbolic representation of one, a metaphor in current and historical Mapuche society for the voyage to the final abode of the dead, located beyond a water body which must be crossed in a boat. This is the first find of a burial in a canoe structure in Argentinian Patagonia, and the most southern example on the whole continent. It is also the earliest record in Argentina of pottery of the Red on White Bichrome tradition used as a grave offering, extending the repertoire of characteristics shared between the two slopes of the Andes mountains during the pottery periods, including ritual as well as material aspects.

[Diagnostic rentability of close pleural biopsy: Tru-cut vs. Cope]. / Rentabilidad diagnóstica de la biopsia pleural cerrada: Tru-cut frente a Cope.

BACKGROUND: The prevalence of pleural effusion in Mexico is over 400 per 100 000 inhabitants. The etiology is infectious in 45.7% and neoplastic in 32.6%. Closed pleural biopsy sensibility is 48-70% in cancer and 50-59% in tuberculosis using Cope or Abrams needle. In 1989, Tru-cut needle biopsy was described in a small study for massive pleural effusions with a sensibility of 86%. Our Institute has a wide experience with this infrequently procedure with reliable results than using Cope needle. Diagnostic yield should be evaluated. We aimed to evaluate the diagnostic yield of Tru-cut vs. standard Cope biopsy in the histopathological diagnosis of pleural effusion. METHODS: Experimental, not blinded, analytical, cross-sectional study. We studied 44 patients (24 male and 20 female) with exudative pleural effusion over a period of 14 months. Every patient underwent four Tru-cut and four Cope needle biopsies. The diagnostic yield of both methods was compared. RESULTS: The mean age of patients was 61.4 ± 12.2 years. The diagnosis was achieved in 25 (57%) of patients using Tru-cut and 22 (50%) of patients using Cope's closed pleural biopsy. The diagnostic value was not significantly higher (p = 0.41). The most common diagnoses were adenocarcinoma (20.5%), mesothelioma (15.9%) and tuberculosis (15.9%). CONCLUSIONS: The diagnostic yield of Tru-cut needle biopsy is slightly higher than Cope pleural biopsy, very similar to that reported previously. The experience in this procedure is an advantage in our clinical practice.

Introducción: la prevalencia del derrame pleural en México es superior a 400 por 100 000 habitantes. Entre los exudados encontramos etiología infecciosa en 45.7% y neoplásica en 32.6%. La biopsia pleural tiene una sensibilidad de 48-70% en cáncer y 50-90% en tuberculosis si se utiliza aguja de Cope o Abrams. En 1989, se describió la biopsia con aguja cortante (Tru-cut) en un estudio con una sensibilidad de 86%. En nuestro hospital contamos con amplia experiencia en este procedimiento poco practicado actualmente. El objetivo fue comparar la rentabilidad diagnóstica y la seguridad de las biopsias pleurales con aguja de Tru-cut contra aguja de Cope en pacientes con patología pleural. Métodos: estudio experimental, no ciego, analítico, transversal. Se incluyeron 44 pacientes con exudado pleural. A cada paciente se le realizaron cuatro biopsias pleurales con aguja de Tru-cut y cuatro con aguja de Cope para comparar la rentabilidad diagnóstica con ambos procedimientos. Resultados: la media de edad de los pacientes fue de 61.4 ± 12.2 años. La rentabilidad diagnóstica con la aguja de Tru-cut fue de 57% y con Cope de 50% (p = 0.411). El valor diagnóstico no fue significativamente alto (p = 0.41). Los diagnósticos más comunes fueron: adenocarcinoma (20.5%), mesotelioma (15.9%) y tuberculosis (15.9%). Conclusiones: la rentabilidad diagnóstica de las biopsias pleurales cerradas con aguja de Tru-cut es ligeramente mayor a la obtenida con aguja de Cope. Se trata de una fortaleza en nuestra práctica clínica.

Atención primaria como elemento de planificación y evaluación académica de la función vinculación Universidad-Sociedad / Primary care as a planning and academic evaluation of university/society linkages function

El modelo educativo de la Universidad Nacional Autónoma de Honduras reformula la educación como una actividad social y concibe los procesos educativos con la finalidad de obtener en la comunidad aprendizajes significativos, contribuir al bienestar integral y al desarrollo humano sostenible de la población y del país. Para lograr esto es necesario incorporar en la planificación académica de vinculación y en los proyectos de intervención en salud; dos elementos de suma importancia: Promoción de la Salud y Atención Primaria de Salud. Orientar las acciones de vinculación con estos elementos permite evaluar a nivel docente-estudiantil, los conocimientos generales que tienen en la formulación de proyectos educativos de vinculación, con el fin de realizar aprendizajes significativos y adquirir las competencias necesarias para trabajar en equipos de Atención Primaria de Salud. Honduras amerita enfoques que busquen el desarrollo del bienestar humano de manera sostenible, que la salud sea vista como un derecho; que los estudiantes se formen bajo el paradigma de la democratización del conocimiento y haciendo acciones que le permitan obtener ese aprendizaje significativo y transformador...(AU)

Molecular taxonomy of Anopheles (Nyssorhynchus) benarrochi (Diptera: Culicidae) and malaria epidemiology in southern Amazonian Peru.

Anopheline specimens were collected in 2011 by human landing catch, Shannon and CDC traps from the malaria endemic localities of Santa Rosa and San Pedro in Madre de Dios Department, Peru. Most specimens were either Anopheles (Nyssorhynchus) benarrochi B or An. (Nys.) rangeli, confirmed by polymerase chain reaction-restriction fragment length polymorphism-internal transcribed spacer 2 (PCR-RFLP-ITS2) and, for selected individuals, ITS2 sequences. A few specimens from Lupuna, Loreto Department, northern Amazonian Peru, were also identified as An. benarrochi B. A statistical parsimony network using ITS2 sequences confirmed that all Peruvian An. benarrochi B analyzed were identical to those in GenBank from Putumayo, southern Colombia. Sequences of the mtDNA COI BOLD region of specimens from all three Peruvian localities were connected using a statistical parsimony network, although there were multiple mutation steps between northern and southern Peruvian sequences. A Bayesian inference of concatenated Peruvian sequences of ITS2 + COI detected a single clade with very high support for all An. benarrochi B except one individual from Lupuna that was excluded. No samples were positive for Plasmodium by CytB-PCR.

[Endoscopic sclerosis of bleeding caused by Dieulafoy's lesion]. / Esclerosis endoscópica de lesión de Dieulafoy Gástrica Sangrante.

The upper gastrointestinal bleeding by Dieulafoy's lesion is a rare cause of bleeding, it is a massive haemorrhage and it is difficult to diagnose. Endoscopy is the diagnostic method of choice, in many cases are necessary repeated examinations. Endoscopic therapy is the therapeutic approach of choice, it can achieve the hemostasis in more than 90% of cases; combined therapy methods being more effective than single monotherapy. Surgical treatment remains for cases of uncontrolled hemorrhaging. Dieulafoy's lesion is a rare condition. We have only two nation wide reports. We present two cases of patients with gastric Dieulafoy's lesion with active bleeding which were successfully treated with injection endoscopic of epinephrine and absolute alcohol therapy, showing no relapse of bleeding after 12 months. They did not present other episode of haemorrhage during the twelve months after initial bleeding.

Esclerosis endoscópica de lesión de Dieulafoy gástrica sangrante / Endoscopic sclerosis of Bleeding Dieulafoy lesion

La hemorragia digestiva alta por Lesión de Dieulafoy es una causa rara de sangrado, siendo en la gran mayoría de casos masiva y de diagnóstico difícil. El método diagnóstico de elección es el endoscópico, requiriéndose a veces endoscopias repetidas. La terapia endoscópica es el método terapéutico de elección, alcanzando la hemostasia en más del 90 por ciento de los casos, siendo los métodos combinados más eficaces que la monoterapia endoscópica; quedando la cirugía para aquellos casos de sangrado incontrolado. Por ser la lesión de Dieulafoy una entidad rara y al encontrar sólo dos publicaciones nacionales, es que se presentan éstos dos casos de pacientes con Lesiones de Dieulafoy gástricas con sangrado activo, que fueron exitosamente tratadas con terapia endoscópica de inyección con adrenalina y alcohol absoluto, no existiendo recidiva del sangrado 12 meses después.

The upper gastrointestinal bleeding by Dieulafoy’s lesion is a rare cause of bleeding, it is a massive haemorrhage and it is difficult to diagnose. Endoscopy is the diagnostic method of choice, in many cases are necessary repeated examinations. Endoscopic therapy is the therapeutic approach of choice, it can achieve the hemostasis in more than 90 per cent of cases; combined therapy methods being more effective than single monotherapy. Surgical treatment remains for cases of uncontrolledhemorraghe. Dieulafoy’s lesion is a rare condition. We have only two nation widereports. We present two cases of patients with gastric Dieulafoy’s lesion with active bleeding which were successfully treated with injection endoscopic of epinephrine and absolute alcohol therapy, showing no relapse of bleeding after 12 months. They did not present other episode of haemorrhage during the twelve months after initialbleeding.

[Peutz-Jeghers syndrome and colon adenocarcinoma]. / Síndrome de Peutz-Jeghers y adenocarcinoma de colon.

The Peutz-Jeghers syndrome is an autosomal dominant disorder characterized by the presence of hamartomatous polyps and characteristic mucocutaneous pigmentations. It is a rare syndrome and its associated to high risk for both gastrointestinal and non-gastrointestinal malignancies. The case of a patient, 32 years old, with symptoms of abdominal pain and rectal bleeding is reported. The upper gastric endoscopy and colonoscopy showed hamartomatous polyps and a tumor in the colon. Reported as a tubular polyp with severe dysplasia, the patient underwent surgical treatment. The final anatomopathologic diagnosis was colon adenocarcinoma.

Síndrome de Peutz-Jeghers y adenocarcinoma de colon / Syndrome of Peutz-Jeghers and adenocarcinoma of colon

El síndrome de Peutz-Jeghers es un desorden autosómico dominante, caracterizado por la presencia de pólipos hamartomatosos intestinales y pigmentaciones mucocutáneas características. Es un síndrome raro y se halla asociado a un alto riesgo de malignidad gastrointestinal y no gastrointestinal. Presentamos el caso de una paciente de 32 años con historia de dolor abdominal y sangrado rectal. La endoscopia digestiva alta y colonoscopia revelaron pólipos hamartomatosos y una tumoración en el colon, informada como pólipo tubular con displasia severa, por lo que fue indicado el tratamiento quirúrgico. El diagnóstico anátomo-patológico final fue un adenocarcinoma de colon.

The Peutz-Jeghers syndrome is an autosomal dominant disorder characterized by the presence of hamartomatous polyps and characteristic mucocutaneous pigmentations. It is a rare syndromeand its associated to high risk for both gastrointestinal and non-gastrointestinal malignancies. The case of a patient, 32 years old, with symptoms of abdominal pain and rectal bleeding is reported.The upper gastric endoscopy and colonoscopy showed hamartomatous polyps and a tumor in the colon. Reported as a tubular polyp with severe dysplasia, the patient underwent surgical treatment. The final anatomopathologic diagnosis was colon adenocarcinoma.