Chemical Characterization of Trichoderma spp. Extracts with Antifungal Activity against Cocoa Pathogens.

Ecuador is one of the major cocoa producers worldwide, but its productivity has lately been affected by diseases. Endophytic biocontrol agents have been used to minimize pathogenic effects; however, compounds produced by endophytes are minimally understood. This work presents the chemical characterization of the Trichoderma species extracts that proved inhibition against cocoa pathogens. Solid-liquid extraction was performed as a partitioning method using medium with the fungal mycelia of Trichoderma reesei (C2A), Trichoderma sp. (C3A), Trichoderma harzianum (C4A), and Trichoderma spirale (C10) in ethyl acetate individually. The extract of T. spirale (C10) exhibited the growth inhibition (32.97-47.02%) of Moniliophthora perniciosa at 10 µg/mL, while a slight stimulation of Moniliophthora roreri was shown by the extracts of T. reesei (C2A) and T. harzianum (C4A) at higher concentrations. The inhibitory activity could be related to alkaloids, lactones, quinones, flavonoids, triterpenes, and sterols, as indicated by chemical screening and antifungal compounds, such as widdrol, ß-caryophyllene, tyrosol, butyl isobutyrate, sorbic acid, palmitic acid, palmitelaidic acid, linoleic acid, and oleic acid, which were identified by gas chromatography-mass spectrometry (GC-MS). The results showed that the extracts, particularly T. spirale (C10), have the potential as biocontrol agents against witches' broom disease; however, further studies are needed to confirm their effectiveness.

The Mechanism of Action between Pulsed Radiofrequency and Orthobiologics: Is There a Synergistic Effect?

Radiofrequency energy is a common treatment modality for chronic pain. While there are different forms of radiofrequency-based therapeutics, the common concept is the generation of an electromagnetic field in the applied area, that can result in neuromodulation (pulsed radiofrequency-PRF) or ablation. Our specific focus relates to PRF due to the possibility of modulation that is in accordance with the mechanisms of action of orthobiologics. The proposed mechanism of action of PRF pertaining to pain relief relies on a decrease in pro-inflammatory cytokines, an increase in cytosolic calcium concentration, a general effect on the immune system, and a reduction in the formation of free radical molecules. The primary known properties of orthobiologics constitute the release of growth factors, a stimulus for endogenous repair, analgesia, and improvement of the function of the injured area. In this review, we described the mechanism of action of both treatments and pertinent scientific references to the use of the combination of PRF and orthobiologics. Our hypothesis is a synergic effect with the combination of both techniques which could benefit patients and improve the life quality.

LKB-1 Expression and High-Risk Histopathology are Independent Prognostic Factors for Patients with Oral Cavity Carcinoma.

BACKGROUND: The expression of liver kinase B1 (LKB-1) has been associated with prognosis in squamous cell carcinoma of the oral cavity (SCCOC). This study aimed to define the prognostic role of LKB-1 expression for patients with SCCOC and the suitability of its integration into a multivariate prognostic model. METHODS: A retrospective cohort study of patients with SCCOC was conducted in a cancer center. Expression of LKB-1 was evaluated by immunohistochemistry, and multivariate analysis defined prognostic factors associated with recurrence, recurrence-free survival (RFS), and overall survival (OS). The logistic regression model was used to construct a predictive computer software program. RESULTS: Of the 201 patients in this study, 104 (51.7%) experienced recurrence of their disease. Lower expression of LKB-1, high-risk histopathology, and advanced tumor-node-metastasis (TNM) stages were independent factors via multivariate analysis associated with the increased recurrence risk, poor RFS, and poor OS. If lack of LKB-1 expression is considered the reference category, the factors independently associated with recurrence were low (odds ratio [OR], 0.157; 95% confidence interval [CI], 0.044-0.557), intermediate (OR, 0.073; 95% CI, 0.017-0.319), and intense (OR, 0.047; 95% CI, 0.007-0.304) expression of LKB-1. This model permitted construction of a computer software program capable of prediction with receiver operating characteristic analysis (area under the curve, 0.925) and led to the definition of five prognostic groups with a biologic gradient. CONCLUSION: These results suggest that LKB-1 expression in patients with SCCOC is of robust prognostic value and complements the TNM staging system. The proposed model requires external validation in prospective observational studies.

Biosurfactants synthesized by endophytic Bacillus strains as control of Moniliophthora perniciosa and Moniliophthora roreri

ABSTRACT: Ecuador is responsible for up to 70 % of the worlds production of fine flavor cocoa. Although fungal diseases have reduced cocoa production, ecofriendly alternatives have been implemented to control the spread of phytopathogens. This study aimed to explore the potential of endophytic strains isolated from fine flavor Nacional cocoa trees to synthetize compounds with antimicrobial and surface active properties. It was determined that under in vitro conditions, seven strains (DS03, DS07, DS18, DS23, DS31, DS34 and DS50) exhibited antifungal activity that inhibited the mycelial growth of Moniliophthora roreri and Moniliophthora perniciosa. The strains were identified based on their morphological (pattern forming Bacilli) and genetic characteristics using the 16S SSU rRNA gene sequences. Furthermore, we determined that the endophytic strains contained genes that encoded the lipopeptides Fengycin (fenA, fenB, fenC, fenE), Iturin (ituB, ituC, ituD), and Bacyllomicin D (bamC, bamD). The production of biosurfactant compounds was determined by a reduction in surface tension in the mineral medium. Additionally, the biosurfactant crude extract (BCE) was tested for its inhibitory activity against M. perniciosa and M. roreri. The minimal inhibitory concentration (MIC) was determined to be 0.07 and 0.035 mg mL1, respectively, in both cases in a fungistatic action mode. The swelling granulation and fragmentation of both phytopathogens hyphae were observed using the BCE treatment. These results suggested the biocontrol capacity of the endophytic strains, which under in vitro conditions, have the ability to synthesize antifungal and surface active compounds that might be used as an ecological alternative in cocoa plants to prevent infection by phytopathogens.

Biosurfactants synthesized by endophytic Bacillus strains as control of Moniliophthora perniciosa and Moniliophthora roreri

Ecuador is responsible for up to 70 % of the world’s production of fine flavor cocoa. Although fungal diseases have reduced cocoa production, eco–friendly alternatives have been implemented to control the spread of phytopathogens. This study aimed to explore the potential of endophytic strains isolated from fine flavor Nacional cocoa trees to synthetize compounds with antimicrobial and surface active properties. It was determined that under in vitro conditions, seven strains (DS03, DS07, DS18, DS23, DS31, DS34 and DS50) exhibited antifungal activity that inhibited the mycelial growth of Moniliophthora roreri and Moniliophthora perniciosa. The strains were identified based on their morphological (pattern forming Bacilli) and genetic characteristics using the 16S SSU rRNA gene sequences. Furthermore, we determined that the endophytic strains contained genes that encoded the lipopeptides Fengycin (fenA, fenB, fenC, fenE), Iturin (ituB, ituC, ituD), and Bacyllomicin D (bamC, bamD). The production of biosurfactant compounds was determined by a reduction in surface tension in the mineral medium. Additionally, the biosurfactant crude extract (BCE) was tested for its inhibitory activity against M. perniciosa and M. roreri. The minimal inhibitory concentration (MIC) was determined to be 0.07 and 0.035 mg mL−1, respectively, in both cases in a fungistatic action mode. The swelling granulation and fragmentation of both phytopathogens’ hyphae were observed using the BCE treatment. These results suggested the biocontrol capacity of the endophytic strains, which under in vitro conditions, have the ability to synthesize antifungal and surface active compounds that might be used as an ecological alternative in cocoa plants to prevent infection by phytopathogens.

Biosurfactants synthesized by endophytic Bacillus strains as control of Moniliophthora perniciosa and Moniliophthora roreri

Ecuador is responsible for up to 70 % of the worlds production of fine flavor cocoa. Although fungal diseases have reduced cocoa production, eco–friendly alternatives have been implemented to control the spread of phytopathogens. This study aimed to explore the potential of endophytic strains isolated from fine flavor Nacional cocoa trees to synthetize compounds with antimicrobial and surface active properties. It was determined that under in vitro conditions, seven strains (DS03, DS07, DS18, DS23, DS31, DS34 and DS50) exhibited antifungal activity that inhibited the mycelial growth of Moniliophthora roreri and Moniliophthora perniciosa. The strains were identified based on their morphological (pattern forming Bacilli) and genetic characteristics using the 16S SSU rRNA gene sequences. Furthermore, we determined that the endophytic strains contained genes that encoded the lipopeptides Fengycin (fenA, fenB, fenC, fenE), Iturin (ituB, ituC, ituD), and Bacyllomicin D (bamC, bamD). The production of biosurfactant compounds was determined by a reduction in surface tension in the mineral medium. Additionally, the biosurfactant crude extract (BCE) was tested for its inhibitory activity against M. perniciosa and M. roreri. The minimal inhibitory concentration (MIC) was determined to be 0.07 and 0.035 mg mL−1, respectively, in both cases in a fungistatic action mode. The swelling granulation and fragmentation of both phytopathogens hyphae were observed using the BCE treatment. These results suggested the biocontrol capacity of the endophytic strains, which under in vitro conditions, have the ability to synthesize antifungal and surface active compounds that might be used as an ecological alternative in cocoa plants to prevent infection by phytopathogens.(AU)

Evaluation of the sensitivity and synergistic effect of Trichoderma reesei and mancozeb to inhibit under in vitro conditions the growth of Fusarium oxysporum.

Trichoderma is a saprophytic, soil-borne fungus with a worldwide distribution that has been extensively studied due to their capacity to synthesize secondary metabolites with antimicrobial activity, parasitize other fungi and directly interact with plant roots, inducing resistance to disease and tolerance to abiotic stresses. Fusarium wilt caused by the soil-inhabiting fungus Fusarium oxysporum is considered one of the most important diseases that affect banana cultivars. Currently, more environmentally friendly alternatives to control this disease are being proposed, these strategies include the application of low doses of synthetic fungicides and the use of biocontrol agents such as Trichoderma or Xylaria. Thus, this study aimed to evaluate under in vitro conditions the synergistic effect of the biological control agent T. reesei C2A combined with low doses of mancozeb to inhibit the mycelial growth of F. oxysporum F1. To perform the synergistic essays, 0.1 mg/mL of mancozeb was suspended in PDA plates, then plugs of T. ressei C2A were placed at the center of the Petri dishes, the plates were incubated for 7 days at 28°C. Results showed that the mycoparasitic capacity of the biocontrol strain to inhibit the mycelial growth of F. oxysporum F1 was enhanced approximately 36% compared to the control plates. Although these results are promising, future studies under greenhouse and field conditions are necessary to corroborate the effectiveness of this approach.

Glass Transition in Crosslinked Nanocomposite Scaffolds of Gelatin/Chitosan/Hydroxyapatite.

The development of biopolymeric scaffolds crosslinked with nanoparticles is an emerging field. Gelatin/chitosan scaffolds are gaining interest in medical areas, e.g., bone tissue engineering, given their suitability for nano-hydroxyapatite incorporation. The glass transition temperature is a thermodynamic property of polymer scaffolds that changes with crosslinker or nanofiller concentration. Here, we report the experimental change in glass transition temperature of gelatin/chitosan scaffolds modified by hydroxyapatite nanoparticles and crosslinker concentration. Our results show synergic effects between nanoparticles and crosslinking, which leads to a non-linear behavior of the glass transition temperature. Furthermore, a theoretical model to predict glass transition is proposed. This model can be used as a mathematical tool for the design of future scaffolds used in bone tissue engineering.

[Comparación del índice de neutrófilos/linfocitos, la escala de SOFA y la concentración sérica de procalcitonina como indicadores de la gravedad de la apendicitis aguda]. / Comparison of the neutrophil-to-lymphocyte ratio, SOFA score and serum procalcitonin as biomarkers of acute appendicitis.

Introducción: La apendicitis aguda (AA) es una de las principales causas de abdomen agudo. Un retraso en su diagnóstico y tratamiento elevan la morbimortalidad. Objetivo: Evaluar el índice de neutrófilos/linfocitos (INL), la escala SOFA (Sequential Organ Failure Assessment), la procalcitonina (PCT) y la bilirrubina total (BT), y ver si existe relación como determinantes de la gravedad de la AA. Método: Estudio retrospectivo, observacional, para comparar el INL contra biomarcadores (PCT, BT) y contra escalas de gravedad (APACHE II [Acute Physiology and Chronic Health Evaluation] y SOFA) y quirúrgica (Mannheim). Resultados: 82 casos de enero a mayo de 2017. El 80.8% de los casos con peritonitis generalizada presentaron un INL > 12 (p = 0.002). El 66% de los casos con perforación apendicular presentaban un INL > 12 (p = 0.024). El 70% de los casos graves por BT mostraron un INL > 12 (p = 0.004). El 75% de los casos graves por PCT presentaban un INL > 12 (p = 0.006). El 50% de los casos con SOFA > 6 mostraron un INL > 12 (U de Mann-Whitney, p = 0.023). Conclusión: Existe una relación entre el INL tanto con SOFA, BT y PCT, lo cual indica que un INL > 12 puntos podría estar relacionado con peritonitis generalizada y apendicitis perforada.

Background: Acute appendicitis (AA) is one of the main causes of acute abdomen that requires urgent surgical treatment, a delay in its diagnosis and therapeutic increase in morbidity and mortality. Objective: To evaluate the usefulness of inflammatory markers as a tool to compare the neutrophil/lymphocyte ratio (NLR), the SOFA scale (Sequential Organ Failure Assessment) and the serum level of procalcitonin, total bilirubin, and see if there is a relationship as indicators and determinants of the severity of AA. Method: An retrospective, observational, and analytical study to evaluate the usefulness of the NLR as a diagnostic and severity indicator of AA, comparing it against biomarkers (BT and PCT), and against two severity scales ­(APACHE II [Acute Physiology and Chronic Health Evaluation] and SOFA) and a surgical scale (Mannheim). Results: We included 82 cases from January to May 2017. 80.8% of those cases with generalized peritonitis had an NLR > 12 (p = 0.002). 66% of the cases with appendiceal perforation presented an NLR > 12 (p = 0.024). 70% of severe cases due to TB showed an NLR > 12 (p = 0.004). 75% of severe cases due to PCT have an NLR > 12 (p = 0.006). 50% of the cases with SOFA > 6 showed an NLR > 12 (U Mann-Whitney, p = 0.023). Conclusions: There is a relationship between the NLR with SOFA, total bilirubin and procalcitonin, indicating that an NLR > 12 points could be related to generalized peritonitis and perforated appendicitis.

[Programa de entrenamiento en reparacion vascular en modelo experimental para residentes de cirugía general]. / Vascular reparation training program in experimental model for general surgery residents.

INTRODUCCIÓN: Los programas de entrenamiento simulado permiten optimizar recursos, aumentar la práctica técnica y acortar curvas de aprendizaje, y constituyen un método seguro, estandarizado y validado de aprendizaje para todos los entrenados. OBJETIVO: Desarrollar un programa de entrenamiento vascular mediante la elaboración de una anastomosis término-terminal de un vaso en un modelo experimental para residentes de cirugía general. MÉTODO: Para el desarrollo de este modelo de entrenamiento se utilizó una extremidad amputada a nivel supracondíleo libre de proceso médico-legal. Se realizó la disección de la arteria femoral, se dividió en dos porciones y se realizó una anastomosis término-terminal. Se diseño un sistema que incluye la evaluación de las siguientes variables utlizando la escalas OSATS (Objetive Structured Assesment of Technical Skills) y Likert: 1) nudo manual y punto simple; 2) permeabilidad de la anastomosis; 3) simetría de los puntos; 4) fuga de anastomosis; y 5) tiempo total de anastomosis. DISCUSIÓN: Al reconocer las ventajas del entrenamiento experimental, se propone un modelo biológico experimental reproducible, estandarizado y de bajo costo. CONCLUSIONES: El desarrollo de modelos biológicos experimentales permite al cirujano general la adquisición de habilidades y destrezas quirúrgicas, mejorando el desempeño durante un procedimiento quirúrgico y reduciendo riesgos. INTRODUCTION: Simulated training programs allow to optimize resources, increase technical practice and shorten learning curves, constituting a safe, standardized and validated method of learning for all those trained. OBJECTIVE: Develop a vascular training program through the elaboration of an end to end anastomosis of a vessel in an experimental model for General Surgery residents. METHOD: For the development of this training model, an amputated limb was used at the supracondylar level free of medical-legal process. The dissection of the femoral artery was performed, it was divided into two portions and an end to end anastomosis was performed. A system was designed that included the evaluation of the following variables using the OSATS (Objective Structured Assessment of Technical Skills) and Likert scales: 1) manual knot and single stitch; 2) permeability of the anastomosis; 3) symmetry of the stitches; 4) Anastomosis leakage; and 5) total time of the anastomosis. DISCUSSION: Recognizing the advantages of experimental training, a reproducible, standardized, and low cost experimental biological model is proposed. CONCLUSIONS: The development of experimental biological models, allows the general surgeon the acquisition of surgical skills and abilities, improving performance during a surgical procedure and reducing risks.

Estudios sobre el virus del papiloma humano (VPH) en el Ecuador: parte I / Studies on human papillomavirus (HPV) in Ecuador: part I

Aprovechando la realización de las XL Jornadas Nacionales de Biología Espol en la ciudad de Guayaquil, se realizó una sesión dedicada a la epidemiología del virus de papiloma humano (VPH) y del cáncer cervical. Esta sesión tuvo la participación de varios investigadores provenientes de diferentes zonas del Ecuador. El presente artículo tiene como objeto presentar un resumen de estas charlas, junto a un análisis de la información mostrada además de una reflexión sobre las preguntas que quedan aún por responder en cuanto al perfil epidemiológico de esta patología en el país.

Taking advantage of the realization of theXL National Conference on Espol Biology in the city of Guayaquil, a session was held dedicated to the epidemiology of Human Papilloma Virus (HPV) and cervical cancer. This session was attended by several researchers from different areas of Ecuador. The object of this article is to present a summary of these talks, together with an analysis of the information shown in addition to a reflection on the questions still to be answered regarding the epidemiological profile of this pathology in the country.

Trauma perineal: parto acuático versus parto convencional en Centro Hospitalario Nuevo Sanatorio Durango en la Ciudad de México / Perineal trauma: water birth versus conventional vaginal deliveries in Hospital Center Nuevo Sanatorio Durango in Mexico City

Resumen Introducción La atención de parto acuático ha incrementado en popularidad en la Ciudad de México. El Centro Hospitalario Nuevo Sanatorio Durango ha sido pionero en ofrecer la atención de parto bajo el agua. Hasta la fecha, no se han realizado estudios sobre la conducta de los partos acuáticos en México. Objetivo Este estudio intenta evaluar si el parto bajo el agua está asociado a mayor incremento en las tasas de trauma perineal comparándolo con un grupo control de pacientes atendidas por parto convencional. Material y métodos Archivos clínicos de mujeres que se atendieron de parto acuático en el Centro Hospitalario Sanatorio Durango en la Ciudad de México en el periodo comprendido entre 2016 y 2017, revisados retrospectivamente. Los resultados de interés fueron estimar el trauma perineal (desgarros de tercer y cuarto grado) comparándolo con un grupo control de parto convencional. Resultados Se registraron 120 pacientes que se atendieron de parto acuático. Hubo diferencia significativa en los resultados en trauma perineal en el grupo de parto acuático: mayores tasas de periné intacto en mujeres atendidas bajo el agua, por lo que se propone que el parto acuático es protector del trauma perineal. Conclusiones El parto en agua en nuestro centro no parece estar asociado a incremento en los resultados adversos maternos (trauma perineal). Los resultados de este estudio establecen que el parto acuático es una alternativa aceptable para el nacimiento en mujeres de bajo riesgo obstétrico, siempre y cuando cuente con adecuada vigilancia y profesional capacitado.

Abstract Introduction Waterbirth has been increasing in popularity in Mexico City. Hospital Center Nuevo Sanatorio Durango in Mexico City is the pioneer hospital offering water births to women. To date, no studies have been done on the conduct of waterbirths in Mexico. Objective This study aims to evaluate if water immersion during delivery is associated with increased rates of perineal trauma as compared with conventional vaginal deliveries. Material and methods Clinical records of women who birthed underwater at Hospital Center Sanatorio Durango in Mexico City between 2016 and 2017 were retrospectively reviewed. The outcomes of interest were estimated perineal trauma, third or fourth degree. Outcomes were compared against a matched control group of women who had conventional vaginal deliveries. Results Records of 120 women who birthed underwater were accrued. There was a significant difference in maternal outcomes in perineal trauma in water birth: higher rates of intact perineums in women who birth underwater, proposing that water birth is protective against perineal trauma. Conclusions Water birth at our center does not appear to be associated with an increased incidence of adverse maternal outcomes (perineal trauma). The results of this study supported water birth as a birthing option for groups of low-risk women in an obstetrician led setting with good midwifery support.

[Protective effect of Helianthus annuus (sunflower) on myocardial infarction in New Zealand rabbit]. / Efecto protector de Helianthus annuus (girasol) sobre el infarto de miocardio en conejos Nueva Zelanda.

OBJECTIVES: Determine the protective effect of oil Helianthus annuus (Sunflower) on myocardial infarction induced by epinephrine in New Zealand rabbits. MATERIALS AND METHODS: The rabbits were randomized into five groups (8 per group): blank, negative control, experimental 1 (10 mg / kg), experimental 2 (20 mg / kg) and three experimental (40 mg/ kg). Experimental groups 1, 2 and 3 received Helianthus annuus oil for two weeks. Epinephrine (2 mg/Kg) to the negative, Experimental Control 1, 2 and 3 groups was given over two consecutive days with an interval of 24 h after pretreatment with oil. Twenty four hours after the last administration, the rabbits were anesthetized and sacrificed. Serum troponin I and polymorphonuclear evaluated by .mu.m.sup.2. RESULTS: Significant difference between the negative control group and the experimental groups 1, 2 and 3 was found in the serum variables troponin I and polymorphonuclear by .mu.m.sup.2. CONCLUSIONS: Helianthus annuus oil at doses of 20 mg/kg has protective effect on myocardial infarction induced by epinephrine in New Zealand rabbits.

Efecto protector de Helianthus annuus (Girasol) sobre el infarto de miocardio en conejos Nueva Zelanda / Protective effect of Helianthus annuus (Sunflower) on myocardial infarction in New Zealand rabbit

Objetivos. Determinar el efecto protector del aceite de Helianthus annuus (Girasol) sobre el infarto de miocardio inducido con epinefrina en conejos Nueva Zelanda. Materiales y métodos. Los conejos fueron asignados aleatoriamente en cinco grupos (n= 8 por grupo): blanco, control negativo, experimental 1 (10 mg/kg), experimental 2 (20 mg/kg) y experimental 3 (40 mg/kg). Los grupos experimentales 1, 2 y 3 recibieron aceite de Helianthus annuus durante dos semanas. La epinefrina (2 mg/Kg) se administró a los grupos control negativo, experimentales 1, 2 y 3 durante dos días consecutivos con un intervalo de 24 h después del pretratamiento con aceite. Veinticuatro horas después de la última administración, los conejos fueron anestesiados y sacrificados. Se evaluaron los niveles séricos de troponina I y número de polimorfonucleares por um2. Resultados. Se encontró diferencia significativa entre el grupo control negativo y los grupos experimentales 1, 2 y 3 en los variables niveles séricos de troponina I y número de polimorfonucleares por um2 . Conclusiones: El aceite de Helianthus annuus a dosis de 20 mg/kg tiene efecto protector sobre el infarto de miocardio inducido con epinefrina en conejos Nueva Zelanda.

Objectives. Determine the protective effect of oil Helianthus annuus (Sunflower) on myocardial infarction induced by epinephrine in New Zealand rabbits. Materials and methods. The rabbits were randomized into five groups (8 per group): blank, negative control, experimental 1 (10 mg / kg), experimental 2 (20 mg / kg) and three experimental (40 mg/ kg). Experimental groups 1, 2 and 3 received Helianthus annuus oil for two weeks. Epinephrine (2 mg/Kg) to the negative, Experimental Control 1, 2 and 3 groups was given over two consecutive days with an interval of 24 h after pretreatment with oil. Twenty four hours after the last administration, the rabbits were anesthetized and sacrificed. Serum troponin I and polymorphonuclear evaluated by .mu.m.sup.2. Results. Significant difference between the negative control group and the experimental groups 1, 2 and 3 was found in the serum variables troponin I and polymorphonuclear by .mu.m.sup.2. Conclusions. Helianthus annuus oil at doses of 20 mg/kg has protective effect on myocardial infarction induced by epinephrine in New Zealand rabbits.

Estudio prospectivo aleatorio del uso de soluciones coloides comparadas con cristaloides en la reanimación de pacientes traumatizados con choque hipovolémico / Prospective randomized study of the use of colloid solutions compared with crystalloids in the resuscitation of patients traumatized with hypovolemic shock

El objetivo de esta investigación fue comparar la respuesta fisiológica de los pacientes traumatizados con choque hipovolémico, tras la administración de 1.000 ml de solución cristaloide o coloide, en etapas tempranas de la reanimación en la sala de urgencias. Se trata de un estudio prospectivo, aleatorio, unicéntrico, triple ciego, realizado durante el año 2007 en el Servicio de Emergencia del Hospital Universitario Dr. Luis Razetti, localizado en Barcelona, Venezuela. El estudio comprendió 97 pacientes, politraumatizados, con trauma por proyectil de arma de fuego y arma blanca, con choque hipovolémico, distribuidos en tres grupos: grupo A (31 pacientes), que recibieron 1.000 ml de lactato de Ringer; grupo B (34 pacientes), a quienes se les administraron 1.000 ml de gelatina y el grupo C (32 pacientes), los cuales recibieron 1.000 ml de almidón. Las variables estudiadas (tensión arterial diastólica, sistólica y media, frecuencia cardiaca, saturación de oxígeno y frecuencia respiratoria) fueron medidas a los 15 minutos de la administración de las soluciones. Los datos se procesaron con el programa estadístico SPSS para Windows, versión 15.0, en el que se utilizó el análisis de varianza (ANOVA). Los hallazgos encontrados evidencian que el lactato de Ringer y la gelatina producían una respuesta fisiológica más favorable, similar y estadísticamente signifcativa, para los pacientes de ambos grupos, en comparación con aquéllos a quienes se les administró solución de almidón.

The objective of this investigation was to compare the physiologic response of hypovolemic shock in trauma patients, after the administration of 1, 000 ml of crystalloid or colloid solutions, in early stages of resuscitation in the emergency room. It was a randomized prospective, triple blind study carried out at Dr. Luis Razetti Universitary Hospital’s emergency room in Barcelona, Venezuela. The study included 97 polytraumatized patients, wounded by fire and white arms. This group of patients presented hypovolemic shock and they same which was divided into three different groups: group A (31 patients), which received 1,000 ml of Ringer’s solution, group B (34 patients) which received 1,000ml of gelatin solution, and group C (32 patients), which received 1,000 ml of a starch solution. The studied variables (diastolic, systolic, medial blood pressure, pulse, heart frequency, oxygen saturation and pulse) were measured 15 minutes after the administration of the solutions. Data was processed with version 15.0 SPSS statistic program for windows, using ANOVA. The fndings indicate that the Ringer’s and gelatin solutions produced a more propitious physiologic response, similar and statiscally signifcant to patients in both groups, compared with those who were treated with the starch solution.