Nodular lymphocytic conjunctivitis in a horse - case report / Conjuntivite linfocítica nodular em equino - relato de caso

The case of an equine with nodular lymphocytic conjunctivitis is described. A 14-year-old crossbred mare was seen presenting with development of a mass in the nasal angle of the right eye, behind the third eyelid. The tutor reported slow growth over 4 years, always accompanied by epiphora, and that no treatment had been performed prior to consultation. The histopathological and immunohistochemical results found a nodular, subepithelial structure, composed predominantly of densely packed small lymphocytes. Through the exams, associated with studies with monoclonal anti B lymphocyte antibodies and polyclonal anti T lymphocyte antibodies, the diagnosis of nodular lymphocytic conjunctivitis was reached. Only clinical pharmacological treatment was chosen, based on the use of topical and intralesional hydrocortisone acetate. After one month of treatment the mass completely disappeared without sequelae.

Descreve-se o caso de um equino com conjuntivite linfocítica nodular. Uma égua, mestiça, de 14 anos, foi atendida apresentando desenvolvimento de uma massa no ângulo nasal do olho direito, atrás da terceira pálpebra. O tutor relatou um crescimento lento durante 4 anos, sempre acompanhado de epífora, para o qual não foi realizado tratamento prévio à consulta. Os resultados histopatológico e imuno-histoquímico constataram uma estrutura nodular e subepitelial, composta predominantemente por linfocitos pequenos densamente agrupados. Por meio dos exames, associados a estudos com anticorpos monoclonais antilinfocitos B e anticorpos policlonais antilinfocitos T, chegou-se ao diagnóstico de conjuntivite linfocítica nodular. Optou-se apenas pelo tratamento clínico farmacológico, baseando-se na utilização de acetato de hidrocortisona tópica e intralesional. Após um mês de tratamento, a massa involuiu por completo, sem deixar sequelas.

Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic.

OBJECTIVE: To describe empirical antimicrobial prescription on admission in patients with severe COVID-19, the prevalence of Hospital-Acquired Infections, and the susceptibility patterns of the causing organisms. METHODS: In this prospective cohort study in a tertiary care center in Mexico City, we included consecutive patients admitted with severe COVID-19 between March 20th and June 10th and evaluated empirical antimicrobial prescription and the occurrence of HAI. RESULTS: 794 patients with severe COVID-19 were admitted during the study period. Empiric antibiotic treatment was started in 92% of patients (731/794); the most frequent regimes were amoxicillin-clavulanate plus atypical coverage in 341 (46.6%) and ceftriaxone plus atypical coverage in 213 (29.1%). We identified 110 HAI episodes in 74/656 patients (11.3%). Ventilator-associated pneumonia (VAP) was the most frequent HAI, in 56/110 (50.9%), followed by bloodstream infections (BSI), in 32/110 (29.1%). The most frequent cause of VAP were Enterobacteriaceae in 48/69 (69.6%), followed by non-fermenter gram-negative bacilli in 18/69 (26.1%). The most frequent cause of BSI was coagulase negative staphylococci, in 14/35 (40.0%), followed by Enterobacter complex in 7/35 (20%). Death occurred in 30/74 (40.5%) patients with one or more HAI episodes and in 193/584 (33.0%) patients without any HAI episode (p < 0.05). CONCLUSION: A high frequency of empiric antibiotic treatment in patients admitted with COVID-19 was seen. VAP and BSI were the most frequent hospital-acquired infections, due to Enterobacteriaceae and coagulase negative staphylococci, respectively.

Recomendaciones Rama de Dermatología Pediátrica, Sociedad Chilena de Pediatría. Pandemia COVID-19 / Recommendations Pediatric Dermatology Branch, Chilean Society of Pediatrics. COVID-19 pandemic

Resumen: La actual pandemia por Covid-19 (SARS-CoV-2) corresponde a una zoonosis viral altamente con tagiosa que ha requerido extremar las medidas de protección personal con el fin de disminuir la transmisión del virus, tanto en ambientes hospitalarios como fuera de ellos, siendo necesaria la adopción de estrictos métodos de aislamiento tanto de contacto como aerosoles. Esto ha reque rido la adopción de múltiples equipos de protección personal, dentro de los que se encuentran la protección ocular, mascarillas, escudo de protección facial, gorros, guantes, etcétera. Lo anterior ha generado un aumento en el daño de la barrera cutánea y, por lo tanto, la aparición de diversas dermatosis dentro de las que se encuentran dermatitis de contacto irritativa o alérgica, reaccio nes acneiformes, agravamiento de dermatosis previas, entre otras, cobrando así vital importancia el cuidado y restablecimiento de la barrera cutánea con medidas esenciales como aplicación de productos humectantes o emolientes y el correcto uso de los equipos en mención. No obstante, no solo se generan dermatosis derivadas del uso de equipos de protección personal, sino que tam bién, dentro del amplio espectro de manifestaciones dermatológicas que puede generar la enfer medad por Covid-19 propiamente tal, incluyendo compromiso cutáneo, piloso (efluvio telógeno) o ungueal (onicomadesis). Por otro lado pero no motivo de este artículo, el compromiso cutáneo puede corresponder a la primera expresión clínica de la enfermedad o ser un predictor de su evolu ción. Dentro de lo anterior encontramos la urticaria aguda, exantema maculo-papular, exantema varicela-like, erupción petequial, perniosis-like y lívedo reticularis como las principales formas de afección cutánea hasta el momento.

Abstract: The current Covid-19 pandemic (SARS-CoV-2) corresponds to a highly contagious viral zoonosis that has required to extreme measures in order to decrease the transmission of the virus in hospi tal settings and outside of them, requiring adoption of strict isolation methods, both contact and aerosols. This has required the adoption of multiple personal protective equipment, including eye protection, masks, face shield, medical caps, gloves, etc. The aforementioned has generated an in crease in the damage of the skin barrier, and therefore, the appearance of various dermatoses, among which are irritative o alergic contact dermatitis, acneiform reactions, aggravation of previous der matoses, and others, thus becoming vital protection and restoration of the skin barrier with mea sures such as the application of moisturizing or emollient products and the correct use of personal protection equipment. However, not only dermatoses are generated derived from the use of perso nal protection equipment, but also, within the wide spectrum of dermatological manifestations that Covid-19 disease itself can generate, including cutaneous, hairy involvement (telogen effluvium) or nail (onychomadesis). Cutaneous involvement may correspond to the first clinical expression of the disease or be a predictor of its evolution. Among the above we find acute urticaria, maculo-papular rash, chickenpox-like rash, petechial rash, perniosis-like, and livedo reticularis as the main forms of skin condition to date.

Ventanillas de Salud: A Collaborative and Binational Health Access and Preventive Care Program.

While individuals of Mexican origin are the largest immigrant group living in the U.S., this population is also the highest uninsured. Health disparities related to access to health care, among other social determinants, continue to be a challenge for this population. The government of Mexico, in an effort to address these disparities and improve the quality of life of citizens living abroad, has partnered with governmental and non-governmental health-care organizations in the U.S. by developing and implementing an initiative known as Ventanillas de Salud-Health Windows-(VDS). The VDS is located throughout the Mexican Consular network and aim to increase access to health care and health literacy, provide health screenings, and promote healthy lifestyle choices among low-income and immigrant Mexican populations in the U.S.

Ganancia inicial de peso del recién nacido de término hijo de madre adolescente / Early weight gain of infants born to adolescent mothers

Introducción: el embarazo de la adolescente es frecuente en Chile; sus hijos pueden tener mayor riesgo de lactancia materna insuficiente de cuidados inadecuados y mal incremento ponderal. Objetivo: Estudiar la ganancia de peso durante el 1er mes de vida de recién nacidos (RN) hijos de madres adolescentes y su asociación con riesgo de ictericia, hospitalización y abandono de lactancia materna. Sujetos y métodos: Se estudiaron 40 RN de término, hijos de madres primíparas adolescentes < 19 anos, de estratos socioeconómicos bajos, adecuados para la edad gestacional (AEG), sin patología aguda o malformaciones, (GE; H/M: 27/ 13) y se compararon con 36 RN de madres adultas primíparas (GC; H/M: 19/17), de un hospital público de Santiago. Fueron controlados en atención primaria (peso, talla) con mediana a los 8 y 30 días en ambos grupos, se consultó por ictericia, lactancia materna y hospitalización. Resultados: Al 8° día la ganancia de peso fue: GE -1,5 g/día (-107 vs +36) vs GC -5,7 g/d (-59 a +39) (NS), < al incremento esperado por OMS (14-21g/d), habían recuperado peso de nacimiento 52% de GE y 44% GC (NS). Al mes no hubo diferencias en el incremento diario (GE 31; -1,7 a 79 g/d, GC 28; -3 a 63 g/d NS), semejantes a estándares OMS (x: 34g/día en hombres y 29g/día en mujeres). Al subdividir GE en grupos de madres: de 15 a 16 y de 17 a 18 anos, se observó un mayor incremento diario el 1er mes en el grupo de 15 a 16 anos: 38 g/d (9-79) vs 17 a 18 anos: 25g/d (-1,7 a 57) (p< 0,02) y con el GC (p<0,02). No hubo diferencias en el riesgo de ictericia al 3° día: GE:12/40, GC: 7/36 (NS), pero hubo diferencia al 8° día, GE: 13/40, GC 2/36 (OR: 8,2 IC:1,7-39; p=0,003), sin mayor riesgo de hospitalización. Ambos grupos recibieron lactancia materna, con fórmula artificial en GE: 8/40, GC: 10/36 (NS). Conclusiones: Los hijos de madre adolescentes no presentan mayor riesgo de retraso en la recuperación de PN comparados con hijos de madres primíparas adultas, el sub-grupo de hijos de adolescentes de 15 a 16 anos tuvieron un mayor incremento de peso que el de 17 a 18 anos y el GC. Si bien el riesgo de ictericia al 8° día es mayor en el GE, este no constituyó un factor de hospitalización. Presentan buena adherencia a lactancia materna.

Background: Adolescent pregnancy is frequent in Chile, and their infants could present an increased risk of inadequate breast feeding and weight gain. Objectives: To assess the early weight gain in infants born to Chilean adolescent mothers and their association with breast feeding, risk ofjaundice and hospitalization. Subjects and methods: Fortyfull-term and adequatefor gestational age newborns (SG; M/F: 27/13), born to healthy adolescent mothers (less than < 19 y at delivery) (SG) from low socioeconomic groups, were recruited in a public hospital in Santiago, Chile. They were paired with 36 born to healthy primiparous adult mothers (control group CG; M/F:19/17); those born with low birth weight or congenital malformations were excluded. They were assessed at well baby clinics in primary care centers for weight, length, (median age: 8 and 30 d.; breast feeding, jaundice and hospitalization were registered). Results: No significant differences were found in weight gain at 8th day of age (SG: -15 g/d (-107 to +36); CG -5,7 g/d (-59 to +39) (NS), both lower than the weight increments of WHO standards (14-21 g/d); birth weight recovery was found in SG: 52%% and CG: 44% (NS). Neither a difference was found at 30 days (SG: 31g/d (-1.7 to +79), CG: 28 g/d (-3 to63); (NS), comparable to WHO standards (males: 34 g/d; females: 29 g/d). However, the sub-group of infants born to adolescent mothers 15-16 y. presented a greater weight gain than those to adolescents mothers 16-17 y. (38 g/d (9 to 79 vs 25 g/d ,-1,7 to + 57) than the CG (p<0.02). Formula breast feeding was provided to 8/40 in SG and 10/36 in CG (NS). No differences in jaundice was found at the 3rd day, but an increased rate was observed at the 8th day (SG 13/40 vs CG2/36) (OR 8.2; CI: 1.7-39; p=0.003), without an increased risk of hospitalization. Conclusions: Infants born to Chilean adolescent mothers have a comparable weight gain to infants born to adult mothers, with a comparable time of birth weight recovery. Those born to mothers 15-16 years of age had a greater weight gain than those born to mothers 17-18 years or adult mothers. Jaundice to the 8° day was greater in the SG with no increased rate of hospitalization. They present a good rate of breast feeding.

[Idiopathic hypertrophic pachymeningitis: a case report]. / Paquimeningitis hipertrófica idiopática: a propósito de un caso.

INTRODUCTION: Hypertrophic pachymeningitis is a clinical condition that is caused by a diffuse or localised thickening of the dura mater. It predominantly affects males and manifests as chronic headache, with or without association to neurological manifestations, such as paralysis of the cranial nerves, cerebellar ataxia and neuro-ophthalmic complications. CASE REPORT: A 61-year-old male, with no relevant past history, who, one month before admission, had begun to suffer from right frontotemporal headache that irradiated to the ipsilateral orbital region and was more pronounced at night. A week later he was affected by a decrease in visual acuity in the right eye and two weeks later he noted the presence of right palpebral ptosis, while the headaches increased. The examination showed: right palpebral ptosis with global ophthalmoparesis with predominance of adduction and abduction, and diminished photomotor reflex in the right eye. The visual acuity of the right eye was reduced and the palpebral fissure was 0 in the right eye. The fundus oculi was normal. Infectious and non-infectious causations of meningitis were precluded. Magnetic resonance imaging revealed a diffuse thickening of the supratentorial and infratentorial meninges, as well as diffuse uptake of the paramagnetic substance; thickening of the mucus in both paranasal maxillary sinuses was also observed. A meningeal biopsy study confirmed the existence of hypertrophic pachymeningitis. Treatment was established with prednisone and the clinical symptoms improved. CONCLUSIONS: Idiopathic hypertrophic pachymeningitis is an underdiagnosed condition that must be taken into consideration in cases of patients with a history of subacute or chronic meningitis in which infectious and non-infectious causations have been precluded, and high-dose steroid treatment must be established.

The in vitro protective effect of alpha-tocopherol on oxidative injury in the dog retina.

Oxidative stress is a risk factor for eye diseases. Free radicals elicited during the inflammatory process often lead to oxidative damage of lipids (lipid peroxidation). The retina is highly vulnerable because of its high content of polyunsaturated fatty acids (PUFAs). The aim of this study was to investigate in vitro the effect of alpha-tocopherol on the Fe(2+)-ascorbate induced lipid peroxidation in the canine retina. Lipid peroxidation of retinal homogenates was carried out with and without the addition of alpha-tocopherol and monitored both by chemiluminescence and production of thiobarbituric acid reactive substances (TBARS). Total chemiluminescence counts per minute was lower in those homogenates pre-incubated with alpha-tocopherol. Thus, with 1 micromol alpha-tocopherol/mg of protein, 100% inhibition of chemiluminescence and a decrease of TBARS content from 20.46+/-0.85 to 2.62+/-2.77 nmol/mg protein were observed. Simultaneously, changes produced by oxidative stress were noted in the fatty acid composition of retinal lipids. Docosahexaenoic acid was decreased from 14.33+/-2.32% to 1.84+/-0.14% after peroxidation, but this fatty acid remained unaltered in the presence of 1 micromol alpha-tocopherol. These results show that under these experimental conditions, alpha-tocopherol may act as anti-oxidant protecting retinal membranes from deleterious effects. Further studies are required to assess its use in free radical generating conditions affecting the canine retina.

Estudio de cepas nativas amilolíticas / Study of amilolytic native microbial stocks

En el presente trabajo se realiza el estudio de cepas microbianas aisladas de diferentes nichos ecológicos, productoras de las enzimas amilolíticas, así: procesado de maíz, de papa y de yuca. Los criterios utilizados para el aislamiento de las cepas amilolíticas, son el crecimiento sobre los medios modificados con almidón y la positividad frente al Test de Lugol. Los medios empleados fueron CZAPEK, PCA y MRS modificados. Las cepas obtenidas son debidamente purificadas, crío conservadas e identificadas bioquímicamente, obteniendo un total de 103 cepas nativas. De éste total de cepas, se seleccionan debido a la similitud fisiológica entre microorganismos aislados, 9 cepas. Estas últimas son identificadas bioquímicamente y se obtienen los géneros Bacillus sp ,Clostridium sp y Kurthia sp. Las enzimas amilolíticas obtenidas a partir de las cepas nativas presentan pesos moleculares que oscilan entre 30 y 150 kDa aproximadamente

Fistula enterocutanea en abdomen abierto / Enterocutanea fistula in trauma

Se analizó una serie clínica de 23 pacientes con diagnóstico de abdomen abierto complicado con fístula intestinal para evaluar su respuesta a la terapia nutricional en lo que respecta al comportamiento de la fístula y a la incidencia sobre la mortalidad global y otras variables de la hospitalización. La edad promedio fue de 44 años. El análisis inicial mostró una preponderancia de la etiología posquirúrgica no traumática sobre la traumática (61 por ciento vs. 39 por ciento). Un 56 por ciento de pacientes se diagnosticó como malnutrido, con una albúmina de ingreso promedio de 1.9 gr/dl. La fístula fue de alto gasto en el 78 por ciento de los casos, 83 por ciento(21) requirió más de 2 cirugías, con un promedio de 4.7 cirugías / paciente. El soporte nutricional mixto fue el más frecuente 16 (74 por ciento) con un promedio de 1282 cal. /día, 14.3 gramos/ N/día y 17 días/pte. El porcentaje global de cierre fue del 65 por ciento (15), 8 (35 por ciento) con tratamiento conservador y 7 (30 por ciento) con cierre quirúrgico. La estancia hospitalaria fue de 62 días (rango 11-168), los costos de atención oscilan entre (pesos colombianos) 1.619.391 y 58.939.583 y el costo global de atención se calculó en 451.341.680 pesos colombianos. El 60 por ciento (15) de los pacientes tuvieron un costo de atención superior a los 15.000.000. La mortalidad fue del 34 por ciento (8), similar a la reportada mundialmente. El análisis del impacto del soporte nutricional sobre la mortalidad y la estancia no mostró ninguna correlación estadísticamente significativa con variables como tiempo de inicio del soporte, calorías administradas, tipo de cierre, tipo de soporte. Otras usualmente pronosticó como albúmina, proteínas y balance nitrogenado al ingreso y egreso tampoco mostraron correlación con la muerte, la tasa de cierre y el pronóstico. Los datos obtenidos permiten concluir que el abdomen abierto complicado con fístula intestinal en una entidad que demanda un enorme cuidado y manejo multidisciplinario en la que el soporte nutricional intensivo pese a la dificultad en la medición de su valor aditivo a la terapia, es una importante herramienta en el afán de disminuir el perfil de mobimortalidad de este síndrome

Diagnóstico y tratamiento de la lesión labral acetabular / Diagnostic and treatment of the acetabular lebrum lesion

Se describe un caso de lesión labral acetabular, haciendo un estudio sobre el diagnóstico y tratamiento de esta lesión

Na2Zn3(CO3)4.3H2O: a potentially useful compound for zinc supplementation.

The infrared and Raman spectra of the title compound were recorded and are briefly discussed on the basis of its structural characteristics. Its thermal behaviour was investigated by means of TG and DTA measurements. Several dissolution tests were also performed. The results support the potential usefulness of this double carbonate as a useful compound for Zn(II) supplementation.

Pigmentacion maculosa eruptiva idiopatica. Comunicacion de cuatro casos. / Idiopathic eruptive macular pigmentation.Communication of four cases

Se comunican cuatro casos de pigmentacion maculosa eruptiva idiopatica, nueva entidad que afecta a ninos y adolescentes y se caracteriza por manchas ovales diseminadas de color cafe claro o gris pizarra, asintomaticas, de evolucion cronica, involucion espontanea y etiologia desconocida