Trombosis espontánea de plexo pampiniforme: Reporte de un caso y revisión de literatura

Introducción: La trombosis de plexo pampiniforme es una entidad poco conocida, solo existen 31 casos reportados a la fecha. Objetivo: Presentación de un caso de una patología poco frecuente, descripción de las publicaciones anteriores y revisión de la literatura. Reporte de caso: Paciente de 20 años, sin antecedentes, con trombosis de plexo pampiniforme derecho. Sospecha inicial de hernia inguinal derecha complicada, el diagnóstico se realizó con ecografía Doppler y recibió tratamiento con anticoagulantes. Se complementó con tomografía y estudio de trombofilias. Discusión: El estudio y manejo ha sido variable, antes prevalecía la estrategia quirúrgica. Actualmente, algunos autores recomiendan el manejo conservador y otros proponen diferenciar el tratamiento según segmento anatómico comprometido. Conclusión: Al ser una entidad poco frecuente, el tratamiento es una decisión que debe ser tomada según cada caso, ya que no existen pautas de tratamiento, pero la tendencia es cada vez mayor hacia el tratamiento conservador. El rol de la anticoagulación está por definir. Es importante realizar un adecuado diagnóstico diferencial y búsqueda de causas subyacentes.

Introduction: Pampiniform plexus thrombosis is a rare entity, with only 31 cases reported to date. Aim: Presentation of a case of a rare disease, description of previous publications and review of the literature. Case report: 20-year-old patient, with no history, with right pampiniform plexus thrombosis. Initial suspicion was complicated right inguinal hernia, diagnosis was made with Doppler ultrasound and treatment with anticoagulation. It was complemented with tomography and study of thrombophilias. Discussion: The study and management has been variable, where the surgical strategy prevailed. Currently some authors recommend conservative management and others differentiate the treatment according to the compromised anatomical segment. Conclusion: Being a rare entity, conservative treatment or surgery continues to be a decision that must be made according to each case since there are no treatment guidelines, but the trend is increasing towards conservative treatment. The role of anticoagulation remains to be defined. It is important to carry out an adequate differential diagnosis and search for underlying causes.

Historical reconstruction of the population dynamics of southern right whales in the southwestern Atlantic Ocean.

Understanding the recovery of whale populations is critical for developing population-management and conservation strategies. The southern right whale (SRW) Eubalena australis was one of the baleen whale species that has experienced centuries of exploitation. We assess here for the first time the population dynamics of the SRW from the southwestern Atlantic Ocean at the regional level to measure numerically the effect of whaling and estimate the population trend and recovery level after depletion. We reconstructed the catch history of whaling for the period 1670-1973 by an extensive review of different literature sources and developed a Bayesian state-space model to estimate the demographic parameters. The population trajectory indicated that the pre-exploitation abundance was close to 58,000 individuals (median = 58,212; 95% CI = 33,329-100,920). The abundance dropped to its lowest abundance levels in the 1830s when fewer than 2,000 individuals remained. The current median population abundance was estimated at 4,742 whales (95% CI = 3,853-6,013), suggesting that the SRW population remains small relative to its pre-exploitation abundance (median depletion P2021 8.7%). We estimated that close to 36% of the SRW population visits the waters of the Península Valdés, the main breeding ground, every year. Our results provide insights into the severity of the whaling operation in the southwestern Atlantic along with the population´s response at low densities, thus contributing to understand the observed differences in population trends over the distributional range of the species worldwide.

Distribution and Pathogenicity of Colletotrichum Species Associated With Mango Anthracnose in Mexico.

Mango anthracnose, caused by Colletotrichum spp., is the most significant disease of mango (Mangifera indica L.) in almost all production areas around the world. In Mexico, mango anthracnose has only been attributed to C. asianum and C. gloeosporioides. The aims of this study were to identify the Colletotrichum species associated with mango anthracnose symptoms in Mexico by phylogenetic inference using the ApMat marker, to determine the distribution of these species, and to test their pathogenicity and virulence on mango fruits. Surveys were carried out from 2010 to 2012 in 59 commercial orchards in the major mango growing states of Mexico, and a total of 118 isolates were obtained from leaves, twigs, and fruits with typical anthracnose symptoms. All isolates were tentatively identified in the C. gloeosporioides species complex based on morphological and cultural characteristics. The Bayesian inference phylogenetic tree generated with Apn2/MAT intergenic spacer sequences of 59 isolates (one per orchard) revealed that C. alienum, C. asianum, C. fructicola, C. siamense, and C. tropicale were associated with symptoms of mango anthracnose. In this study, C. alienum, C. fructicola, C. siamense, and C. tropicale are reported for the first time in association with mango tissues in Mexico. This study represents the first report of C. alienum causing mango anthracnose worldwide. The distribution of Colletotrichum species varied among the mango growing states from Mexico. Chiapas was the only state in which all five species were found. Pathogenicity tests on mango fruit cultivar Manila showed that all Colletotrichum species from this study could induce anthracnose lesions. However, differences in virulence were evident among species. C. siamense and C. asianum were the most virulent, whereas C. alienum and C. fructicola were considered the least virulent species.

Phylogeny, Distribution, and Pathogenicity of Lasiodiplodia Species Associated With Cankers and Dieback Symptoms of Persian Lime in Mexico.

Persian lime (Citrus latifolia Tan.) is an important and widely cultivated fruit crop in several regions of Mexico. In recent years, severe symptoms of gummosis, stem cankers, and dieback were detected in the Persian lime-producing region in the states of Veracruz and Puebla, Mexico. The aims of this study were to identify the species of Lasiodiplodia associated with these symptoms, determine the distribution of these species, and test their pathogenicity and virulence on Persian lime plants. In 2015, symptomatic samples were collected from 12 commercial Persian lime orchards, and 60 Lasiodiplodia isolates were obtained. Fungal identification of 32 representative isolates was performed using a phylogenetic analysis based on DNA sequence data of the internal transcribed spacer region and part of the translation elongation factor 1-α and ß-tubulin genes. Sequence analyses were carried out using the Maximum Likelihood and Bayesian Inference methods. Six Lasiodiplodia species were identified as Lasiodiplodia pseudotheobromae, Lasiodiplodia theobromae, Lasiodiplodia brasiliense, Lasiodiplodia subglobosa, Lasiodiplodia citricola, and Lasiodiplodia iraniensis. All Lasiodiplodia species of this study are reported for the first time in association with Persian lime in Mexico and worldwide. L. pseudotheobromae (46.9% of isolates) was the most frequently isolated species followed by L. theobromae (28.1%) and L. brasiliense (12.5%). Pathogenicity on Persian lime young plants using a mycelial plug inoculation method showed that all identified Lasiodiplodia species were able to cause necrotic lesions and gummosis, but L. subglobosa, L. iraniensis, and L. pseudotheobromae were the most virulent.

Análisis de la evidencia disponible para el consumo de edulcorantes no calóricos. Documento de expertos / Analysis of the available evidence for the intake of non-caloric sweeteners. Expert document

Resumen Los edulcorantes no calóricos representan una buena alternativa para sustituir los sabores dulces sin la respuesta fisiológica que genera el consumo de azúcares. Por sí solos no son herramientas para el control de peso. Su consumo debe ir acompañado de una dieta correcta y un estilo de vida saludable que incluya actividad física. Su utilidad radica en proporcionar el agradable sabor dulce sin el aporte energético. La inocuidad de cada uno de los compuestos aprobados está comprobada y se reevalúa constantemente para tomar en cuenta los resultados de nuevos estudios. Debido a que no existe un edulcorante perfecto, la variedad ayuda a que se desarrollen productos cada vez más agradables para el consumidor. Este trabajo es fruto de una revisión exhaustiva de la bibliografía y de las discusiones de un panel de expertos de diversas especialidades: toxicología, ginecoobstetricia, pediatría, endocrinología, nutrición, medicina interna, salud pública y medicina preventiva, en el que se analizó extensamente la bibliografía se revisó una variedad de trabajos científicos que responden a las interrogantes que habitualmente se hacen los profesionales de la salud acerca de seguridad en diferentes grupos etáreos y con afecciones específicas, ingestión diaria admisible, etc.

Abstract Non-caloric sweeteners are a good alternative to replace the sweet flavors without the physiological response generated by the consumption of sugars. Alone they are not tools for weight control. Its intake must be accompanied by a proper diet and a healthy lifestyle that includes physical activity. Its usefulness lies in providing a pleasant sweet taste without the energy intake. The safety of each of the compounds is tested and approved and constantly reassessed to take into account the results of new studies. Since there is no perfect sweetener, variety helps that more and more pleasing to the consumer products are developed. This work is the result of a comprehensive review of the literature and discussions of a panel of experts from various specialties: toxicology, obstetrics and gynecology, pediatrics, endocrinology, nutrition, internal medicine, public health and preventive medicine, where literature was widely analyzed reviewing a variety of scientific papers that address the questions that usually are made by health professionals on safety in different age groups and with specific diseases, acceptable daily intake, etc.

Knowledge of appropriate foods and beverages needed for weight loss and diet of patients in an Obesity Clinic.

BACKGROUND/OBJECTIVE: Knowledge does not automatically translate into behaviour change. This study examined the relationship between knowledge of appropriate foods and beverages needed for weight loss and the diet of patients seeking weight management. SUBJECTS/METHODS: A cross-sectional study of 104 consecutive first-time patients (55 women and 49 men) seeking weight management, with a mean age of 37.3 ± 11.8 years and a BMI of 44.9 ± 9.4 kg/m(2), was carried out; 67.3% of these patients had a BMI of 40 kg/m(2) or greater. Patients were told to design a detailed weight-loss diet that they would recommend to a person with the same characteristics (recommended diet or RD) as themselves and asked whether the RD was similar to their own. Consumed diet (CD) was assessed by a different dietitian through a 24-h diet recall. Estimated energy requirement (EER), energy content of RD and CD and number of fruit, vegetable, cereal and sweetened-beverage portions were calculated. Statistical differences were assessed through the Pearson's correlation and the Wilcoxon's rank-sum tests. RESULTS: RD and CD were 1104 ± 243 and 1976 ± 708 kcal for women and 1254 ± 287 and 2743 ± 1244 kcal for men, with statistical differences for both genders (P<0.001). Energy content of the RD was lower than the EER in men and women (P<0.001); CD was lower than the EER in women (P=0.033). Number of fruit/vegetable portions was lower in CD than in the RD in women (P<0.001), whereas cereal and sweetened-beverage portions were higher in CD than in the RD in both genders (P<0.001). RD was not followed by 46.1% of the patients. CONCLUSIONS: Patients with obesity seeking care have knowledge of the appropriate dietary strategies needed for weight loss, but do not translate it into practice. Treatment approaches should include tools that help patients to implement their nutrition knowledge.

First Report of Stalk Rot Disease of Sugarcane Caused by Phaeocytostroma sacchari in Mexico.

In April 2009 and 2010, severe symptoms of stalk rot of sugarcane (Saccharum officinarum L.) plants cvs. MEX-79-431, MEX-69-749, and RB-73-9735 were observed in commercials fields located in southeast Michoacan state, Mexico. The diseased plants exhibited complete discoloration of foliage, ascendant necrosis and rot in the internal stalk tissue, and disintegration of vascular tissue. Symptoms were most evident in the nodes with intense purple coloration. Dead plants were observed. Two diseased plants of each cultivar were collected. Pieces of symptomatic stem tissue were surface sterilized with 2% sodium hypochlorite solution for 1 min, washed with sterile distilled water, dried on sterilized paper, and plated onto potato dextrose agar (PDA). Petri dishes were incubated at 22°C under continuous white light for 72 h. A fungus was consistently isolated. On PDA, colonies had sparse aerial mycelium in the center and dense in the margins with black masses of conidia. The fungus isolated was grown on dishes containing 2% water agar (WA) overlaid with pine needles and incubated at 22°C under continuous white light for 2 weeks to induce the formation of fruiting bodies. Pycnidia produced in WA were black, up to 500 µm in diameter, usually globose, blister shaped without peaks, scattered, and multilocular. Conidiophores were cylindrical, hyaline, 5 to 20 × 1.5 to 2 µm, and formed in the pycnidial cavity. Conidia were ellipsoidal to oblong, unicellular, pale brown to dark brown, 8.5 to 12.5 × 3 to 4.5 µm, biguttulate, and non-septate. Paraphyses were hyaline, aseptate, occasionally branched, and flexuous. On the basis of cultural and morphological characteristics, the fungus was identified as Phaeocytostroma sp. DNA from an isolate was extracted and the internal transcribed spacer region (ITS1-5.8S-ITS2) of rDNA was amplified using primers ITS1 and ITS4 (2). PCR products were purified and sequenced. The resulting sequence of 536 bp was deposited in GenBank (Accession No. KC893550). BLAST analysis showed a 99% similarity with the sequence of Phaeocytostroma sacchari (FR748047). Pathogenicity tests of an isolate of P. sacchari were performed on 6-month-old sugarcane plants (cvs. MEX-79-431, MEX-69-749, and RB-73-9735). A 1-cm-deep wound near the base of the stem was created with a sterilized needle. Mycelial plugs (9 mm diameter) of 6-day-old PDA cultures were deposited on wounds and wrapped with Parafilm. Four plants of each cultivar were inoculated and 12 control plants were treated similarly with PDA plugs instead of fungal inoculum. Plants were placed at 28°C and 95% relative humidity for 72 h. All the inoculated plants exhibited typical wilt symptoms 4 weeks after inoculation, whereas control plants remained healthy. P. sacchari was consistently re-isolated from artificially inoculated plants. To our knowledge, this is the first report of P. sacchari on sugarcane in Mexico. The occurrence of stalk rot disease of sugarcane caused by P. sacchari has been described causing severe losses in sugarcane-producing countries such as South Africa and India (1). References: (1) R. Viswanathan et al. Sugar Tech. 5: 61, 2003. (2) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, 1990.

Comparación de la estabilización precoz versus tardía en el trauma raquimedular / Comparison of early versus delayed stabilization in spinal cord injury

El Trauma Raquimedular (TRM) es el resultado del daño18, 19 producido por lesiones traumáticas vertebrales a cualquier nivel y que comprometen a las diferentes estructuras que componen la columna vertebral, particularmente la médula espinal o sus raíces. Su incidencia14, 16 varía entre 11.5 y 53.4 por cada millón de habitantes y la causa más frecuente en nuestro país son las caídas. La región cervical es la más afectada seguida de la unión toracolumbar. Los segmentos torácicos y lumbares se comprometen con menor frecuencia, siendo similar en ambos niveles. Es una patología catastrófica para los pacientes y sus familias, ya que habitualmente los afectados son personas jóvenes en edad productiva17. Conjuntamente con el inmenso problema social, esta patología constituye un gran problema económico15 para los sistemas de salud debido al alto costo que implica su tratamiento tanto en la fase aguda como su posterior rehabilitación. El tratamiento del TRM se debe iniciar desde el momento en que se sospecha una lesión medular. Con el fin de evitar el daño medular secundario, además de la inmovilización precoz1,2,3,4,5,6,9, 20 se han probado distintos protocolos de tratamientos farmacológicos7,8,10,12,13, sin resultados que avalen su uso. Los protocolos basados en los estudios NASCIS21,22,23,24 utilizados en la actualidad emplean metilprednisolona en dosis de 30 mg/kg en bolo infundido en 15 minutos, seguido de una infusión en dosis de 5.4 mg/kg/hora. Dependiendo si el tiempo transcurrido desde la lesión es menor a 3 horas la infusión se mantiene por 23 horas y si la lesión se encuentra entre 3 y 8 horas se mantiene por 47 horas. Del mismo modo se han utilizado TRH26, Gaciclidina, Naloxona22, Tirilizad24, Nimodipino25 y más recientemente se ha propuesto el tratamiento de células madres27,28. Por otra parte una serie de trabajos11 sugieren que la descompresión y estabilización precoz en TRM disminuye el daño medular así como las complicaciones médicas...

Spinal Cord Injury (SCI) is due to traumatic lesions involving spine, specially spinal cord and its roots. This is a catastrophic neurological disorder for the patients which are usually young people in productive age. The incidente range is from 11.5 to 53.4 per million people. Besides the great social problem it brings another important issue for health systems due to high costs involved. Different pharmacologic protocols have been proposed to avoid a possible further damage, without results supporting their use. Otherwise multiple studies suggest that early spine decompression and stabilization diminish secondary spinal cord damage as well as medical complications and period of hospitalization. Our study retrospectively evaluated a group of patients who received a late decompression and stabilization and one that received an early within the first 72 hours focusing in pre and post surgical stay and associated medical complications. The data were obtained of the Neurosurgical Department of The Rancagua Regional Hospital database and includes 233 patients with spinal cord injury between May 1997 and October 2009. Cervical Spinal Cord Injury is more prevalent and more common in middle age men. Patients who underwent early decompression were hospitalized less time and suffer less medical complications.

Nutrition and cataract in low-income Mexicans: experience in an Eye camp.

Surgical Eye-camps for cataract treatment of low-income adult Mexicans have been undertaken over the last 10 years. Despite the high prevalence of cataracts among these subjects, no assessment of their nutritional or health status has ever been made. We compare the results obtained for 81 adults (44 men and 37 women) who received treatment in May 1997 with those for a "control" group of age and sex-matched but affluent individuals in Mexico City. alpha-Tocopherol and beta-carotene were assessed and analysed by HPLC and colorimetric procedures, respectively. The plasma tocopherol to cholesterol ratio did not reveal deficiencies of this vitamin, and only 5 patients (2 men and 3 women) had low beta-carotene plasma levels. The patients had high BMI values, with 32% of men and 30% of women overweight, and 2% and 14%, respectively, obese, with higher glucose, cholesterol and triglyceride values reflecting enhanced insulin resistance and lipid abnormalities. The alkaline phosphatase values were elevated suggesting that many of these blind patients are osteomalacic because they now remain indoors. Although it has been suggested that an adequate intake of carotenes and tocopherol are associated with absence of cataract, this appears not to be the case in our study population. Surveys in Mexico have revealed, however, a highly prevalent deficiency of other vitamins such as niacin and riboflavin, both of which have been proved to be protective against cataract. It appears that nutritional deficiencies, obesity, incipient diabetes and lipid disorders co-exist in modern Mexico. We have identified a need for research to aid the design of preventive nutritional approaches at the population level that could be applied in parallel with ongoing surgical treatment.