Mexican consensus on cow's milk protein allergy.

BACKGROUND: The aim of this study is to present the current views of a diverse group of experts on the diagnosis and treatment of Cow's Milk Protein Allergy (CMPA) in children under 2 years of age in Mexico. MATERIAL AND METHODS: The study, led by a scientific committee of five experts in CMPA, was divided into six phases, including a modified Delphi process. A total of 20 panelists, all of whom were pediatric specialists, participated in administering a comprehensive 38-item questionnaire. The questionnaire was divided into two blocks: Diagnosis and Treatment (20 items each). RESULTS: Consensus was reached on all the proposed items, with an agreement rate of over 70% for each of them. As a result, a diagnostic and treatment algorithm was developed that emphasized the reduction of unnecessary diagnostic studies and encouraged breastfeeding whenever possible. In cases where breast milk is not available, appropriate use of hypoallergenic formulas was recommended. In addition, recommendations on treatment duration and gradual reintroduction of cow's milk protein were provided. CONCLUSIONS: The recommendations endorsed by 20 Mexican pediatricians through this study are applicable to everyday clinical practice, thereby enhancing the diagnosis and treatment of children under 2 years of age with CMPA. This, in turn, will foster improved health outcomes and optimize the utilization of healthcare resources.

Who's your data? Primary immune deficiency differential diagnosis prediction via machine learning and data mining of the USIDNET registry.

PURPOSE: There are currently more than 480 primary immune deficiency (PID) diseases and about 7000 rare diseases that together afflict around 1 in every 17 humans. Computational aids based on data mining and machine learning might facilitate the diagnostic task by extracting rules from large datasets and making predictions when faced with new problem cases. In a proof-of-concept data mining study, we aimed to predict PID diagnoses using a supervised machine learning algorithm based on classification tree boosting. METHODS: Through a data query at the USIDNET registry we obtained a database of 2396 patients with common diagnoses of PID, including their clinical and laboratory features. We kept 286 features and all 12 diagnoses to include in the model. We used the XGBoost package with parallel tree boosting for the supervised classification model, and SHAP for variable importance interpretation, on Python v3.7. The patient database was split into training and testing subsets, and after boosting through gradient descent, the predictive model provides measures of diagnostic prediction accuracy and individual feature importance. After a baseline performance test, we used the Class Weighting Hyperparameter, or scale_pos_weight to correct for imbalanced classification. RESULTS: The twelve PID diagnoses were CVID (1098 patients), DiGeorge syndrome, Chronic granulomatous disease, Congenital agammaglobulinemia, PID not otherwise classified, Specific antibody deficiency, Complement deficiency, Hyper-IgM, Leukocyte adhesion deficiency, ectodermal dysplasia with immune deficiency, Severe combined immune deficiency, and Wiskott-Aldrich syndrome. For CVID, the model found an accuracy on the train sample of 0.80, with an area under the ROC curve (AUC) of 0.80, and a Gini coefficient of 0.60. In the test subset, accuracy was 0.76, AUC 0.75, and Gini 0.51. The positive feature value to predict CVID was highest for upper respiratory infections, asthma, autoimmunity and hypogammaglobulinemia. Features with the highest negative predictive value were high IgE, growth delay, abscess, lymphopenia, and congenital heart disease. For the rest of the diagnoses, accuracy stayed between 0.75 and 0.99, AUC 0.46-0.87, Gini 0.07-0.75, and LogLoss 0.09-8.55. DISCUSSION: Clinicians should remember to consider the negative predictive features together with the positives. We are calling this a proof-of-concept study to continue with our explorations. A good performance is encouraging, and feature importance might aid feature selection for future endeavors. In the meantime, we can learn from the rules derived by the model and build a user-friendly decision tree to generate differential diagnoses.

Use of discrete event simulation and genetic algorithms to estimate the necessary resources to respond in a timely manner in the Medical Emergency System in Bogotá. / Uso de simulación de eventos discretos y algoritmos genéticos para estimar los recursos necesarios para responder oportunamente en el sistema de emergencias médicas en Bogotá.

Introduction: Bogotá has a Medical Emergency System of public and private ambulances that respond to health incidents. However, its sufficiency in quantity, type and location of the resources demanded is not known. Objective: Based on the data from the Medical Emergency System of Bogotá, Colombia, we first sought to characterize the prehospital re- sponse in cardiac arrest and determine with the model which is the least number of resources necessary to respond within eight minutes, taking into account their location, number, and type. Methods: A database of incidents reported in administrative records of the district health authority of Bogotá (2014 to 2017) was obtained. Based on this information, a hybrid model based on discrete event simulation and genetic algorithms was designed to establish the amount, type and geographic location of resources according to the frequencies and typology of the events. Results: From the database, Bogotá presented 938 671 ambulances dispatches in the period. 47.4% high priority, 18.9% medium and 33.74% low. 92% of these corresponded to 15 of 43 medical emergency codes. The response times recorded were longer than expected, especially in out-of-hospital cardiac arrest (median 19 minutes). In the proposed model, the best scenario required at least 281 ambulances, medicalized and basic in a 3:1 ratio, respectively, to respond in adequate time. Conclusions: Results suggest the need for an increase in the resources that respond to these incidents to bring these response times to the needs of our population.

Introducción: Bogotá cuenta con un sistema de emergencias médicas de ambulancias públicas y privadas que responden a incidentes de salud. No se conoce, sin embargo, su suficiencia en cantidad, tipo y ubicación de recursos demandados. Objetivos: A partir de los datos del sistema de emergencias médicas de Bogotá, Colombia, se buscó primero caracterizar la respuesta pre hospitalaria en paro cardiaco. Luego, con el modelo se buscó determinar cuál sería el menor número de recursos necesarios para responder antes de ocho minutos, teniendo en cuenta su ubicación, número y tipo. Métodos: Se obtuvo una base de datos de incidentes reportados en registros administrativos de la autoridad sanitaria distrital de Bogotá (de 2014 a 2017). A partir de esa información, se diseñó un modelo híbrido basado en la simulación de eventos discretos y algoritmos genéticos para establecer la cantidad, tipo y ubicación geográfica de recursos, conforme a frecuencias y tipología de los eventos. Resultados: De la base de datos, Bogotá presentó 938 671 envíos de ambulancias en el período. El 47,4% de prioridad alta, 18,9% media y 33,74% baja. El 92% de estos correspondieron a 15 de 43 códigos de emergencias médicas. Los tiempos de respuesta registrados fueron mayores a lo esperado, especialmente en paro cardiaco extra hospitalario (mediana de 19 minutos). En el modelo planteado, el mejor escenario requirió al menos 281 ambulancias, medicalizadas y básicas en proporción de 3:1 respectivamente para responder en tiempos adecuados. Conclusiones: Los resultados sugieren la necesidad de incrementar los recursos que responden a estos incidentes para acercar estos tiempos de respuesta a las necesidades de nuestra población.

Uso de simulación de eventos discretos y algoritmos genéticos para estimar los recursos necesarios para responder oportunamente en el sistema de emergencias médicas en Bogotá / Use of discrete event simulation and genetic algorithms to estimate the necessary resources to respond in a timely manner in the Medical Emergency System in Bogotá

INTRODUCCIÓN: Bogotá cuenta con un sistema de emergencias médicas de ambulancias públicas y privadas que responden a incidentes de salud. No se conoce, sin embargo, su suficiencia en cantidad, tipo y ubicación de recursos demandados. OBJETIVOS: A partir de los datos del sistema de emergencias médicas de Bogotá, Colombia, se buscó primero caracterizar la respuesta pre hospitalaria en paro cardiaco. Luego, con el modelo se buscó determinar cuál sería el menor número de recursos necesarios para responder antes de ocho minutos, teniendo en cuenta su ubicación, número y tipo. MÉTODOS: Se obtuvo una base de datos de incidentes reportados en registros administrativos de la autoridad sanitaria distrital de Bogotá (de 2014 a 2017). A partir de esa información, se diseñó un modelo híbrido basado en la simulación de eventos discretos y algoritmos genéticos para establecer la cantidad, tipo y ubicación geográfica de recursos, conforme a frecuencias y tipología de los eventos. RESULTADOS: De la base de datos, Bogotá presentó 938 671 envíos de ambulancias en el período. El 47,4% de prioridad alta, 18,9% media y 33,74% baja. El 92% de estos correspondieron a 15 de 43 códigos de emergencias médicas. Los tiempos de respuesta registrados fueron mayores a lo esperado, especialmente en paro cardiaco extra hospitalario (mediana de 19 minutos). En el modelo planteado, el mejor escenario requirió al menos 281 ambulancias, medicalizadas y básicas en proporción de 3:1 respectivamente para responder en tiempos adecuados. CONCLUSIONES: Los resultados sugieren la necesidad de incrementar los recursos que responden a estos incidentes para acercar estos tiempos de respuesta a las necesidades de nuestra población.

INTRODUCTION: Bogotá has a Medical Emergency System of public and private ambulances that respond to health incidents. However, its sufficiency in quantity, type and location of the resources demanded is not known. OBJECTIVE: Based on the data from the Medical Emergency System of Bogotá, Colombia, we first sought to characterize the prehospital response in cardiac arrest and determine with the model which is the least number of resources necessary to respond within eight minutes, taking into account their location, number, and type. METHODS: A database of incidents reported in administrative records of the district health authority of Bogotá (2014 to 2017) was obtained. Based on this information, a hybrid model based on discrete event simulation and genetic algorithms was designed to establish the amount, type and geographic location of resources according to the frequencies and typology of the events. RESULTS: From the database, Bogotá presented 938 671 ambulances dispatches in the period. 47.4% high priority, 18.9% medium and 33.74% low. 92% of these corresponded to 15 of 43 medical emergency codes. The response times recorded were longer than expected, especially in out-of-hospital cardiac arrest (median 19 minutes). In the proposed model, the best scenario required at least 281 ambulances, medicalized and basic in a 3:1 ratio, respectively, to respond in adequate time. CONCLUSIONS: Results suggest the need for an increase in the resources that respond to these incidents to bring these response times to the needs of our population.

Influence of high density planting and spatial arrangement on growth and development in Musa AAA Simmonds / Influencia de altas densidades de siembra y distribución espacial sobre el crecimiento y desarrollo en Musa AAA Simmonds

ABSTRACT Banana is after apple, the most consumed fruit in the world for its nutritional contribution. Given its importance, it is necessary to advance in the development of agronomic management strategies that contribute to increase productivity and offer alternatives to regulate the consequences derived from the seasonality of production in the Urabá area (Colombia). For this, the clone Williams (Musa AAA Simmonds), at different planting densities (2000, 2500, 3000 and 3500 plants ha-1), different population arrangements (triangle, rectangle and double furrow), compared with a relative control (1700 plants ha-1 in triangle) was evaluated. The design used was randomized complete blocks in factorial arrangement of 4 x 3 + 1 (densities x arrays + control). The variables height and perimeter of the pseudostem, number of leaves from planting to harvest, leaf area index (IAF), light extinction coefficient, number of suckers and developmental stages (days elapsed after flowering and harvest) were determined. An analysis of general variance was carried out and another one excluding the control. The Tukey test (P <0.05) was applied to the qualitative variables and contrasts of orthogonal polynomials were made to test the linear and quadratic effects of the population density factor. The results indicated that the high planting densities and the population arrangements had a negative effect on the perimeter of the pseudostem and the height of the main sucker, favored the LAI, influenced the extinction coefficient, but did not affect the development of the plants.

RESUMEN El banano es después de la manzana la fruta más consumida en el mundo, por su aporte nutricional. Dada su importancia, se requiere avanzar en el desarrollo de estrategias de manejo agronómico, que contribuyan a incrementar la productividad y ofrezcan alternativas para regular las consecuencias derivadas de la estacionalidad de la producción, en la zona del Urabá (Colombia). Para ello, se evaluaron en el clon Williams (Musa AAA Simmonds), diferentes densidades de plantación (2.000, 2.500, 3.000 y 3.500 plantas ha-1), distintos arreglos poblacionales (triángulo, rectángulo y doble surco) y un testigo relativo (1.700 plantas ha-1 en triángulo). El diseño utilizado fue de bloques completos al azar en arreglo factorial, de 4 x 3 + 1 (densidades x arreglos + testigo). Se determinaron la altura y perímetro del pseudotallo, el número de hojas de siembra a cosecha, el índice de área foliar (IAF), el coeficiente de extinción de luz, el número de hijos y fases de desarrollo: días transcurridos a floración y cosecha. Se realizó un análisis de varianza general y otro excluyendo el testigo. Se aplicó la prueba de Tukey (P<0,05) a las variables cualitativas y se hicieron contrastes de polinomios ortogonales, para probar los efectos lineal y cuadrático del factor densidad de población. Los resultados indicaron que las altas densidades de plantación y los arreglos poblacionales tuvieron un efecto negativo sobre el perímetro del pseudotallo y la altura del hijo a parición, favorecieron el IAF, influyeron en el coeficiente de extinción, pero no afectaron el desarrollo de las plantas.

Lactobacillus acidophilus LB: a useful pharmabiotic for the treatment of digestive disorders.

Dysbiosis, a loss of balance between resident bacterial communities and their host, is associated with multiple diseases, including inflammatory bowel diseases (nonspecific chronic ulcerative colitis and Crohn's disease), and digestive functional disorders. Probiotics, prebiotics, synbiotic organisms and, more recently, pharmabiotics, have been shown to modulate the human microbiota. In this review, we provide an overview of the key concepts relating to probiotics, prebiotics, synbiotic organisms, and pharmabiotics, with a focus on available clinical evidence regarding the specific use of a unique pharmabiotic, the strain Lactobacillus acidophilus LB (Lactobacillus boucardii), for the management of gastrointestinal disorders. Since it does not contain living organisms, the administration of L. acidophilus LB is effective and safe as an adjuvant in the treatment of acute diarrhea, chronic diarrhea, and antibiotic-associated diarrhea, even in the presence of immunosuppression.

Grado de severidad de la disfagia orofaríngea neurogénica en el paciente de unidad de cuidado intermedio / Severity degree neurogenic oropharyngeal dysphagia in the patient of intermediate care unit

Objetivo: Indagar el grado de severidad de la disfagia orofaríngea neurogénica en los pacientes de la unidad de cuidado intermedio, por medio de la escala de severidad de la disfagia de Horacio Cámpora que considera habilidades alimentarias a través de consistencias que puede manejar el paciente realizadas con el Método de Exploración Clínica Volumen ­ Viscosidad (MECV-V). Metodología: El estudio es de tipo exploratorio, no experimental, con un grupo de 32 pacientes con desórdenes neurológicos. Resultado: Se detecta que el grado de severidad de la disfagia orofaríngea neurogénica en los pacientes de la unidad de cuidados intermedios es moderada ­ severa, en la cual la ingesta oral no es exitosa y requiere supervisión constante y asistencia por el fonoaudiólogo. Conclusión: La investigación aporta elocuentemente al abordaje fonoestomatognatico y/o motricidad orofacial, en cuanto a la labor asistencial del fonoaudiólogo en las unidades de cuidados intermedios. (AU)

Purpose: The aim of this study is to investigate the degree of severity of neurogenic oropharyngeal dysphagia in patients of the intermediate care unit, using Horacio Campora's severity scale for dysphagia. This takes into account eating assestment for patients employing the volume-viscocity swallow test for clinical evaluation (V-VST). Methodology: The study, which is an exploratory research and not experimental, was performed on a group of 32 patients with neurological disorders. Results: A moderate -severe degree of neurogenic oropharyngeal dysphagia is detected in the patients of the intermediate care unit, where the oral intake of food/liquid is not successful. As a consequence, the patients require the constant assistance and supervision by a speech pathologist and language. Conclusion: The research contributes to the stomatognathic and/or orofacial motricity, regarding the assistance work of speech pathologist and language in the intermediate care unit. (AU)

New species of predatory mites (Acari: Prostigmata: Cunaxidae) for southern Brazil.

Two new species of Cunaxidae, Cunaxoides lajeadensis Wurlitzer Monjarás-Barrera sp. nov. and Lupaeus waldumirus Wurlitzer Monjarás-Barrera sp. nov., are described from Ipomoea alba L. (Convolvulaceae) on the edge of an urban forest fragment.

Uso de la tarjeta colorimétrica visual para la detección oportuna de atresia de vías biliares / Colorimetric card use for early detection visual biliary atresia

Resumen: Introducción: La atresia de vías biliares (AVB) es una condición que provoca obstrucción al flujo biliar, y de no corregirse quirúrgicamente, provoca cirrosis y la muerte antes de los 2 años de edad. En México, a partir del año 2013 se incorporó la tarjeta colorimétrica visual (TCV) para la detección oportuna de la AVB a la Cartilla Nacional de Salud (CNS). El objetivo de este estudio fue evaluar el impacto de la TCV para la detección de AVB antes y después de su incorporación a la CNS. Métodos: Estudio ambispectivo, observacional y analítico. Se incluyeron pacientes con AVB atendidos en dos hospitales pediátricos de tercer nivel de atención. Se compararon la edad de referencia, el diagnóstico y la cirugía antes y después de la incorporación de la TCV. Además, se realizó un cuestionario a los padres para conocer su percepción sobre la TCV. Resultados: En 59 niños no hubo diferencias en la edad al diagnóstico (75 vs 70 días) ni en la edad al momento de la cirugía (84 vs 90 días) entre antes y después de la implementación de la TCV. Solo el 30% de los padres recibieron información del uso de la TCV y solo el 38% identificaron las evacuaciones anormales. Conclusiones: Este estudio no mostró cambios en el tiempo para la detección oportuna de AVB mediante el uso de la TCV. Por lo tanto, es necesario reforzar el programa en los tres niveles de atención en nuestro país.

Abstract: Background: Bile duct atresia (BVA) is a condition that causes obstruction to biliary flow, not corrected surgically, causes cirrhosis and death before 2 years of age. In Mexico from 2013 the visual colorimetric card (VVC) was incorporated for the timely detection of BVA to the National Health Card (NHC). The aim of this study was to evaluate the impact of VCT for the detection of BVA before and after the use of NHC incorporation. Methods: Ambispective, analytical observational study. We included patients with AVB treated in two pediatric hospitals of third level care. We compared the age of reference, diagnosis and surgery before and after incorporation of the TCV. In addition, a questionnaire was made to the parents to know their perception about the TCV. Results: In 59 children, there were no differences in age at diagnosis (75 vs 70 days) and age at surgery (84 vs 90 days) between the pre and post-implementation period of the VVC. The questionnaire showed that 10 (30%) of the parents received information about the use of the VVC and 13 (38%) identified the abnormal evacuations. Conclusions: This study did not show changes in time for the timely detection of BVA by using VVC. Therefore, it is necessary to reinforce the program in the three levels of care in our country.

[Colorimetric card use for early detection visual biliary atresia]. / Uso de la tarjeta colorimétrica visual para la detección oportuna de atresia de vías biliares.

Background: Bile duct atresia (BVA) is a condition that causes obstruction to biliary flow, not corrected surgically, causes cirrhosis and death before 2 years of age. In Mexico from 2013 the visual colorimetric card (VVC) was incorporated for the timely detection of BVA to the National Health Card (NHC). The aim of this study was to evaluate the impact of VCT for the detection of BVA before and after the use of NHC incorporation. Methods: Ambispective, analytical observational study. We included patients with AVB treated in two pediatric hospitals of third level care. We compared the age of reference, diagnosis and surgery before and after incorporation of the TCV. In addition, a questionnaire was made to the parents to know their perception about the TCV. Results: In 59 children, there were no differences in age at diagnosis (75 vs 70 days) and age at surgery (84 vs 90 days) between the pre and post-implementation period of the VVC. The questionnaire showed that 10 (30%) of the parents received information about the use of the VVC and 13 (38%) identified the abnormal evacuations. Conclusions: This study did not show changes in time for the timely detection of BVA by using VVC. Therefore, it is necessary to reinforce the program in the three levels of care in our country.

Introducción: La atresia de vías biliares (AVB) es una condición que provoca obstrucción al flujo biliar, y de no corregirse quirúrgicamente, provoca cirrosis y la muerte antes de los 2 años de edad. En México, a partir del año 2013 se incorporó la tarjeta colorimétrica visual (TCV) para la detección oportuna de la AVB a la Cartilla Nacional de Salud (CNS). El objetivo de este estudio fue evaluar el impacto de la TCV para la detección de AVB antes y después de su incorporación a la CNS. Métodos: Estudio ambispectivo, observacional y analítico. Se incluyeron pacientes con AVB atendidos en dos hospitales pediátricos de tercer nivel de atención. Se compararon la edad de referencia, el diagnóstico y la cirugía antes y después de la incorporación de la TCV. Además, se realizó un cuestionario a los padres para conocer su percepción sobre la TCV. Resultados: En 59 niños no hubo diferencias en la edad al diagnóstico (75 vs 70 días) ni en la edad al momento de la cirugía (84 vs 90 días) entre antes y después de la implementación de la TCV. Solo el 30% de los padres recibieron información del uso de la TCV y solo el 38% identificaron las evacuaciones anormales. Conclusiones: Este estudio no mostró cambios en el tiempo para la detección oportuna de AVB mediante el uso de la TCV. Por lo tanto, es necesario reforzar el programa en los tres niveles de atención en nuestro país.

Pyogenic granuloma associated with mandibular odontoma / Granuloma piógeno asociado a odontoma mandibular

Background: pyogenic granuloma is a kind of inflammatory hyperplasia of multifactorial origin, which is usually related to trauma or constant irritation, drug use, hormonal factors, among others. Meanwhile the odontoma is a benign tumor odontogenic composed of epithelial and mesenchymal cells, their development is usually associated with trauma, infections, inherited disorders or hyperactivity odontoblast. Objectives: The objective is to present the clinical case of a patient that presented a case of pyogenic granuloma related to the presence of a mandibular odontoma, and therapeutic management and postoperative results. Case report: The case shows a female patient of 32 years old with a history of multinodular goiter and hypothyroidism, developing a mandibular odontoma of the left side associated with pyogenic granuloma in the same area, which was treated with surgical excision and reconstructed affected tissues with lyophilized bone and collagen membrane. Favorable outcome after surgery without evidence of recurrence, with proper osseointegration of alloplastic materials and soft tissues. Conclusions: The irritant effect of the presence of a tumor (odontoma) in developing confirmed pyogenic granuloma.

Antecedentes: el granuloma piógeno es una especie de hiperplasia inflamatoria de origen multifactorial, que suele relacionarse a trauma o irritaciones constantes, uso de drogas, factores hormonales, entre otras. Por su parte el odontoma es una tumoración odontogénica benigna, compuesta de células epiteliales y mesenquimatosas, su desarrollo suele relacionarse con traumatismos, procesos infecciosos, alteraciones hereditarias o hiperactividad odontoblástica. Objetivos. El objetivo es presentar el caso clínico de una paciente la cual presento un caso de granuloma piógeno relacionado a la presencia de un odontoma mandibular; así como el manejo terapéutico y los resultados posoperatorios. Caso clínico: El caso muestra a una paciente del sexo femenino de 32 años de edad con antecedentes de bocio multinodular e hipotiroidismo, desarrollando un granuloma piógeno asociado al desarrollo de un odontoma mandibular del lado izquierdo, el cual fue tratado con extirpación quirúrgica y los tejidos incidido reconstruidos con hueso liofilizado y membrana de colágeno. Evolución favorable pos quirúrgica, sin evidencia de recidiva, con correcta osteointegración de materiales aloplásticos y tejidos blandos. Conclusiones: se confirma el efecto irritante de la presencia de una tumoración (odontoma) en el desarrollo de un granuloma piógeno.

[Guía latinoamericana para el diagnóstico y tratamiento de alergia a las proteínas de la leche de vaca (GL-APLV)].

Cow's milk allergy (CMA) is an immune-based disease that has become an increasing problem. The diagnosis and management of CMA varies from one clinical setting to another and represents a challenge in pediatric practice. In addition, because nonallergic food reactions can be confused with CMA symptoms, there is an overdiagnosis of the disease. In response to these situations, pediatric specialties from recognized institutions throughout Latin America decided to develop a clinical guideline for diagnosis and management of cow's milk allergy. These guidelines include definitions, epidemiology, pathophysiology overview, clinical and evidencebased recommendations for the diagnosis and treatment of CMA. They also include prevention and prognosis sections and identify gaps in the current knowledge to be addressed through future research.

Análisis de datos meteorológicos para identificar y definir el clima en Yopal, Casanare / Analysis of Meteorological Data to Identify and Define Climate in Yopal, Casanare / Análise de dados meteorológicos para identificar e definir o clima em Yopal, Casanare

El objetivo de este artículo fue analizar datos meteorológicos para identificar el comportamiento de variables físicas de relevancia y definir el clima de la región y el microclima de Yopal, Casanare. Se estudiaron los registros de las variables climáticas en una serie de tiempo de treinta años en la estación meteorológica del aeropuerto de Yopal, los cuales fueron suministrados por el Instituto de Estudios Ambientales y Meteorológicos (Ideam). Luego se llevó a cabo una tipificación climática basada en las clasificaciones más utilizadas por la comunidad científica, como son Thornthwaite, De Martone y Koppen, con el propósito de situar climáticamente la región de estudio. Por último, se analizaron las dos variables físicas más importantes en cuanto al comportamiento del microclima del lugar respecto al crecimiento de la vegetación, por sus procesos de evapotranspiración y uso del recurso hídrico.

The purpose of this article was to analyze meteorological data to identify the behavior of relevant physical variables and to define the regional climate and microclimate of Yopal, Casanare. The records of climatic variables in a time period of thirty years at the Yopal airport weather station, supplied by the Institute of Environmental and Meteorological Studies (Ideam), were studied. Then, a climatic classification was performed, based on the most used classifications by the scientific community, such as Thornthwaite, De Martone and Koppen, in order to climatically locate the region under study. Finally, the two most important physical variables were analyzed, in terms of behavior of the microclimate of the site regarding the growth of vegetation, by its processes of evapotranspiration and water use.

O objetivo deste artigo foi analisar dados meteorológicos para identificar o comportamento de variáveis físicas de relevância e definir o clima da região e o microclima de Yopal, Casanare. Estudaram-se os registros das variáveis climáticas em uma série de tempo de trinta anos na estação meteorológica do aeroporto de Yopal, os quais foram fornecidos pelo Instituto de Estudos Ambientais e Meteorológicos (Ideam). Depois foi realizada uma tipificação climática baseada nas classificações mais utilizadas pela comunidade científica, como é Thornthwaite, De Martone e Koppen, com o propósito de situar climaticamente a região de estudo. Por último, analisaram-se as duas variáveis físicas mais importantes, em quanto ao comportamento do microclima do lugar com relação ao crescimento da vegetação, por seus processos de evapotranspiração e uso do recurso hídrico.

Guidelines for the diagnosis and treatment of extrahepatic portal vein obstruction (EHPVO) in children.

INTRODUCTION: Extrahepatic portal vein obstruction is an important cause of portal hypertension among children. The etiology is heterogeneous and there are few evidences related to the optimal treatment. AIM AND METHODS: To establish guidelines for the diagnosis and treatment of EHPVO in children, a group of gastroenterologists and pediatric surgery experts reviewed and analyzed data reported in the literature and issued evidence-based recommendations. RESULTS: Pediatric EHPVO is idiopathic in most of the cases. Digestive hemorrhage and/or hypersplenism are the main symptoms. Doppler ultrasound is a non-invasive technique with a high degree of accuracy for the diagnosis. Morbidity is related to variceal bleeding, recurrent thrombosis, portal biliopathy and hypersplenism. Endoscopic therapy is effective in controlling acute variceal hemorrhage and it seems that vasoactive drug therapy can be helpful. For primary prophylaxis of variceal bleeding, there are insufficient data for the use of beta blockers or endoscopic therapy. For secondary prophylaxis, sclerotherapy or variceal band ligation is effective; there is scare evidence to recommend beta-blockers. Surgery shunt is indicated in children with variceal bleeding who fail endoscopic therapy and for symptomatic hypersplenism; spleno-renal or meso-ilio-cava shunting is the alternative when Mesorex bypass is not feasible due to anatomic problems or in centers with no experience. CONCLUSIONS: Prospective control studies are required for a better knowledge of the natural history of EHPVO, etiology identification including prothrombotic states, efficacy of beta-blockers and comparison with endoscopic therapy on primary and secondary prophylaxis.

Productividad en materia seca y captura de carbono en un sistema silvopastoril y un sistema tradicionalen cinco fincas ganaderas de piedemonte en el departamento de Casanare / Dry matter productivity and carbon sequestration in a silvopastoral System and a Traditional system in five foothill cattle farms in the department of Casanare

El objetivo fue comparar, en cuanto a productividad en materia seca y captura de carbono, entre un sistema silvopastoril y un sistema tradicional en cinco fincas ganaderas de piedemonte del departamento de Casanare. En el lote experimental de cada finca se sembró una mezcla de cuatro especies de pastos, de los cuales Brachiaria brizantha fue la especie que tuvo un desarrollo exitoso en las cinco fincas, y con la cual se analizó su productividad en materia seca y captura de carbono. A los cinco meses después de la renovación de pastos en los lotes experimentales se obtuvo una productividad en materia seca entre 6,3 y 14,9 tMS/ha, y encaptura de carbono entre 2,7 y 6,4 tCOT/ha; mientras que en los lotes tradicionales estuvo entre 4 y 5 tMS/ha, y en captura de carbono entre 1,7 y 2,9 tCOT/ha. A los 20 meses en los lotes experimentales se obtuvo una productividad en materia seca entre 12 y 13,7 tMS/ha, y en captura de carbono entre 4,1 y 4,5 tCOT/ha; mientras que en los lotes tradicionales estuvo entre 4,4 y 6,5 tMS/ha, y en captura de carbono entre 1,4 y 2,1 tCOT/ha. Esto indica que la renovación de praderas con pastos adecuados y el pastoreo de rotación favorecen la producción en materia seca y la captura de carbono...

The goal was to compare, in terms of dry matter productivity and carbon sequestration, asilvopastoral system with a traditional system in five foothill cattle farms in the Departmentof Casanare. A mixture of four species of grass was planted in the experimental plot of eachfarm, of which Brachiaria brizantha was the species that had a successful development in thefive farms, and whose dry matter and carbon sequestration productivity was analyzed. Fivemonths after pasture renovation in the experimental lots, a dry matter productivity between6.3 and 14.9 tMS/ha and carbon sequestration productivity between 2.7 and 6.4 tCOT/ha were obtained; in traditional lots, dry matter productivity was between 4 and 5 tMS/ha,while carbon sequestration productivity was between 1.7 and 2.9 tCOT/ha. At 20 months, dry matter productivity between 12 and 13.7 tMS/ha, and carbon sequestration productivitybetween 4.1 and 4.5 tCOT/ha were obtained in experimental lots, while in traditionallots, dry matter productivity was between 4.4 and 6.5 tMS/ha, while carbon sequestrationproductivity was between 1.4 and 2.1 tCOT/ha. This indicates that renewal of grasslandswith suitable pastures and rotational grazing favor dry matter and carbon sequestration production...

O objetivo foi comparar, com respeito à produtividade em matéria seca e captura de carbono,um sistema silvipastoril e um sistema tradicional em cinco fazendas de criação de gado nodepartamento de Casanare. No lote experimental de cada fazenda plantou-se uma misturade quatro espécies de pastos, dos quais Brachiaria brizantha foi a espécie que teve um desenvolvimentobem-sucedido nas cinco fazendas, e com a qual analisou-se sua produtividadeem matéria seca e captura de carbono. Cinco meses depois da renovação de pastos nos lotesexperimentais obteve-se uma produtividade em matéria seca entre 6,3 e 14,9 tMS/ha, e umacaptura de carbono entre 2,7 e 6,4 tCOT/ha; enquanto que nos lotes tradicionais esteveentre 4 e 5 tMS/ha, e uma captura de carbono entre 1,7 e 2,9 tCOT/ha. Aos 20 meses noslotes experimentais obteve-se uma produtividade em matéria seca entre 12 e 13,7 tMS/ha, eem captura de carbono entre 4,1 e 4,5 tCOT/ha; enquanto que nos lotes tradicionais esteveentre 4,4 e 6,5 tMS/ha, e uma captura de carbono entre 1,4 e 2,1 tCOT/ha. Isto indica quea renovação de pastos com variedades adequadas e o pastoreio de rotação favorecem a produçãode matéria seca e a captura de carbono...

Genetic and antigenic relationships of vesicular stomatitis viruses from South America.

Vesicular stomatitis (VS) viruses have been classified into two serotypes: New Jersey (VSNJV) and Indiana (VSIV). Here, we have characterized field isolates causing vesicular stomatitis in Brazil and Argentina over a 35-year span. Cluster analysis based on either serological relatedness, as inferred from virus neutralization and complement fixation assays, or nucleotide sequences of two separate genes (phosphoprotein or glycoprotein) grouped the field isolates into two distinct monophyletic groups within the Indiana serogroup. One group included seven viruses from Brazil and Argentina that were serologically classified as Indiana-2 and Cocal virus (COCV). The other group contained three viruses from Brazil that were serologically classified as Indiana-3 and the prototype of this group, Alagoas virus (VSAV). Interestingly, two vesiculoviruses that were isolated from insects but do not cause disease in animals, one from Brazil (Maraba virus; MARAV) and the other from Colombia (CoAr 171638), grouped into two separate genetic lineages within the Indiana serotype. Our data provide support for the classification of viruses causing clinical VS in livestock in Brazil and Argentina into two distinct groups: Indiana-2 (VSIV-2) and Indiana-3 (VSIV-3). We suggest using nomenclature for these viruses that includes the serotype, year and place of occurrence, and affected host. This nomenclature is consistent with that currently utilized to describe field isolates of VSNJV or VSIV in scientific literature.

[Guidelines for diagnosis and treatment of constipation in Mexico. D) Evaluation and treatment of constipation in pediatric population]. / Guías de diagnóstico y tratamiento del estreñimiento en México. D) Evaluación y tratamiento del estreñimiento en población pediátrica.

BACKGROUND: Constipation is one of the most common causes of consultation in pediatric practice, it has a multifactorial etiology and its treatment can be complex. OBJECTIVES AND METHODS: To establish the clinical guidelines for diagnosis and treatment of chronic constipation in pediatric population in Mexico, a review of the epidemiological, diagnostic and therapeutic aspects was conducted by an expert group of pediatric gastroenterologist in our country. RESULTS: Constipation is a symptom that reflects the presence of fecal retention, which is reported by patients or their relatives as decreased stool frequency, hard stools, and sometimes pain and excessive pushing. Constipation can occur at any stage of childhood. The main trigger for fecal retention is the painful evacuation. Patients who meet the Rome III criteria for functional constipation do not require diagnostic tests. The diagnostic tests are reserved for cases in which alarm signs are present and in patients refractory to conventional treatment. The goal of treatment is to promote smooth and painless evacuations preventing reaccumulation of stool. Osmotic laxatives such as polyethylene glycol and lactulose are the most effective treatments. In special cases, biofeedback therapy, the use of botulinum toxin and surgery can be effective, although the evidence is weak. CONCLUSIONS: Management of chronic constipation in pediatric population requires a comprehensive diagnostic approach.

Estereología renal en el cobayo (Cavia porcellus) / Renal stereology in the guinea pig (Cavia porcellus)

El cobayo (Cavia porcellus) es un roedor perteneciente al Orden Rodentia y a la Familia Caviidae, utilizado como animal de laboratorio y de consumo humano. Los parámetros cuantitativos del riñón entregan importante información de su morfofunción dada su labor en la homeostasis del organismo. El objetivo de este estudio fue describir el riñón de cobayo (Cavia porcellus), analizando las características estereológicas para futuros estudios experimentales. Se utilizaron 5 cobayos machos, obtenidos del Bioterio de la Universidad de La Frontera, Temuco, Chile. El riñón de cobayo pesó 3,2 g, aproximadamente. El riñón posee 140.298 glomérulos en total, Nv de 458 mm³, Vv de 7,89% y Sv de 3,58 mm²/ mm³. El volumen glomerular del riñón fue de 1,73 x 10(4)mm³ y el diámetro glomerular de 90 jm. Factores como especie, edad, peso corporal, peso y volumen renal, son importantes a considerar, ya que diferencian los resultados en investigaciones morfofuncionales.

The guinea pig, (Cavia porcellus) is a rodent pertaining to the Rodentia group and the Caviidae family, used as a laboratory animal and for human consumption. Quantitative parameters of the kidney provides important information of its morphofunction, given its labor in the organism's homeostasis. The aim or this study was to describe the kidney of the guinea pig (Cavia porcellus), analyzing the stereological characteristics for future experimental studies. Five male guinea pigs (Cavia porcellus) obtained from the Biotery of the Universidad de la Frontera, Temuco, Chile, were used. The kidney of the guinea pig weighed approximately 3.2g. The kidney has 140,298 total glomerulus, Nv of 458 mm³, Vv of 7.89% and Svof 3.58mm²/mm³. The glomerular volume of the kidney was of 1.73 x 10(4)mm³ and a glomerular diameter of 90 urn. Factors such as species, age, body weight and renal volume, are important to consider, as they differentiate the results in the morphofunctional investigations.

Human papilloma virus in oral squamous cell carcinoma in a Mexican population.

OBJECTIVE: To determine the human papilloma virus (HPV) infection in oral cancer and its association with smoking and drinking habits. STUDY DESIGN: A cross-sectional study was performed; samples were collected from 51 patients with histological diagnosis of squamous-cell carcinoma were collected at the Instituto Nacional de Cancerología in Mexico City. HPV infection was detected by polymerase chain reaction, and the clinical characteristics of this population were analyzed. RESULTS: Fifty samples out of 51 were positive for beta-globin; 21 (42%) cases were HPV-positive, and 14/21 were positive for HPV-16. We found more samples positive in men than in women (71% vs 29%). No differences were observed between HPV-positive and -negative patients in relation to smoking and drinking habits (81% vs 79%). CONCLUSIONS: HPV infection was present in 42% of patients with oral squamous-cell carcinoma (OSCC); HPV-16 was the most frequent type, identified in 66.6%. Other cofactors participate in the development of OSCC, independent of HPV infection.