Tamaulipan thornscrub after fire: an analysis of the composition of species / Espinho de Tamaulipan após incêndio: uma análise da composição das espécies

Forest fires are a natural element in many terrestrial ecosystems, in Mexico one of the main causes of loss of vegetation coverage is related to them. Nevertheless, no research has been carried out in the Tamaulipan thornscrub communities regarding post-fire regenerative strategies of plant species, therefore, is important to generate knowledge about the ecological role of fire in them. The aim of this study is to characterize the arboreal and shrub vegetation of a Tamaulipan thornscrub community in the Northeast of Mexico after a fire. To determine the composition, diversity and structure of the floral community consisting of trees and shrubs, 6 square-shaped sampling sites of 1,600 m2 were established 3 years after the fire. Margalef (DMg), Shannon-Weiner (H) and Pretzsch (A) indices were calculated to determine the richness, diversity and vertical stratification of species, respectively.23 species, 21 genera and 14 families of vascular plants were registered. The most species were Fabaceae (6) and Rhamnaceae (3) and Cordia boissieri was the specie with greater ecological weight (IVI = 20.3%). The indexes of richness and true diversity (DMg = 3.16; D = 16.44) showed high values, which suggests that the post-fire area has a good regeneration and a high species diversity. With these results we can conclude that the fire is an important agent of change in successional stages of Tamaulipan thornscrub with high values of regeneration after a surface fire.(AU)

Os incêndios florestais são um elemento natural em muitos ecossistemas terrestres, no México uma das principais causas de perda de cobertura vegetal está relacionada a eles, no entanto, nenhuma pesquisa foi realizada nas comunidades de espinheiros de Tamaulipan sobre as estratégias regenerativas pós-fogo de espécies de plantas, portanto, é importante gerar conhecimento sobre o papel ecológico do fogo neles. O objetivo deste estudo é caracterizar a vegetação arbórea e arbustiva de uma comunidade de plantas espinhosas no Tamaulipas, nordeste do México após um incêndio. Para determinar a composição, diversidade e estrutura da comunidade vegetal constituída por árvores e arbustos, seis locais de amostragem em forma de quadrado de 1.600 m2 cada um, foram estabelecidos três anos após o incêndio. Índices de Margalef (DMg), Shannon-Weiner (H) e Pretzsch (A) foram calculados para determinar a riqueza, diversidade e estratificação vertical das espécies, respectivamente. Foram registradas 23 espécies, 21 gêneros e 14 famílias de plantas vasculares. As mais ricas foram Fabaceae (6) e Rhamnaceae (3), Cordia boissieri foi a espécie com maior peso ecológico (IVI = 20,3%). Os índices de riqueza e diversidade verdadeira (DMg = 3,16; D = 16,44) apresentaram valores elevados, o que sugere que a área pós-fogo apresenta boa regeneração e alta diversidade Vegetal. Com estes resultados podemos concluir que o fogo é um importante agente de mudança nos estágios sucessionais do espinho de Tamaulipan com altos valores de regeneração após um incêndio na superfície.(AU)

Tamaulipan thornscrub after fire: an analysis of the composition of species / Espinho de Tamaulipan após incêndio: uma análise da composição das espécies

Abstract Forest fires are a natural element in many terrestrial ecosystems, in Mexico one of the main causes of loss of vegetation coverage is related to them. Nevertheless, no research has been carried out in the Tamaulipan thornscrub communities regarding post-fire regenerative strategies of plant species, therefore, is important to generate knowledge about the ecological role of fire in them. The aim of this study is to characterize the arboreal and shrub vegetation of a Tamaulipan thornscrub community in the Northeast of Mexico after a fire. To determine the composition, diversity and structure of the floral community consisting of trees and shrubs, 6 square-shaped sampling sites of 1,600 m2 were established 3 years after the fire. Margalef (DMg), Shannon-Weiner (H') and Pretzsch (A) indices were calculated to determine the richness, diversity and vertical stratification of species, respectively.23 species, 21 genera and 14 families of vascular plants were registered. The most species were Fabaceae (6) and Rhamnaceae (3) and Cordia boissieri was the specie with greater ecological weight (IVI = 20.3%). The indexes of richness and true diversity (DMg = 3.16; D = 16.44) showed high values, which suggests that the post-fire area has a good regeneration and a high species diversity. With these results we can conclude that the fire is an important agent of change in successional stages of Tamaulipan thornscrub with high values of regeneration after a surface fire.

Resumo Os incêndios florestais são um elemento natural em muitos ecossistemas terrestres, no México uma das principais causas de perda de cobertura vegetal está relacionada a eles, no entanto, nenhuma pesquisa foi realizada nas comunidades de espinheiros de Tamaulipan sobre as estratégias regenerativas pós-fogo de espécies de plantas, portanto, é importante gerar conhecimento sobre o papel ecológico do fogo neles. O objetivo deste estudo é caracterizar a vegetação arbórea e arbustiva de uma comunidade de plantas espinhosas no Tamaulipas, nordeste do México após um incêndio. Para determinar a composição, diversidade e estrutura da comunidade vegetal constituída por árvores e arbustos, seis locais de amostragem em forma de quadrado de 1.600 m2 cada um, foram estabelecidos três anos após o incêndio. Índices de Margalef (DMg), Shannon-Weiner (H') e Pretzsch (A) foram calculados para determinar a riqueza, diversidade e estratificação vertical das espécies, respectivamente. Foram registradas 23 espécies, 21 gêneros e 14 famílias de plantas vasculares. As mais ricas foram Fabaceae (6) e Rhamnaceae (3), Cordia boissieri foi a espécie com maior peso ecológico (IVI = 20,3%). Os índices de riqueza e diversidade verdadeira (DMg = 3,16; D = 16,44) apresentaram valores elevados, o que sugere que a área pós-fogo apresenta boa regeneração e alta diversidade Vegetal. Com estes resultados podemos concluir que o fogo é um importante agente de mudança nos estágios sucessionais do espinho de Tamaulipan com altos valores de regeneração após um incêndio na superfície.

Tamaulipan thornscrub after fire: an analysis of the composition of species.

Forest fires are a natural element in many terrestrial ecosystems, in Mexico one of the main causes of loss of vegetation coverage is related to them. Nevertheless, no research has been carried out in the Tamaulipan thornscrub communities regarding post-fire regenerative strategies of plant species, therefore, is important to generate knowledge about the ecological role of fire in them. The aim of this study is to characterize the arboreal and shrub vegetation of a Tamaulipan thornscrub community in the Northeast of Mexico after a fire. To determine the composition, diversity and structure of the floral community consisting of trees and shrubs, 6 square-shaped sampling sites of 1,600 m2 were established 3 years after the fire. Margalef (DMg), Shannon-Weiner (H') and Pretzsch (A) indices were calculated to determine the richness, diversity and vertical stratification of species, respectively.23 species, 21 genera and 14 families of vascular plants were registered. The most species were Fabaceae (6) and Rhamnaceae (3) and Cordia boissieri was the specie with greater ecological weight (IVI = 20.3%). The indexes of richness and true diversity (DMg = 3.16; D = 16.44) showed high values, which suggests that the post-fire area has a good regeneration and a high species diversity. With these results we can conclude that the fire is an important agent of change in successional stages of Tamaulipan thornscrub with high values of regeneration after a surface fire.

Tamaulipan thornscrub after fire: an analysis of the composition of species

Abstract Forest fires are a natural element in many terrestrial ecosystems, in Mexico one of the main causes of loss of vegetation coverage is related to them. Nevertheless, no research has been carried out in the Tamaulipan thornscrub communities regarding post-fire regenerative strategies of plant species, therefore, is important to generate knowledge about the ecological role of fire in them. The aim of this study is to characterize the arboreal and shrub vegetation of a Tamaulipan thornscrub community in the Northeast of Mexico after a fire. To determine the composition, diversity and structure of the floral community consisting of trees and shrubs, 6 square-shaped sampling sites of 1,600 m2 were established 3 years after the fire. Margalef (DMg), Shannon-Weiner (H) and Pretzsch (A) indices were calculated to determine the richness, diversity and vertical stratification of species, respectively.23 species, 21 genera and 14 families of vascular plants were registered. The most species were Fabaceae (6) and Rhamnaceae (3) and Cordia boissieri was the specie with greater ecological weight (IVI = 20.3%). The indexes of richness and true diversity (DMg = 3.16; D = 16.44) showed high values, which suggests that the post-fire area has a good regeneration and a high species diversity. With these results we can conclude that the fire is an important agent of change in successional stages of Tamaulipan thornscrub with high values of regeneration after a surface fire.

Resumo Os incêndios florestais são um elemento natural em muitos ecossistemas terrestres, no México uma das principais causas de perda de cobertura vegetal está relacionada a eles, no entanto, nenhuma pesquisa foi realizada nas comunidades de espinheiros de Tamaulipan sobre as estratégias regenerativas pós-fogo de espécies de plantas, portanto, é importante gerar conhecimento sobre o papel ecológico do fogo neles. O objetivo deste estudo é caracterizar a vegetação arbórea e arbustiva de uma comunidade de plantas espinhosas no Tamaulipas, nordeste do México após um incêndio. Para determinar a composição, diversidade e estrutura da comunidade vegetal constituída por árvores e arbustos, seis locais de amostragem em forma de quadrado de 1.600 m2 cada um, foram estabelecidos três anos após o incêndio. Índices de Margalef (DMg), Shannon-Weiner (H) e Pretzsch (A) foram calculados para determinar a riqueza, diversidade e estratificação vertical das espécies, respectivamente. Foram registradas 23 espécies, 21 gêneros e 14 famílias de plantas vasculares. As mais ricas foram Fabaceae (6) e Rhamnaceae (3), Cordia boissieri foi a espécie com maior peso ecológico (IVI = 20,3%). Os índices de riqueza e diversidade verdadeira (DMg = 3,16; D = 16,44) apresentaram valores elevados, o que sugere que a área pós-fogo apresenta boa regeneração e alta diversidade Vegetal. Com estes resultados podemos concluir que o fogo é um importante agente de mudança nos estágios sucessionais do espinho de Tamaulipan com altos valores de regeneração após um incêndio na superfície.

Tamaulipan thornscrub after fire: an analysis of the composition of species

Abstract Forest fires are a natural element in many terrestrial ecosystems, in Mexico one of the main causes of loss of vegetation coverage is related to them. Nevertheless, no research has been carried out in the Tamaulipan thornscrub communities regarding post-fire regenerative strategies of plant species, therefore, is important to generate knowledge about the ecological role of fire in them. The aim of this study is to characterize the arboreal and shrub vegetation of a Tamaulipan thornscrub community in the Northeast of Mexico after a fire. To determine the composition, diversity and structure of the floral community consisting of trees and shrubs, 6 square-shaped sampling sites of 1,600 m2 were established 3 years after the fire. Margalef (DMg), Shannon-Weiner (H) and Pretzsch (A) indices were calculated to determine the richness, diversity and vertical stratification of species, respectively.23 species, 21 genera and 14 families of vascular plants were registered. The most species were Fabaceae (6) and Rhamnaceae (3) and Cordia boissieri was the specie with greater ecological weight (IVI = 20.3%). The indexes of richness and true diversity (DMg = 3.16; D = 16.44) showed high values, which suggests that the post-fire area has a good regeneration and a high species diversity. With these results we can conclude that the fire is an important agent of change in successional stages of Tamaulipan thornscrub with high values of regeneration after a surface fire.

Resumo Os incêndios florestais são um elemento natural em muitos ecossistemas terrestres, no México uma das principais causas de perda de cobertura vegetal está relacionada a eles, no entanto, nenhuma pesquisa foi realizada nas comunidades de espinheiros de Tamaulipan sobre as estratégias regenerativas pós-fogo de espécies de plantas, portanto, é importante gerar conhecimento sobre o papel ecológico do fogo neles. O objetivo deste estudo é caracterizar a vegetação arbórea e arbustiva de uma comunidade de plantas espinhosas no Tamaulipas, nordeste do México após um incêndio. Para determinar a composição, diversidade e estrutura da comunidade vegetal constituída por árvores e arbustos, seis locais de amostragem em forma de quadrado de 1.600 m2 cada um, foram estabelecidos três anos após o incêndio. Índices de Margalef (DMg), Shannon-Weiner (H) e Pretzsch (A) foram calculados para determinar a riqueza, diversidade e estratificação vertical das espécies, respectivamente. Foram registradas 23 espécies, 21 gêneros e 14 famílias de plantas vasculares. As mais ricas foram Fabaceae (6) e Rhamnaceae (3), Cordia boissieri foi a espécie com maior peso ecológico (IVI = 20,3%). Os índices de riqueza e diversidade verdadeira (DMg = 3,16; D = 16,44) apresentaram valores elevados, o que sugere que a área pós-fogo apresenta boa regeneração e alta diversidade Vegetal. Com estes resultados podemos concluir que o fogo é um importante agente de mudança nos estágios sucessionais do espinho de Tamaulipan com altos valores de regeneração após um incêndio na superfície.

Actividad de las enzimas antioxidantesen el riñon de la rata con preeclampsia experimental / Rat kidney antioxidant enzyme activities in experimental preeclampsia

La preeclampsia (PE) es un trastorno multisistémico del embarazo caracterizado por hipertensión, proteinuria y edema. La PE se asocia con la disfunción endotelial, el estrés oxidativo y con la disminución de la actividad de la sintasa del óxido nítrico (SON) endotelial. Los mecanismos de la vasodilatación asociada al embarazo normal sugieren que el óxido nítrico (NO) es el más importante mediador en la reducción de la resistencia vascular, mientras que en la PE la respuesta dilatadora dependiente de endotelio y mediada por el NO se encuentra reducida. Se ha demostrado que la inhibición de la síntesis del NO mediante la administración crónica de LNAME en ratas preñadas, resulta en un modelo animal que ocasiona un síndrome similar a la PE, el cual cursa con hipertensión, proteinuria, trombocitopenia y retardo de crecimiento intrauterino. Con el fin de caracterizar las alteraciones renales que ocurren durante la PE, empleamos este modelo animal de preeclampsia inducido por la inhibición de la SON, en ratas de 13 días de gestación. Se cuantifico la posible alteración en la actividad de las enzimas antioxidantes como la catalasa (CAT), superoxido dismutasa (SOD) y glutatión peroxidasa (GPx), así como la SON renal. El tratamiento crónicocon L-NAME en ratas preñadas incrementó la PAM (+20mmHg), produjo proteinuria, sin embargo no altero significativamente el número y el peso de los fetos. El estudio histológico de los riñones de animales pre-eclámpticos mostró que los mismos presentan tumefacción turbia de epitelios tubulares, focos hemorrágicos y congestión de capilares glomerulares. El tratamiento crónico con L-NAME en las ratas preñadas redujo la actividad de las tres enzimas antioxidantes evaluadasy de la SON renal. Estos hallazgos sugieren que la PE experimental cursa con alteración renal asociada con la reducciónde la actividad antioxidante y la inhibición de la SON.

Preeclampsia (PE) is a multisystem disorder of pregnancy characterized by hypertension, proteinuria and edema. PE is associated with endothelial dysfunction, oxidative stress and decreased endothelial nitric oxide synthase activity. The mechanisms of normal pregnancy-associated vasodilation suggest that nitric oxide (NO) is the most important mediator for the reduction of vascular resistance. Many studies demonstrat ereduction of endothelium-dependent dilator response mediated by NO in PE. Inhibition of NO synthesis is an animal model which results in a PE-like syndrome, hypertension, proteinuria, thrombocytopenia and intrauterine growth retardation. In order to assess the possible renal alteration in this animal model of preeclampsia induced by chronic administration of L-NAME, we determined the antioxidant enzymes activities (catalase, superoxide dismutase and gluthation peroxidase) and nitric oxide sinthase in the rat kidney. Chronic L-NAME treatment in pregnant rats increased MAP (+20mm Hg), produced proteinuria and did not change the number and weight of fetuses. Histological examination of the kidneys showed cloudy swelling PE tubular epithelia, hemorrhagic fociand congestion of glomerular capillaries. In addition, L-NAME treatment reduced CAT, SOD, GPx and NOS activity in the kidney. These findings suggest that in experimental preeclampsia, renal alterations are associated with a reduction in the antioxidant enzyme and NOS activities.

Infection rate and risk factors associated with infections related to external ventricular drain.

OBJECTIVE: To describe incidence rates and risk factors associated with external ventricular drain (EVD)-related infections at a tertiary Brazilian teaching hospital. METHODS: The patient cohort consisted of all patients at a major teaching hospital in Brazil with an EVD during the period 1 April 2007 to 30 June 2008 (15 months). Patients were followed up for 30 days after catheter removal. According to the Center for Diseases Control and Prevention criteria for meningitis/ventriculitis, all of the central nervous system (CNS) infections that occurred during this period could be considered to be meningitis or ventriculitis related to EVD placement. Infection rates were calculated using different denominators, such as (1) per patient (incidence), (2) per procedure, and (3) per 1,000 catheter-days (drain-associated infection rate). Patient demographic data, medical history of underlying diseases, antibiotic prophylaxis usage, American Society of Anesthesiologists Score classification, duration of surgery and hospitalization, length of time the EVD was in place, and overall mortality were evaluated during the study period. A logistic regression model was developed to identify factors associated with infection. RESULTS: A total of 119 patients, 130 EVD procedures, and 839 catheter-days were evaluated. The incidence of infection was 18.3%, the infection rate was 16.9% per procedure, and the drain-associated infection rate was 22.4 per 1,000 catheter-days; 77% of the infections were caused by Gram-negative micro-organisms. Only 75% of patients received antibiotic prophylaxis. The infection rate increased with length of the hospital stay. The length of time the catheter was in place was the only independent risk factor associated with infection (p = 0.0369). CONCLUSION: The incidence of EVD-related infections is high in our hospital, Gram-negative micro-organisms were the most frequent causal agents identified and length of time that the catheter was in place contributed to the infection rate.

El Sistema Nervioso Simpático Cerebral y la natriuresis inducida por la administración central de endotelinas

Se evaluó el papel de los receptores alfa1- alfa2- y beta-adrenérgicos cerebrales en la acción renal de las endotelinas (ETs). La administración intracerebroventricular (ICV) de ETs a ratas macho conscientes resultó en un incremento en la excreción urinaria de sodio a la 1, 3 y 6 horas del período de recolección de orina. La administración ICV de prazosin, un antagonista selectivo del receptor alfa1-adrenérgico, inhibió la respuesta natriurética de las ETs-ICV. Por el contrario, el pretratamiento central con yohimbina (un antagonista del receptor alfa2-adrenérgico) o con atenolol (un antagonista del receptor beta1-adrenérgico) no alteró significativamente la respuesta urinaria a la ET-ICV. Nuestros resultados demuestran que las endotelinas cerebrales se encuentran involucradas en los procesos que regulan el balance electrolítico e indican que el sistema nervioso simpático cerebral, a través del receptor alfa1-adrenérgico, participa en la acción natriurética de las ETs.

Experiments were conducted to investigate the role of brain the alpha1- alpha2 and beta-adrenergic receptors on the renal effects elicited by central injection of ETs. Cerebroventricular administration of endothelins (ETs) to conscious male hydrated rats resulted in an increase in urinary sodium excretion at 1, 3 and 6 hr period of urine collection. Central administration of prazosin (an alpha1-adrenergic receptor antagonist) inhibited the increase in sodium and urine excretion induced by ICV-ETs. Yohimbine (an alpha2-adrenergic receptor antagonist) or atenolol (an beta-adrenergic receptor antagonist) did not altered the urinary response to ET-IVT. Our results demonstrate a role for brain endothelin in the regulation of electrolyte balance and indicate that the sympathetic nervous system, through the alpha1-adrenergic receptor subtype, is involved in the natriuretic action of ETs.

Lymphoscintigraphic evaluation in patients after erysipelas.

Erysipelas (cellulitis/lymphangitis) is a superficial cutaneous infection spread by the lymphatic system which may result in permanent injury to the lymphatic vessels. The study evaluated the lymphatic drainage in the lower limbs of 30 patients with at least two episodes of erysipelas by means of lymphoscintigraphy. Twenty-two (73%) were female and 8 (27%) were male with ages ranging from 26 to 77 years (mean 52 years). Lymphoscintigraphy was performed by intradermal administration of 500 microCi (20 Mbq) of 99mTc antimony sulfur-colloid in two interdigital spaces of the feet. Whole body scintigraphy was performed 45 minutes after the administration of the radiopharmaceutical using a computerized gamma camera. Significant lymphatic abnormalities were found in 23 (77%) of these patients. We conclude that most patients with repeated erysipelas have significant and even permanent abnormalities in regional lymphatic drainage. Recurrent erysipelas suggests underlying primary or secondary lymphedema.

Immunization against the colonization factor antigen I of enterotoxigenic Escherichia coli by administration of a bivalent Salmonella typhimurium aroA strain.

An expression plasmid (pCFA-1) carrying the cfaB gene that codes for the enterotoxigenic Escherichia coli (ETEC) fimbrial adhesin colonization factor antigen I (CFA/I) subunit was constructed and used to transform a derivative of the attenuated Salmonella typhimurium aroA vaccine strain SL3261 carrying an F'lacIq. Treatment of the transformed strain with isopropyl-beta-D-thiogalactopyranoside (IPTG) resulted in elevated in vitro expression of the CFA/I subunit. Although flagellar function and lipopolysaccharide (LPS) synthesis were similar in both the parental and the recombinant strains, spleen colonization was reduced in the recombinant strain. All BALB/c mice parenterally inoculated with the recombinant strain developed significant anti-CFA/I and anti-LPS serum antibody titers (P < 0.05). Moreover, 2 of 5 mice orally inoculated with the engineered Salmonella strain developed anti-CFA/I intestinal IgA (P > 0.05) while 4/5 of the same mice developed anti-LPS IgA (P < 0.05). The results indicate that the vaccine strain elicited an antibody response against the bacterial host both after oral and intravenous immunization while the response against the CFA/I antigen was significant only after inoculation by the intravenous route.

Immunization against the colonization factor antigen I of enterotoxigenic Escherichia coli by administration of a bivalent Salmonella typhimurium aroA strain

An expression plasmid (pCFA-1) carrying the cfaB gene that codes for the enterotoxigenic Escherichia coli (ETEC) fimbrial adhesin colonization factor antigen I(CFA/I) subunit was constructed and used to transform a derivative of the attenuated Salmonella typhimurium aroA vaccine strain SL3261 carrying an F'lacl(q). Treatment of the transformed strain with isopropyl-beta-D-thiogalactopyranoside (IPTG) resulted in elevated in vitro expression of the CFA/I subunit. Although flagellar function and lipopolysaccharide (LPS) synthesis were similar in both the parental and the recombinant strains, spleen colonization was reduced in the recombinant strain. AII BALB/c mice parenteally inoculated with the recombinant strain developed significant anti-CFA/I and anti-LPS serum antibody titers (P<0.05). Moreover, 2 of 5 mice orally inoculated with the engineered Salmonella strain developed anti-CFA/I intestinal IgA (P>0.05) while 4/5 of the same mice developed anti-LPS (P<0.05). The results indicate that the vaccine strain elicited an antibody response against the bacterial host both after oral and intravenous immunization while the response against the CFA/I antigen was significant only after inoculation by the intravenous route.

[An anthropometric study of a group of elderly men and women of Mexico City]. / Estudio antropométrico en un grupo de hombres y mujeres de la tercera edad en la Ciudad de México.

OBJECTIVE: The aim of the present study was to estimate basic anthropometric measurements in a group of elderly men and women from Mexico City. MATERIAL AND METHODS: A cross-sectional study was carried out among senior citizens registered in the National Institute of the Elderly and National Institute of Social security in Mexico City. Standardized protocols were used to measure the anthropometric characteristics of the study group. The analysis included Student t tests to detect differences in average values between men and women in general and in each age subgroup formed. In addition, Pearson correlation analysis of the body mass index (BMI) with anthropometric variables was performed; p < 0.05 was taken as the level of significance. RESULTS: A total of 508 people aged 60 or older participated in the study; 230 were males and 278 were females. The average age was 66.9-years-old in the male group and 67.3-years-old in the female group. Among men the average weight was 70.7 kg, standard deviation (SD 9.9), height was 164 cm (SD 6.5) and BMI was 26.4 (SD 3.7). Among women the average weight was 60.8 kg (SD 9.9), height was 150 cm (SD 5.9) and BMI was 27.1 (SD 4.0). The distribution of the BMI showed that 50.9% of men and 54% of women were between 25.0 and 29.9. A correlation coefficient over r 0.70 (p < 0.001) was found between BMI and waist and hip circumferences. CONCLUSIONS: Based on the BMI about three-quarters of the population was overweight or obese. It is possible that the assessment of being overweight and of obesity in elderly people needs to be adjusted considering revised normality values.

Absceso cerebeloso por colesteatoma: a propósito de un caso / Braian abcess for cholesteatoma: a propos the a case a purpose

Las infecciones de origen otógeno tales como otitis media, otomastoiditis y colesteatoma pueden complicarse con infecciones a nivel del sistema nervioso central. Se presenta el caso de un escolar de 12 años de edad, con otomastoiditis y colesteatoma del oído derecho, quien desarrolló un absceso cerebeloso, el cual fue diagnosticado por resonancia magnética nuclear. Mediante este estudio se le hizo seguimiento para evaluar respuesta al tratamiento médico y tomar la decisión de tratamiento quirúrgico. Los sígnos y síntomas iniciales fueron inespecíficos, desarrollando posteriormente hipertensión endocraneana y síndrome de lesión de ocupación de espacio de fosa posterior. Se realizó resonancia magnética nuclear (RMN) confirmándose el diagnóstico de hidrocefalia obstructiva y cerebelitis bilateral a predominio derecho. Se procedió a colocar válvula de derivación ventricular peritoneal y antibioticoterapia. A las 4 semanas se realizó RMN de control evidenciándose absceso cerebeloso derecho por lo que se decide practicar exéresis del mismo, de cuyo material extraído se logró aislar Bacteroides fragilis. Evoluciona satisfactoriamente. Posteriormente se realiza resección del colesteatoma. El paciente egresa con parálisis facial periférica posterior a cirugía del colesteatoma. La audiometría revela ausencia total de audición por el oído derecho. El propósito de presentar este caso es resaltar la alta incidencia de complicaciones intracraneales que tienen las infecciones otógenas y la importancia del diagnóstico precoz y tratamiento adecuado de estas afecciones

[The health situation in Nicaragua: between a desire to change and aggression]. / La situación sanitaria de nicaragua: entre el deseo de cambio y la agresión.

Before 1979, the health situation in Nicaragua was characterized by a high infant mortality, a high morbidity and mortality related with infectious causes in most cases preventable, as well as by a health care system with multiple non-coordinated institutions, a low coverage and deep social and geographical inequalities in the provision of services. The revolution develops a new regionalized model with an extension of the coverage especially through primary care services, preventive and curative programs targeted at risk groups and health problems, with a large community involvement. The achievements of this new policy are assessed by an increase and a greater equality in the availability and utilization of health resources, by a reduction in morbidity due to transmissible diseases, and by a spectacular decrease in infant mortality. The externally promoted war is having a strong impact on health care and has been slowing down the improvements observed from 1979 to 1983; it violates the principles of the Geneva Convention, it has been condemned by the Tribunal of the Hague, and deserves condemnation from Public Health professionals.