Increase in forest structural complexity along a precipitation gradient is mediated by partial harvests in temperate Patagonian forests.

Increasing forest structural complexity is becoming a common goal in forestry worldwide. However, the lack of empirical quantification clouds its implementation. Here we quantified the long-term effects (> 30 y) of partial harvest on stand structural complexity and net primary productivity using the east-west precipitation gradient (318-2508 mm, mean annual precipitation-MAP) of western Patagonian as a study system. In this gradient, pairs of 1-ha plots on 20 sites (20 plots harvested and 20 plots unharvested) were installed. In each plot terrestrial laser scanning was used to quantify the stand structural complexity index (SSCI), and Sentinel satellite images to obtain the Enhanced Vegetation Index (EVI: proxy of net primary productivity). Generalized linear mixed-effect models were used to relate SSCI to MAP and EVI to SSCI, with harvesting as indicator variable, and site as random variable (two plots nested to same precipitation). Results showed that harvested plots on mesic-to-humid sites (but not on dry sites) had higher SSCI and EVI values compared to unharvested plots, likely due to a greater vertical canopy packing. These results show the influence of precipitation on SSCI, which resulted in a more diversified stand structure and higher EVI. Such insights support site-specific management aimed to increase forest structural complexity.

Relationship of vitamin D with the anthropometric indicators and lifestyle of adults. Medellín. Colombia

Introduction: Serum vitamin D levels depend on sunlight, diet, and other factors. Objective: We aimed to determine serum vitamin D levels and evaluate their relationship with anthropometric indicators and lifestyle habits in apparently healthy volunteers. Materials and Methods: In this cross-sectional study (n=75), socio-demographic, anthropometric, and lifestyle habit-related data were collected. Serum vitamin D levels were determined with high performance liquid chromatography, food intake was measured by semiquantitative frequency and nutritional status was assessed by anthropometry. Chi-square test and also principal component analysis were used to analyze the relationship between some variables and vitamin D status. Spearman's test was used to determine correlations between quantitative variables. Results: 73% were women and 61% belonged to medium socio-economic level. Median vitamin D intake was 137 (83.1­227.3) IU/day. Based on body mass index (BMI), 44% individuals had overweight/obesity. The 68% exhibited deficient/insufficient vitamin D levels (Hypovitaminosis D). BMI classification and waist circumference (CW) were not related with vitamin D status; however, activities with higher sun exposure were highly related (p = 0.013). Sun exposure time explained variation in component 2 (16.60%), where most of the individuals with normal level were grouped. Sun exposure time was positively correlated with vitamin D status (r = 0.263; p = 0.023). Discussion: Excess weight and abdominal obesity are not always associated with hypovitaminosis D. Conclusions: The majority of individuals showed hypovitaminosis D but their status was not related with anthropometric indicators. A Sun exposure time was the only factor positively correlated with vitamin D status.

Introducción: Los niveles séricos de vitamina D dependen de la luz solar, la dieta y otros factores. Objetivo: Nuestro objetivo fue determinar los niveles séricos de vitamina D y evaluar su relación con indicadores antropométricos y estilos de vida en voluntarios aparentemente sanos. Materiales y métodos: En este estudio trasversal (n=75) se recogieron datos sociodemográficos, antropométricos y aquellos relacionados con hábitos y estilos de vida. La vitamina D se determinó por cromatografía liquida de alta eficiencia; la ingesta de alimentos, mediante frecuencia semicuantitativa, y el estado nutricional por antropometría. Para analizar la relación entre algunas variables y el estado de la vitamina D se usó la prueba de Chi cuadrado y también el análisis de componentes principales. Se empleó la prueba de Spearman para determinar la correlación entre variables cuantitativas. Resultados: El 73% eran mujeres y el 61% pertenecían a un estrato socioeconómico medio. La mediana de la ingesta de vitamina D fue de 137 (83,1­227,3) UI/día. Según el índice de masa corporal (IMC), el 44% de los individuos tenían sobrepeso/obesidad. El 68% mostro deficiencia/insuficiencia de vitamina D (hipovitaminosis D). La clasificación del IMC y la circunferencia abdominal no se relacionaron con el estado de la vitamina D; sin embargo, las actividades con una mayor exposición solar estuvieron altamente relacionadas (p=0,013). El tiempo de exposición solar explico la variación en el componente 2 (16,60%) donde se agruparon la mayoría de los individuos con niveles normales. El tiempo de exposición solar tuvo una correlación positiva con el estado de la vitamina D (r = 0,263; p = 0,023). Discusión: El exceso de peso y la obesidad abdominal no siempre se relacionan con la hipovitaminosis D. Conclusiones: La mayoría de los individuos presentaron hipovitaminosis D, pero su estado no se relacionó con los indicadores antropométricos. El tiempo de exposición al sol fue el único factor que se correlaciono positivamente con el estado de la vitamina D.

Introdução: Os níveis séricos de vitamina D dependem da luz solar, da dieta e de outros fatores. Objetivo: Nosso objetivo foi determinar os níveis séricos de vitamina D e avaliar sua relação com indicadores antropométricos e hábitos de vida em voluntários aparentemente saudáveis. Materiais e métodos: Neste estudo transversal (n=75), foram coletados dados sociodemográficos, antropométricos e relacionados a hábitos de vida. Os níveis séricos de vitamina D foram determinados por cromatografia liquida de alto desempenho, a ingestão de alimentos foi medida por frequência semiquantitativa e o estado nutricional foi avaliado por antropometria. O teste do qui-quadrado e a análise de componentes principais foram utilizados para analisar a relação entre algumas variáveis e o estado da vitamina D. O teste de Spearman foi usado para determinar as correlações entre as variáveis quantitativas. Resultados: 73% eram mulheres e 61% pertenciam a um nível socioeconômico médio. A ingestão media de vitamina D foi de 137 (83,1-227,3) UI/dia. Com base no índice de massa corporal (IMC), 44% dos indivíduos tinham sobrepeso/obesidade. Os 68% apresentaram níveis deficientes/insuficientes de vitamina D (hipovitaminose D). A classificação do IMC e a circunferência da cintura (CW) não foram relacionadas ao status da vitamina D; entretanto, as atividades com maior exposição ao sol foram altamente relacionadas (p = 0,013). O tempo de exposição ao sol explicou a variação no componente 2 (16,60%), onde a maioria dos indivíduos com nível normal foi agrupada. O tempo de exposição ao sol foi positivamente correlacionado com o status de vitamina D (r = 0,263; p = 0,023). Discussão: O excesso de peso e a obesidade abdominal nem sempre estão associados com a hipovitaminose D. Conclusões: A maioria dos indivíduos apresentou hipovitaminose D, mas seu status não foi relacionado com indicadores antropométricos. O tempo de exposição ao sol foi o único fator positivamente correlacionado com o status da vitamina D.

Spotting what's important: Priority areas, connectivity, and conservation of the Northern Tiger Cat (Leopardus tigrinus) in Colombia.

Leopardus tigrinus is among the least known carnivore species in the Neotropics, including considerable taxonomic uncertainty. Here we model the distribution, connectivity and overlap with existing conservation areas for the species in Colombia. Using a Species Distribution Modeling approach, we estimated current potential range of the species in Colombia and identified potential habitat blocks remaining in the country. In addition, we designed a connectivity network across the available cores, using a circuit theory approach, to evaluate habitat linkage. Finally, we defined a prioritization scheme for the remaining habitat cores and assessed the level of coverage of protected areas for the country. L. tigrinus is potentially present across the three Andean branches of Colombia, with still considerable continuous habitat cores, mostly located on the eastern and central Andean ranges. Most habitat cores are theoretically connected, but nearly 15% are isolated. Priority areas were located across the eastern and central ranges, but with very significant and promising cores in the northern eastern and western ranges. Current level of protection indicates nearly 30% of the range is "protected", but only about 25% is under national strict protected areas. Evolution of this coverage showed some periods of significant increase but interestingly the number of cores grew at a faster rate than overall proportion protected, likely indicating numerous discontinuous fragments, and not contiguous functional landscapes. This represents the most updated assessment of the distribution and conservation status for the species in Colombia, and indicates the numerous conservation opportunities, especially in most populated areas of the country. We found unique business environmental passive's opportunities, including compensation and development potential, which are becoming more available in the country.

Fire-induced loss of the world's most biodiverse forests in Latin America.

Fire plays a dominant role in deforestation, particularly in the tropics, but the relative extent of transformations and influence of fire frequency on eventual forest loss remain unclear. Here, we analyze the frequency of fire and its influence on postfire forest trajectories between 2001 and 2018. We account for ~1.1% of Latin American forests burnt in 2002-2003 (8,465,850 ha). Although 40.1% of forests (3,393,250 ha) burned only once, by 2018, ~48% of the evergreen forests converted to other, primarily grass-dominated uses. While greater fire frequency yielded more transformation, our results reveal the staggering impact of even a single fire. Increasing fire frequency imposes greater risks of irreversible forest loss, transforming forests into ecosystems increasingly vulnerable to degradation. Reversing this trend is indispensable to both mitigate and adapt to climate change globally. As climate change transforms fire regimes across the region, key actions are needed to conserve Latin American forests.

Cooperation With Universities in the Development of Eco-Innovations and Firms' Performance.

In recent decades, the expansion of economic activity has been accompanied by negative environmental impacts. In response, there have been dramatic changes worldwide in terms of an increased demand for environmentally friendly products and services. To achieve these eco-innovations, firms have sought to acquire knowledge and implement operational flexibility by cooperating with different agents such as universities through a value cocreation system that is also expected to enhance firms' performance. Using a sample of 250 companies, the present paper examines the role of cooperation with universities in the development of diverse environmental innovations and building operational flexibility and, through this, improving firm performance. Results show that firms that value cooperation with universities develop a wider range of environmental innovations and increase their sales and benefits.

Conocimientos del médico sobre responsabilidad profesional médica / Physician ́s knowledge about professional medical responsibility

Justificación: Las fallas en la responsabilidad profesional médica representan un problema de interés por el impacto que tienen en la salud de los pacientes y de los médicos. Objetivo: Evaluar cuál es el nivel de conocimientos de los profesionales de la medicina hondureños sobre aspectos relevantes de la responsabilidad profesional o mala praxis médica. Metodología:Se realizó un estudio transversal descriptivo; la recolección de datosse hizo mediante un instrumento tipo encuesta electrónica con formato de Google®, la cual se validó con un grupo de expertos y cubrió, variables sociodemográficas; de los encuestados, así como cinco ámbitos de conocimiento definidos como: el ámbito legal,el conceptual, el de derechos de los pacientes, el de deberes del médico y el de condicionantes para la denuncia. La población encuestada: estudiantes de medicina con seis o más años cursados de la carrera, indistintamente de la universidad donde estudiaron; médicos residentes y profesionales, ya sea médicos generales o especialistas, todos hondureños. El análisis de los datos se realizó utilizando Excel® 2010, y el Programa R, versión 3.6. Para mejor comprensión de los resultados se construyó una escala descriptiva de acuerdo a los porcentajes de acierto obtenidos. De 0-39% "deficiente", de 40-59% "insuficiente", de 60 a 80% "aceptable", 81-90% "adecuado", de 91% en adelante se clasificócomo "conoce el tema". Resultados: El nivel de conocimiento de los médicos, indistintamente de su formación académica, edad, sexoocentro donde labora, se ubicó en un nivel entre insuficiente y aceptable,siendo el ámbito donde se observó el menor puntaje, con 51,2% de aciertos. Conclusiones: Las fallas en la responsabilidad profesional podrían estar estrechamente ligadas al déficit de competencias y habilidades adecuadas de estudiantes y médicos durante el acto médico...(AU)

Bibliometría o altimetría: desde las métricas tradicionales a las actuales. Revisión bibliográfica / Bibliometry or altimetry: from traditional metrics to present. A review

Introducción:La forma en la que se mide la difusión de la información en la comunidad científica ha sufrido cambios en la última década. Objetivo:Esta revisión tiene como objetivo contextualizar al lector sobre las diferentes formas de medir el impacto de un artículo, tomando en cuenta el "sistema de medición tradicional" y el de "métricas alternativas". Metodología de búsqueda:Se realizó una búsqueda en las bases de datos "PubMed/MEDLINE", "Dialnet", "Scielo" y "ScienceDirect", utilizando las palabras clave: Bibliometría, alt métricas, métricas alternativas y factor de impacto. Conclusiones:El "sistema de medición tradicional", basado en el factor de impacto y que se apoya esencialmente en la opinión de expertos, con el fin asegurar la calidad de las investigaciones, es una herramienta aún vigente que en conjunto con las métricas alternativas o altmétricas, favorecen la difusión del conocimiento, sin que necesariamente midan de manera precisa la calidad del artículo y su impacto...(AU)

Noninferiority and Equivalence Evaluation of Clinical Performance among Computed Radiography, Film, and Digitized Film for Telemammography Services.

Objective. The aim of this study was to evaluate and compare the clinical performance of different alternatives to implement low-cost screening telemammography. We compared computed radiography, film printed images, and digitized films produced with a specialized film digitizer and a digital camera. Material and Methods. The ethics committee of our institution approved this study. We assessed the equivalence of the clinical performance of observers for cancer detection. The factorial design included 70 screening patients, four technological alternatives, and cases interpreted by seven radiologists, for a total of 1,960 observations. The variables evaluated were the positive predictive value (PPV), accuracy, sensitivity, specificity, and the area under the receiver operating characteristic curves (AUC). Result. The mean values for the observed variables were as follows: accuracy ranged from 0.77 to 0.82, the PPV ranged from 0.67 to 0.68, sensitivity ranged from 0.64 to 0.74, specificity ranged from 0.87 to 0.90, and the AUC ranged from 0.87 to 0.90. At a difference of 0.1 to claim equivalence, all alternatives were equivalent for all variables. Conclusion. Our findings suggest that telemammography screening programs may be provided to underserved populations at a low cost, using a film digitizer or a digital camera.

Pentoxifylline immunomodulation in the treatment of experimental chronic pulmonary paracoccidioidomycosis.

BACKGROUND: Pentoxifylline (PTX) is a methylxanthine compound with immunomodulatory and antifibrotic properties. The simultaneous use of PTX and antifungal therapy (itraconazole) has previously been evaluated in an experimental model of pulmonary paracoccidioidomycosis (PCM), a systemic fungal disease caused by the fungus Paracoccidioides brasiliensis (Pb) and characterized by chronic inflammation and lung fibrosis that appears even after a successful course of antifungal therapy. The results revealed prompt and statistically significant reductions in inflammation and fibrosis when compared to itraconazole alone. However, the effect of monotherapy with PTX on the host response to PCM has not been well-documented. Our aim was to determine the effect of PTX on the course of pulmonary lesions and on the local immune response. RESULTS: At the middle and end of treatment, the Pb-infected-PTX-treated mice exhibited significant reductions in lung density compared to the Pb-infected-non-treated mice as assessed by the quantification of Hounsfield units on high-resolution computed tomography (HRCT) (p <0.05 by Kruskal-Wallis test); additionally, at the end of therapy, the lung areas involved in the inflammatory reactions were only 3 vs. 22 %, respectively, by histomorphometry (p <0.05 by Mann-Whitney test), and this reduction was associated with a lower fungal burden and limited collagen increment in the pulmonary lesions. PTX treatment restored the levels of IFN-γ, MIP-1ß, and IL-3 that had been down-regulated by Pb infection. Additionally, IL-12p70, IL-10, IL-13, and eotaxin were significantly increased, whereas Regulated upon Activation, Normal T cell Expressed and Secreted (RANTES) levels were decreased in the lungs of the Pb-infected-PTX-treated mice compared to the non-treated group. CONCLUSIONS/SIGNIFICANCE: This study showed that PTX therapy administered at an "early" stage of granulomatous inflammation controlled the progress of the PCM by diminishing the pulmonary inflammation and the fungal burden and avoiding the appearance of collagen deposits in the pulmonary lesions.

Fagoterapia, alternativa para el control de las infecciones bacterianas. Perspectivas en Colombia / Phage-therapy, an alternative to control bacterial infections. Perspectives in Colombia / Fagoterapia, alternativa para o controle das infeccóes bacterianas. Perspectivas na Colombia

La capacidad de las bacterias para adquirir resistencia a agentes antimicrobianos ha reducido el número de antibióticos efectivos para combatir infecciones bacterianas. De otro lado, existen bacterias contaminantes de alimentos, que no pueden controlarse con antibióticos por tratarse de productos de consumo humano, lo que se traduce en pérdidas económicas y riesgos para la salud. Si a esto se suma la falta de desarrollo de nuevos antibióticos, es evidente que se requiere desarrollar otras estrategias para el tratamiento y control de las bacterias. Los bacteriófagos (fagos), virus que infectan bacterias, se proponen como uno de estos tratamientos alternativos en una estrategia conocida como fagoterapia. Diversos estudios han evaluado y demostrado su efectividad contra bacterias patógenas y ya existen empresas privadas que desarrollan productos basados en cocteles de fagos para controlar algunas infecciones bacterianas. En Colombia no existen antecedentes del uso de fagos pero estos representan una gran oportunidad para el aprovechamiento de la diversidad de la microbiota nativa. En este artículo presentamos las perspectivas de uso de la fagoterapia en Colombia como tratamiento de infecciones bacterianas.

Bacteria easily acquire resistance to antimicrobial agents and this reduces the number of effective antibiotics available to treat bacterial infections. Food contamination by bacteria also generates important economic losses and health risks. Products for human consumption must be free of antibiotics used in clinical treatments, and the control of bacteria with antimicrobials is strictly regulated; however, there is a lack of development of new antibiotics. As a result, the development of new antimicrobial strategies is vital. Viruses that infect bacteria called bacteriophages (phages) have been proposed as an alternative treatment in an approach known as phage-therapy. Several studies have evaluated and demonstrated their effectiveness against pathogenic bacteria; currently, there are private companies dedicated to the development of new products based on phage cocktails, to control some bacterial infections. In Colombia, there is no previous information about the use of phages, but phage-therapy represents a great opportunity to use the diversity of the native microbiota. In this review, we present the perspectives for phage-therapy in Colombia as a treatment against bacterial infections.

A capacidade das bactérias para adquirir resistencia a agentes antimicrobianos tem levado a que o número de antibióticos efetivos para combater infectes bacterianas em humanos seja cada vez menor. Nos alimentos se reportam bactérias causantes de contaminares que representam grandes perdas económicas e riscos para a saúde; estas bactérias nao podem ser tratadas com antibióticos por tratar-se de produtos para consumo humano. Tendo em conta a situado, e a falta de novos antibióticos, precisa-se do desenvolvimento de novas estratégias para o tratamento e controle das bactérias. Os bacteriófagos (fagos), vírus que infectam bactérias, propoem-se como um destes tratamentos alternativos, numa estratégia conhecida como fagoterapia. Diversos estudos tem demostrada a efetividade contra bactérias patógenas e já existem empresas privadas desenvolvendo produtos baseados em coqueteis de fagos, para controlar algumas infectes bacterianas. Na Colombia nao existe antecedente do uso de fagos, mas este apresenta uma grande oportunidade para o aproveitamento da diversidade da microbiota nativa. Nesta revisao apresentamos as perspectivas para a fagoterapia na Colombia como tratamento alternativo contra infectes bacterianas.

Disponibilidad de servicios de mamografía en Colombia / Availability of mammography services in Colombia

Objetivos: Determinar la disponibilidad de servicios de mamografía a nivel nacional para mujeres colombianas entre los 50 y 69 años. Adicionalmente, describir la disponibilidad del servicio de mamografía dentro y fuera del departamento de residencia. Métodos: Se elige Sistema Integral de Información de la Protección Social (SISPRO) como la fuente de información adecuada para desarrollar la investigación. Se calculó la tasa de lugar de prestación de servicio de mamografía por 10.000 mujeres entre los 50 y 69 años. Se dispuso esta información en mapas, y se calculó la proporción de mujeres que recibieron el servicio según el lugar de residencia. Resultados: A nivel nacional se observó una tasa de lugar de prestación promedio de 5,4 por 10.000 mujeres entre los 50 y 69 años, con un máximo de 9,6 y un mínimo de 0. El 23% de las mujeres colombianas entre los 50 y 69 años deben salir de su departamento de residencia para recibir el servicio de mamografía, con un mínimo de 3% y un máximo de 100%. Conclusiones: Existe una distribución heterogénea de los lugares de prestación del servicio de mamografía. En algunos departamentos no existe prestación del servicio y el total de la población reportada en estos lugares debe salir de su departamento de residencia para recibir la prestación. Determinar la disponibilidad de los servicios de mamografía permitió conocer la situación de la oferta para enfocar los recursos y mejorar la disponibilidad de estos, pues tienen un impacto directo en los resultados de cáncer de mama en el país.

Objective: To determine the availability of mammography services at national level targeted at women between 50 and 69 years, as well as to report on the availability of these services within and outside the area of residence. Methods: The Integrated Information System on Social Protection (SISPRO, in its abbreviation in Spanish) was chosen as the source of information to develop an appropriate research study. The rate of places providing mammography services per 10,000 women aged 50 to 69 years was calculated. This information was then displayed on maps. Finally, an estimation of was made of the proportion of women who received the service related to the place of residence. Results: Nationally, an average rate of 5.4 centers providing mammography services per 10,000 women aged 50 to 69 years was observed, with a maximum of 9.6 and a minimum of 0 services per 10,000 women aged 50 to 69 years. It was observed that around 23% of Colombian women had to travel from their department of residence to use the mammography service, with a maximum of 100% and a minimum of 3%. Conclusions: There is a heterogeneous distribution of mammography service delivery. Some departments completely lack mammography service facilities. The population reported in those departments had to travel from their department of residence to receive the service. Determining the availability of mammography services has the aim of finding out the status of the mammogram services offered, and to focus resources to improve access to mammography services, which have a direct impact on health outcomes.

Orina particulada: ¿se correlaciona con infección urinaria? / Particulate echoes within the bladder: this is correlated with urinary infection?

Introducción: La infección de las vías urinarias (IVU) es una entidad frecuente en los servicios de urgencias que requiere diagnóstico y manejo oportuno para evitar posibles complicaciones. En su diagnóstico, el uroanálisis es el estudio empleado en urgencias. La ecografía de vías urinarias se utiliza para descartar complicaciones y variantes anatómicas que predispongan a IVU y no para el diagnóstico de la entidad, que se hace fácilmente con la clínica y los hallazgos de laboratorio. Objetivo: Evaluar si el aspecto particulado de la orina identificado en la ecografía de vías urinarias se relaciona con IVU. Métodos: Se realizó un análisis descriptivo de variables como edad, diagnóstico inicial y diagnóstico final, determinando su relación y estableciendo características operativas (sensibilidad, especificidad, valores predictivos y razones de probabilidad). Resultados: El 70 de los pacientes con IVU eran los mayores de 65 años; el 56,5 de los que presentaban orina de aspecto particulado en la ultrasonografía tenían IVU y el 34 no presentaba orina particulada en el ultrasonido y cursaban con IVU. Conclusión: En el ultrasonido es frecuente el reporte del aspecto particulado de la orina. Ello sugiere correlación con uroanálisis por parte del radiólogo para descartar IVU; sin embargo, la literatura no refiere este hallazgo como indicativo de infección. En esta serie de casos, la orina particulada presenta baja especificidad y sensibilidad intermedia, lo cual indica que el hallazgo de “orina particulada” en el ultrasonido no es criterio diagnóstico de IV.

[Susceptibility to fluconazole and voriconazole of Candida species isolated from intensive care units patients in Medellin, Colombia (2001-2007)]. / Sensibilidad a fluconazol y voriconazol de especies de Candida aisladas de pacientes provenientes de unidades de cuidados intensivos en Medellín, Colombia (2001-2007).

BACKGROUND: Disseminated candidiasis is caused by different Candida species and mainly affects immunocompromised patients and those hospitalized in intensive care units (ICU). OBJECTIVE: Our aim was to determine the frequency and susceptibility of Candida spp. isolates to fluconazole and voriconazole, obtained from patients hospitalized in ICU in the city of Medellin during the years 2001-2007. METHODS: The agar diffusion technique based on the protocols recommended by the CLSI from the United States (M44A) was used. The Chi² test and the Kruskal Wallis statistical methods were used to compare changes in the frequency of Candida spp. isolates and their susceptibility to azoles by year of isolation. RESULTS: A total of 337 isolates were analyzed, 147 (43.6%) of which corresponded to Candida albicans, followed by 79 (23.4%) Candida tropicalis, 47 (13.9%) Candida parapsilosis, 32 (9.5%) Candida glabrata, 12 (3.6%) Candida guilliermondii and 11 (3.3%) Candida krusei. The remaining isolates (2.7%) were distributed among other species (Candida famata, Candida lusitaniae, Candida lipolytica, Candida pelliculosa and Candida spp.) Most of these isolates (78.3%) were susceptible; 11.9% were dose-dependent susceptible (DDS) and 9.8% resistant to fluconazole. For voriconazole, we observed that 94.1% of the isolates were susceptible, 2.4% DDS and 3.6% resistant. CONCLUSIONS: These data indicate a notable change in the species frequency, as well as a new susceptibility patterns that requires the precise identification of the causative organism and susceptibility testing in order to determine the characteristics of the isolates circulating in ICUs and then to treat them appropriately.

El caso de infecciosas. Histoplasmosis osea / The case of infectious diseases. Histoplasmosis bone

Se presenta el caso de un paciente de 11 años de edad con una lesión lítica en la tibia izquierda, diagnosticada como linfoma de células B y tratado con quimioterapia durante nueve meses, al final de los cuales se observó la presencia de nuevas lesiones líricas en el miembro inferior derecho y la persistencia de las lesiones tibiales izquierdas. La biopsia de estas lesiones reportó estructuras compatibles con H. capsulatum. El paciente fue tratado con itraconazol por 12 meses, terapia que controló adecuadamente el proceso micótico.

This is a case ofa 11 years old boy with a lytic lesion on his left tibia, diagnosed as a B Cell Lymphoma and treated with chemotherapy during nine months, atter which new lytic lesions where noticed on his right inferior limb as well as the persistence of the left tibial lesions. The biopsy yielded structures compatible with H. capsulatum. The patient was treated with ltraconazol during 12 months; the mycotic process was appropriately treated with this therapy.

Tumor carcinoide y endometriosis en ápendice cecal, asociación curiosa

El tumor carcinoide del ápendice cecal es una neoplasia cuyo diagnóstico se realiza de manera incidental por el departamento de anatomía patológica, en una de cada 200 o 3000 apendicectomias. La endometriosises una entidad que se presenta en el periodo fertil de la mujer y se puede encontrar en cualquier sitio del organismo, sólo ocasionalmente compromete el apendice cecal en 0.38 a 0.8 porciento de los casos. El hallazgo de estas dos patologías asociadas es una curiosidad de dignostico, no publicada hasta el momento en la literatura mundial. Se presenta el caso de una joven de 23 años de edad, con signos y sintomas de apendicitis aguda, aquien se le practica apendicectomía y al estudio anatomopatológico muestra hiperplasia de foliculos linfoides, tumor carcinoide y endometriosis