Efficacy of Probiotic Consumption on Oral Outcomes in Children and/or Adolescents: A Meta-Analysis.

We assessed the impact of probiotics on outcomes related to caries in children and/or adolescents without underlying systemic diseases. We performed a comprehensive meta-analysis of randomised controlled trials (RCTs). Searches were performed in Embase, PubMed, Scopus and Web of Science until March 2023 for RCTs assessing probiotics with a minimum intake duration of 0.2 months vs. control (no treatment or placebo) and reporting at least one primary or secondary outcome. Primary outcomes were number of carious, Streptococcus mutans count, and Lactobacillus count; secondary outcomes were bacterial plaque index, gingival index, salivary pH, and bleeding index. We performed meta-analyses with random effects models and the inverse variance method. Effects were described as mean difference (MD) with their 95% confidence intervals (95%CI). The risk of bias was assessed with the RoB 2.0 tool. The GRADE methodology was used to assess the quality of evidence (QoE). Nineteen RCTs were included (n = 2622), with a follow-up range of 0.2 to 108 months. Probiotics had no effect on reduction of dental caries (MD -0.24 carious pieces, 95%CI -0.72 to 0.23; I2 = 52%, low QoE) or Lactobacillus count (MD -0.78 CFU/mL, 95%CI -1.65 to 0.09; I2= 52%, very low QoE) vs. control. However, probiotics probably reduced S. mutans count vs. control (MD -0.40 CFU/mL, 95%CI -0.57 to -0.24; I2 = 11%, moderate QoE). Probiotics had no effect on bacterial plaque index (MD 0.21 units of bacterial plaque, 95%CI -0. 55-0.96; I2 = 80%, very low QoE), gingival index (MD 0.04 units of gingival index, 95%CI -0.18 to 0.27; I2= 0%, low QoE), and salivary pH (MD -0.12 pH units, 95%CI -0.72 to 0.48; I2 = 92%, very low QoE) vs. control. Probiotics were found to likely reduce S. mutans counts. However, no significant effect of probiotics was observed in reducing other outcomes compared to the control group.

Changes in floristic and vegetation structure in a chronosequence of abandoned gold-mining lands in a tropical Amazon forest.

This study analyzes floristic and vegetation structure changes during forest succession after disturbances caused by small-scale gold mining in Madre de Dios (Peru). We compared the floristic and vegetation structure of a reference forest against three sites with different periods of abandonment after mining (5, 11 and 23-years). Three 20 × 60 m plots were defined on each site, and all tree species with a DBH >1 cm within the plots were inventoried. To evaluate species diversity and similarity, the Importance Value, effective numbers of species (0D, 1D, and 2D), and Chao-Jaccard similarity index were calculated. We used the Nonmetric multidimensional scaling for similarity ordination and the PERMANOVA test to evaluate differences in floristic composition. We recorded 129 tree species in the study areas and statistically significant differences between initial and intermediate stages were observed regarding floristic composition, basal area, height, and DBH. The transition from the initial successional stage to the reference forest produces an increase in basal area, species diversity, and floristic similarity. The 23-year-old stand had more species in common with the 11-year-old stand than the reference forest. Our results showed a high proportion of pioneer species and anemochory dispersal syndrome in the initial successional stages, but they decreased in later stages of the chronosequence. The floristic and structural attributes of forests throughout the chronosequence showed a fast recovery during secondary succession. After 23 years, the recovery of tree species density was 77 % of reference forest, while the relative recovery of species composition was much slower, on average 23 %. These results provide essential information to guide the selection of suitable species in ecological restoration projects after abandonment. Implementing forest restoration strategies based on reliable information to accelerate the process of vegetation succession is critical for recuperating areas degraded by gold mining at the Peruvian Amazon.

Spatio-temporal trends of mercury levels in alluvial gold mining spoils areas monitored between rainy and dry seasons in the Peruvian Amazon.

Artisanal and small-scale gold mining (ASGM) in the Amazon has degraded tropical forests and escalated mercury (Hg) pollution, affecting biodiversity, ecological processes and rural livelihoods. In the Peruvian Amazon, ASGM annually releases some 181 tons of Hg into the environment. Despite some recent advances in understanding the spatial distribution of Hg within gold mine spoils and the surrounding landscape, temporal dynamics in Hg movement are not well understood. We aimed to reveal spatio-temporal trends of soil Hg in areas degraded by ASGM.,. We analyzed soil and sediment samples during the dry and rainy seasons across 14 ha of potentially contaminated sites and natural forests, in the vicinities of the Native community of San Jacinto in Madre de Dios, Peru. Soil Hg levels of areas impacted by ASGM (0.02 ± 0.02 mg kg-1) were generally below soil environmental quality standards (6.60 mg kg-1). However, they showed high variability, mainly explained by the type of natural cover vegetation, soil organic matter (SOM), clay and sand particles. Temporal trends in Hg levels in soils between seasons differed between landscape units distinguished in the mine spoils. During the rainy season, Hg levels decreased up to 45.5% in uncovered soils, while in artificial pond sediments Hg increased by up to 961%. During the dry season, uncovered degraded soils were more prone to lose Hg than sites covered by vegetation, mainly due to higher soil temperatures and concomitantly increasing volatilization. Soils from natural forests and degraded soil covered by regenerating vegetation showed a high capacity to retain Hg mainly due to the higher plant biomass, higher SOM, and increasing concentrations of clay particles. Disturbingly, our findings suggest high Hg mobility from gold mine spoil to close by sedimentary materials, mainly in artificial ponds through alluvial deposition and pluvial lixiviation. Thus, further research is needed on monitoring, and remediation of sediments in artificial to design sustainable land use strategies.

Functional characterization of the tomato HAIRPLUS gene reveals the implication of the epigenome in the control of glandular trichome formation.

Trichomes are specialised epidermal cells developed in the aerial surface of almost every terrestrial plant. These structures form physical barriers, which combined with their capability of synthesis of complex molecules, prevent plagues from spreading and confer trichomes a key role in the defence against herbivores. In this work, the tomato gene HAIRPLUS (HAP) that controls glandular trichome density in tomato plants was characterised. HAP belongs to a group of proteins involved in histone tail modifications although some also bind methylated DNA. HAP loss of function promotes epigenomic modifications in the tomato genome reflected in numerous differentially methylated cytosines and causes transcriptomic changes in hap mutant plants. Taken together, these findings demonstrate that HAP links epigenome remodelling with multicellular glandular trichome development and reveal that HAP is a valuable genomic tool for pest resistance in tomato breeding.

Indicadores de ansiedad, depresión, somatización y evitación experiencial en estudiantes universitarios del Perú en cuarentena por COVID-19 / Anxiety, Depression, Somatization And Experiential Avoidance Indicators In Peruvian University Students In Quarantine By COVID-19

Introducción: La cuarentena por COVID-19 ha afectado de gran manera a los estudiantes universitarios del Perú, generando una serie de efectos físicos, psicológicos y conductuales. Objetivo: Determinar los factores asociados a ansiedad, depresión, somatización y evitación experiencial en estudiantes universitarios del Perú en cuarentena por COVID-19. Métodos: Se realizó un estudio observacional transversal. La muestra estuvo constituida por 1264 estudiantes universitarios de diversos departamentos del Perú, se tomó como variables dependientes a la ansiedad, depresión, somatización y evitación experiencial, las cuales se evaluaron con el cuestionario de "El Inventario de comportamiento psicosocial desajustado, ante la presencia del COVID-19 en la población peruana" y el AAQ II, para el análisis estadístico se empleó el chi cuadrado. Resultados: Más de la mitad de los estudiantes universitarios del Perú, presenta entre 3 y 6 de los 6 indicadores de ansiedad, y este mismo número de indicadores de depresión lo presenta el 45% de la muestra. El 30 % de la muestra presenta entre 3 y 6 indicadores de somatización y el 40,3% de la muestra se ubica de la mitad hacia arriba en la escala de evitación experiencial. Conclusiones: Existen diferencias en los niveles de ansiedad, somatización y evitación experiencial entre varones y mujeres, asimismo se encontró que los estudiantes de mayor edad presentaban niveles más bajos de ansiedad, depresión y evitación experiencial, pero no en somatización.

Introduction: The COVID-19 quarantine has greatly affected university students in Peru, generating a series of physical, psychological and behavioral effects. Objective: To determine the factors associated with anxiety, depression, somatization and experiential avoidance in peruvian university students quarantined by COVID-19. Methods: A cross-sectional observational study was carried out. The sample was made up of 1264 university students from various departments of Peru, anxiety, depression, somatization and experiential avoidance were taken as dependent variables, which were evaluated with the questionnaire "The Inventory of unadjusted psychosocial behavior, in the presence of COVID-19 in the Peruvian population" and the AAQ II, for the statistical analysis the chi square was used Results: More than half of the university students in Peru present between 3 and 6 of the 6 anxiety indicators, and this same number of depression indicators is presented by 45% of the sample. 30% of the sample has between 3 and 6 indicators of somatization and 40.3% of the sample is located in the middle upwards on the experiential avoidance scale. Conclusions: There are differences in the levels of anxiety, somatization and experiential avoidance between men and women, it was also found that older students had lower levels of anxiety, depression and experiential avoidance, but not in somatization.

In vitro inhibitory effect of aluminum phthalocyanine tetrasulfonate chloride against Leishmania (Viannia) Peruviana and Leishmania (Viannia) Braziliensis. / Efecto inhibitorio in vitro de la ftalocianina de aluminio tetrasulfonada clorada frente a Leishmania (Viannia) peruviana y Leishmania (Viannia) braziliensis.

OBJECTIVES: To evaluate the in vitro photodynamic activity of aluminum phthalocyanine tetrasulfonate chloride (AlPcClS4) on promastigotes and amastigotes of Leishmania (Viannia) peruviana and Leishmania (Viannia) braziliensis. MATERIALS AND METHODS: The activity of photodynamic therapy using AlPcClS4 on Leishmania promastigote and amastigotes was determined by the Methyl Thiazole Tetrazolium (MTT) colorimetric method and quantitative PCR, respectively. RESULTS: Photodynamic treatment showed an inhibitory effect on promastigotes, particularly on Leishmania (V.) peruviana, to a lesser extent on Leishmania (V.) braziliensis and also on intracellular forms of both species. At 24 hours post-radiation, using concentrations of 200 µM and 350 µM, the inhibitory effect on Leishmania (V.) peruviana was 72.9% and 73.9% respectively; at 96 hours the inhibitory effect was of 78.8% and 80.6%, respectively. Regarding intracellular forms, the inhibitory effect on Leishmania (V.) peruviana amastigotes was 57.8% at 72 hours post-treatment, using a concentration of 200 µM. The IC50 was 56.5, 50, 44 and 39.7 µM, at 24, 48, 72 and 96 hours post-radiation, respectively. CONCLUSIONS: Photodynamic therapy using AlPcClS4 against Leishmania species showed encouraging results, mainly on Leishmania (V.) peruviana, suggesting a potential use as an alternative or complement to the usual treatment of tegumentary leishmaniasis. However, new trials are still required to determine the selectivity index for the intracellular form of the parasite, and to develop methods to facilitate the efficient entry of the molecule into the host cell and the parasite.

OBJETIVOS: Evaluar la actividad fotodinámica in vitro de la ftalocianina de aluminio tetrasulfonada clorada (AlPcClS4) sobre promastigotes y amastigotes de Leishmania (Viannia) peruviana y Leishmania (Viannia) braziliensis. MATERIALES Y MÉTODOS: La actividad del tratamiento fotodinámico empleando AlPcClS4 sobre promastigotes y amastigotes de Leishmania fue determinada mediante el método colorimétrico Metil Tiazol Tetrazolium (MTT) y PCR cuantitativo, respectivamente. RESULTADOS: El tratamiento fotodinámico presentó un efecto inhibitorio sobre promastigotes, principalmente sobre Leishmania (V.) peruviana, en menor proporción sobre Leishmania (V.) braziliensis y sobre las formas intracelulares de ambas especies. En Leishmania (V.) peruviana, a las 24 horas posirradiación a 200 µM y 350 µM el efecto inhibitorio fue del 72,9% y 73,9%, respectivamente y a las 96 horas fue del 78,8% y 80,6%, respectivamente. En las formas intracelulares, empleando 200 µM y evaluado a las 72 horas postratamiento, se observó una inhibición del 57,8% de amastigotes de Leishmania (V.) peruviana. El IC50 fue del 56,5; 50; 44; y 39,7 µM, que corresponde a las 24, 48, 72 y 96 horas posirradiación, respectivamente. CONCLUSIONES: El tratamiento fotodinámico empleando AlPcClS4 frente a las especies de Leishmania presentó resultados alentadores principalmente sobre Leishmania (V.) peruviana, lo cual sugiere su potencial uso como alternativa o complemento del tratamiento convencional de la leishmaniasis tegumentaria. Sin embargo, aún se requiere continuar con nuevos ensayos para determinar el índice de selectividad sobre el parásito en su forma intracelular, y desarrollar estrategias que faciliten el ingreso eficiente de la molécula hacia la célula hospedera y al parásito.

Efecto inhibitorio in vitro de la ftalocianina de aluminio tetrasulfonada clorada frente a Leishmania (Viannia) peruviana y Leishmania (Viannia) braziliensis / In vitro inhibitory effect of aluminum phthalocyanine tetrasulfonate chloride against Leishmania (Viannia) Peruviana and Leishmania (Viannia) Braziliensis

RESUMEN Objetivos: Evaluar la actividad fotodinámica in vitro de la ftalocianina de aluminio tetrasulfonada clorada (AlPcClS4) sobre promastigotes y amastigotes de Leishmania (Viannia) peruviana y Leishmania (Viannia) braziliensis. Materiales y métodos: La actividad del tratamiento fotodinámico empleando AlPcClS4 sobre promastigotes y amastigotes de Leishmania fue determinada mediante el método colorimétrico Metil Tiazol Tetrazolium (MTT) y PCR cuantitativo, respectivamente. Resultados: El tratamiento fotodinámico presentó un efecto inhibitorio sobre promastigotes, principalmente sobre Leishmania (V.) peruviana, en menor proporción sobre Leishmania (V.) braziliensis y sobre las formas intracelulares de ambas especies. En Leishmania (V.) peruviana, a las 24 horas posirradiación a 200 µM y 350 µM el efecto inhibitorio fue del 72,9% y 73,9%, respectivamente y a las 96 horas fue del 78,8% y 80,6%, respectivamente. En las formas intracelulares, empleando 200 µM y evaluado a las 72 horas postratamiento, se observó una inhibición del 57,8% de amastigotes de Leishmania (V.) peruviana. El IC50 fue del 56,5; 50; 44; y 39,7 µM, que corresponde a las 24, 48, 72 y 96 horas posirradiación, respectivamente. Conclusiones: El tratamiento fotodinámico empleando AlPcClS4 frente a las especies de Leishmania presentó resultados alentadores principalmente sobre Leishmania (V.) peruviana, lo cual sugiere su potencial uso como alternativa o complemento del tratamiento convencional de la leishmaniasis tegumentaria. Sin embargo, aún se requiere continuar con nuevos ensayos para determinar el índice de selectividad sobre el parásito en su forma intracelular, y desarrollar estrategias que faciliten el ingreso eficiente de la molécula hacia la célula hospedera y al parásito.

ABSTRACT Objectives: To evaluate the in vitro photodynamic activity of aluminum phthalocyanine tetrasulfonate chloride (AlPcClS4) on promastigotes and amastigotes of Leishmania (Viannia) peruviana and Leishmania (Viannia) braziliensis. Materials and methods: The activity of photodynamic therapy using AlPcClS4 on Leishmania promastigote and amastigotes was determined by the Methyl Thiazole Tetrazolium (MTT) colorimetric method and quantitative PCR, respectively. Results: Photodynamic treatment showed an inhibitory effect on promastigotes, particularly on Leishmania (V.) peruviana, to a lesser extent on Leishmania (V.) braziliensis and also on intracellular forms of both species. At 24 hours post-radiation, using concentrations of 200 μM and 350 μM, the inhibitory effect on Leishmania (V.) peruviana was 72.9% and 73.9% respectively; at 96 hours the inhibitory effect was of 78.8% and 80.6%, respectively. Regarding intracellular forms, the inhibitory effect on Leishmania (V.) peruviana amastigotes was 57.8% at 72 hours post-treatment, using a concentration of 200 μM. The IC50 was 56.5, 50, 44 and 39.7 μM, at 24, 48, 72 and 96 hours post-radiation, respectively. Conclusions: Photodynamic therapy using AlPcClS4 against Leishmania species showed encouraging results, mainly on Leishmania (V.) peruviana, suggesting a potential use as an alternative or complement to the usual treatment of tegumentary leishmaniasis. However, new trials are still required to determine the selectivity index for the intracellular form of the parasite, and to develop methods to facilitate the efficient entry of the molecule into the host cell and the parasite.

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Actinomicetos con actividad anti-candida aisladas de hormigas cortadoras de hojas Atta cephalotes (Formicidae: Myrmicinae: Attini) / Actinomyces with anti-candida activity isolated from leaf-cutting ants Atta cephalotes (Formicidae: Myrmicinae: Attini)

RESUMEN Objetivos. Aislar, seleccionar e identificar actinomicetos asociados a hormigas cortadoras de hojas Atta cephalotes (Linnaeus, 1758), que presenten mayor actividad anti-Candida. Materiales y métodos. Estudio transversal realizado en hormigas recolectadas de una localidad de Huánuco, Perú, a partir de las cuales se aislaron cepas de actinomicetos que fueron evaluadas mediante pruebas in vitro para determinar su capacidad antagonista frente a especies de Candida. Los actinomicetos de mayor antagonismo fueron seleccionados y cultivados en agitación, luego se obtuvieron los metabolitos extracelulares con solventes orgánicos y finalmente se evaluaron los extractos crudos para determinar cuantitativamente la concentración mínima inhibitoria (CMI). Resultados. Se logró aislar 30 actinomicetos, de los cuales el 47 % presentaron actividad antagonista a Candida albicans (C. albicans) ATCC 7516, el 43 % a Candida parapsilosis ATCC 7307, el 37% a Candida tropicalis ATCC 7206 y C. albicans ATCC 10231 y el 30% a C. albicans ATCC 98028. Extractos orgánicos de las cepas HAA-16 y HAA-17 presentaron marcada actividad anti-Candida; siendo el extracto de acetato de etilo de la cepa HAA17 el de mejor rendimiento por tener mayor espectro de actividad y presentar una CMI de 3,25 mg/ml frente a C. albicans ATCC 7516 y Candida parapsilosis ATCC 7307. Los actinomicetos seleccionados se identificaron mediante técnicas moleculares como miembros del género Streptomyces. Conclusiones. Los actinomicetos asociados a Atta cephalotes son excelentes productores de compuestos bioactivos, capaces de inhibir el crecimiento de levaduras patógenas del género Candida y con potencial aplicación en el desarrollo de nuevos productos naturales de interés biomédico.

ABSTRACT Objectives. To isolate, select and identify actinomyces associated to leaf-cutting ants Atta cephalotes (Linnaeus, 1758), that present a greater anti-Candida activity. Materials and Methods. Cross-sectional study made with ants collected at a location in Huánuco, Peru, from which strands of actinomyces were isolated and later evaluated by in vitro testing in order to determine its antagonistic capacity against species of Candida. The actinomyces with greater antagonism were selected and cultured by agitation, then the reliable extracellular metabolites were obtained with organic solvents, and finally the crude extracts were evaluated to determine quantitatively the minimum inhibiting concentration (MIC). Results. Thirty (30) actinomyces were isolated, of which 47% exhibited antagonistic activity against Candida albicans (C. albicans) ATCC 7516, 43% to Candida parapsilosis ATCC 7307, 37% to Candida tropicalis ATCC 7206 and C. albicans ATCC 10231, and 30% to C. albicans ATCC 98028. Organic extracts of the HAA-16 and HAA-17 strands exhibited noticeable anti-Candida activity, being the ethyl acetate extract of the HAA-17 strand the one with the highest performance thanks to a wider activity spectrum of MIC 3.25 mg/mL against C. albicans ATCC 7516 and Candida parapsilosis ATCC 7307. The selected actinomyces were identified by means of molecular techniques as members of the Streptomyces genus. Conclusions. Actinomyces associated to Atta cephalotes are excellent producers of bioactive compounds, being able to inhibit the growth of pathogenic mold of the Candida genus and with potential for application in the development of new natural products for the biomedical field.

[Martius procedure in complex anorectal-vaginal fistula management: five-case report]. / Manejo de la fístula ano-recto-vaginal compleja mediante el procedimiento de Martius: reporte de cinco casos.

The repair of complex anorectal-vaginal fistulas represents an anatomic-surgical challenge for the surgeon, and the appropriate surgical procedure must be selected for each case. The procedure of Martius is described as the transposition of the bulbocavernosus muscle to repair the recto-vaginal fistula. Five cases of anorectal-vaginal fistulae were repaired by this procedure from 2010 to 2014. The mean age was 38.2 years; three fistulas (60%) were of obstetric etiology, one induced by radiation and one of unknown etiology. The mean follow-up was 25 months, with a 100% success rate. The Martius procedure is a good alternative for the surgical repair of complex anorectal-vaginal fistulas.

Análise volumétrica do septo no seio maxilar exibida por tomografia computadorizada feixe cônico na população peruana ­ estudo retrospectivo transversal / Volumetric analysis of the maxillary sinus septa by CBCT in a Peruvian population ­ cross-sectional retrospective study

Objetivos: avaliar a presença do septo sinusal na população peruana. Materiais e métodos: um estudo transversal foi realizado em 298 seios maxilares de pacientes encaminhados ao Serviço de Radiologia Oral e Maxilofacial do Hospital Nacional Arzobispo Loayza, em Lima, Peru. A presença do septo, o número, a localização, o comprimento e a orientação dos avaliados, bem como idade, sexo e tipo de dentulismo, foram quantificados nas imagens da tomografi a computadorizada feixe cônico (TCFC), usando o software CS 3D Imaging. O teste Qui-quadrado foi realizado para tentar identifi car associações entre a presença do septo, condição dentária, idade e sexo, com 5% de significância, usando-se o SPSS20. Resultados: o septo no seio maxilar foi visto em 36,2% dos casos e estava ausente em 63,8%. Quanto à localização, 49,4% dos septos estavam no lado direito e 50,6% no lado esquerdo. Houve septos completos em 22,9% e incompletos em 77,1% dos casos. A localização do septo em maior proporção foi encontrada na parede basal, com 48,2%, seguido pelo setor anterior e medial do seio maxilar. O comprimento médio foi de 6,86 mm. Houve associação entre a frequência do septo e o sexo dos pacientes (teste Qui-quadrado de Pearson, p=0,015, graus de liberdade 1, ᵪ2= 5,894). Conclusão: cada população apresentará variações na localização e tamanho do septo do seio maxilar que devem ser cuidadosamente estudadas por TCFC para evitar rompimento da membrana e outras intercorrências que levam ao insucesso das terapias regenerativas e restauradoras.

Objectives: to evaluate the presence of the sinus septa in a Peruvian population. Materials and methods: a cross-sectional study was performed on 298 maxillary sinuses of patients referred to the Oral and Maxillofacial Radiology Service of the Arzobispo Loayza National Hospital, Lima, Peru. The presence of the septum, the number, location, length and orientation of the evaluated, as well as age, gender, type of dentulism were quantified in conical beam computed tomography (CTT) images using CS 3D Imaging software. The Chi-square test was performed to try to identify associations between the presence of the septum, dental condition, age and sex, with 5% of signifi cance, using SPSS20. Results: the septum in the maxillary sinus was seen in 36.2% of the cases and absent in 63.8%. Regarding the location, 49.4% of the septa on the right side and 50.6% on the left side. There were complete septa in 22.9% and incomplete septa in 77.1% of the cases. The location of the septum in greater proportion was found in the basal wall with 48.2%, followed by the anterior and medial sector of the maxillary sinus. The average length was 6.86 mm. There was an association between septum frequency and patients' gender (Pearson's Chi-Square test, p=0.015, degrees of freedom 1, ᵪ2 = 5.894). Conclusions: each population will present variations in the location and size of the septum of the maxillary sinus that must be carefully studied by CBCT to avoid membrane rupture and other intercurrences that lead to the failure of regenerative and restorative therapies.

Manejo de la fístula ano-recto-vaginal compleja mediante el procedimiento de Martius: reporte de cinco casos / Martius procedure in complex anorectal-vaginal fistula management: five-case report

La reparación de fístulas ano-recto-vaginales complejas representa un reto anatomoquirúrgico para el cirujano, debiendo seleccionarse el procedimiento quirúrgico adecuado para cada caso. El procedimiento de Martius consiste en la trasposición del músculo bulbocavernoso para reparar la fístula recto-vaginal. Se presentan cinco casos de fístulas ano-recto-vaginales reparadas por este procedimiento desde el 2010 hasta el 2014. La edad promedio fue de 38,2 años, tres fístulas (60%) fueron de etiología obstétrica, una inducida por radiación y otra de etiología desconocida. El seguimiento promedio fue de 25 meses, con una tasa de éxito de 100%. El procedimiento de Martius es una buena alternativa para la reparación quirúrgica de fístulas ano-recto-vaginales complejas.

The repair of complex anorectal-vaginal fistulas represents an anatomic-surgical challenge for the surgeon, and the appropriate surgical procedure must be selected for each case. The procedure of Martius is described as the transposition of the bulbocavernosus muscle to repair the recto-vaginal fistula. Five cases of anorectal-vaginal fistulae were repaired by this procedure from 2010 to 2014. The mean age was 38.2 years; three fistulas (60%) were of obstetric etiology, one induced by radiation and one of unknown etiology. The mean follow-up was 25 months, with a 100% success rate. The Martius procedure is a good alternative for the surgical repair of complex anorectal-vaginal fistulas.

[Actinomyces with anti-candida activity isolated from leaf-cutting ants Atta cephalotes (Formicidae: Myrmicinae: Attini)]. / Actinomicetos con actividad anti-candida aisladas de hormigas cortadoras de hojas Atta cephalotes (Formicidae: Myrmicinae: Attini).

OBJECTIVES.: To isolate, select and identify actinomyces associated to leaf-cutting ants Atta cephalotes (Linnaeus, 1758), that present a greater anti-Candida activity. MATERIALS AND METHODS.: Cross-sectional study made with ants collected at a location in Huánuco, Peru, from which strands of actinomyces were isolated and later evaluated by in vitro testing in order to determine its antagonistic capacity against species of Candida. The actinomyces with greater antagonism were selected and cultured by agitation, then the reliable extracellular metabolites were obtained with organic solvents, and finally the crude extracts were evaluated to determine quantitatively the minimum inhibiting concentration (MIC). RESULTS.: Thirty (30) actinomyces were isolated, of which 47% exhibited antagonistic activity against Candida albicans (C. albicans) ATCC 7516, 43% to Candida parapsilosis ATCC 7307, 37% to Candida tropicalis ATCC 7206 and C. albicans ATCC 10231, and 30% to C. albicans ATCC 98028. Organic extracts of the HAA-16 and HAA-17 strands exhibited noticeable anti-Candida activity, being the ethyl acetate extract of the HAA-17 strand the one with the highest performance thanks to a wider activity spectrum of MIC 3.25 mg/mL against C. albicans ATCC 7516 and Candida parapsilosis ATCC 7307. The selected actinomyces were identified by means of molecular techniques as members of the Streptomyces genus. CONCLUSIONS.: Actinomyces associated to Atta cephalotes are excellent producers of bioactive compounds, being able to inhibit the growth of pathogenic mold of the Candida genus and with potential for application in the development of new natural products for the biomedical field.

OBJETIVOS.: Aislar, seleccionar e identificar actinomicetos asociados a hormigas cortadoras de hojas Atta cephalotes (Linnaeus, 1758), que presenten mayor actividad anti-Candida. MATERIALES Y MÉTODOS.: Estudio transversal realizado en hormigas recolectadas de una localidad de Huánuco, Perú, a partir de las cuales se aislaron cepas de actinomicetos que fueron evaluadas mediante pruebas in vitro para determinar su capacidad antagonista frente a especies de Candida. Los actinomicetos de mayor antagonismo fueron seleccionados y cultivados en agitación, luego se obtuvieron los metabolitos extracelulares con solventes orgánicos y finalmente se evaluaron los extractos crudos para determinar cuantitativamente la concentración mínima inhibitoria (CMI). RESULTADOS.: Se logró aislar 30 actinomicetos, de los cuales el 47 % presentaron actividad antagonista a Candida albicans (C. albicans) ATCC 7516, el 43 % a Candida parapsilosis ATCC 7307, el 37% a Candida tropicalis ATCC 7206 y C. albicans ATCC 10231 y el 30% a C. albicans ATCC 98028. Extractos orgánicos de las cepas HAA-16 y HAA-17 presentaron marcada actividad anti-Candida; siendo el extracto de acetato de etilo de la cepa HAA17 el de mejor rendimiento por tener mayor espectro de actividad y presentar una CMI de 3,25 mg/ml frente a C. albicans ATCC 7516 y Candida parapsilosis ATCC 7307. Los actinomicetos seleccionados se identificaron mediante técnicas moleculares como miembros del género Streptomyces. CONCLUSIONES.: Los actinomicetos asociados a Atta cephalotes son excelentes productores de compuestos bioactivos, capaces de inhibir el crecimiento de levaduras patógenas del género Candida y con potencial aplicación en el desarrollo de nuevos productos naturales de interés biomédico.

Reconstrucción autóloga de mama con colgajo de latissimus dorsi y microinjerto graso / Autologous breast reconstruction with latissimus dorsi flap and microfat grafting

Antecedentes y Objetivo. En reconstrucción mamaria existen diversas técnicas quirúrgicas basadas en el uso de colgajos y/o implantes, que se utilizan según la particularidad de cada caso. En nuestra práctica, preferimos aquellas que utilizan solo tejidos autólogos porque ofrecen, a nuestro juicio, mayores ventajas. Presentamos una alternativa de reconstrucción mamaria total utilizando solo tejidos autólogos; esta técnica fusiona el colgajo miocutáneo de latissimus dorsi con la técnica de micro injerto graso que proporciona relleno autólogo, evitando así el uso de prótesis. Material y Método. Incluimos en el estudio a todas las pacientes con mastectomía radical modificada que aceptaron y concluyeron su reconstrucción mamaria diferida con la técnica propuesta, entre enero del 2011 y junio del 2015, en el Servicio de Cirugía Plástica y Quemados del Hospital Nacional Guillermo Almenara (Lima, Perú). Resultados. Se realizó este tipo de reconstrucción en 24 pacientes; el volumen total lipoinjertado fue de 380 a 780 cc (media de 525 cc) en 1 a 4 sesiones quirúrgicas. Se inició con el colgajo y la primera sesión de microinjerto graso intraoperatorio, aplicando entre 260 a 400 cc (media de 332 cc) en todos los tejidos expuestos. El 80% de este volumen inicial se inyectó en el colgajo miocutáneo, evidenciándose clínicamente un alto grado de prendimiento. En el 45.8%de los casos fue necesaria la desepitelización de la isla cutánea y en el 37.5% se realizaron colgajos de transposición en la zona lateral de la mama. Todos los resultados fueron satisfactorios y las complicaciones fueron menores. Conclusiones. Consideramos esta técnica como una buena alternativa, segura y versátil, para la reconstrucción mamaria total con tejidos autólogos, con ventajas a corto y largo plazo (AU)

Background and Objective. There are several surgical techniques based on the use of flaps and/or implants for breast reconstruction, which are used according to the particularity of each case. In our practice, we prefer those that use only autologous tissues because they offer, in our opinion, greater advantages We present an alternative for total breast reconstruction with autologous tissue that fuses the latissimus dorsi myocutaneous flap technique with microfat grafting as autologous filler, thus avoiding the use of prostheses. Methods. We included all patients with total mastectomy that accepted and culminated her breast delayed reconstruction with latissimus dorsi myocutaneous flap and microfat grafting in the period from January 2011 to November 2015 at the Plastic Surgery and Burn Department of Guillermo Almenara Hospital (Lima, Peru) . Results. The reconstruction was performed in 24 patients; the total volume was 380 to 780 cc (mean 525 cc) in 1 to 4 sessions. We started with the flap and the first session of microfat grafting intraoperative applying between 260-400 cc (mean 332 cc) of fatty tissue in all exposed tissues; 80% of the initial volume was injected into the myocutaneous flap, with a high degree of graftment. In 45.8% of cases was necessary the des-epithelialization of the skin island and in37.5% was performed transposition flaps in the lateral area of the breast. All results were satisfactory and the complications were minor. Conclusions. We considerer this technique as a good, secure and versatile alternative for total breast reconstruction using autologous tissues, with short and long term benefits (AU)

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