Evaluación de la efectividad del Triclabendazol como fasciolicida en caprinos de la provincia de Neuquén, Argentina / Evaluation of the efficacy of Triclabendazol to treat liver worm in goats in Nequen province, Argentina

Resumen Debido al uso frecuente del triclabendazol (TCBZ) por parte de los productores, sumado al reporte reciente de resistencia de Fasciolahepatica al fármaco detectada en rodeos y majadas de Neuquén, se llevó a cabo el presente trabajo con el objetivo de evaluar la eficacia del TCBZ como fasciolicida en caprinos bajo un sistema de producción trashumante del norte de la provincia de Neuquén, Argentina. La eficacia se evaluó mediante un test de reducción de conteo de huevos de F. hepatica en caprinos Criollo Neuquino parasitados naturalmente. Se utilizaron dos grupos de animales: un Grupo Control (n: 10) que no recibió tratamiento y un Grupo Tratado (n: 10) al que se le administró TCBZ al 10% (Biofasiolex T10-Biogénesis Bagó ®) vía oral a dosis de 10 mg/kg PV. Al día 0 y 21 post tratamiento, se tomaron muestras de materia fecal para análisis coproparasitológicos. Se evidenció una reducción del conteo de huevos de F. hepatica del 100%, indicando el mantenimiento de la eficacia del fasciolicida en los caprinos evaluados. Se discuten los alcances del uso del test de reducción de conteo de huevos en zonas con producción trashumante del ganado.

Abstract Because of the frequent use of triclabendazole TCBZ by farmers and the recent reports of Fasciola hepatica resistance to this drug in herds and flocks from Neuquén, we carried out this study with the aim to evaluate the efficacy of TCBZ as fasciolicide in goats under a transhumance system from northern of Neuquén, Argentina. A fecal egg count reduction test (FECRT) was performed on Creale Neuquino goats naturally parasitized with F. hepatica. Twenty goats were divided into two groups: A control group (n: 10) which was left untreated, and a treatment group (n: 10) that was dosed orally with TCBZ 10% (Biofasiolex T10-Biogénesis Bagó ®). On Day 0 and Day 21 post-treatment, fecal samples were taken and analyzed by coproscopical examination. According to the FECRT, drug efficacy was 100 % and confirms that TCBZ maintains its efficacy against F. hepatica on goats. The usefulness of the FECRT in these zones under transhumance livestock production is discussed.

Encefalitis vírica y convulsiones refractarias por gripe A en época no estacional / Influenza A viral encephalitis and refractory seizures out of season

El virus H1N1 se caracteriza por producir sobretodo sintomatología respiratoria y presentarse en época invernal o epidemiológica. Presentamos el caso de una paciente que debutó con cuadros convulsivos en mayo, fuera de la poca invernal y requirió cuidados intensivos (AU)

The H1N1 virus is characterized by producing respiratory symptoms mostly in winter or epidemiological time. We report the case of a patient that started with seizures in May, out of the winter, and required intensive care (AU)

[Clinical assessment of peritoneal drainages for necrotizing enterocolitis. A Bayesian approach]. / Evaluación del drenaje peritoneal en la enterocolitis necrosante mediante metodología bayesiana.

AIM: To assess effectiveness of peritoneal drainages for necrotizing enterocolitis. MATERIAL AND METHODS: Retrospective cohort study (years 2000 to 2006). Laparotomy or patient's death were considered as failure. STUDY VARIABLES: sex, gestational age, weight at delivery, Apgar score at minutes 1 and 5, modified Bell score, radiology and ventilatory status. RESULTS: 25 patients were diagnosed with necrotizing enterocolitis and treated with peritoneal drainages. Sample's Bell score was: 13(52%) Ia, 6 (24%) IIa, 5 (20%) IIb, and 1 (4%) IIIa. Mean gestational age was 31.8 (+/- 4.2) weeks, and mean weight 1,564 (+/- 810) g. Patients classified as Bell I presented statistically significat differences compared with Bell II-III as for radiology (unspecific), delivery weight (lower) and ventilatory status (higher mechanical ventilation rates). For the 12 patients with Bell scores II-III, peritoneal drains were enough for 5 cases (41.7%) and failed in 7 (58.3%), who were operated on. Multivariate analysis (logistic regression) was not able to show any conection with collected variables. However, a bayesian analysis using data from similar studies showed that the probability for drainage success rate to be higher than 50% is 99%. CONCLUSIONS: In our centre, 52% of peritoneal drainages were used in patinets with low clinical suspect for necrotizing enetrocolitis, maybe in relation with their lower body weight and need for ventilatory support. In patients affected with necrotizing enterocolitis, drainages were effective in 41.7%. Although limited for its retrospective nature, our study suggests that peritoneal drainages can be curative in, at least, 50% of patients with necrotizing enterocolitis without pneumoperitoneum and clinical signs of peritonitis.

Evaluación del drenaje peritoneal en la enterocolitisnecrosante mediante metodología bayesiana / Clinical assessment of peritoneal drainages for necrotizing enterocolitis. A bayesian approach

Introducción: El objetivo del presente estudio es evaluar la eficacia del drenaje peritoneal para la enterocolitis necrosante en la prácticaclínica. Material y métodos: Estudio de cohorte retrospectiva (periodo2000-2006). Se consideró como fracaso del tratamiento la indicación de laparotomía o el exitus del paciente. Variables del estudio: sexo, edad gestacional, peso al nacimiento, Apgar 1 y 5, estadio de Bell modificado, patrón radiológico y tipo de ventilación. Resultados: 25 pacientes fueron diagnosticados de enterocolitisy tratados inicialmente mediante drenaje peritoneal. La distribución según estadios de Bell fue: 13 (52%) Ia, 6 (24%) IIa, 5 (20%) IIb, y 1(4%) IIIa. La media de la edad gestacional fue de 31,8 (±4,2) semanas, y la del peso 1.564 (±810) g. Los pacientes con estadio I presentaron diferencias estadísticamente significativas en cuanto al patrón radiológico (más inespecífico), peso al nacimiento (menor peso) y tipo de ventilación (mayor necesidad de soporte ventilatorio), que los pacientes con estadios II-III. En los 12 casos restantes el drenaje fue efectivo (..) (AU)

Aim: To assess effectiveness of peritoneal drainages for necrotizing enterocolitis. Material and methods: Retrospective cohort study (years 2000 to2006). Laparotomy or patient’s death were considered as failure. Study variables: sex, gestational age, weight at delivery, Apgar score at minutes 1 and 5, modified Bell score, radiology and ventilatory status. Results: 25 patients were diagnosed with necrotizing enterocolitis and treated with peritoneal drainages. Sample’s Bell score was: 13(52%)Ia, 6 (24%) IIa, 5 (20%) IIb, y 1 (4%) IIIa. Mean gestational age was31,8 (±4,2) weeks, and mean weight 1,564 (±810) g. Patients classified as Bell I presented statistically significat differences compared with BellII-III as for radiology (unspecific), delivery weight (lower) and ventilatory status (higher mechanical ventilation rates). For the 12 patients with Bell scores II-III, peritoneal drains were enough for 5 cases (41,7%)and failed in 7 (58,3%), who were operated on. Multivariate analysis(logistic regression) was not able to show any conection with collected variables. However, a bayesian analysis using data from similar studies showed that the probability for drainage success rate to be higher than 50% is 99%. Conclusions: In our centre, 52% of peritoneal drainages were used in patinets with low clinical suspect for necrotizing enetrocolitis, maybe (..) (AU)

[Acute gastric volvulus secondary to asplenia in a child with Smith-Lemli-Opitz syndrome]. / Vólvulo gástrico agudo por asplenia en un paciente con síndrome de Smith-Lemli-Opitz.

An acute gastric volvulus in a 10 years old boy with Smith-Lemli-Opitz syndrome is reported. He was immediately operated on and an organoaxial volvulus secondary to spleen agenesia was found. No other visceral malformation was present. Because of gastric ischemia, a second-look procedure was performed 48 hours later in order to asses necrosis extent. Gastric fundus had to be resected and the stomach was definitively fixed to the abdominal wall. Clinical, radiological and therapeutic characteristics of this unusual pathology are reviewed.

Vólvulo gástrico agudo por asplenia en un paciente con síndrome de Smith-Lemli-Opitz / Acute gastric volvulus secondary to asplenia in a child with Smith-Lemli-Opitz syndrome

Presentamos un caso de vólvulo gástrico agudo en un niño de 10 años con síndrome de Smith-Lemli-Opitz. El paciente fue intervenido con carácter urgente hallando un vólvulo organoxial secundario a una agenesia de bazo en ausencia de otras alteraciones viscerales. Ante el importante compromiso vascular se realizó una revisión quirúrgica 48 horas más tarde para valorar la extensión de la necrosis gástrica procediendose a la resección del fundus y a la fijación definitiva del estómago. Se revisan las características clínicas, radiológicas y terapéuticas de esta infrecuente patología (AU)