Transradial versus transfemoral access for mechanical thrombectomy in acute ischemic stroke: A retrospective cohort study.

BACKGROUND: The objective of this study was to compare procedural and clinical outcomes in patients with acute ischemic stroke (AIS) treated via transradial access (TRA) mechanical thrombectomy (MT) versus conventional transfemoral access (TFA). METHODS: We performed a retrospective analysis of consecutive patients with AIS treated with TRA versus TFA MT at our tertiary comprehensive stroke center. Access choice was individualized based on occlusion site, aortic and arch anatomy. Outcomes were extracted from our institutional stroke registry and included procedural time, Thrombolysis in Cerebral Infarction (TICI) reperfusion score, NIHSS, 90-day mRS and 90-day mortality. Comparisons were performed using Student t-Test and Fischer's exact test as appropriate. RESULTS: 175 mechanical thrombectomies were performed during the study interval; 39 (22%) were performed via TRA and 136 (79%) TFA. Access to reperfusion time was 36.3 ± 24.5 minutes in the TRA group and 21.9 ± 17.6 in the TFA group (p<0.001). The proportion of patients with a TICI reperfusion score of 2b or 3 was similar in both groups (TRA: 34 (87%) vs. TFA: 121 (89%) p=0.559. The median 90-day mRS was similar between both groups (p=0.170), as was the 90-day mortality (p = 0.509). CONCLUSIONS: While TFA is faster in our cohort, TFA and TRA are both safe and effective for MT in acute ischemic stroke. While TFA remains mainstay, TRA can be valuable in variant anatomy despite its technical limitations. Individualizing access based on advanced imaging and patient factors may improve practice; however, updates in catheter and access technology are necessary to optimize outcomes with TRA.

Evidence that ectoparasites influence the hematological parameters of the host: a systematic review.

Ectoparasites are important to the one health concept because their parasitism can result in the transmission of pathogens, allergic reactions, the release of toxins, morbidity, and even death of the host. Ectoparasites can affect host physiology, as reflected in immune defenses and body condition as well as hematological and biochemical parameters. Thus, evidence that ectoparasites influence host hematological parameters was systematically reviewed, and the methodological quality of these studies was analyzed. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed, and the studies included were limited to those that evaluated changes in hematological tests in ectoparasite-infested and non-infested animals, and bias and methodological quality were evaluated using the Animal Research: Reporting of In Vivo Experiments guideline. Thirty-four studies were selected and information about the host, ectoparasite infestation, blood collection, and analysis was collected and compared whenever possible. In this review, the presence of ectoparasites influenced both the red series and the white series of hematological parameters. Among the main parameters analyzed, hematocrit, red blood cells, hemoglobin, and lymphocytes showed reductions, probably due to ectoparasite blood-feeding, while including eosinophils, neutrophils, and basophils increased in infested animals due to the host immune response. However, methodologic improvements are needed to reduce the risk of bias, enhance the reproducibility of such studies, and ensure results aligned with the mechanisms that act in the ectoparasite-host relationship.

Circulating oxidative stress and acute phase protein levels in horses infested with ticks.

Ticks have saliva rich in immunoregulatory molecules that interfere with the host's physiology in order to feed. This study aimed to evaluate the concentration of acute phase proteins and circulating oxidative stress in response to infestation by Amblyomma sculptum and Dermacentor nitens in two breed horses, Mangalarga Marchador and Breton Postier, to define resistance or susceptibility to ticks. Among the oxidative stress markers, we observed lower malondialdehyde and nitric oxide in horses with tick infestation, consequently not altering the antioxidant enzymes. Breton Postier with tick infestation showed a reduction in the ferric reducing ability of plasma (FRAP), which may be due to lower feeding of the host due to the stress caused by the infestation or even to sequestration of components induced by the tick during blood feeding. The alpha-1-antitrypsin, an acute phase protein, showed an increase in Mangalarga Marchador with tick infestation; curiously it is related to a protective action against tissue damage, pathogens and parasites. We could assume that Mangalarga Marchador showed a better response to ticks when compared to Breton Postier. However, it is still early to define the resistance or susceptibility to ticks, as we did not observe significant changes in most of the analyzed variables. Further studies are needed to understand the compounds and mechanisms of action of the tick saliva in the acute phase proteins and the possible relationships of oxidative stress in the host and the tick during blood feeding.

Breaking the clean room barrier: exploring low-cost alternatives for microfluidic devices.

Microfluidics is an interdisciplinary field that encompasses both science and engineering, which aims to design and fabricate devices capable of manipulating extremely low volumes of fluids on a microscale level. The central objective of microfluidics is to provide high precision and accuracy while using minimal reagents and equipment. The benefits of this approach include greater control over experimental conditions, faster analysis, and improved experimental reproducibility. Microfluidic devices, also known as labs-on-a-chip (LOCs), have emerged as potential instruments for optimizing operations and decreasing costs in various of industries, including pharmaceutical, medical, food, and cosmetics. However, the high price of conventional prototypes for LOCs devices, generated in clean room facilities, has increased the demand for inexpensive alternatives. Polymers, paper, and hydrogels are some of the materials that can be utilized to create the inexpensive microfluidic devices covered in this article. In addition, we highlighted different manufacturing techniques, such as soft lithography, laser plotting, and 3D printing, that are suitable for creating LOCs. The selection of materials and fabrication techniques will depend on the specific requirements and applications of each individual LOC. This article aims to provide a comprehensive overview of the numerous alternatives for the development of low-cost LOCs to service industries such as pharmaceuticals, chemicals, food, and biomedicine.

Importancia del microbioma en la salud humana y aplicaciones médicas / Importance of the microbiome in human health and medical implications

Recientes investigaciones han relacionado la microbiota intestinal con la salud humana en múltiples aspectos. La evolución de los estilos de vida ha determinado un cambio en la composición de las bacterias intestinales, así como la implicación que la comunidad de estas ejerce sobre la salud. Actualmente, se conoce que la mayoría de las bacterias presentes en el sistema gastrointestinal pertenecen principalmente a los fila Firmicutes y Bacterioidetes, aunque también se encuentran otros grupos tales como proteobacterias y actinobacterias. A medida que se avanza en el tracto gastrointestinal predominan algunos géneros de bacterias. Los efectos de la microbiota pueden ser directos e indirectos, además, dependen de muchos factores tales como la edad de la persona, el grupo etario, la genética del individuo, la dieta y el estilo de vida. Durante los últimos años, la accesibilidad a tecnologías de secuenciación ha permitido tener un acercamiento más estrecho a la microbiota intestinal. Esto, sumado a herramientas bioinformáticas, ha permitido establecer relaciones microbiales entre la cantidad y estructura poblacional y las manifestaciones clínicas en el ser humano. Algunas de las afecciones estudiadas y que tienen relación con la microbiota intestinal son: la obesidad, la diabetes, el cáncer, las enfermedades relacionadas con el cerebro, las enfermedades cardiovasculares y las enfermedades gastrointestinales. De acuerdo con lo mencionado, se hizo una recopilación de información de carácter científico en cuanto a estudios relevantes que describen la relación microbiota-salud humana y casos donde se observa compromiso del organismo, al mismo tiempo que se describen opciones terapéuticas propuestas y un abordaje de perspectivas futuras.

Recent research has linked gut microbiota to human health in multiple ways. The evolution of lifestyles has determined a change in the composition of intestinal bacteria, as well as the implications that they exert on health. Currently, it is known that most of the bacteria present in the gastrointestinal sector belong mainly to the phylum Firmicutes and Bacterioidetes, although there are also other groups such as proteobacteria and actinobacteria. As it progresses through the gastrointestinal tract, some genera of bacteria and species predominate. The effects of the microbiota can be direct and indirect, and also depend on many factors such as the age of the person, the age group, the individual's genetics, diet, and lifestyle. In recent years, accessibility to sequencing technologies has allowed for a closer approach to the intestinal microbiota. This, added to bioinformatic tools has allowed establishing microbial relationships in terms of quantity and population structure with clinical manifestations in humans. Some of the pathologies studied that are related to intestinal microbiota are obesity, diabetes, cancer, brain-related diseases, cardiovascular diseases, and gastrointestinal diseases. A compilation of scientific information is made regarding relevant studies that describe the microbiota-human health relationship, cases where the organism is affected, as well as proposed therapeutic options and an approach to future perspectives

'Candidatus Mycoplasma Haemoalbiventris' and Tick-Borne Pathogens in Black-Eared Opossum (Didelphis aurita) from Southeastern Brazil.

The black-eared opossum (Didelphis aurita) is a South American synanthropic marsupial. The presence of opossums in domestic spaces is relevant in the One-Health context since they are hosts of pathogens and ectoparasites that may affect the health of domestic animals and humans. In this study, we aim to determine the occurrence of hemoplasmas and selected tick-borne pathogens in free-ranging black-eared opossums, along with their molecular characterization, hematological and biochemical evaluation and factors associated with infection, in the municipality of Viçosa, State of Minas Gerais, southeastern Brazil. Thirty black-eared opossums were trapped between March 2021 and June 2022. Ectoparasites were collected. Hematological and biochemical analyses were performed. DNA from EDTA-blood samples were analyzed by PCR and qPCR assays. By molecular analyses, 'Candidatus Mycoplasma haemoalbiventris' was the most prevalent hemoparasite (73.3%), followed by Hepatozoon sp. (22.2%). Significant differences were observed in the number of platelets, and in the concentration of protein and globulins in the animals infected by 'Ca. M. haemoalbiventris' when compared with the negative group. This is the first report of 'Ca. M. haemoalbiventris' infection in D. aurita.

Influence of Short and Medium Distance Road Transport on the Acute Phase Proteins in Horses.

Horse transport is a common practice and is usually associated as a cause of stress in animals, with consequences for their well-being. There are several of evidence that stress can increase an acute phase response. The aim of this study was to verify whether the road transport of horses over distances of 50 and 300 kilometers induces changes in the values of acute phase proteins. To do this, the serum SDS-PAGE was performed and the bands obtained were identified by mass spectrometry (MALDI-TOF). The blood samples were collected in tubes without anticoagulant to obtain the serum, and the evaluations occurred before the road transportation (T0), immediately after the journey (T1), six hours later (T2), and 24 hours (T3), 48 hours (T4), 72 hours (T5), 96 hours (T6), 120 hours (T7) and 144 hours (T8) after the end of the trip. All analyzes were performed using the Minitab 17 statistical package, and significance was considered when P<0.05. The APPs found through SDS-PAGE and properly identified were α2-macroglobulin, ceruloplasmin, transferrin, albumin, α1-antitrypsin, haptoglobin, apolipoprotein alpha 1, and α1-acid glycoprotein. No differences were observed in the concentration values between 50 and 300 km or between the moments after each route. The distances covered with the horses were not challenging enough to provoke an acute phase response reflected in changes in APPs.

Radial Access Intervention.

Leveraging from the interventional cardiology experience, the transradial access (TRA) for neurointervention has also started to become more used for both diagnostic and therapeutic procedures. A growing body of evidence is showing a superiority of the TRA compared with the conventional transfemoral access (TFA) in terms of access site complications (ACSs), patient satisfaction and preference, hospital length of stay, and cost. Outcomes via the transradial are noninferior, and at times superior, in select neuroendovascular procedures. Future advancements in technology with radial-specific catheters and further operator experience will aid in the full adoption of the TRA for endovascular procedures.

Calidad de vida relacionada con la salud en adolescentes de una institución educativa privada de bucaramanga

RESUMEN Objetivo: Evaluar la calidad de vida relacionada con la salud (CVRS) y su relación con factores sociodemográficos en adolescentes en una institución educativa privada de Bucaramanga (Colombia). Material y Método: Estudio cuantitativo, descriptivo de corte transversal, participaron 280 adolescentes escolarizados de 10 a 19 años sanos de ambos sexos. Se utilizó el KIDSCREEN-27 para la evaluación de la calidad de vida relacionada con la salud. Resultados: En cuanto a la calidad de vida relacionada con la salud, los adolescentes perciben más problemas con el estado de ánimo y sentimientos especialmente en las mujeres adolescentes, evidenciándose diferencias significativas en ambos sexos respecto a la percepción del total de la escala CVRS. Conclusiones: Las dimensiones de CVRS con menores puntuaciones corresponden al estado de ánimo y sentimientos en ambos sexos, evidenciándose diferencias significativas por sexo. Es imprescindible desarrollar investigaciones en CVRS en adolescentes sin ninguna condición de enfermedad y ampliar estos factores que pueden afectar el bienestar y la salud con la finalidad de desarrollar intervenciones encaminadas en la promoción de la salud y prevención de la enfermedad a tempranas edades, incorporando un enfoque de sexo/género.

ABSTRACT Objective: To evaluate the health-related quality of life (HRQOL) and its relationship with sociodemographic factors in adolescents from a private educational institution in Bucaramanga (Colombia). Materials and Methods: Quantitative, descriptive, cross-sectional study, carried out with 280 healthy adolescents of both sexes, between the ages of 10 and 19 years. The KIDSCREEN-27 was used to assess health-related quality of life. Results: Regarding health-related quality of life, adolescents perceive more problems related to mood and feelings, especially adolescent girls, with significant differences being evident in both sexes with respect to the perception of the total HRQOL scale. Conclusions: The HRQOL dimensions with the lowest scores correspond to mood and feelings in both sexes, with significant differences by sex. It is essential to carry out research on HRQL in adolescents without any disease or illness and to focus on the factors that can affect well-being and health in order to develop interventions aimed at promoting health and preventing disease at an early age, integrating a sex/gender approach.

RESUMO Objetivo: Avaliar a qualidade de vida relacionada à saúde (QVRS) e sua relação com fatores sociodemográficos em adolescentes de uma instituição de ensino privada em Bucaramanga (Colômbia). Material e Método: Estudo quantitativo, descritivo, transversal, realizado com adolescentes saúdaveis, entre 10 a 19 anos de idade, de ambos os sexos. O KIDSCREEN-27 foi utilizado para a avaliação da qualidade de vida relacionada à saúde. Resultados: Em relação à qualidade de vida relacionada à saúde, os adolescentes percebem mais problemas relacionados ao estado emocional e os sentimientos, especialmente as mulheres adolescentes, sendo evidentes diferenças significativas em ambos os sexos quanto à percepção da escala de QVRS total. Conclusões: As dimensões da QVRS que obtiveram a pontuação mais baixa correspondem ao estado emocional e os sentimientos en ambos os sexos, com diferenças significativas por sexo. Portanto, é imprescindível a realização de pesquisas sobre a QVRS em adolescentes sem nenhuma doença e analizar os fatores que podem afetar o bem-estar e a saúde, a fim de desenvolver intervenções encaminhadas a promover a saúde e prevenir doenças desde a infancia, incorporando uma abordagem de sexo/gênero.

Combined Decompressive Hemicraniectomy and Port-Based Minimally Invasive Parafascicular Surgery for the Treatment of Subcortical Intracerebral Hemorrhage: Case Series, Technical Note, and Review of Literature.

BACKGROUND: Intracerebral hemorrhage (ICH) is a neurosurgical emergency. Combined decompressive hemicraniectomy (DHC) and minimally invasive parafascicular surgery (MIPS) may provide a practical method of managing subcortical ICH. OBJECTIVE: 1) To present a case series of combined DHC-MIPS for the treatment of subcortical-based ICH; 2) to describe technical nuances of DHC-MIPS; and 3) to provide a literature overview of MIPS for ICH. METHODS: The following inclusion criteria were used: 1) Glasgow Coma Scale (GCS) score <3-4; 2) admission within 6 hours of onset; 3) increased intracranial pressure caused by hemorrhage; 4) patient unresponsive to medical management; 5) hemorrhage >30 cm3; 6) subcortical location; and 7) midline shift (mm). Before DHC, sulcal cannulation used the following coordinates: intersection of tragus-frontal bone and midpoint of midpupillary line and midline; coronal suture: 3-4 cm posterior to this point). RESULTS: Three patients were selected: a 62-year old woman, a 45-year old woman, and a 36-year-old man. GCS and ICH scores on admission were 7 and 3, 3 and 4, and 3 and 4, respectively. ICH was located in left basal ganglia in patients 1 and 3 and right basal ganglia in patient 2, all with intraventricular extension. ICH volume was 81.7, 68.2, and 42.3 cm3, respectively. The postoperative GCS score was 11, 10, and 6, respectively. There were no intraoperative complications or mortalities. Evacuation was within 15 minutes in all patients. The modified Rankin Scale score was 3, 4, and 5, respectively, with semi-independence in case 1. CONCLUSIONS: Combined DHC-MIPS, with the use of craniometric points, can provide a unique and simple surgical option for the management of subcortical ICH.

Profile of Acute-Phase Proteins of Horses Submitted to Low-Level Show Jumping Classes.

The objective of this study was to evaluate the serum proteinogram, identifying and quantifying the acute-phase proteins (APPs) of horses used in show jumping activity with obstacles of a meter in height. As it is an equestrian sport that involves high intensity and excessive impact, the possibility of injury is relevant. The serum of 10 horses was evaluated in a competition for beginners. The material was collected at rest (T0), immediately after exercise (T1), 30 minutes after the effort (T2), 1 hour after the effort (T3), and 24 hours after the effort. Acute-phase proteins were separated by polyacrylamide gel electrophoresis and their concentrations determined by computerized densitometry. Protein identification was performed using mass spectrometry. The data were evaluated using analysis of variance for repeated measures, considering the level of significance of P < .05. Eight APPs were identified: α2-macroglobulin (α2-macro), ceruloplasmin (Cp), transferrin (Trf), albumin (Alb), α1-antitrypsin (α1-atp), haptoglobin (Hp), acid glycoprotein (AGP), and apolipoprotein A1 (Apo A1). There was a difference in Cp, AGP, and Apo A1 between moments. As the other proteins were not influenced by exercise, they were established as a valuable resource in the monitoring of inflammatory processes and an important complementary element in controlling the impact of training on the animals, thus guaranteeing their welfare.

The effects of sex, body length, and different habitats on the serum protein electrophoresis of the broad-snouted caiman (Caiman latirostris).

BACKGROUND: Knowledge of mammalian inflammatory responses is vast; however, many aspects of the inflammatory response in non-mammalian vertebrates, such as reptiles, remain unclear, including those regarding acute-phase proteins (APPs). Recent studies have focused on the use of serum protein electrophoresis (SPE) to assess inflammatory responses in the broad-snouted caiman (Caiman latirostris) and other reptiles. OBJECTIVES: The purpose of this study was to examine the effects of sex, body length, and different habitats on SPE patterns in C latirostris using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). METHODS: A total of 40 animals of both sexes and varying body lengths were collected; of these, 23 were free-living in an industrial complex (site 1), and 17 were captive on a rural property (site 2). Sodium dodecyl sulfate-polyacrylamide gel electrophoresis was performed to fractionate different serum protein constituents. RESULTS: Sex affected protein levels, with females showing higher serum levels of total protein, as well as the 90-, 66-, and 58-kDa proteins compared with males. Similarly, body length affected protein levels, with male adults >1.70 m in length showing the lowest serum levels of 152-, 58-, 54-, and 27-kDa proteins of all other animals. Finally, habitat affected protein levels, with animals at site 1 showing higher serum levels of 152- and 41-kDa proteins compared with those at site 2. CONCLUSIONS: This preliminary study was the first to evaluate the SPE of C latirostris using SDS-PAGE. Further studies to identify the proteins in each band with more specific and sensitive techniques (eg, mass spectrometry) should be conducted to elucidate the standard of APPs in reptiles better.

Plasma cholinesterase activity as an environmental impact biomarker in juvenile green turtles (Chelonia mydas) / Atividade da colinesterase plasmática como biomarcador de impacto ambiental em tartarugas verdes juvenis (Chelonia mydas)

The objective of this study was to evaluate the enzymatic activity of plasma cholinesterase in Chelonia mydas marine turtles belonging to two populations, according to their capture sites, under the absence and probable influence of anthropic effects. A total of 74 animals were used and later divided into two groups, based on the capture site. Blood samples were collected from all captured animals, which were then released into the sea at the site of capture. A descriptive statistical analysis of the plasma cholinesterase activity values and an analysis comparing these values based on the capture site were performed. Samples of heparinized plasma from animals captured at the two different sites were analyzed. Plasma cholinesterase activity ranged from 121 to 248U/L, with a mean and standard deviation of 186.1±30.68U/L. When comparing plasma cholinesterase activity values in individuals based on the capture site, a significant difference was observed. Establishing reference values for different sea turtle populations is necessary to interpret future sampling results and to allow sea turtles to be used as sentinels of ecosystem health. Future studies are needed to evaluate other populations and the activity of plasma cholinesterase in juvenile marine turtles, in relation to environmental contamination.(AU)

O objetivo desse estudo foi avaliar a atividade enzimática da colinesterase plasmática em tartarugas marinhas da espécie Chelonia mydas em duas populações de acordo com o local de captura, sob ausência e provável influência de efeito antrópico. Foi utilizado um total de 74 animais e posteriormente divididos em dois grupos de acordo com o local de captura. Foram coletadas amostras de sangue de todos os animais capturados e em seguida liberados ao mar no mesmo local. Foi realizada uma análise estatística descritiva dos valores da atividade plasmática de colinesterase do total de animais e análise comparando os valores de acordo com o local de captura. Foram analisadas amostras de plasma heparinizado de animais capturados em dois locais distintos. Os valores da atividade plasmática de colinesterase variaram de 121 a 248U/L, com média e desvio padrão de 186.1±30.7U/L. Quando comparados os valores de atividade plasmática da colinesterase nos indivíduos de acordo com o local de captura, foi observada diferença significativa. O estabelecimento de valores de referência para diferentes populações de tartarugas marinhas são necessários para interpretar os futuros resultados amostrais e permitir que as tartarugas marinhas sejam usadas como sentinelas da saúde do ecossistema. Estudos futuros são necessários para avaliar outras populações e a atividade da colinesterase plasmática de tartarugas marinhas juvenis em relação à contaminação ambiental.(AU)

Acute-Phase Proteins of Healthy Horses and Horses Naturally Affected by Colic Syndrome.

The purpose of this study was to evaluate and compare the serum proteinogram, identifying and quantifying the acute-phase proteins (APPs) of healthy horses and those naturally affected by colic syndrome. Blood samples were collected from 9 healthy horses and 17 horses with clinical (G1) or surgical (G2) colic at the time of arrival at the veterinary hospital (M0) and 24 (M1), 48 (M2), and 72 (M3) hours after the initiation of treatment. The APPs were separated by polyacrylamide gel electrophoresis (SDS-PAGE), and their concentrations were determined by computerized densitometry. Protein identification was performed using matrix assisted laser desorption/ionization-time of flight mass spectrometry. Nine APPs were identified: α2-macroglobulin, ceruloplasmin, transferrin, albumin, α1-antitrypsin, haptoglobin, α1-acid glycoprotein, apolipoprotein A1, and serum amyloid A. Ceruloplasmin (Cp) presented an elevation at M0 in G2 in relation to G1 and the control group (CG). Serum amyloid A (SAA) presented an elevation with a difference at M3 in G1 and G2, compared with CG. In the comparison between the time points within each group (G1 and G2), there was an increase in SAA in G2 with a difference at M1, M2, and M3. Cp and SAA were suitable for evaluating the acute-phase response in horses with colic. Cp was an indicator of colic with surgical resolution. SAA presented favorable behavior for its use as a biomarker to establish the prognosis in horses with colic. The serial measurement of these proteins was useful in differentiating the clinical or surgical treatment and prognosis of horses with this disorder.

Serum amyloid A and muscle activity biomarkers in horses submitted to equestrian show jumping / Biomarcadores de amilóide sérica A e de atividade muscular em cavalos submetidos a salto equestre

The aim of this study was to evaluate the serum amyloid A (SAA) and biomarkers of muscle activity of horses submitted to show jumping activity. To do this, the variables SAA, glucose, lactate and the biomarkers creatine kinase (CK) and aspartate amino transferase (AST) were evaluated in 10 horses submitted to the show jumping exercise in a tournament for beginners. The evaluations occurred before exercise (T0), immediately after (T1), 30 minutes (T2), 60 minutes (T3) and 24 hours after the end (T4). Data were evaluated using analysis of variance for repeated measures. The statistical software SAEG 9.1 was used to verify the level of significance between the moments for P<0.05. Glucose presented a difference between the moments T0 (97.7±13.3mg/dL) and T1 (79.7±14.1mg/dL). Lactate presented elevation in T1 (15.3±6.1mmol/L) compared to the others T0 (3.8±0.8mmol/L), T2 (6.5±3.9mmol/L), T3 (5.3±2.2mmol/L) and T4 (5.1±1.6mmol/L). The CK showed a significant difference between T0 (82.8±51.2U/L) and T1 (140.1±58.5U/L) and between T4 (74.4±43.1U/L) with T1 (140.1±58.5U/L). The AST presented no difference between moments. The show jumping activity with one-meter obstacles did not induce changes in the SAA protein between the moments.(AU)

O objetivo deste estudo foi avaliar a amilóide sérica A (SAA) e biomarcadores de atividade muscular de equinos submetidos a atividade de salto, ou hipismo clássico. Para tanto, foram avaliadas as variáveis SAA, glicose, lactato e os biomarcadores creatina quinase (CK) e aspartatoaminotransferase (AST) em 10 equinos submetidos ao exercício de saltos em torneio para iniciantes. As avaliações ocorreram antes do exercício (T0), imediatamente após (T1), 30 minutos (T2), 60 minutos (T3) e 24 horas após o término (T4). Os dados foram avaliados utilizando análise de variância para medidas repetidas. O software estatístico SAEG 9.1 foi utilizado para verificar o nível de significância entre os momentos para P<0,05. A glicose diferenciou-se entre os momentos T0 (97.7±13.3mg/dL) e T1 (79.7±14.1mg/dL). O lactado apresentou elevação comparada com o momento T1(15.3±6.1mmol/L) e os demais T0 (3.8±0.8mmol/L), T2 (6.5±3.9mmol/L), T3 (5.3±2.2mmol/L) e T4 (5.1±1.6mmol/L). A CK mostrou diferença significativa entre T0 (82.8±51.2U/L) e T1 (140.1±58.5U/L) e entre T4 (74.4±43.1U/L) com T1 (140.1±58.5U/L). A AST não apresentou diferença entre os momentos. A atividade de hipismo clássico com obstáculos de um metro não induziu alterações na proteína SAA entre os momentos.(AU)

Disfagia y neurología: ¿una unión indefectible? / Dysphagia and neurology: an unfailing union?

RESUMEN INTRODUCCIÓN: La disfagia es un signo y síntoma que acompaña con una elevada prevalencia a los trastornos neurológicos y neuromusculares, siendo responsable de varias de las complicaciones mayores que impactan negativamente la recuperación del paciente neurológico como la aspiración, infecciones respiratorias a repetición, desnutrición y deshidratación. Irónicamente la disfagia, al ser tan frecuente y producida por múltiples procesos fisiopatológicos, es uno de los trastornos más descuidados en cuanto al diagnóstico y tratamiento por los profesionales de la salud. OBJETIVO: Invitar a los profesionales de la salud, a conocer sobre disfagia neurogénica y neuromuscular, su etiología, manifestaciones, consecuencias y aspectos clínicos para su reconocimiento. DESARROLLO: Revisión de tema desde una óptica epidemiológica y clínica del estado del arte en disfagia neurogénica y neuromuscular. CONCLUSIONES: La disfagia altera la seguridad de la vía aérea y modifica de varias maneras el pronóstico del paciente neurológico. Las principales causas de disfagia son de origen neurológico (ataque cerebrovascular, traumatismo encéfalo craneano, esclerosis múltiple, enfermedad de Parkinson y demencias), al existir una estrecha relación y unión casi indefectible entre las enfermedades, trastornos y traumatismos neurológicos y neuromusculares con alteración de uno o varios componentes del proceso deglutorio. Si bien existen estudios complementarios para reconocer la disfagia, la semiología y el examen físico, son los puntos centrales para reconocer el espectro y variabilidad etiológica de la disfagia.

SUMMARY INTRODUCTION: Dysphagia is a sign and accompanying symptom, with a high prevalence of neurological and neuromuscular disorders, being responsible for several of the major complications that negatively impact neurological recovery such as aspiration, respiratory infections, malnutrition and dehydration. Ironically dysphagia, being so frequent and produced by multiple pathophysiological processes, is one of the most neglected disorders in terms of diagnosis and treatment by health professionals. OBJECTIVE: To invite health professionals, to know about neurogenic and neuromuscular dysphagia, its etiology, manifestations, consequences and clinical aspects for its recognition. DEVELOPMENT: Revision of the topic from an epidemiological and clinical perspective of the state of the art in neurogenic and neuromuscular dysphagia. CONCLUSIONS: Dysphagia alters the safety of the airway and modifies the neurological patient's prognosis in several ways. The main causes of dysphagia are of neurological origin (stroke, traumatic brain injury, multiple sclerosis, Parkinson's disease and dementias), as there is a close relation and almost indefectible union between neurological and neuromuscular diseases and disorders with alteration of one or various components of the process. Although there are complementary studies to recognize dysphagia, semiology and physical examination are the central points to recognize the spectrum and etiological variability of dysphagia.

Coagulopatía temprana en trauma: ¿llegan los pacientes coagulopáticos a la sala de cirugía?: [revisión] / Early coagulopathy in trauma: do coagulopathic patients reach the operating room?: [review]

Introducción. De la coagulopatía aguda en el trauma, resultan múltiples complicaciones como la necesidad de administración de hemoderivados, mayor incidencia de disfunción orgánica, aumento de estancia en unidad de cuidados intensivos y mayor mortalidad. Con el conocimiento actual de la fisiopatología del trauma y la vía celular de la coagulación es ahora posible mejorar el dignóstico y tratamiento de la coagulopatía inicial y conseguir mejores resultados en nuestros centros. Métodos. Este artículo examina la fisiología básica de la coagulación, la etiología, el diagnóstico y el tratamiento de la coagulopatía temprana en trauma. La búsqueda se realizó con términos Mesh y no Mesh con conectores AND: Anesthesia-coagulophaty, postinjury and trauma thromboelastography, transfusion and trauma, shock-Mechanism and trauma review. Resultados. La coagulopatía aguda o temprana en trauma está directamente asociada al estado de shock y se caracteriza por anticoagulación e hiperfibrinolisis sistémica; hay evidencia de la implicación de la proteína C en este proceso. Se ha establecido que seis mecanismos fisiopatológicos multifactoriales pueden perpetuar la coagulopatía en los pacientes traumatizados; éstos son: inflamación, acidosis, hipotermia, shock, trauma tisular y hemodilución. El diagnóstico se realiza con las diferentes pruebas (TP, TPT, plaquetas) ya conocidas desde hace mucho tiempo, pero con limitaciones que reducen su utilidad clínica. Ahora la tromboelastografía nos puede ayudar a guiar la transfusión, con el concepto actual de transfusión temprana de glóbulos rojos, plasma y plaquetas, utilizando la mejor proporción según la evidencia disponible. Conclusiones. Contamos, con algún conocimiento sobre la fisiopatología de la coagulopatía asociada con trauma pero son necesarias más investigaciones, en este campo. El diagnóstico rápido y una intervención directa inmediata son importantes para mejorar el desenlace de nuestros pacientes.

Introduction. Acute coagulopathy in trauma results in multiple complications such as the need for blood products, higher rates of organ dysfunction, longer stay in the ICU and higher mortality. With the current knowledge of the pathophysiology of trauma and of the cellular coagulation pathway it is now possible to improve diagnosis and treatment of the initial coagulopathy and achieve better outcomes in our trauma centers. Methods. This paper looks into the basic physiology of coagulation, and the etiology, diagnosis and treatment of early coagulopathy in trauma. The search was done using Mesh and non-Mesh terms with AND connectors: Anesthesia-coagulopathy, postinjury and trauma thromboelastography, transfusion and trauma, shock-Mechanism and trauma review. Results. Acute or early coagulopathy in trauma is directly associated with a state of shock and is characterized by anticoagulation and systemic hyperfibrinolysis; protein C is known to be implicated in this process. It has also been determined that six multi-factorial pathophysiological mechanisms may perpetuate coagulopathy in trauma patients, namely, inflammation, acidosis, hypothermia, shock, tissue trauma and hemodilution. Diagnosis is made using the different tests (PT, PPT, platelets) that have been in use for a long time; however, these tests have drawbacks that limit their clinical usefulness. Thromboelastography can now help guide early transfusion using the best proportion of red blood cells, plasma and platelets on the basis of the best available evidence. Conclusions. We have some knowledge about the pathophysiology coagulopathy associated with trauma but more research in this field is needed. Rapid diagnosis and immediate intervention are important to improve the outcomes with our patients.

Marcapaso permanente transfemoral: Técnica alternativa de implantación en pacientes con contraindicaciones para abordaje pectoral / Transfemoral permanent marcapaso: Alternative technique of implantation in patients with contraindications for approach pectoral

Reportamos el caso de una paciente con bloqueo aurículoventricular completo, con un marcapaso epicárdico infectado y venas torácicas inabordables, en quien se realizó exitosamente el implante transfemoral de un marcapaso unicameral VVIR. Revisamos la literatura con algunas series en las que se demuestra la factibilidad y seguridad de la técnica.

We report the case of a patient with complete atrioventricular block, with an infected epicardial pacemaker and intractable thoracic veins, in which it was performed successfully the transfemoral implant of a unicameral pacemaker VVIR. We check literature with some series in which the feasibility and safety of The technique.

Absceso cerebral por escherichia coli: ¿una simple diarrea doctor? / Brain abscess from escherichia coli: a simple diarrhea, doctor? / Abcesso cerebral por escherichia coli: uma simples diarréia doutor?

Se presenta el caso de un soldado de veinte años de edad que desarrolló un absceso cerebral por Escherichia coli, secundario a un episodio de diarrea de siete días de evolución. Además de mostrar el curso clínico de la enfermedad y su tratamiento, se discuten las etiologías de los abscesos cerebrales, resaltando la importancia del seguimiento de las enfermedades diarreicas por simples que estas parezcan...

A case of a 20 year-old soldier, who developed a brain abscess from Escherichia coli after a 7 day episode of diarrhea, is presented. The clinical course of the disease, its treatment and the different aetiologies of brain abscesses are discussed, emphasizing the importance of the follow up of diarrheic diseases no matter how simple they may look...

Apresenta-se o caso de um soldado de vinte anos de idade que desenvolveu um abcesso cerebral por Escherichia coli, secundário a um episódio de diarréia de sete dias de evolução. Além de mostrar o curso clínico da doença e seu tratamento, discutem-se as etiologias dos abcessos cerebrais, ressaltando a importância do seguimento das doenças diarréicas por simples que estas pareçam...

Manifestaciones orales en una paciente con esclerodermia linear; reporte de un caso / Oral manifestations in a female patient with linear scleroderma. One case report

La esclerodermia se caracteriza por cambios fibróticos de la piel y otros órganos. Se presenta de forma sistémica o localizada. Las manifestaciones orales de la enfermedad resultan del depósito de colágeno en los tejidos o alrededor de vasos y nervios. La manifestación oral más común reconocida en esta entidad, es el ensanchamiento del espacio del ligamento periodontal. Se presenta el caso de un paciente de sexo femenino, de 11 años de edad, con diagnóstico de esclerodermia lineal, con manifestaciones orales severas y cutáneas mínimas; hallazgos no descritos previamente en la literatura.