First insights into the prokaryotic community structure of Lake Cote, Costa Rica: Influence on nutrient cycling.

Prokaryotic diversity in lakes has been studied for many years mainly focusing on community structure and how the bacterial assemblages are driven by physicochemical conditions such as temperature, oxygen, and nutrients. However, little is known about how the composition and function of the prokaryotic community changes upon lake stratification. To elucidate this, we studied Lake Cote in Costa Rica determining prokaryotic diversity and community structure in conjunction with physicochemistry along vertical gradients during stratification and mixing periods. Of the parameters measured, ammonium, oxygen, and temperature, in that order, were the main determinants driving the variability in the prokaryotic community structure of the lake. Distinct stratification of Lake Cote occurred (March 2018) and the community diversity was compared to a period of complete mixing (March 2019). The microbial community analysis indicated that stratification significantly altered the bacterial composition in the epi-meta- and hypolimnion. During stratification, the Deltaproteobacteria, Chloroflexi, Bacteroidetes, Nitrospirae, and Euryarchaeota were dominant in the hypolimnion yet largely absent in surface layers. Among these taxa, strict or facultative anaerobic bacteria were likely contributing to the lake nitrogen biogeochemical cycling, consistent with measurements of inorganic nitrogen measurements and microbial functional abundance predictions. In general, during both sampling events, a higher abundance of Alphaproteobacteria, Betaproteobacteria, Actinobacteria, and Cyanobacteria was found in the oxygenated layers. Lake Cote had a unique bacterial diversity, with 80% of Amplicon Sequence Variant (ASV) recovered similar to unclassified/uncultured strains and exhibits archetypal shallow lake physicochemical but not microbial fluctuations worthy of further investigation. This study provides an example of lake hydrodynamics impacts to microbial community and their function in Central American lakes with implications for other shallow, upland, and oligotrophic lake systems.

Anaerobic methane oxidation in a coastal oxygen minimum zone: spatial and temporal dynamics.

Coastal waters are a major source of marine methane to the atmosphere. Particularly high concentrations of this potent greenhouse gas are found in anoxic waters, but it remains unclear if and to what extent anaerobic methanotrophs mitigate the methane flux. Here we investigate the long-term dynamics in methanotrophic activity and the methanotroph community in the coastal oxygen minimum zone (OMZ) of Golfo Dulce, Costa Rica, combining biogeochemical analyses, experimental incubations and 16S rRNA gene sequencing over 3 consecutive years. Our results demonstrate a stable redox zonation across the years with high concentrations of methane (up to 1.7 µmol L-1 ) in anoxic bottom waters. However, we also measured high activities of anaerobic methane oxidation in the OMZ core (rate constant, k, averaging 30 yr-1 in 2018 and 8 yr-1 in 2019-2020). The OPU3 and Deep Sea-1 clades of the Methylococcales were implicated as conveyors of the activity, peaking in relative abundance 5-25 m below the oxic-anoxic interface and in the deep anoxic water respectively. Although their genetic capacity for anaerobic methane oxidation remains unexplored, their sustained high relative abundance indicates an adaptation of these clades to the anoxic, methane-rich OMZ environment, allowing them to play major roles in mitigating methane fluxes.

Marine litter on sandy beaches with different human uses and waste management along the Gulf of Nicoya, Costa Rica.

This study was a baseline with quantitative data of marine litter along the Gulf of Nicoya, Costa Rica. The objective of the study was to quantify marine litter and its association with human activities in this estuarine gulf. A total of fourteen sandy beaches were cataloged by the degree of urbanization, tourism intensity, beach cleaning programs, and tributary rivers as possible drivers of marine litter presence. The items of the marine litter were separated and weighted by type. Analysis by the clean coastal index (CCI) and multivariate statistics were applied to find spatial patterns in marine litter in the gulf. On beaches with the highest touristic activity, cigarette butts and straws were the main components. Locations with river plume influence, less frequent cleanup, or waste cans showed more bottles, plastic parts, and sanitary waste than beaches in other conditions. A beach in a fisherman town had recently utilized plastic bags, household goods, and boat parts in the marine litter. A wildlife refuge beach showed only small plastic and coffee foam cup fragments that came with currents from other points in the estuary. River basin management, solid waste disposal programs, and environmental education to avoid single-use items combined with correct waste disposal are needed to reduce marine litter in tropical countries focused on ecological tourism.

A fjord-like tropical ecosystem, Pacific coast of Costa Rica: overview of research in Golfo Dulce / Un ecosistema tropical similar a un fiordo, costa del Pacífico de Costa Rica: panorama de la investigación en el Golfo Dulce

Abstract Introduction: Coastal ecosystems worldwide are under the influence of local, regional and global stressors, such as pollution, eutrophication and climate change. Golfo Dulce is a relatively pristine and accessible deep tropical ecosystem that provides opportunities for comparative and collaborative research. Objective: To summarize published reports on past research conducted in this ecosystem, identify topics for further study, and suggest new research issues. Methods: A search was made on the web for reports based on research conducted in Golfo Dulce and published in scientific journals. Reports focusing on environmental parameters and on the biota were included. Results: A total of 123 studies that include data from Golfo Dulce are cited. The four topics more frequently addressed were reports based on the results of the R/V Victor Hensen expedition (1993-1994) and follow-up work on microbiology, studies on water parameters, research on vertebrates, and zooplankton studies. The reports focusing on vertical profiles of oxygen and temperature are discussed in detail, followed by those on the biota. Conclusions: Golfo Dulce has low oxygen concentrations below 50 m and is frequently anoxic at the 200 m deep basin with occasional formation of H2S. However, the ecosystem contains a relatively high diversity of identified organisms, from bacteria to whales. Of particular relevance for future studies are multidisciplinary surveys aiming at obtaining data on primary productivity, the diversity and biomass of the main groups of planktonic, demersal and benthic organisms, and the frequency and magnitude of the influx of deep offshore waters over the sill into the basin. These data, as well as the information gathered in the past, are essential for updating the trophic model developed more than 25 years ago and in support of new predictive models on the functioning of the ecosystem.

Resumen Introducción: Los ecosistemas costeros alrededor del mundo están bajo la influencia de tensores locales, regionales y globales, como la contaminación, la eutroficación y el cambio climático. El Golfo Dulce es un profundo ecosistema tropical relativamente inalterado y accesible, que provee oportunidades para la investigación comparativa y colaborativa. Objetivo: Resumir los informes publicados sobre investigaciones pasadas realizadas en el ecosistema, identificar tópicos para estudios futuros y sugerir nuevas áreas de investigación. Métodos: Se hizo una búsqueda en la red de informes basados en investigaciones hechas en Golfo Dulce y publicadas en revistas científicas. Fueron incluidos aquellos informes sobre parámetros ambientales y la biota. Resultados: Un total de 123 estudios que incluyen datos sobre Golfo Dulce son citados. Los cuatro tópicos citados con más frecuencia fueron: Los resultados de la expedición del R/V Victor Hensen (1993-1994) y estudios de seguimiento sobre microbiología, informes sobre parámetros acuáticos, investigaciones sobre vertebrados y estudios sobre zooplancton. Los informes sobre perfiles de oxígeno y temperatura son presentados con mayor detalle, seguidos por aquellos sobre la biota. Conclusiones: Golfo Dulce tiene bajas concentraciones de oxígeno por debajo de 50 m y es usualmente anóxico a 200 m en el fondo, con formación ocasional de H2S. Sin embargo, el ecosistema contiene una diversidad de organismos identificados relativamente alta, desde bacterias hasta ballenas. De relevancia particular para futuros estudios es, entre otros, la conducción, de muestreos multidisciplinarios orientados a obtener datos sobre productividad primaria, la diversidad y biomasa de los principales grupos de organismos planctónicos, demersales y bénticos, así como la frecuencia y magnitud del flujo de agua oceánica hacia el interior. Estos datos, así como los obtenidos en el pasado, son esenciales para actualizar el modelo trófico desarrollado hace más de 25 años, o en apoyo de nuevos modelos predictivos de funcionamiento del ecosistema.

Water column dissolved silica concentration limits microphytobenthic primary production in intertidal sediments.

Primary production of microphytobenthos (MPB) contributes significantly to the total production in shallow coastal environments. MPB is a diverse community in which diatoms are usually the main microalgal group. Diatoms require N, P, and other nutrients as with other autotrophs, but in addition require silicate to create their outer cell wall. Therefore, dissolved silica (DSi) might be a potential limiting factor for benthic primary production in areas with reduced freshwater input. To test this hypothesis, a microcosm experiment was conducted using intact sediment cores collected from an intertidal mudflat in the Bay of Cádiz and supplied with increasing concentrations of DSi (0, 5, 10, 25, and 45 µmol · L-1 ). After 7 d of enrichment, we determined chlorophyll a and c (Chl a, c) contents, metabolic rates (Net [Pn ] and Areal Gross [PgA ] Production and Light [RL ] and Dark [RD ] Respiration), as well as fluxes of inorganic nutrients across the sediment-water interface. Chl a and c contents increased significantly with respect to the initial conditions but no differences between treatments were found. Both Pn and PgA showed a saturating-like pattern with silicate concentration, reaching maximum rates at a DSi concentration of 45 µmol · L-1 . The addition of DSi also resulted in an increase of DSi and ammonium uptake by the sediment, which was significantly higher in light than in darkness. Our results clearly show that water column DSi concentrations have a direct impact on benthic primary production, also controlling other related processes such as inorganic nutrient fluxes.

NC10 bacteria in marine oxygen minimum zones.

Bacteria of the NC10 phylum link anaerobic methane oxidation to nitrite denitrification through a unique O2-producing intra-aerobic methanotrophy pathway. A niche for NC10 in the pelagic ocean has not been confirmed. We show that NC10 bacteria are present and transcriptionally active in oceanic oxygen minimum zones (OMZs) off northern Mexico and Costa Rica. NC10 16S rRNA genes were detected at all sites, peaking in abundance in the anoxic zone with elevated nitrite and methane concentrations. Phylogenetic analysis of particulate methane monooxygenase genes further confirmed the presence of NC10. rRNA and mRNA transcripts assignable to NC10 peaked within the OMZ and included genes of the putative nitrite-dependent intra-aerobic pathway, with high representation of transcripts containing the unique motif structure of the nitric oxide (NO) reductase of NC10 bacteria, hypothesized to participate in O2-producing NO dismutation. These findings confirm pelagic OMZs as a niche for NC10, suggesting a role for this group in OMZ nitrogen, methane and oxygen cycling.

Productividad primaria en el Humedal Nacional Térraba-Sierpe, Costa Rica / Primary productivity in the National Térraba-Sierpe Wetland, Costa Rica

Resumen Se determinó la productividad primaria (PP) del fitoplancton en un amplio sector del Humedal Nacional Térraba Sierpe (HNTS) de Costa Rica, durante la estación lluviosa del año 2008 y en la estación seca del año 2009. Seis sitios se ubicaron en las áreas norte y central del humedal, donde por lo general ocurre la mayor influencia del aporte de caudal del Río Grande de Térraba. Se realizaron adicionalmente determinaciones de otros parámetros ambientales, asociados con la productividad primaria, como profundidad de penetración del disco de Secchi, la concentración de sólidos en suspensión, la concentración de clorofila a, la salinidad, la temperatura, la concentración del oxígeno disuelto en el agua, la concentración de nutrimentos inorgánicos disueltos (amonio, nitrito, fósforo disuelto, silicato), la conductividad eléctrica específica y se llevó a cabo un estudio basado en el análisis de componentes principales. La PP en el HNTS fue en general baja, con un valor máximo de 8.16gC/m2·d de PPN, el cual se registró en la estación seca, en marzo del 2009, en Isla Loros. Los sitios de mayor influencia del río (Samu y El Caite en la estación lluviosa), fueron los que tuvieron valores más bajos, mientras que los sitios con mayor influencia marina fueron los que presentaron los valores más altos de este estudio, cuyo promedio y desviación estándar fue de 0.79±0.50gC/m2.d (n=12), y la mediana fue 0.80gC/m2.d. Esta diferencia se debe principalmente al elevado aporte de agua dulce y de sólidos en suspensión del Río Grande de Térraba que limita el desarrollo del fitoplancton marino en el humedal. Es importante que se establezca y mantenga un programa de monitoreo de los parámetros medidos en este estudio, con al menos dos muestreos por año, uno en la época seca y otro en la época lluviosa, siguiendo el gradiente de salinidad desde el río hasta el mar al menos en dos direcciones.

Abstract Phytoplankton primary production (PP) was determined in a broad sector of the Térraba-Sierpe National Wetland, Costa Rica, from September to November 2008 in the rainy season and from January to March 2009 in the dry season. Six sampling stations were located at the Northern and Central zone of the wetland, according to the main expected flux of Río Grande de Térraba. Additionally other environmental parameters such as Secchi disk depth, suspended solid matter concentration, chlorophyll-a concentration, salinity, temperature, dissolved oxygen concentration, dissolved inorganic nutrients concentrations (phosphate, nitrate, ammonium and silicate), specific conductivity were also measured and a principal components analysis was performed. The PP in the Terraba-Sierpe National Wetland (HNTS by its Spanish name) was generally low, with a maximum value of 8.16gC/m2·d of Net Primary Productivity (NPP), which was recorded in the dry season, in March 2009, at Loros island. Sites that had a greater riverine influence showed lower PP values, while sites with greater marine influence presented higher PP values. These latter had an average and standard deviation of 0.79±0.50gC/m2·d (n=12). This difference is the result of the high input of freshwater and suspended solids from the Río Grande de Térraba which limits the development of marine phytoplankton in the wetland. Rev. Biol. Trop. 63 (Suppl. 1): 9-28. Epub 2015 April 01.

Evolución clínica de pacientes pediátricos post-tratamiento de coartación aórtica / Clinical evolution of pediatric patients post-treatment of aortic coarctation

La Coartación Aórtica representa del 5% - 10% de las malformaciones congénitas cardiovasculares. Lamayoría se localizan, en la pared posterior de la aorta (yuxtaductales) Objetivo: Establecer evolución clínicapost tratamiento de coartación aórtica, en el Hospital General de Enfermedad del Instituto Guatemalteco deSeguridad Social. Metodología: Estudio descriptivo, retrospectivo, en pacientes <15 años de edad, condiagnóstico de coartación aórtica que ya hubieran recibido tratamiento. Resultados: Se encontraron 39pacientes. 21 de sexo masculino y 18 de sexo femenino; 18 pacientes (9 masculino / 9 femenino) fuerontratados por intervencionismo; 12 pacientes con tratamiento medico. Las complicaciones fueron 10pacientes con recoartación y 7 pacientes con hipertensión arterial, el 100% en clase funcional NYHA tipo I y0% de mortalidad. Conclusiones: Los pacientes post tratamiento de coartación de aorta, cursaron conevolución clínica adecuada, 43% de ellos tuvo algún tipo de complicación, la mortalidad fue 0%.(

Aortic Coarctation represent 5 % - 10 % of congenital cardiovascular malformations. Most are located in theposterior wall of the aorta (yuxtaductal) Objective: To establish clinical outcome after treatment of aorticcoarctation in the General Hospital of Disease in Guatemalan Institute of Social Security. Methodology: Descriptive, retrospective study, in patients <15 years of age, diagnosed with aortic coarctation who hadalready received treatment. Results: 39 patients were found. 21 male and 18 female, 18 patients (9 male / 9female) were treated for interventional cardiology, 12 patients with medical treatment. Complications werepresent in 10 patients with Re coarctation and 7 patients with hypertension, 100% in NYHA functional class Itype and 0% mortality. Conclusions: The post treatment of aortic coarctation patients, presented with goodclinical course, 43 % of them had some type complication, and mortality was 0 %.

Leucoaraiosis. Aspectos fisiopatológicos y diagnóstico por imagen / Leukoaraiosis. Physiopathologic aspects and diagnostic imaging

Introducción: el concepto de Leucoaraiosis, entidad relacionada con la enfermedad de pequeños vasos, hipertensión arterial y envejecimiento poblacional, surge a raíz de la introducción de nuevas modalidades de diagnóstico por imagen como la Tomografía Computarizada y la imagen por Resonancia Magnética. Objetivos: describir los aspectos fisiopatológicos más importantes de la Leucoaraiosis y la importancia de las técnicas de imagen como la imagen por Resonancia Magnética en su diagnóstico. Material y Métodos: se realizó una búsqueda bibliográfica automatizada en bases de datos MEDLINE (motor de búsqueda PubMed) a través de las palabras clave: Leucoaraiosis, enfermedad cerebral de pequeños vasos e imagen por Resonancia Magnética, basándonos en la selección y análisis crítico de publicaciones preferentemente emitidas en los últimos 5 años. Desarrollo: la Leucoaraiosis está caracterizada por cambios de la sustancia blanca. Múltiples han sido las hipótesis que sustentan la fisiopatología de la Leucoaraiosis: causa isquémica (la más defendida), disfunción endotelial, ruptura de la barrera hematoencefálica o combinación de ellas. No obstante, los cambios fisiopatológicos asociados a la Leucoaraiosis permanecen inciertos. Por otro lado, técnicas de imagen como la Resonancia Magnética logran profundizar en los diferentes hallazgos que caracterizan a la condición. Conclusiones: el envejecimiento poblacional asociado a la alta prevalencia de Leucoaraiosis unido a la mayor disponibilidad de técnicas de imagen neurodiagnóstica condiciona un mejor entendimiento de sus aspectos fisiopatológicos, los cuales aún son controvertidos(AU)

Introduction: Leukoaraiosis is related to the small cerebral vessel disease and mainly associated with the aging of population and the high prevalence of hypertension. Computed tomography and magnetic resonance imaging pave the way to its apparition. Objectives: To describe the most importance physiopathologic aspects of leukoaraiosis and the relevance of imaging techniques as magnetic resonance imaging to diagnose it. Material and Methods: It was made a review through automatized data base MEDLINE (PubMed as search engine) using leukoaraiosis, cerebral small vessel disease and magnetic resonance imaging as descriptors. The review was based on the selection and critical analysis of publications, most appearing in the last five years. Development: Leukoaraiosis is characterized by changes in the periventricular white matter. The associated physiopathologic changes remain doubtful and not completely explained being the hypothesis centred in the chronic ischemia, bloodbrain barrier breakdown and endothelial damage or in their combination. On the other hand, new neuroradiologic techniques as magnetic resonance imaging appear to allow to deeply analyze the different imaging findings that support the diagnosis of the leukoaraiosis. Conclusions: Aging associated to high prevalence of leukoaraiosis as well as the availability of improved brain imaging techniques permit a better understanding of its physiopathologic aspects which are even controversial(AU)

Leucoaraiosis. Aspectos fisiopatológicos y diagnóstico por imagen / Leukoaraiosis. Physiopathologic aspects and Ddiagnostic imaging

Introducción: El concepto de Leucoaraiosis, entidad relacionada con la enfermedad de pequeños vasos, hipertensión arterial y envejecimiento poblacional, surge a raíz de la introducción de nuevas modalidades de diagnóstico por imagen como la Tomografía Computarizada y la imagen por Resonancia Magnética. Objetivos: Describir los aspectos fisiopatológicos más importantes de la Leucoaraiosis y la importancia de las técnicas de imagen como la imagen por Resonancia Magnética en su diagnóstico. Material y Métodos: Se realizó una búsqueda bibliográfica automatizada en bases de datos MEDLINE (motor de búsqueda PubMed) a través de las palabras clave: Leucoaraiosis, enfermedad cerebral de pequeños vasos e imagen por Resonancia Magnética, basándonos en la selección y análisis crítico de publicaciones preferentemente emitidas en los últimos 5 años. Desarrollo: La Leucoaraiosis está caracterizada por cambios de la sustancia blanca. Múltiples han sido las hipótesis que sustentan la fisiopatología de la Leucoaraiosis: causa isquémica (la más defendida), disfunción endotelial, ruptura de la barrera hematoencefálica o combinación de ellas. No obstante, los cambios fisiopatológicos asociados a la Leucoaraiosis permanecen inciertos. Por otro lado, técnicas de imagen como la Resonancia Magnética logran profundizar en los diferentes hallazgos que caracterizan a la condición. Conclusiones: El envejecimiento poblacional asociado a la alta prevalencia de Leucoaraiosis unido a la mayor disponibilidad de técnicas de imagen neurodiagnóstica condiciona un mejor entendimiento de sus aspectos fisiopatológicos, los cuales aún son controvertidos.

Introduction: Leukoaraiosis is related to the small cerebral vessel disease and mainly associated with the aging of population and the high prevalence of hypertension. Computed tomography and magnetic resonance imaging pave the way to its apparition. Objectives: To describe the most importance physiopathologic aspects of leukoaraiosis and the relevance of imaging techniques as magnetic resonance imaging to diagnose it. Material and Methods: It was made a review through automatized data base MEDLINE (PubMed as search engine) using leukoaraiosis, cerebral small vessel disease and magnetic resonance imaging as descriptors. The review was based on the selection and critical analysis of publications, most appearing in the last five years. Development: Leukoaraiosis is characterized by changes in the periventricular white matter. The associated physiopathologic changes remain doubtful and not completely explained being the hypothesis centred in the chronic ischemia, bloodbrain barrier breakdown and endothelial damage or in their combination. On the other hand, new neuroradiologic techniques as magnetic resonance imaging appear to allow to deeply analyze the different imaging findings that support the diagnosis of the leukoaraiosis. Conclusions: Aging associated to high prevalence of leukoaraiosis as well as the availability of improved brain imaging techniques permit a better understanding of its physiopathologic aspects which are even controversial.

Enfermedades quirúrgicas en la unidad de cuidados intensivos pediátricos / Surgical Diseases in the Pediatric Intensive Care Unit

Con el objetivo de determinar el comportamiento de los niños, portadores de enfermedades quirúrgicas en la Unidad de Cuidados Intensivos del Hospital Pediátrico Mártires de Las Tunas, se realizó un estudio descriptivo, longitudinal y retrospectivo en 33 pacientes, que presentaron afecciones quirúrgicas en el año 2011. La muestra la constituyeron los pacientes que fueron atendidos por presentar enfermedad quirúrgica. Se obtuvo que predominara el sexo masculino y el grupo de edad de 11 a 18 años. La apendicitis aguda y los politraumatizados fueron los diagnósticos más comunes. La mayoría de los pacientes se reportaron grave al ingreso, y las complicaciones de mayor incidencia fueron los trastornos del equilibrio hidromoneral y el íleo paralitico. La estadía promedio fue de dos a cinco días en la Unidad de Cuidados Intensivos (UCI). Se concluyó que los pacientes con afecciones quirúrgicas que requieren cuidados intensivos se han incrementado, aunque el porciento es bajo comparado con las afecciones clínicas que requieren tratamiento intensivo (AU)

To determine the behavior of children with surgical diseases in the Intensive Care Unit (ICU) of Mártires de Las Tunas Pediatric Hospital, a descriptive, longitudinal and retrospective study was carried out with 33 patients that presented surgical affections during 2011. The sample was made up by the patients who were assisted for suffering from surgical diseases. Males and the age from 11 to 18 were those that prevailed. Acute appendicitis and those with multiple traumas were the most common diagnosis. Most of the patients were reported grave at the admission, and the most frequent complications were hydro mineral balance and paralytic ileus. The average stay was about 2 to 5 days in the ICU. As conclusion: the quantities of patients with surgical affections that require intensive care have increased, although the percentage is low when compared to the clinical affections that require intensive treatment (AU)

Comportamiento de la neumonía asociada a la ventilación artificial en hospital pediátrico Mártires de Las Tunas 2010-2011 / Behavior of Pneumonias Associated to Artificial Ventilation in Mártires de Las Tunas Pediatric Hospital 2010 2011

Con el objetivo de realizar una caracterización del comportamiento de los niños que adquirieron neumonía durante la ventilación artificial, se realizó un estudio descriptivo, de corte transversal, en los pacientes ingresados en la unidad de cuidados intensivos del Hospital Pediátrico Provincial Mártires de las Tunas, durante el periodo comprendido de enero del 2010 a diciembre del 2011. Se encontró que los menores de dos años y del sexo masculino fueron los que con mayor frecuencia desarrollaron neumonía asociada a la ventilación artificial; la desnutrición estuvo presente en el 58,8 porciento de los niños infectados; los traumatismos, las infecciones respiratorias y el shock fueron las principales causas de ventilación; la klebsiella, la pseudomona y enterobacter fueron los gérmenes que se aislaron con mayor frecuencia en el tubo endotraqueal y el hemocultivo. La mayoría de los pacientes que desarrollaron neumonía nosocomial permanecieron en ventilación más de siete días y sólo dos fallecieron (AU)

To determine the behavior of children with pneumonia acquired during artificial ventilation, a descriptive and transversal study was carried out in 17 patients at the Intensive Care Unit (ICU) during 2010 and 2011. It was found that males under two years were the ones who most frequently developed pneumonia associated to the artificial ventilation. Malnutrition was present in 58,8 percent of the infected children; traumatisms, respiratory infections and shock were the main ventilation causes; klebsiella, pseudomona and enterobacter were the most frequent germs isolated in the endotracheal tube and blood tests. Most of the patients that developed nosocomial pneumonia remained in ventilation for more than 7 days and only two of them died (AU)

Caracterización clínico-patológica de los niños apendicectomizados en hospital pediátrico Mártires de Las Tunas 2011 / Clinical-pathological characterization of children operated of appendectomy at Mártires de Las Tunas pediatric hospital 2011

Con el objetivo de realizar una caracterización clínico-patológica de los niños apendicectomizados en Hospital Pediátrico Mártires de Las Tunas se realizó un estudio transversal y descriptivo en 116 pacientes, operados con dicho diagnóstico en el año 2011. La muestra estuvo formada por los niños y niñas entre las edades de 11 días de nacido hasta 17 años 11 meses y 29 días. Los datos se recolectaron en un cuestionario que respondió a los objetivos trazados y se almacenaron en una base de datos creada al efecto y se les efectuó procesamiento estadístico por método de frecuencias o porcentual. Se encontró que el sexo masculino fue el que predominó; así como, los niños de diez a 14 años. La mayoría de los pacientes procedieron del municipio Las Tunas. El dolor en fosa ilíaca derecha fue síntoma mayormente observado, la apendicitis aguda fue el reporte anatomopatológico de mayor incidencia y la mayoría de los pacientes tuvieron una estadía hospitalaria de cuatro a seis días. Predominó el diagnóstico precoz y la operación oportuna(AU)

A cross-sectional and descriptive study was carried out at Mártires de Las Tunas pediatric hospital to make a clinical-pathological characterization of 116 children operated of appendectomy in the year 2011. The sample was formed by the boys and girls from 11 days of life to 17 years old 11 months and 29 days. The information was gathered in a questionnaire following the objectives established and stored in a database created to the effect with statistical processing by means of the frequencies or percentage method. It was found that the masculine sex was the predominant one, as well as the children from ten to 14 years old. Most of the patients were located in Las Tunas municipality. Pain in the right iliac fossa was the most observed symptom; acute appendicitis was the pathological report of major incidence and most of the patients stood at the hospital from four to six days. The study concludes that there was predominance of the precocious diagnosis and opportune operation(AU)

[TP53 codon 72 polymorphism and gastric cancer risk: a case-control study in individuals from the central-western region of Venezuela]. / Polimorfismo del codón 72 de TP53 y riesgo de cancer gástrico: estudio caso-control en individuos de la región centroccidental de Venezuela.

Codon 72 polymorphism of the tumor suppressor gene TP53 has been associated with a higher risk in the development of several types of cancer. The polymorphism results in a variant protein with either an arginine (CGC) or a proline residue (CCC). The aim of this study was to analyze the association of the TP53 codon 72 polymorphism with the risk of developing gastric cancer in a high-risk population from the central-western region of Venezuela. DNA was extracted from paraffin-embedded gastric adenocarcinoma biopsies (n=65) and endoscopic biopsies from chronic gastritis patients (n=87). TP53 codon 72 polymorphism was determined by PCR-RFLP from all samples. Patients with gastric cancer had a significantly higher frequency (P = 0.037) of the Arg allele than those with chronic gastritis. A logistic regression analysis suggested that Arg carrier individuals had a 4.6-fold higher risk (95% CI 1.0-21.3) of developing gastric cancer. An increment of the Arg/Arg genotype was observed in poor-differentiated gastric adenocarcinoma (OR: 3.1; 95% CI 1.0-9.2), and of the Arg/Pro genotype in well/moderate-differentiated adenocarcinoma samples (OR: 3.5; 95% CI 1.1-11.0), when comparing within the gastric cancer samples; and the last group also when contrasting it with chronic gastritis patients (OR: 2.4; 95% CI 1.1-5.2). The results of this study suggest that the carriage of the Arg allele could be associated with the development of gastric cancer in this Venezuelan population.

Colangiopancreatografia retrograda endoscópica en pacientes con patología biliopancreática: Experiencia en 322 casos

Introducción: La Colangiopancreatografía retrógrada endoscópica (CPRE) es el procedimiento de elección actual en la patología biliopancreática, principalmente en casos de obstrucción biliar y colangitis, jugando un rol importante en el tratamiento de las estenosis benignas y malignas de las vías biliares. Objetivo: Presentar la experiencia de la Unidad de Gastroenterología del Hospital Central Universitario Antonio María Pineda en CPRE en pacientes con patología bilio-pancreatica. Material y métodos: Se realizó un estudio descriptivo retrospectivo mediante la revisión de historias clínicas de pacientes con patología biliopancreática que ameritaron una CPRE en el Servicio de Gastroenterología del Hospital Central Universitario Antonio María Pineda durante 2004- 2007, excluyéndose las historias incompletas para la información requerida. Resultados: Se revisaron 322 casos encontrándose que 69% pertenecía al sexo femenino. El grupo etario predominante estuvo comprendido entre 30 y 42 años. La indicación de la CPRE fue Coledocolitiasis en 61% seguida de neoplasias bilio-pancreaticas en 17%. Los hallazgos ecográficos más frecuentes previos a la CPRE fueron la dilatación de vías biliares en 44% y coledocolitiasis en 19%. Los hallazgos más frecuentes encontrados en la CPRE fueron Odditis en 23%, cálculos en via biliar en 21% y dilatación coledociana en 15%. Se realizaron 202 papiloesfinterotomias, se colocaron 58 prótesis y realizaron 40 dilataciones con balón. El 88% de las CPRE fue exitoso siendo la principal complicación la hemorragia leve en 9%. Conclusiones: la CPRE es un procedimiento seguro y efectivo en el tratamiento y diagnóstico de algunas patologías del árbol hepatobiliar, con resultados de morbilidad comparables a los entregados por las series internacionales.

Background: Endoscopic Retrograde Cholangiopancreatography (ERCP) is currently the first choice of treatment for biliopancreatic pathologies, mostly in cases of biliary obstruction and cholangitis, playing a leading role in the treatment of either benign or malign strictures of the biliary tree. Objectives: to present the experience at the Gastroenterology Department of the Antonio Maria Pineda Central University Hospital in patients undergoing ERCP for a biliopancreatic pathology. Materials and methods: a descriptive, retrospective study was conducted by review of clinical histories of patients with biliopancreatic pathology requiring the performance of an ERCP between years 2004-2007, excluding clinical histories with incomplete data. Results: overall, 322 histories were reviewed, 69% of the patients were female and a predominance of subjects aged 30-42 was found. The most frequent indication for ERCP was choledocolithiasis (61%), followed by biliopancreatic neoplasms (17%). The most common echographic findings previous to ERCP were dilation of the biliary tree in 44% and choledocolithiasis in 19% of the cases. Findings on ERCP were mostly odditis (23%), gallstones (21%) and choledocian dilation (16%). 202 papillotomies were performed, 58 prostheses were implanted and 40 balloon dilations were performed. Eighty-eight percent of the ERCPs were successful, with mild bleeding as the most frequent complication (9%). Conclusions: ERCP is both and effective and safe procedure for the treatment and diagnosis of some pathologies of the hepatobiliary tree, with morbidity results matching those seen in international series.

Polimorfismo del codón 72 de TP53 y riesgo de cáncer gástrico: estudio caso-control en individuos de la región centroccidental de Venezuela / TP53 codon 72 polymorphism and gastric cancer risk: a case-control study in individuals from the central-western region of Venezuela

El polimorfismo del codón 72 del gen TP53 ha sido asociado con un riesgo elevado para el desarrollo de cáncer. Este polimorfismo origina dos variantes de la proteína, una con un residuo de Arginina (CGC), y otra con Prolina (CCC). El objetivo del estudio fue analizar la asociación de este polimorfismo con el riesgo de desarrollar cáncer gástrico en individuos procedentes de la región centroccidental de Venezuela, considerada de alto riesgo para esta neoplasia maligna. El ADN fue extraído de biopsias de adenocarcinoma gástrico incluídas en parafina (n = 65) y biopsias endoscópicas de pacientes con gastritis crónica (n = 87). El polimorfismo del codón 72 de TP53 fue determinado por PCR-RFLP. Se observó un incremento significativo de la frecuencia del alelo Arg en los pacientes con cáncer gástrico (P = 0,037), originando un riesgo 4,6 veces mayor (95% IC 1,0-21,3) de desarrollar esta enfermedad. Se evidenció un incremento del genotipo Arg/Arg en adenocarcinoma gástrico poco diferenciado (OR: 3,1; 95% IC 1,0-9,2), y del genotipo Arg/Pro en adenocarcinoma de moderado/buen grado de diferenciación (OR: 3,5; 95% IC 1,1-11,0) al comparar con el grupo de cáncer gástrico, y este último también al contrastar con los individuos con gastritis crónica (OR: 2,4; 95% IC 1,1-5,2). Los resultados de este estudio sugieren que la condición de portador del alelo Arg podría estar asociado con el desarrollo de cáncer gástrico en esta región de Venezuela.

Codon 72 polymorphism of the tumor suppressor gene TP53 has been associated with a higher risk in the development of several types of cancer. The polymorphism results in a variant protein with either an arginine (CGC) or a proline residue (CCC). The aim of this study was to analyze the association of the TP53 codon 72 polymorphism with the risk of developing gastric cancer in a high-risk population from the central-western region of Venezuela. DNA was extracted from paraffin-embedded gastric adenocarcinoma biopsies (n = 65) and endoscopic biopsies from chronic gastritis patients (n = 87). TP53 codon 72 polymorphism was determined by PCR-RFLP from all samples. Patients with gastric cancer had a significantly higher frequency (P = 0.037) of the Arg allele than those with chronic gastritis. A logistic regression analysis suggested that Arg carrier individuals had a 4.6-fold higher risk (95% CI 1.0-21.3) of developing gastric cancer. An increment of the Arg/Arg genotype was observed in poor-differentiated gastric adenocarcinoma (OR: 3.1; 95% CI 1.0-9.2), and of the Arg/Pro genotype in well/ moderate-differentiated adenocarcinoma samples (OR: 3.5; 95% CI 1.1-11.0), when comparing within the gastric cancer samples; and the last group also when contrasting it with chronic gastritis patients (OR: 2.4; 95% CI 1.1-5.2). The results of this study suggest that the carriage of the Arg allele could be associated with the development of gastric cancer in this Venezuelan population.

[Interleukin-1 genetic polymorphism: association with gastric cancer in the high-risk Central-Western population of Venezuela]. / Polimorfismo genético de interleuquina-1: asociación con cáncer gástrico en la población de alto riesgo del Centroccidente de Venezuela.

BACKGROUND: Genetic predisposition may play a role in the prevalence of gastric cancer (GC). AIM: To investigate the relationship between selected interleukin-1 (IL-1) loci polymorphisms and gastric cancer risk in the Central-Western region of Venezuela, where gastric cancer represents the first cause of cancer-related deaths. MATERIAL AND METHODS: In a case-control study we compared the frequencies of IL-1B-511 and IL-1B+3954 biallelic polymorphism, and the pentallelic VNTR of IL-IRN in 84 gastric adenocarcinoma paraffin-embedded biopsies and 84 endoscopic biopsies from cancer-free controls. RESULTS: No significant increase in genotypic frequencies in gastric cancer was observed for any of the IL-1B-511 allelic combinations. However, in a logistic regression analysis, a significant association emerged for the IL-1B+3954C carrier genotype (odds ratio (OR): 6.2; 95% confidence intervals (CI) 1.3-28.8). On the other hand, a significantly higher risk was evidenced for the IL-IRN*2/*2 genotype (OR: 7.0; 95% CI2.3-21.5). Only patients with a well/moderately-differentiated adenocarcinoma that were homozygotes for the E-IRN*2/*2 genotype, had a higher risk than the complete gastric cancer group (OR: 8.1, 95% CI 2.5-26.8). Some genotype combinations among IL-1B-511, IL-1B+3954 and IL-IRN showed an increased risk for developing gastric cancer and well/moderate differentiated adenocarcinoma, that was dependent of the presence of IL-IRN*2/*2 genotype. CONCLUSIONS: IL-IRN*2/*2 genotype is associated with increased risk of gastric cancer in the Venezuelan population.

Frecuencia de consumo de Aines en los pacientes con hemorragia digestiva superior no variceal

Introducción: La eficacia de los AINES contrasta con la aparición de diversas lesiones gastrointestinales, siendo las úlceras gastro-duodenales las de mayor importancia por su frecuencia y potencial de complicaciones. Objetivo: Determinar la frecuencia de consumo de antiinflamatorios no esteroideos (AINE) en los pacientes con hemorragia digestiva superior no variceal. Materiales y métodos: la población estuvo constituida por todos los pacientes con hemorragia digestiva superior que ingresaron al servicio de emergencia del Hospital Central Universitario Antonio María Pineda durante Julio 2007- Enero 2008, excluyéndose a los pacientes con varices esofágicas o cirrosis. Se aplico una entrevista estructurada registrándose los datos de identificación, antecedentes patológicos, consumo de AINE, tipo y tiempo de consumo y hallazgos endoscópicos. Resultados: Se estudiaron 97 pacientes con hemorragia digestiva superior no variceal de los cuales 69 % pertenecía al sexo masculino y 33 % tenían edades comprendidas entre 48 y 62 años. El 57% de los pacientes consumían algún tipo de AINE y 9% refirió recibir más de dos AINE simultáneamente; de estos 64% eran adultos mayores. El AINE consumido con mayor frecuencia fue la Aspirina en 67%. El antecedente patológico más frecuente fue la hipertensión arterial en 50% seguido de las artropatías en 13%. Los hallazgos endoscópicos más frecuentes fueron la Ulcera gástrica en 27% y Gastritis erosiva en 23%. El 85 % de los pacientes recibían AINE con prescripción médica. Conclusiones: La hemorragia digestiva superior no variceal relacionada con el uso de AINE es alta, principalmente en el adulto mayor, siendo el hallazgo endoscópico más frecuente la úlcera gástrica.

Background: efficacy of non-steroidal anti-inflammatory drugs (NSAID) contrasts with the onset of diverse gastrointestinal lesions, being gastroduodenal ulcers the most important of them, given their frequency and potential complications. Objective: Determine the frequency of NSAID use in patients with nonvariceal upper digestive bleeding. Material and methods: the studied population was constituted by all patients with non-variceal higher digestive bleeding admitted to the Emergency Department of Antonio Maria Pineda Central University Hospital from July 2007 to January 2008, excluding patients with esophageal varices and cirrhosis. A structured survey was conducted to collect identification data, pathological background, use of NSAID, type and duration of use, and endoscopic findings. Results: 97 patients with non-variceal upper digestive bleeding were studied, 69% of them were male and 33% were aged from 48 to 62 years. Fifty-two percent of the patients used some type of NSAID and 9% mentioned using more than two NSAIDs simultaneously; 64% were elderly patients. The most frequent NSAID used was aspirin in 67% of the patients. The most common pathological background was high blood pressure in 50%, followed by arthropaties in 13% of the cases. Endoscopic findings were mostly gastric ulcers (27%) and erosive gastritis (23%). Eighty-five percent of the patients were receiving NSAID under medical prescription. Conclusions: non-variceal upper digestive bleeding related to the use of NSAID is frequent, mostly in older patients, being gastric ulcer the most frequent endoscopic finding.

Polimorfismo genético de interleuquina-1: Asociación con cáncer gástrico en la población de alto riesgo del Centroccidente de Venezuela / lnterleukin-1 genetic polymorphism: Association with gastric cancer in the high-risk Central-Western population of Venezuela

Background: Genetic predisposition may play a role in the prevalence of gastric cancer (GC). Aim: To investigate the relationship between selected interleukin-1 (IL-1) loci polymorphisms and gastric cancer risk in the Central-Western region of Venezuela, where gastric cancer represents the first cause of cancer-related deaths. Material and methods: In a case-control study, we compared the frequencies of IL-1B-511 and IL-1B+3954 biallelic polymorphism, and the pentallelic VNTR of IL-IRN in 84 gastric adenocarcinoma paraffin-embedded biopsies and 84 endoscopic biopsies from cancer-free controls. Results: No significant increase in genotypic frequencies in gastric cancer was observed for any of the IL-1B-511 allelic combinations. However, in alogistic regression analysis, a significant association emerged for the IL- 1B+3954C carrier genotype (odds ratio (OR): 6.2; 95% confidence intervals (CI) 1.3-28.8). On the other hand, a significantly higher risk was evidenced for the IL-IRN*2/*2 genotype (OR: 7.0; 95% CI 2.3-21.5). Only patients with awell/moderately-differentiated adenocarcinoma that were homozygotes for the IL-IRN*2/*2 genotype, had a higher risk than the complete gastric cancer group (OR: 8.1, 95% CI 2.5-26.8). Some genotype combinations among IL-1B-511, IL-1B+3954 and IL-IRN showed an increased risk for developing gastric cancer and well/moderate differentiated adenocarcinoma, that was dependent of the presence of IL-IRN*2/*2 genotype. Conclusions: IL-IRN*2/*2 genotype is associated with increased risk of gastriccancer in the Venezuelan population.