Major differences in the larval anatomy of the digestive and excretory systems of three Oestridae species revealed by micro-CT.

Oestrid flies (Diptera: Oestridae) do not feed during the adult stage, so they depend on an efficient assimilation and storage of nutrients during their parasitic larval stage. We describe the general morphology and provide volumetric data for the digestive and excretory organs of the three larval instars of the nasal bot fly Oestrus ovis L., using micro-computed tomography. The size of the digestive and excretory organs greatly increased across larval instars. In all instars, the two salivary glands were remarkably large and formed a 'glandular band' by coming together, but without lumina uniting, at their posterior ends. The distal region of the anterior Malpighian tubules was greatly enlarged and full of highly radio-opaque concretions. Moreover, the anatomy of O. ovis third-instar larva was compared to that of two species of, respectively, similar and different feeding habits: Cephenemyia stimulator (Clark) and Hypoderma actaeon Brauer. Whereas the general morphology and arrangement of the digestive and excretory systems of C. stimulator was similar to that of O. ovis, some differences were observed in H. actaeon: a swollen anterior region of the midgut, salivary glands shorter and not forming a 'band' and anterior Malpighian tubules narrowly uniform throughout their entire length.

Internal morphological changes during metamorphosis in the sheep nasal bot fly, Oestrus ovis.

During the larval stage, oestrid flies (Diptera: Oestridae) are obligate parasites, whereas during the adult stage they are free-living and do not feed. Like other cyclorrhaphous flies, oestrids undergo metamorphosis inside an opaque puparium, formed by the contracted and hardened cuticle of the third-instar larva. The present study documents the internal morphological changes taking place during metamorphosis of the sheep nasal bot fly, Oestrus ovis L., using non-invasive, micro-CT-based virtual histology and provides quantitative data of volumetric changes in specific organs. Virtual histological sections allowed visualisation of the progression and completion of the apolyses, which delimit the different intra-puparial stages, and the connection to the tracheal system of a large gas bubble, which plays an essential role during early metamorphosis. Overall, our results show that the sequence of morphological and volumetric changes in tissues and organs is similar to those found in other cyclorrhaphous flies, but they also reveal developmental differences that result in an adult vestigial digestive tract. Future studies could develop non-invasive, reliable methods for aging the intra-puparial forms of different oestrid species of veterinary importance, based on both qualitative and quantitative markers, thus improving our knowledge of their development and the efficiency of control strategies.

Epidemiología de las intoxicaciones agudas en los servicios de urgencias hospitalarias. Medellín, Colombia / Epidemiology of acute poisoning in the emergency departments. Medellín, Colombia

El presente trabajo tiene como objetivo describir la epidemiología de los pacientes que se presentan con intoxicaciones agudas en los servicios de urgencias de los hospitales de alta complejidad en la ciudad de Medellín entre los años 2010 y 2013, con el propósito de mejorar el manejo de estos pacientes en los servicios de urgencias y contribuir con la actualización de protocolos y guías de atención institucional. Para ello, se realizó un estudio descriptivo retrospectivo de corte transversal, que analizó variables sociodemográficas y clínicas de los pacientes atendidos por intoxicación en los servicios de urgencias de instituciones de alta complejidad participantes de la ciudad de Medellín en un periodo de 4 años. Se realizó el análisis univariado y análisis bivariado con el fin de determinar la relación entre las variables. Como resultados, se incluyeron 244 pacientes intoxicados, con mediana para la edad de 28 años y rango intercuartílico igual a 26. La principal causa de toxicidad fue por intento suicida se presentó en el 60,2%(147) y 39,8%(97) fueron por intoxicaciones accidentales. Las sustancias más frecuentemente utilizadas fueron plaguicidas, analgésicos y psicofármacos. La proporción de letalidad fue de 3%(7), siendo más frecuente en los residentes en área rural (p<0,05). Conclusiones: La intoxicación con intención suicida es más frecuente que la accidental, afectando mayoritariamente a mujeres; implica sobre todo a plaguicidicas, rodenticidas y herbicidas, medicamentos de uso común (analgésicos) y medicamentos psiquiátricos (antidepresivos)

This work describe the epidemiology of patients presenting with acute poisonings to the emergency services of high level hospitals in the city of Medellín between 2010 and 2013, with the purpose of improving the management of these patients in the emergency services and contribute with updating protocols and institutional care guidelines. Methods: Cross-sectional descriptive study, which analyzed epidemiological variables of patients treated for poisoning in the emergency services of the participating institutions of the city of Medellin over a period of 4 years. The SPSS v.21 and Epida v.3.1 programs were used to perform univariate analyzes to characterize and describe the study population and bivariate analysis in order to determine the relationship between the variables. Results: 244 intoxicated patients were included, with median for age of 28 years and interquartile range equal to 26. Of all causes, 60.2% (147) were due to suicide attempt and 39.8% (97) accidental. The most frequently used substances were pesticides, rodenticides and herbicides, commonly used medicines and psychiatric medicines. The lethality proportion was 3% (7), being more frequent among residents of the rural area (p <0.05). Conclusions: Intoxication with suicidal intention is more frequent than accidental poisoning, affecting mainly women; It mainly involves pesticides, rodenticides and herbicides, commonly used medicines (pain killers) and psychiatric drugs (antidepressants)

Examiner dependence on physical diagnostic tests for the detection of splenomegaly: a prospective study with multiple observers.

OBJECTIVE: To determine the reliability and validity of various physical diagnostic techniques (including three methods of palpation and three methods of percussion) in detecting ultrasonographically identified splenomegaly. DESIGN: Prospective, double-blind study. SETTING: University hospital. PATIENTS: Twenty-seven hospitalized male patients with suspected human immunodeficiency virus (HIV) infection. INTERVENTIONS: Three methods of palpation (bimanual, ballottement, and palpation from above) and three methods of percussion (as described by Nixon, Castell, and Barkun et al.) were performed on each patient by eight examiners. Splenic ultrasonography was performed within 96 hours of admission. MEASUREMENTS AND MAIN RESULTS: The prevalence of splenomegaly by ultrasonography (defined as a spleen > or = 13 cm on the longitudinal scan) in this population was 33.3%. The sensitivity and specificity of each method of palpation and percussion varied by examiner. The ranges of sensitivity across examiners for the three methods of palpation and the three methods of percussion were 0%-64.3% and 7.7%-75%, respectively. The ranges of specificity across examiners for the three methods of palpation and the three methods of percussion were 50%-100% and 60%-100%, respectively. Likelihood ratios pooled across observers revealed that for palpation, palpation from above, and percussion, Castell's method had the highest likelihood ratios [LR = 2.66 and 1.97, respectively; 95% CI = 1.52-4.64 and 1.22-3.19, respectively]. A combination of tests (either palpation or percussion) increased the diagnostic accuracy. CONCLUSION: Physical diagnostic techniques for the detection of splenomegaly are relatively insensitive but specific. In this study there was high interobserver variability, which did not appear to be associated to the level of experience. Combining tests increases diagnostic accuracy.

[Aplasia cutis congenita]. / Aplasia cutis congénita.

Communication of fifteen cases of Aplasia Cutis Congenita, seen from 1971 to 1977, in the Department of Pediatric Dermatology at the Hospital del Niño DIF (formerly IMAN). Patients of both sexes were equally affected. The scalp was by far the most common location of lesions. Lesiones were usually single and when multiple, they were symmetrical. The family history for the disease was negative. No relationship could be found with obstetric trauma or with the number of pregnancies. Epithelialized lesions were present in fourteen cases and ulcerated lesions in one. The more frequent congenital associated malformations were: cutaneous, neurological, ocular and osseous.