RESUMEN

OBJECTIVE: The aim of the study was to present our experience with the vertical musculocutaneous trapezius (VMCT) flap and highlight its utility in the thoracic wall reconstruction in patients with bronchopleural fistula (BPF). MATERIALS AND METHODS: We present a five case series of patients with long-standing cavities and BPF. The VMCT flap was used, and a direct pathway into the defect was made through a separate posterior thoracotomy shortening the distance between the flap and the defect. RESULTS: In 80% of the cases, the flap succeeded in solving the fistula and filling the defect, quality of life improved, and the need for oxygen decreased. CONCLUSIONS: Management of open window thoracostomy is challenging. Debridement, thoracoplasty, and flap coverage are the mainstream of their treatment, but these patients have scarce available muscle. The VMCT flap represents the major non-affected musculocutaneous unit in the thoracic area after lung surgery. Its dermal component offers a rigid matrix to form a seal over the bronchial stump. Its muscular component adds a good amount of vascularized tissue. No functional impairment has been described after its use.

---

OBJETIVO: Exponer nuestra experiencia con el colgajo vertical de trapecio y destacar su utilidad en la reconstrucción de la pared torácica en pacientes con fístulas broncopleurales. MATERIAL Y MÉTODOS: Presentamos una serie de cinco pacientes con cavidades y fístulas broncopleurales de larga evolución. Utilizamos el colgajo musculocutáneo vertical de Trapecio, con un redireccionamiento del mismo a través de una ventana costal que permite acortar la distancia entre el colgajo y el defecto. RESULTADOS: La fístula y el defecto fueron solucionados en el 80% de los casos. La calidad de vida mejoró y las necesidades de oxígeno disminuyeron. CONCLUSIONES: El manejo de las toracotomías es un reto. El desbridamiento, toracoplastia y cobertura con colgajo son los pilares de su tratamiento, pero estos pacientes tienen escasa disponibilidad muscular. El colgajo musculocutáneo vertical de Trapecio representa la mayor unidad intacta musculocutánea en el tórax tras cirugía pulmonar. Su componente dérmico ofrece una matriz rígida para sellar el muñón bronquial, su componente muscular añade una gran cantidad de tejido vascularizado. No se han descrito déficits funcionales tras su uso.

Asunto(s)

Fístula Bronquial , Empiema Pleural , Enfermedades Pleurales , Músculos Superficiales de la Espalda , Humanos , Empiema Pleural/etiología , Empiema Pleural/cirugía , Calidad de Vida , Colgajos Quirúrgicos/efectos adversos , Enfermedades Pleurales/etiología , Enfermedades Pleurales/cirugía , Fístula Bronquial/etiología , Fístula Bronquial/cirugía , Neumonectomía

RESUMEN

The efficacy of the combination of milbemycin oxime and afoxolaner was evaluated in desert tortoises infested with fly larvae. Oral administration of the combination of milbemycin oxime and afoxolaner eliminated the infestation without generating any evident adverse effects on the tortoises.

---

L'efficacité de la combinaison de milbémycine oxime et d'afoxolaner a été évaluée chez des tortues du désert infestées par des larves de mouches. L'administration orale de la combinaison de milbémycine oxime et d'afoxolaner traite l'infestation sans générer d'effets indésirables évidents sur les tortues.

---

A eficácia da associação de milbemicina oxima e afoxolaner foi avaliada em tartarugas do deserto infestadas por larvas de moscas. A administração oral da combinação de afoxolaner e milbemicina oxima eliminou a infestação sem gerar nenhum efeito adverso evidente às tartarugas.

---

Se evaluó la eficacia de la combinación de milbemicina oxima y afoxolaner en tortugas del desierto infestadas con larvas de mosca. La administración oral de la combinación de milbemicina oxima y afoxolaner eliminó la infestación sin generar efectos adversos evidentes en las tortugas.

Asunto(s)

Enfermedades de los Perros , Moscas Domésticas , Miasis , Tortugas , Animales , Perros , Macrólidos/uso terapéutico , Miasis/veterinaria , Administración Oral , Enfermedades de los Perros/tratamiento farmacológico

RESUMEN

Bovine genital campylobacteriosis (BGC) is a leading cause of return to estrus in cows. The etiologic agent, Campylobacter fetus subsp. venerealis (Cfv) is transmitted by venereal route. Hence, the surrounding reproductive tract microenvironment could play a role in return to estrus in cows. The presence of Cfv in cervicovaginal mucus of Angus breed females provide three experimental groups, which were subject to bacteriome analyses: 10 Cfv-positive cows (CVP), 10 Cfv-negative cows (CVN), and 10 nonsexually active heifers (NSA). Cows with return to estrus showed higher bacterial richness than NSA. Beta diversity analysis showed a significant difference (P = 0.006) in bacterial composition among the three groups analyzed (CVP, CVN, and NSA). However, no significant difference was found when comparing the CVP versus CVN groups. Ureaplasma and Pseudomonas were the genera most frequently observed in NSA, being Ureaplasma the predictor genus to that group, whereas Alistipes, Bacteroides, Rikenellaceae_RC9_gut_group, UCG-005, and UCG-10 were both significantly more abundant and predictors genera in cows with return to estrus. Our results provide an overview of the cervicovaginal bacterial microbiota in cows harboring Cfv and improve the knowledge of the pathogenesis of BGC.

Asunto(s)

Infecciones por Campylobacter , Campylobacter fetus , Bovinos , Animales , Femenino , Campylobacter fetus/genética , Infecciones por Campylobacter/veterinaria , Infecciones por Campylobacter/microbiología , Moco

RESUMEN

Abstract Tranexamic acid (TXA) significantly reduces blood loss in a wide range of surgical procedures and improves survival rates in obstetric and trauma patients with severe bleeding. Although it mainly acts as a fibrinolysis inhibitor, it also has an anti-inflammatory effect, and may help attenuate the systemic inflammatory response syndrome found in some cardiac surgery patients. However, the administration of high doses of TXA has been associated with seizures and other adverse effects that increase the cost of care, and the administration of TXA to reduce perioperative bleeding needs to be standardized. Tranexamic acid is generally well tolerated, and most adverse reactions are considered mild or moderate. Severe events are rare in clinical trials, and literature reviews have shown tranexamic acid to be safe in several different surgical procedures. However, after many years of experience with TXA in various fields, such as orthopedic surgery, clinicians are now querying whether the dosage, route and interval of administration currently used and the methods used to control and analyze the antifibrinolytic mechanism of TXA are really optimal. These issues need to be evaluated and reviewed using the latest evidence to improve the safety and effectiveness of TXA in treating intracranial hemorrhage and bleeding in procedures such as liver transplantation, and cardiac, trauma and obstetric surgery.

Asunto(s)

Humanos , Femenino , Embarazo , Ácido Tranexámico/efectos adversos , Antifibrinolíticos , Pérdida de Sangre Quirúrgica , Procedimientos Ortopédicos , Hemorragia

RESUMEN

Liver lipidosis is a metabolic disorder mostly observed in high yielding dairy cattle, especially during the transition period. The aim of this study was to determine the correlation between hepatic lipid infiltration, biochemical indicators of liver function, and body condition score (BCS) variation in dairy cows. Fifty-one multiparous Holstein cows raised in a confined system were evaluated. Liver biopsies and blood samples were collected, and BCS was measured on days 3 and 28 postpartum. Lipid infiltration was determined by histologic examination. The plasma activity of aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase and concentration of beta-hydroxybutyrate, non-esterified fatty acids, albumin, total bilirubin, and cholesterol were determined. BCS was measured using objective (camera) and subjective (visual) methods. Mild lipid infiltration was found in 3.92% of cows sampled on day 3 and 5.88% on day 28. Bilirubin was significantly higher on day 3 than on day 28 postpartum, and cholesterol was significantly higher on day 28 than on day 3 in all cows. There was no difference in biochemical analytes between cows with and without lipidosis. On day 3, mean subjective BCS was 3.10 and objective BCS was 3.16, while on day 28, these scores were 2.91 and 2.99, respectively. The calculated liver function index (LFI) was found to be a more sensitive indicator of liver function than the hepatic analytes evaluated. No correlation between BCS variation and lipid infiltration was found. Cholesterol and bilirubin levels showed the most remarkable changes during the early postpartum period. LFI is a potential indicator of postpartum liver function.

---

A lipidose hepática é um distúrbio metabólico principalmente observado nos bovinos de leite de alto rendimento, especialmente no período de transição. O objetivo deste estudo foi determinar a correlação entre infiltração lipídica hepática, indicadores bioquímicos de função hepática e variação da condição corporal em bovinos leiteiros. Foram avaliadas cinquenta e um vacas multíparas de raça Holandesa em confinamento. Coletaram-se biopsias de fígado e amostras de sangue, e a condição corporal (BCS) aferiu-se nos dias 3 e 28 pós-parto. A infiltração lipídica determinou-se mediante avaliação histológica. Mensuraram-se a atividade da aspartato aminotransferase, fosfatase alcalina e da gama-glutamil transferase, concentração de beta-hidroxibutirato, ácidos graxos não esterificados, albumina, bilirrubina total e colesterol. A BCS mediu-se utilizando método objetivo (câmera) e subjetivo (visualmente). Observou-se discreta infiltração lipídica em 3,92% dos bovinos amostrados no dia 3 e 5,88% no dia 28. Em todos os bovinos a bilirrubina foi significativamente mais alta no dia 3 do que no dia 28 e o colesterol foi superior no dia 28 do que no dia 3. Não houve diferença nos analitos bioquímicos dos bovinos com e sem lipidose. No dia 3, a média subjetiva da BCS foi 3,10 e a objetiva 3,16, enquanto no dia 28, obtiveram-se valores de 2,91, e 2,99 respectivamente. O índice calculado de função hepática mostrou ser um indicador mais sensível da função hepática do que os analitos avaliados individualmente. Não houve correlação entre a variação do BCS e infiltração lipídica.

RESUMEN

Tranexamic acid (TXA) significantly reduces blood loss in a wide range of surgical procedures and improves survival rates in obstetric and trauma patients with severe bleeding. Although it mainly acts as a fibrinolysis inhibitor, it also has an anti-inflammatory effect, and may help attenuate the systemic inflammatory response syndrome found in some cardiac surgery patients. However, the administration of high doses of TXA has been associated with seizures and other adverse effects that increase the cost of care, and the administration of TXA to reduce perioperative bleeding needs to be standardized. Tranexamic acid is generally well tolerated, and most adverse reactions are considered mild or moderate. Severe events are rare in clinical trials, and literature reviews have shown tranexamic acid to be safe in several different surgical procedures. However, after many years of experience with TXA in various fields, such as orthopedic surgery, clinicians are now querying whether the dosage, route and interval of administration currently used and the methods used to control and analyze the antifibrinolytic mechanism of TXA are really optimal. These issues need to be evaluated and reviewed using the latest evidence to improve the safety and effectiveness of TXA in treating intracranial hemorrhage and bleeding in procedures such as liver transplantation, and cardiac, trauma and obstetric surgery.

Asunto(s)

Antifibrinolíticos , Procedimientos Ortopédicos , Ácido Tranexámico , Embarazo , Femenino , Humanos , Ácido Tranexámico/efectos adversos , Hemorragia , Pérdida de Sangre Quirúrgica

RESUMEN

Background: Primary erythrocytosis is a rare myeloproliferative disorder in dogs and cats characterized by an autonomous proliferation of erythroid precursors in the bone marrow, with low to normal serum erythropoietin concentration, resulting in elevated red blood cell count, hematocrit and hemoglobin concentration. Clinical signs are associated with increased blood volume and viscosity, and may include erythema, hyperemic mucous membranes and neurological signs such as seizures and ataxia. In veterinary medicine, the diagnosis should be made by exclusion of secondary or relative causes, after complementary exams. This report aims to describe a case of primary erythrocytosis in a bitch. Case: A 4-year-old mixed-breed bitch was referred to the Veterinary Medical Teaching Hospital from UFRGS with 3 convulsive episodes related by the owner. A previous abdominal ultrasonography revealed splenomegaly and the electrocardiogram showed no abnormalities. No alterations were observed at the physical examination. The laboratorial blood tests demonstrated a persistent erythrocytosis, with high hematocrit, hemoglobin and red blood cells count, thrombocytopenia and neutropenia, and total plasmatic protein within the reference interval. The bone marrow cytology revealed reduced cellularity, normal myeloid:erythroid ratio, erythroid hyperplasia, mild myeloid hyperplasia and moderate myelofibrosis. The serum erythropoietin measurement was within the reference range, and the blood gas analysis detected a slight decrease in partial oxygen pressure. Therefore, no evidence of secondary conditions was observed and the diagnosis of primary erythrocytosis could be made. Discussion: Since there is no definitive method, the diagnosis of primary erythrocytosis could be based on the exclusion of all secondary and relative causes of erythrocytosis. The absence of clinical signs of dehydration and high serum albumin levels were findings that conduced for the exclusion of the relative form of the disturbance. The echocardiography and the abdominal ultrasonography ruled out any cardiopulmonary condition or kidney neoplasm, the most common causes of absolute secondary erythrocytosis. The persistently high hematocrit levels and red blood cell counts are significant for the suspicion of primary erythrocytosis, although thrombocytopenia and neutropenia are not commonly reported. The clinical signs of seizure were correlated with increased blood viscosity and reduced blood flow at the central nervous system. The blood gas analysis discarded the occurrence of systemic hypoxia, and the normal levels of erythropoietin gives higher evidence of the occurrence of an autonomous proliferation of the erythroid precursors within the bone marrow. The bone marrow cytology confirmed erythroid hyperplasia and the reduced cellularity that could be attributed to myelofibrosis. Myelofibrosis was described in humans with polycythemia vera, but there are no reports in veterinary, and this occurrence must be elucidated. An identical mutation in the JAK2 gene was observed in humans with polycythemia vera and dogs with primary erythrocytosis, and occurs in more than 50% of humans with myelofibrosis. Further investigations are necessary for veterinary medicine. In conclusion, the systematic approach of all organic systems and the assessment of complementary exams are necessary for the diagnostic of primary erythrocytosis in dogs. This condition should be considered in the differential diagnosis of any erythrocytosis, considering the guarded prognosis of this hematologic disorder.

Asunto(s)

Animales , Femenino , Perros , Policitemia/veterinaria , Eritropoyetina/análisis , Mielofibrosis Primaria/veterinaria , Esplenomegalia/veterinaria , Ultrasonografía/veterinaria

RESUMEN

Trichophyton benhamiae was diagnosed in a 9-year-old female dog by histopathological evaluation, fungal culture and confirmation by sequencing of the internal transcribed spacer region of ribosomal DNA. Successful therapy was achieved with itraconazole, bathing with miconazole and chlorhexidine shampoo, and topical application of sodium hypochlorite as a rinse.

---

Trichophyton benhamiae a été diagnostiqué chez une chienne de 9 ans par examen histopathologique, culture fongique et confirmation par séquençage de la région ITS (internal trasbcriber spacer) de l'ADN ribosomique. Une guérison thérapeutique a été obtenue par de l'itraconazole, des shampooings de miconazole et chlorhexidine et application topique d'hypochlorite de sodium en rinçage.

---

Trichophyton benhamiae foi diagnosticado em uma cadela de 9 anos através de avaliação histopatológica, cultura de fungos e confirmação por sequenciamento da região espaçadora transcrita interna do DNA ribossomal. Sucesso terapêutico foi obtido com o uso de itraconazol, banho com shampoo à base de miconazol e clorexidina e aplicação tópica de hipoclorito de sódio.

---

Se diagnosticó infección por Trichophyton benhamiae en una perra de 9 años mediante evaluación histopatológica, cultivo de hongos y confirmación mediante secuenciación de la región espaciadora transcrita interna del DNA ribosómico. Se logró un tratamiento exitoso con itraconazol, baños con champú de miconazol y clorhexidina y aplicación tópica de hipoclorito de sodio como enjuague.

Asunto(s)

Enfermedades de los Perros , Tiña , Animales , Arthrodermataceae , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/tratamiento farmacológico , Perros , Femenino , Itraconazol/uso terapéutico , Miconazol/uso terapéutico , Tiña/diagnóstico , Tiña/tratamiento farmacológico , Tiña/veterinaria , Trichophyton

RESUMEN

Plasmodium parasites' invasion of their target cells is a complex, multi-step process involving many protein-protein interactions. Little is known about how complex the interaction with target cells is in Plasmodium vivax and few surface molecules related to reticulocytes' adhesion have been described to date. Natural selection, functional and structural analysis were carried out on the previously described vaccine candidate P. vivax merozoite surface protein 10 (PvMSP10) for evaluating its role during initial contact with target cells. It has been shown here that the recombinant carboxyl terminal region (rPvMSP10-C) bound to adult human reticulocytes but not to normocytes, as validated by two different protein-cell interaction assays. Particularly interesting was the fact that two 20-residue-long regions (388DKEECRCRANYMPDDSVDYF407 and 415KDCSKENGNCDVNAECSIDK434) were able to inhibit rPvMSP10-C binding to reticulocytes and rosette formation using enriched target cells. These peptides were derived from PvMSP10 epidermal growth factor (EGF)-like domains (precisely, from a well-defined electrostatic zone) and consisted of regions having the potential of being B- or T-cell epitopes. These findings provide evidence, for the first time, about the fragments governing PvMSP10 binding to its target cells, thus highlighting the importance of studying them for inclusion in a P. vivax antimalarial vaccine.

Asunto(s)

Antígenos de Protozoos/metabolismo , Plasmodium vivax/metabolismo , Proteínas Protozoarias/metabolismo , Reticulocitos/parasitología , Secuencia de Aminoácidos , Animales , Antígenos de Protozoos/química , Antígenos de Protozoos/genética , Sitios de Unión/genética , Secuencia Conservada , Epítopos/química , Epítopos/genética , Epítopos/metabolismo , Genes Protozoarios , Humanos , Técnicas In Vitro , Malaria Vivax/sangre , Malaria Vivax/parasitología , Modelos Moleculares , Fragmentos de Péptidos/química , Fragmentos de Péptidos/genética , Fragmentos de Péptidos/metabolismo , Plasmodium vivax/genética , Plasmodium vivax/patogenicidad , Dominios Proteicos/genética , Proteínas Protozoarias/química , Proteínas Protozoarias/genética , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Reticulocitos/metabolismo , Electricidad Estática

RESUMEN

BACKGROUND AND AIM: Rabbits often experience skin diseases. The beneficial effects of plant extracts and essential oils are well known in other species, but the properties of these natural ingredients have not been evaluated in rabbits in vivo. The objective of the current study was to evaluate the effect of a topical, commercial solution made of essential oils, plant-extracted polyunsaturated fatty acids, and Vitamin E on rabbits suffering from skin problems. MATERIALS AND METHODS: Thirty New Zealand rabbits (no sex distinction) were included in this study, with an average weight of 2-3 kg. The rabbits were divided into two groups: The first group was treated with a topical solution made from natural ingredients, and the second was a control group. The rabbits' hair and skin conditions were evaluated on days 1, 14, 28, and 35 after treatment. Data were analyzed using a Kruskal-Wallis range test. RESULTS: Significant differences were determined in terms of glossy hair variability on days 28 and 35 (p≤0.0001). On days 14-35, hair loss was determined to have reduced (p=0.001), and flaking and odor improved in the treatment group, showing increased scores and significant differences (p=0.0001). By contrast, the control group showed stable overall skin and hair score and an increase in the dryness score. CONCLUSION: The topical application of essential oils and polyunsaturated fatty acids with Vitamin E was able to improve hair shine and skin hydration and reduce flaking, bad odor, and hair loss, improving the general, and cutaneous aspect of rabbits.

RESUMEN

Objetivo: determinar los niveles de estrés que experimentan los estudiantes de enfermería que realizan sus prácticas clínicas en una institución universitaria de la ciudad de Cartagena (Colombia). Materiales y métodos: se realizó un estudio descriptivo, transversal, con una muestra de 98 estudiantes de enfermería matriculados en semestres de IV a IX. Se aplicó cuestionario KEZKAK sobre percepción de estrés en estudiantes de enfermería en prácticas clínicas. Los análisis emplearon estadística descriptiva. Resultados: los estudiantes tuvieron edades comprendidas entre 20 ­ 24 años (61,2%), fueron mujeres (93,9%). Presentaron nivel alto de estrés (51%), durante las prácticas clínicas por considerar falta de competencias (68,4%), impotencia e incertidumbre, y el enfermo busca una relación íntima y/o amorosa con 48% respectivamente. Conclusiones: los estudiantes evidencian que la falta de competencias al brindar cuidado a los pacientes en situaciones críticas, se convierte en un determinante generador de estrés..Au

---

Objective: to determine the levels of stress experienced by nursing students who carry out their clinical practices in a university institution in the city of Cartagena (Colombia).Materials and methods: a descriptive, cross-sectional study was carried out.With a sample of 98 Nursing students enrolled in semesters from IV to IX. A KEZKAK questionnaire on the perception of stress in nursing students in clinical practices was applied. The analyzes were performed using descriptive statistics. Results: the students were aged 20-24 years (61.2%), were women (93.9%).They presented a high level of stress (51%), during clinical practices because they considered lack of skills (68.4%) impotence and uncertainty, and the patient seeks an intimate and / or loving relationship with 48%, respectively. Conclusions: students show that the lack of skills in providing care to patients in critical situations becomes a determinant of stress..Au

Asunto(s)

Adulto Joven , Estrés Fisiológico , Estudiantes de Enfermería

RESUMEN

Lice are ectoparasites capable of affecting birds, and can result in direct and indirect damage to their host. Afoxolaner is an isoxazoline that has been shown to be effective against these ectoparasites without known adverse effects. The objective of this research was to evaluate the effect of afoxolaner on lice in pheasants and plain chachalacas. A total of 29 pheasants of different genera and species (Chrysolophus pictus, C. amherstiae, Lophura swinghoii, L. nycthemera, Phasianus colchicus, and Syrmaticus reevesii) and 18 West Mexican Chachalacas (Ortalis poliocephala) naturally infested with Goniodes pavonis were used. The birds were allocated to one of two groups: group 1 treated with 2.50 mg/kg of afoxolaner, and group 2 given no treatment. Ectoparasites were collected using the adhesive tape technique and identified. Afoxolaner was administered later as a single dose to group 1, and the clinical assessment to detect ectoparasites was repeated 28 days post-treatment. On day 28 post-treatment, group 1 was found to be negative for the presence of lice. The body weights were compared at the beginning and end of the clinical assessment in both groups and a significant difference in weight of treated birds was found. The mean body weight decreased by 0.017 g in control group, whereas it increased by 0.016 g in treated group. Oral administration of afoxolaner is an effective option for the treatment of Goniodes pavonis infestations in zoo birds.

Asunto(s)

Enfermedades de las Aves/prevención & control , Galliformes , Control de Insectos , Insecticidas , Ischnocera , Isoxazoles , Infestaciones por Piojos/veterinaria , Naftalenos , Animales , Enfermedades de las Aves/parasitología , Infestaciones por Piojos/parasitología , Infestaciones por Piojos/prevención & control

RESUMEN

The wheat flour tortilla (WFT) is a Mexican food product widely consumed in the world, despite lacking fiber and micronutrients. Ramón seed flour (RSF) is an underutilized natural resource rich in fiber, minerals and bioactive compounds that can be used to improve properties of starchy foods, such as WFT. The study evaluated the impact of partial replacement of wheat flour with RSF on the physicochemical, sensory, rheological and nutritional properties and antioxidant capacity (AC) of RSF-containing flour tortilla (RFT). Results indicated that RFT (25% RSF) had higher dietary fiber (4.5 times) and mineral (8.8%; potassium 42.8%, copper 33%) content than WFT. Two sensory attributes were significantly different between RTF and WFT, color intensity and rollability. RFT was soft and it was accepted by the consumer. Phenolic compounds (PC) and AC were higher in RFT (11.7 times, 33%-50%, respectively) than WFT. PC identification by ultra-performance liquid chromatography quadrupole time of flight mass spectrometry (UPLC-QTOF-MS) showed that phenolic acids esterified with quinic acid, such as chlorogenic and other caffeoyl and coumaroyl derivatives were the major PC identified in RSF, resveratrol was also detected. These results show that RSF can be used as an ingredient to improve nutritional and antioxidant properties of traditional foods, such as the WFT.

RESUMEN

RESUMEN El hiperadrenocorticismo (HAC) es una de las endocrinopatías más frecuentes en caninos, producida por la síntesis excesiva de cortisol. El HAC atípico u oculto es un síndrome caracterizado por la presentación de alteraciones clínicas, bioquímicas e imagenológicas compatibles con hipercortisolismo, pero con resultados normales en las pruebas endocrinológicas utilizadas convencionalmente para diagnóstico de HAC. Sin embargo, estos pacientes presentan elevada concentración sérica de precursores u otras hormonas corticoadrenales. El presente estudio describe el caso de una canina hembra, Bichón Frisé de 8 años de edad, epiléptica y tratada con fenobarbital, presentando signos clínicos asociados a HAC, en la que el test de supresión con dexametasona a dosis bajas y de estimulación con ACTH arrojaron valores normales. La medición de esteroides adrenales, post estimulación con ACTH, mostró elevación anormal de estrógenos y progesterona, persistiendo esta última después de que la paciente fuera esterilizada. El tratamiento con trilostano permitió la disminución de los niveles de progesterona y la resolución parcial de los signos clínicos. Sin em bargo, la recuperación clínica en su totalidad sólo se obtuvo después del diagnóstico y tratamiento del hipotiroidismo concomitante. El desafio que representa el diagnóstico del HAC atípico resalta la importância de realizar y disponer de paneles que incluyan medición de hormonas esteroideas adrenales diferentes al cortisol, además de considerar la ocurrencia de otras enfermedades endocrinas metabólicas concomitantes.

---

ABSTRACT Hyperadrenocorticism (HAC) is one of the most common endocrinopathies in dogs, caused by excessive synthesis of cortisol. Atypical or occult HAC is a syndrome characterized by the presentation of clinical, biochemical, and imaging alterations compatible with hypercortisolism, but normal results in endocrine tests that are conventionally used for HAC diagnosis. However, these patients present high serum concentrations of precursors or other corticoadrenal hormones. The present study describes the case of an 8 years old female canine, Bichón Frisé, epileptic and treated with phenobarbital, presenting clinical signs associated with HAC, in which the low-dose dexamethasone suppression test and stimulation with ACTH resulted within normal values. The measurement of adrenal steroids, after ACTH stimulation, showed abnormal elevation of estrogen and progesterone, the latter persisting after the patient was spayed. Treatment with trilostane allowed the reduction of progesterone levels and the partial resolution of clinical signs. However, full clinical recovery was only achieved after the diagnosis and treatment of concomitant hypothyroidism. The challenge that represent the diagnosis of atypical HAC highlights the importance of performing and having availability of panels that include measurement of adrenal steroid hormones other than cortisol, as well as considering the occurrence of other concomitant endocrine metabolic diseases.

Asunto(s)

Esteroides , Hiperfunción de las Glándulas Suprarrenales , Perros

RESUMEN

Objetivo: Descrever o significado desde o olhar cultural que atribuem puérperas com morbidade materna extrema a sua internação na Unidade de Terapia Intensiva (UTI). Materiais eMétodos: Estudo qualitativo com abordagem etnográfica, utilizou-se como referente teórico a Madeleine Leininger. As entrevistas a profundidade e a aná-lise qualitativa realizou-se considerando o método de James Spradley. Obtiveram--se 21 entrevistas a profundidade em 9 mulheres puérperas com morbidade materna extrema e estiveram internadas numa UTI de uma clínica da cidade de Sincelejo, Sucre, Colômbia entre março e dezembro de 2017. Resultados: Os significados que atribuíram as puérperas com morbidade materna extrema respeito à sua internação na UTI incluíram oito domínios: conhecimento dos sinais de alarma, temor da mor-te, muito difícil para o meu parceiro, adiamento da amamentação, retorno à clinica, minha família cuida de mim, a enfermeira me cuida e aprender dessa experiência.Conclusões: Os significados de puérperas com morbidade materna extrema estão carregados de experiências, crenças culturais e sentimentos, onde o cuidado compas-sivo e congruente de enfermagem ajuda na sua sobrevivência e a internação na UTI constitui-se num ensinamento para a vida.

---

Objetivo: Describir el significado desde lo cultural que atribuyen puérperas con Morbilidad Materna Extrema a su hospitalización en la Unidad de Cuidados Intensi-vos. Materiales y Métodos: Estudio cualitativo con abordaje etnográfico, utilizando como referente teórico a Madeleine Leininger. Las entrevistas a profundidad y el análisis cualitativo se realizaron teniendo en cuenta el método de James Spradley. Se efectuaron 21 entrevistas a profundidad a 9 puérperas con Morbilidad Materna Extrema que estuvieron hospitalizadas en la Unidad de Cuidados Intensivos de una clínica de la ciu-dad de Sincelejo-Sucre - Colombia entre marzo y diciembre de 2017. Resultados: Los significados que atribuyen puérperas con Morbilidad Materna Extrema sobre su hospitalización en la Unidad de Cuidados Intensivos incluyeron 8 dominios: conocimiento de los signos de alarma, temor a morir, muy difícil para mi compañero, aplazar la lactancia materna, de regreso a la clínica, mi familia me cuida, la enfermera me cuida y aprender de esta experiencia. Conclusiones: Los significados de puérperas con Morbilidad Materna Extrema están colmados de experiencias, creencias culturales y sentimientos, donde el cuidado compasivo y congruente de enfermería les ayuda a sobrevivir y la hospitalización en la UCI se constituye en una enseñanza para la vida.

---

Objective: To describe the cultural significance attributed by postpartum women with Extreme Maternal Morbidity to their hospitalization in the Intensive Care Unit. Materials and Methods: Qualitative study with ethnographic approach, using Madeleine Leininger as theoretical reference. In-depth interviews and qualitative analysis were carried out using James Spradley's method. Twen-ty-one in-depth interviews were conducted with nine postpartum women with Extreme Maternal Morbidity who were hospitalized in the Intensive Care Unit of a clinic in the city of Sincelejo-Sucre - Colombia between March and December 2017. Results: The meanings attributed by postpartum women with Extreme Maternal Morbidity to their hospitalization in the Intensive Care Unit included 8 domains: knowledge of alarm signs, fear of death, very difficult for my partner, postponement of breastfeeding, return to the clinic, my family cares for me, the nurse cares for me and learning from this experience. Conclusions: The meanings of postpartum with Extreme Maternal Morbidity are full of experiences, cultural beliefs and feelings, where compassionate and congruent nursing care helps them to survive and hospitalization in the ICU becomes a teaching for life

Asunto(s)

Cuidados Críticos , Enfermería , Cultura , Periodo Posparto

RESUMEN

El uso indiscriminado de antibióticos y el mal manejo de los mismos por parte del personal médico es un problema frecuente a nivel mundial, esto ha incrementado la resistencia bacteriana, los costos del tratamiento y ha creado la necesidad de contar con nuevos antibióticos, frecuentemente más costosos y de mayor toxicidad.Objetivo : evaluar el uso de antibióticos profilácticos en pacientes sometidos a cirugías electivas limpias, en centros privados del estado Aragua, en el periodo comprendido entre febrero y agosto del año 2019.Métodos : estudio prospectivo, observacional, comparativo, longitudinal. La muestra fue no probabilística intencional, se dividió en 2 grupos: grupo A, a quienes se les administró antibioticoterapia profiláctica, y un grupo B, a quienes no se les administró antibiótico.Resultados : Se incluyeron 49 pacientes sometidos a cirugías electivas limpias de tipo colecistectomías (14/28.57%), herniorrafía umbilical (6/12.24%) y hernioplastia inguinal (29/59.18%). La edad promedio fue de 37,7±12,17 años. Predomino el sexo masculino. Al quinto día del postoperatorio no se observaron signos de complicación infecciosa en los grupos A y B. Al décimo día de postoperatorio se observaron signos de complicación infecciosa en un paciente (4.3%) perteneciente al grupo A. No se observó complicación infecciosa en el grupo sin administración de antibiótico, grupo B.Conclusión : La indicación y mantenimiento por 7-10 días de antibiótico profiláctico en cirugía limpia no presenta diferencia en la presentación de complicaciones infecciosas comparado con la no administración de antibióticos para este tipo de cirugía, con el riesgo potencial de producción de efectos adversos y desarrollo de resistencia bacteriana(AU)

---

The indiscriminate use of antibiotics and their mishandling by medical personnel is a frequent problem worldwide, which has increased bacterial resistance, treatment costs and the need for new antibiotics, often more expensive and of greater toxicity.Objective : to evaluate the use of prophylactic antibiotics in patients undergoing clean elective surgeries, in private centers in the Aragua state, in the period between February and August of 2019.Methods : we conducted a prospective, longitudinal, observational, analytical epidemiological clinical study. The participants consisted of non-probabilistic sample of the intentional type of 49 patients of the total study population, undergoing elective surgery, cholecystectomy (14 / 28.57%), umbilical herniorrhaphy (6 / 12.24%) and inguinal hernioplasty (29 /59.18%). The sample was classified into 2 groups, a group A, who received prophylactic antibiotic therapy and a group B, who did not receive it.Results : the mean age was 37.7 ± 12.17 years, predominantly male. On the fifth day of the postoperative period, no signs of infectious complication were observed neither in group A nor in group B. On the tenth day after the postoperative period, signs of infectious complication were observed in one patient (4.3%) belonging to the antibiotic administration group. No infectious complication was observed in the group without antibiotic administration.Conclusion : it was confirmed that the administration of antibiotics does not reduce the incidence of infection, when comparing an experimental group with a control group(AU)

Asunto(s)

Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Colecistectomía , Farmacorresistencia Bacteriana , Hernia Inguinal , Hernia Umbilical , Antibacterianos/uso terapéutico , Periodo Posoperatorio , Cirugía General , Incidencia

RESUMEN

Introducción. Babesia bovis es el principal agente causal de la babesiosis bovina, una importante enfermedad veterinaria transmitida por garrapatas a nivel mundial. Las estrategias convencionales para controlar esta parasitosis han presentado múltiples limitaciones por lo que el desarrollo de una vacuna basada en antígenos representa una estrategia apropiada para la prevención y el tratamiento. Objetivo. Describir los aspectos relevantes del ciclo de vida del parásito B. bovis, la epidemiología, diagnóstico y la aplicación de diferentes estrategias usadas para controlar esta parasitosis. Además, se discuten potenciales puntos de intervención para desarrollar una vacuna contra este parásito. Metodología. Se realizó una búsqueda en las bases de datos usando los términos: "Babesia bovis AND lyfe cycle", "B. bovis vaccine and Vaccine candidates", entre otras. Los estudios con mayor pertinencia publicados hasta la actualidad se revisaron completamente. Resultados. Los detalles de la biología de parásito B. bovis y el proceso molecular usado para ocasionar la enfermedad en el hospedador son poco conocidos, lo que explica que el desarrollado de estrategias para el control de esta parasitosis no hayan sido del todo eficientes. Por lo tanto, se requiere diseñar nuevas medidas, por ejemplo, desarrollar vacunas de nueva generación basadas en un enfoque funcional que permitan mejorar las condiciones de sanidad animal. Conclusiones. Comprender el complejo ciclo de vida de B. bovis permitirá estudiar las interacciones huésped-parásito-garrapata e identificar moléculas implicadas en la adhesión/invasión celular para evaluar su utilidad como componente de una vacuna que controle esta parasitosis.

---

Introduction. Babesia bovis is the main causal agent of babesiosis bovine, one important veterinary diseases transmitted by ticks worldwide. Conventional strategies to control this parasitosis have shown several limitations and therefore the development of a vaccine will be an appropriate strategy for prevention and treatment. Objective. To describe relevant aspects of B. bovis parasite's life cycle, the epidemiology, diagnosis, the application of different strategies used to control this parasitosis. In addition, potential points of intervention to develop a vaccine against this parasite has been discussed. Methodology. A search was made using keywords as "Babesia bovis AND lyfe cycle", "B. bovis vaccine and Vaccine candidates" and others. The most relevant studies published to date were completely revised. Results. The details of the B.bovis parasite biology and the molecular process used to cause disease in the host had not been describe in deep; explaining that the development of strategies for the control of this parasitosis have not been entirely efficient. Therefore, it is necessary to design new procedures, for example, to develop new generation vaccines based on a functional approach which improve the animal health conditions. Conclusions. Understand the B. bovise's life cycle complex will allow the host-parasite-tick interactions study and the identification of molecules involved in cell adhesion / invasion to evaluate its usefulness as a vaccine component that controls this parasitosis.

---

Introdução. Babesia bovis é o principal agente causador da babesiose bovina, uma importante doença veterinária transmitida por carrapatos a nível mundial. As estratégias convencionais para o controle das parasitoses têm presentado múltiplas limitações pelo que o desenvolvimento de uma vacina baseada em antígenos representa uma estratégia apropriada para a prevenção e o tratamento. Objetivo. Descrever os aspectos relevantes do ciclo de vida do parasita B. bovis, a epidemiologia, diagnostico e aplicação de diferentes estratégias usadas para o controle desta parasitose. Além disso, são discutidos possíveis pontos de intervenção para o desenvolvimento de uma vacina contra o parasita. Metodologia. Uma pesquisa foi realizada nas bases de dados usando os termos: "Babesia bovis AND lyfe cycle", "B. bovis vaccine and Vaccine candidates", entre outras. Os estudos mais relevantes publicados até o momento foram completamente revisados. Resultados. Os detalhes da biologia do parasita B. bovis e o processo molecular usado para causar doenças no hospedeiro é pouco conhecido, o que explica que o desenvolvimento de estratégias para o controle desta parasitose não foram completamente eficientes. Portanto, é necessário projetar novas medidas, por exemplo, desenvolver vacinas de nova geração com base em uma abordagem funcional que permita melhorar as condições de saúde animal. Conclusões. Compreender o complexo ciclo de vida de B. bovis permitirá estudar as interações hospede­parasita­carrapatos e identificar moléculas envolvidas na adesão/invasão celular para avaliar sua utilidade como componente de uma vacina que controla essa parasitose.

Asunto(s)

Vacunas , Babesiosis , Babesia bovis , Estadios del Ciclo de Vida , Antígenos

RESUMEN

The RBSA protein is encoded by a gene described in Plasmodium species having tropism for reticulocytes. Since this protein is antigenic in natural infections and can bind to target cells, it has been proposed as a potential candidate for an anti-Plasmodium vivax vaccine. However, genetic diversity (a challenge which must be overcome for ensuring fully effective vaccine design) has not been described at this locus. Likewise, the minimum regions mediating specific parasite-host interaction have not been determined. This is why the rbsa gene's evolutionary history is being here described, as well as the P. vivax rbsa (pvrbsa) genetic diversity and the specific regions mediating parasite adhesion to reticulocytes. Unlike what has previously been reported, rbsa was also present in several parasite species belonging to the monkey-malaria clade; paralogs were also found in Plasmodium parasites invading reticulocytes. The pvrbsa locus had less diversity than other merozoite surface proteins where natural selection and recombination were the main evolutionary forces involved in causing the observed polymorphism. The N-terminal end (PvRBSA-A) was conserved and under functional constraint; consequently, it was expressed as recombinant protein for binding assays. This protein fragment bound to reticulocytes whilst the C-terminus, included in recombinant PvRBSA-B (which was not under functional constraint), did not. Interestingly, two PvRBSA-A-derived peptides were able to inhibit protein binding to reticulocytes. Specific conserved and functionally important peptides within PvRBSA-A could thus be considered when designing a fully-effective vaccine against P. vivax.

RESUMEN

Objetivo: Describir el significado que atribuyen puérperas con Morbilidad Materna Extrema a su hospitalización en la Unidad de Cuidados Intensivos y la del hijo(a) prematuro en la Unidad Neonatal. Metodología: Estudio de tipo cualitativo con abordaje etnográfico, utilizando como referente teórico a Madeleine Leininger a través de la Teoría de la Universalidad y Diversidad de los Cuidados Culturales; las entrevistas a profundidad y el análisis cualitativo se realizó teniendo en cuenta el método de James Spradley. Se efectuaron 21 entrevistas a profundidad a 9 puérperas con Morbilidad Materna Extrema (MME) que estuvieron hospitalizadas al igual que sus hijos(as) prematuros en la UCIA y UCIN respectivamente de una clínica de la ciudad de Sincelejo-Sucre, entre Marzo y Diciembre de 2017. Resultados: Surgen 2 temas, los significados de puérperas con MME sobre su hospitalización incluye 8 dominios: conocimiento de los signos de alarma, temor a morir, muy difícil para mi compañero, aplazar la lactancia materna, de regreso a la clínica, mi familia me cuida, la enfermera me cuida y aprender de esta experiencia; y los significados sobre la hospitalización del hijo(a) prematuro conformado por 5 dominios: el mejor momento de mi vida, el canguro, cuidar al recién nacido prematuro, conocimientos educación sobre los cuidados del prematuro y milagro de Dios. Conclusión: Para las puérperas con MME su hospitalización en la Unidad de Cuidados Intensivos significo tener "temor a morir" y tener a su hijo(a) prematuro hospitalizado en la Unidad Neonatal significo "un milagro" porque es "hijo(a) de Dios".

---

Objective: Describe the significance conferred postpartum women with Maternal Near Miss about her hospitalization in the Intensive Care Unit and her premature child in the Neonatal Unit. Methodology: Qualitative study with ethnographic approach, using as a theoretical reference Madeleine Leininger through the Theory of Universality and Diversity of Cultural Care; the in-depth interviews and the qualitative analysis were carried out taking into account James Spradley's method. There were 21 in-depth interviews with 9 puerperal women with Maternal Near Miss who were hospitalized as well as their premature children in the ICU and NICU respectively of a clinic in the city of Sincelejo-Sucre, between March and December 2017. Results: 2 themes arise, the meanings of postpartum women with Near Miss Maternal Morbidity about their hospitalization includes 8 domains: knowledge of the warning signs, fear of dying, very difficult for my partner, postpone breastfeeding, back to the clinic, my family take care, the nurse takes care of me and learn from this experience; and the meanings about the hospitalization of the premature child conformed by 5 domains: the best moment of my life, the kangaroo, to care for the premature newborn, knowledge and education about the care of the premature and miracle of God. Conclusion: For the postpartum women with Maternal Near Miss, their hospitalization in the Intensive Care Unit meant having "fear of dying" and having their premature child hospitalized in the Neonatal Unit meant "a miracle" because it is "son of God"

Asunto(s)

Humanos , Recién Nacido , Morbilidad , Periodo Posparto , Unidades de Cuidado Intensivo Neonatal , Enfermería Transcultural , Unidades de Cuidados Intensivos

RESUMEN

Resumen Introducción. La prevalencia de infección por VIH es tema de constante análisis en el sistema de salud y se toma como referente para las políticas de salud pública. Conociendo las diferentes dinámicas poblacionales de esta infección se generan nuevos enfoques para intervenir de manera adecuada en su manejo. Objetivo. Realizar un análisis de prevalencia de la infección por VIH en las localidades de Bogotá, D.C. en el año 2012. Materiales y métodos. Estudio observacional, descriptivo, retrospectivo y de fuente secundaria realizado a partir de los diagnósticos positivos de VIH, proporcionados en una base de datos por la Secretaria Distrital de Salud, y las proyecciones poblacionales suministradas por la Secretaria Distrital de Planeación para el 2012. Resultados. Con una población proyectada de 7 571 345 habitantes en Bogotá D.C., se estimó una tasa global de prevalencia de 19 por 100 000 habitantes, la razón hombre:mujer fue de 6H:1M y el grupo de edad más afectado por la infección fue el de 20 a 34 años. Conclusión. De las 20 localidades de Bogotá, D.C., 8 superan el promedio encontrado para la ciudad, por lo que se constituyen en localidades prioritarias de intervención.

---

Abstract Introduction: The prevalence of HIV infection is the subject of constant analysis in the health system and is taken as a reference for public health policies. By knowing the different population dynamics of this infection, new approaches to proper management interventions are generated. Objective: To analyze the prevalence of HIV infection in the localities of Bogotá D.C. during 2012. Materials and methods: Observational, descriptive, retrospective and secondary source study conducted based on positive HIV diagnoses obtained from a database of the District Department of Health, and population projections provided by the District Department of Planning for 2012. Results: With a projected population of 7 571 345 inhabitants in Bogotá D.C., an overall prevalence rate of 19 per 100 000 inhabitants was estimated; the ratio man:woman was 6M:1W, and the age group most affected by the infection was 20 to 34 years. Conclusion: Of the 20 localities of Bogotá D.C., 8 are above the average for the city, therefore, they are a priority for intervention.