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Introducción La cirugía de manguito rotador ha mejorado los síntomas y la función asociada a las lesiones que no han respondido al manejo conservador, sin embargo, puede presentarse dolor severo e incomodidad en el postoperatorio requiriendo una adecuada analgesia. Se busca evaluar el dolor durante el postoperatorio de acuerdo a la técnica utilizada: artroscópica o mini abierta bajo el protocolo de analgesia multimodal. Materiales y métodos Fueron incluidos 60 pacientes en el estudio, de los cuales se llevaron 24 pacientes a cirugía mini abierta y 36 pacientes a cirugía artroscópica entre mayo 2017 y junio 2018. Se realizo seguimiento hasta el primer mes postoperatorio. El desenlace primario es el dolor de acuerdo a la escala visual análoga (EVA) en los diferentes grupos de acuerdo a los diferentes momentos del postoperatorio. Resultados La mediana de dolor postoperatorio fue menor en los pacientes llevados a cirugía mini-abierta con una diferencia estadísticamente significativa en la primera (0 vs 4 (p = 0.001)), segunda hora de postoperatorio (0 vs 1 (p=0.016)) y en el control al mes postoperatorio (3 vs 5 (p=0.043)). Conclusión El dolor en el postoperatorio es menor para el grupo de cirugía mini abierta, con diferencia estadísticamente significativa en las dos primeras horas del postoperatorio y al mes de la cirugía. Estos resultados podrían atribuirse a la inflamación del hombro dada por la hidratación de los tejidos con la artroscopia y también por que las lesiones eran de mayor tamaño en el grupo de cirugía artroscópica. Nivel de Evidencia: II

Background Rotator cuff surgery improve symptoms and function in patients who have not responded to a conservative treatment. However, pain can be severe and uncomfortable after surgery requiring adequate analgesia. We aimed to evaluate pain during the postoperative period after rotator cuff surgery in two different groups: arthroscopic and mini open surgical repair both under a multimodal analgesia protocol. Methods Sixty patients were included in the study, 24 patients underwent mini-open surgery and 36 patients underwent arthroscopic surgery between May 2017 and June 2018. Final follow-up was done on postoperative day 30. The primary outcome is pain according to the visual analog scale (VAS) in the two different groups during different postoperative moments. Results Median postoperative pain was lower in patients undergoing mini-open surgery than in patients undergoing arthroscopic surgery on the first postoperative hour (0 vs 4 (p=0.001)), during the second postoperative hour (0 vs 1 (p=0.016)) and at final follow up (3 vs 5 (p=0.043)). Conclusion Pain during the postoperative period was lower for patients undergoing mini-open surgery, with a statistically significant difference during the first two postoperative hours and at final follow up. These results can be attributed to the local inflammation of the shoulder caused by the hydration of the tissues with arthroscopy surgery and bigger size tears in the group of arthroscopy surgery. Evidence Level: II.

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Cu, Mn, Fe, Zn, Cd and Pb levels were measured in liver and muscle samples of Rainbow Trout Oncorhynchus mykiss collected from three watersheds with different land-uses: native forest, exotic plantation, and agriculture in Chile, during January, April, July, and October 2012. Cd and Pb levels were not detected in the liver and muscle, probably since they are under the detection limits. Higher metal concentrations (liver-muscle tissues) were detected in samples from agriculture and exotic plantation streams, whereas trout from native forest streams had lower metal concentrations. Higher metal concentrations were detected in liver tissue compared to muscle tissue, and both negatively correlated to the length and weight of the fish. This suggest the liver had higher ability to accumulate Cu, Mn, Fe and Zn compared to muscle tissue. The concentration range of Fe and Zn recorded in the muscle are within the range reported by other authors, whereas Mn and Cu concentrations are higher than reported in the literature. However, at all sites the concentration of selected metals were below the limits permitted by current legislation (FAO), and therefore did not put the human population at risk, suggesting that is eating wild rainbow trout safe in Chile.

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Toxic metal content were measured in samples of mollusc Concholepas concholepas obtained from the Chilean coast. Samples were collected during two periods, one before and one after the earthquake-tsunami which occurred in the Maule Region, Chile, February 27th, 2010 as a result of an earthquake with a magnitude of 8.8. Quantification of toxic metals in samples of hepatopancreas and muscle tissue was performed using flame atomic absorption spectroscopy. The analytical methodology was validated with certified reference material. The content means measured in muscle tissue for January 2010 were Cu: 10.3; Cr: 0.7; Cd: < 0.1; Mn: 3.6 and Zn: 38.6 µg g-1 (dry weight). For October 2014, the means were Cu: 8; Cr: 2.4; Cd: < 0.1; Mn: 5.6 and Zn: 45.4 µg g-1 (dry weight). In hepatopancreas tissue, the content means were Cu: 14.8; Cr: 2.4; Cd: 246.2; Mn: 4.4 and Zn: 1552.9 µg g-1 (dry weight). For October 2014, the means were Cu: 53.7; Cr: 3.5; Cd: 118; Mn: 13.4 and Zn: 1352.3 µg g-1 (dry weight). Cd, Cr, Cu, Mn and Zn content in the samples of hepatopancreas were generally higher than those recorded in muscle tissue however they were not always statistically significant. Statistical analysis showed that Cu and Mn content in the post-tsunami period increased in the hepatopancreas tissue. The concentrations of Cd, Cr, Cu, Mn, and Zn measured in the muscular tissue (edible part) of the species Conchalepas concholepas, were lower than the maximum contents allowed by the current legislation (FAO/WHO, 2004; EU, 2001) and its consumption is not a risk to human health.

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La enfermedad de mano-pie-boca es una patología originada en la mayoría de los casos por el virus coxsackie A tipo 16, aunque también puede ser ocasionada por otras cepas de la familia de los coxsackievirus. Dicho virus se propaga principalmente por vía fecal oral y, en menor proporción, por secreciones. Se presenta principalmente en verano, siendo frecuente en niños menores de 10 años. Dentro de dicha enfermedad las lesiones mucocutáneas que evolucionen en necrosis son poco frecuentes, constituyéndose en una complicación severa que requiere hospitalización. En el presente artículo se reporta un caso con diagnóstico de enfermedad mano-pie-boca, que evolucionó hacia lesiones mucocutáneas necróticas, mostrando una respuesta favorable a una terapia de soporte de aciclovir, líquidos y electrolitos.

In most cases, the cause of hand, foot, and mouth disease (HFMD) is coxsackievirus A type 16. The infection can also be caused by other strains of coxsackievirus, spreading mainly by the oral-fecal route, while it is less likely to be transmitted through secretions. HFMD occurs mainly in summer and is more common in children under ten. Skin lesions develop during the disease but rarely become necrotic. When present, they are a severe complication requiring hospitalization. This paper reports the case of a patient with HFMD who developed necrotic mucocutaneous lesions that responded favorably to intravenous acyclovir, fluids, and electrolyte support therapy.

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Research on biological influence of vanadium has gained major importance because it exerts potent toxic, mutagenic, and genotoxic effects on a wide variety of biological systems. However, hematological toxicity is one of the less studied effects. The lack of information on this issue prompted us to study the structural effects induced on the human erythrocyte membrane by vanadium (V). Sodium orthovanadate was incubated with intact erythrocytes, isolated unsealed human erythrocyte membranes (IUM) and molecular models of the erythrocyte membrane. The latter consisted of bilayers of dimyristoylphosphatidylcholine (DMPC) and dimyristoylphosphatidylethanolamine (DMPE), phospholipid classes located in the outer and inner monolayers of the human erythrocyte membrane, respectively. This report presents evidence in order that orthovanadate interacted with red cell membranes as follows: a) in scanning electron microscopy (SEM) studies it was observed that morphological changes on human erythrocytes were induced; b) fluorescence spectroscopy experiments in isolated unsealed human erythrocyte membranes (IUM) showed that an increase in the molecular dynamics and/or water content at the shallow depth of the lipids glycerol backbone at concentrations as low as 50µM was produced; c) X-ray diffraction studies showed that orthovanadate 0.25-1mM range induced increasing structural perturbation to DMPE; d) somewhat similar effects were observed by differential scanning calorimetry (DSC) with the exception of the fact that DMPC pretransition was shown to be affected; and e) fluorescence spectroscopy experiments performed in DMPC large unilamellar vesicles (LUV) showed that at very low concentrations induced changes in DPH fluorescence anisotropy at 18°C. Additional experiments were performed in mice cholinergic neuroblastoma SN56 cells; a statistically significant decrease of cell viability was observed on orthovanadate in low or moderate concentrations.

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