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La lesión del manguito rotador es una causa importante de dolor y disfunción del hombro. El tratamiento de las roturas masivas e irreparables del manguito rotador sigue siendo un gran reto para los ortopedistas por su complejidad y severidad. Una de las alternativas prometedoras para su manejo es el uso del balón subacromial. Presentamos el caso de una mujer de 67 años con diagnóstico de rotura masiva e irreparable del manguito rotador en el hombro derecho (grado III de Patte, grado IV Goutallier y grado II de Hamada) sin artrosis glenohumeral, tenosinovitis del bíceps y subescapular íntegro. La escala de constant preoperatorio fue de 40 puntos. Se realizó una reparación parcial artroscópica del tendón supraespinoso e infraespinoso asociado a una tenodesis suprapectoral del bíceps y la colocación del balón subacromial. La paciente realizó rehabilitación con mejoría de los arcos de movilidad, disminución del dolor e incremento de la fuerza del hombro derecho. La escala de constant postoperatorio fue de 80 puntos a la semana doce. El balón subacromial es una buena alternativa de tratamiento para las lesiones irreparables del manguito rotador con resultados óptimos a corto plazo en cuanto a dolor y función.

The rotator cuff injury is a significant cause of shoulder pain and dysfunction. Treating massive and irreparable rotator cuff tears remains a major challenge for orthopedists due to their complexity and severity. One promising alternative for managing these cases is the use of subacromial balloons. In this study, we present the case of a 67-year-old woman diagnosed with a massive and irreparable rotator cuff tear in her right shoulder (Grade III Patte, Grade IV Goutallier, and Grade II Hamada), without glenohumeral arthritis, intact biceps tenosynovitis, and subscapularis. The preoperative Constant score was 40 points. The patient underwent partial arthroscopic repair of the supraspinatus and infraspinatus tendons, along with a suprapectoral biceps tenodesis and subacromial balloon placement. Postoperative rehabilitation led to improved range of motion, reduced pain, and increased strength in the right shoulder. The postoperative Constant score reached 80 points at the twelve-week mark. The subacromial balloon proves to be a promising treatment alternative for irreparable rotator cuff injuries, providing optimal short-term results in terms of pain relief and functionality.

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Las lesiones multiligamentarias de rodilla son traumatismos complejos de alta energía cuyo pronóstico puede ser devastador. Esta lesión es infrecuente en adultos mayores cuyo tratamiento es controversial. El tratamiento quirúrgico en adultos mayores puede presentar resultados funcionales similares que en pacientes jóvenes. Presentamos el caso de una mujer de 75 años, quien presentó ruptura total del ligamento cruzado posterior (LCP), ruptura total del ligamento colateral medial (LCM) y ruptura parcial del ligamento cruzado anterior (LCA) con < 50% de espesor en la rodilla derecha. La cirugía realizada fue una reconstrucción artroscópica del LCP con aloinjerto de tibial posterior y reparación del LCM superficial. El score KOS-ADL preoperatorio fue de 42,9% y el postoperatorio fue de 81,4% a los 18 meses de seguimiento. Por tanto, la cirugía reconstructiva en lesiones multiligamentarias de rodilla es clínicamente factible en pacientes adultos mayores con un resultado clínico aceptable y satisfactorio.

The multiligamentary knee injuries are complex high-energy trauma with a devastating prognosis. This injury is rare in older adults whose treatment is controversial. Surgical treatment in older adults may present similar functional results as in younger patients. Present the case of a 75-year-old woman with total posterior cruciate ligament (PCL) rupture, total medial collateral ligament (MCL) rupture and partial anterior cruciate ligament (ACL) rupture with <50% thickness in the right knee. The surgery performed was an arthroscopic reconstruction of the PCL with a posterior tibial allograft and repair of the superficial MCL. The preoperative KOS-ADL score was 42.9% and the postoperative was 81.4% at 18 months of follow-up. The reconstructive surgery in multiligamentary knee injuries is clinically feasible in older adult patients with an acceptable and satisfactory clinical outcome.

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La técnica de reconstrucción del ligamento patelofemoral medial es eficaz, segura, reproducible y con baja morbilidad para el tratamiento de la luxación patelar recurrente. Los pasos a seguir son: 1) Paciente en decúbito dorsal. 2) Artroscopía diagnóstica con liberación del retináculo lateral y valoración de lesiones asociadas. 3) Incisión de 2 a 3 cm sobre el borde superomedial de la patela. 4) Realización de dos túneles de 20 a 22 mm de profundidad y 4 mm de diámetro a través del grosor de la patela bajo fluoroscopia. 5) Fijar dos anclas desde el borde medial de la patela y anudar al aloinjerto con sutura de alta resistencia. 6) Identificar el punto de Schöttle bajo fluoroscopia. 7) Incisión de 2 a 3 cm a nivel del epicóndilo medial. 8) Colocar un Kirschner de 2 mm de medial a lateral, de posterior a anterior y de distal a proximal. 9) Medir la longitud, el grosor y la tensión final deseada del aloinjerto. 10) Realizar el túnel femoral con broca canulada, 1 mm mayor al grosor del aloinjerto. 11) Utilizar el clavo con ojal para pasar la sutura y traccionar el aloinjerto de medial a lateral. 12) Fijar el aloinjerto con un tornillo biodegradable con la rodilla a 30° de flexión valorando la tensión final deseada. 13) Realizar el lavado y cierre por planos. Nivel de Evidencia: IV

The medial patellofemoral ligament reconstruction technique is effective, safe, reproducible and with low morbidity in the treatment of recurrent patellar luxation. The steps in this technique: 1) Patient in supine position. 2) Diagnostic arthroscopy with release of the lateral retinaculum and assessment of associated lesions. 3) 2 to 3 cm incision on the supero - medial border of the patella. 4) Make two tunnels 20 to 22 mm deep and 4 mm in diameter through the thickness of the patella under fluoroscopy. 5) Fix two anchors from the medial edge of the patella and tie to the allograft with high strength suture. 6) The Schöttle's point is identified under fluoroscopy. 7) 2 to 3 cm incision in the medial epicondyle. 8) A 2 mm Kirschner is placed from medial to lateral, posterior to anterior, and distal to proximal. 9) The length, thickness and desired final tension of the allograft are measured. 10) The femoral tunnel is made with a cannulated drill, 1 mm greater than the thickness of the allograft. 11) The eyelet nail is used to pass the suture and pull the allograft from medial to lateral. 12) The allograft is fixed with a biodegradable screw with the knee at 30 ° flexion, assessing the desired final tension. 13) The washing and closing are carried out by planes up to the skin. Level of Evidence: IV

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Por la importancia que reviste ampliar los conocimientos del odontólogo en esta área, la presente revisión bibliográfica propone como objetivo resumir las modificaciones del sis-tema estomatognático que se presentan en músicos que practican instrumentos de viento. Dentro de las anomalías bucales que más abundan en la literatura se encuentran distonía focal, xerostomía, faringitis, queilitis angular, herpes labial y maloclusiones de una gran prevalencia e impacto, dentro de las más frecuentes registradas en este tipo de músicos se encuentran: el resalte aumentado, el apiñamiento y la adaquia. El resalte aumentado es consecuencia de la presión que ejerce la boquilla en la cara palatina de los incisivos superiores, esto provoca que aumente la distancia entre la cara vestibular de los incisivos inferiores y la cara palatina de los incisivos superiores, en sentido anteroposterior (con las arcadas en oclusión). Se concluye que las presiones anormales que generan los instrumentos de viento sobre el aparato estomatognático, provocan una serie de alteraciones que pueden afectar la mucosa oral, los músculos implicados en la práctica instrumental y la oclusión dentaria. Palabras clave: Cavidad bucal, Factores de riesgo; Maloclusiones.

This bibliographical review proposes as an objective to summarize the stomatognathic system modifications that occur in musicians who play wind instruments. Among the oral anomalies that abound most in the literature are focal dystonia, xerostomia, pharyngitis, angular cheilitis, cold sores and malocclusions but the impact and high prevalence among this type of musicians are: the increased teeth protrusion, crowding and adaquia. The increased teeth protrusion is a consequence of the pressure exerted by the mouthpie-ce on the palatal surface of the upper incisors, increasing the anteroposterior distance between the upper and lower incisors (with arcades in occlusion). It is concluded that the abnormal pressures generated by wind instruments on the stomatognathic apparatus cause alterations that may affect the oral mucosa, the muscles involved in the instrumen-tal playing and dental occlusion. Keywords: Malocclusions; Oral cavity; Risk factors.

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Serological tests are needed to estimate the prevalence of Taenia solium cysticercosis in endemic rural areas. The predictive value of serum antibody levels to diagnose porcine cysticercosis and human neurocysticercosis (NC) was herein assessed by ELISA using serum samples from 247 backyard pigs (141 without cysticercosis and 106 with cysticercosis) and 183 human subjects (116 non-NC subjects and 67 NC patients) in central Mexico diagnosed by necropsy and computed tomography, respectively. A sensitivity of 77.3 and 92.5% and a specificity of 88.6 and 100% were found to diagnose porcine and human cysticercosis, respectively. The prevalence of porcine and human cysticercosis in the state of Morelos was estimated by ELISA. Anti-cysticercal antibodies were found in 8.4 and 19.02% of assayed sera from 1,811 humans and 804 pigs, respectively. Marginalization and living in the eastern region were risk factors for humans, whereas free-roaming, medium marginalization levels and living in Sierra de Huautla were risk factors for pigs. These results clearly evidence the persistence of cysticercosis transmission and neurocysticercosis in a region neighboring Mexico City, pointing out the need to apply effective measures already available for its control.

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Objetivo: Determinar el nivel de conocimientos sobre el manejo post exposición a objetos punzocortantes y su relación con las actitudes de los trabajadores de salud del Hospital III Emergencias Grau frente a un accidente punzocortante, diciembre 2014. Materiales y Métodos. El estudio es de tipo cuantitativo, analítico y de corte transversal. De una población de 775 trabajadores de salud, se obtuvo una muestra total de 124. La técnica de recolección de datos empleado fue la encuesta y el instrumento, el cuestionario aplicado. Resultados: Del 100 por ciento (124) de la muestra, el 23.4 por ciento de los trabajadores de salud obtuvo un nivel de conocimiento alto, el 41.1 por ciento obtuvo un nivel de conocimientos medio y el 35.5 por ciento obtuvo un nivel de conocimiento bajo sobre el manejo post exposición a objetos punzocortantes. En cuanto al área actitudinal, el 54 por ciento de la nuestra presentaron actitudes positivas y el 46 por ciento presentaron actitudes negativas. Asimismo se encontró diferencia significativa entre el nivel de conocimientos y las actitudes:" Los trabajadores de salud con un bajo nivel de conocimientos sobre el manejo post exposición a objetos punzocortantes tienen 2,6 veces mayor probabilidad de presentar actitudes negativas al momento de afrontar un accidente punzocortante respecto a quienes obtuvieron nivel de conocimientos medio-alto. El 53.2 por ciento de la muestra refiere no conocer el protocolo de manejo de accidentes punzocortantes. El 53.2 por ciento de la muestra considera que existe muy poca capacitación sobre el manejo post exposición a objetos punzocortantes. Conclusión: El bajo nivel de conocimientos de los trabajadores de salud sobre el manejo post exposición a objetos punzocortantes se relaciona con presentar una actitud negativa frente a un accidente punzocortante.

Objective: To determine the level of knowledge about post exposure to sharps management and its relationship with the attitudes of health workers to the Hospital III Emergencias Grau against a needle stick accident in, December 2014. Materials and Methods: The study is quantitative, analytical and transversal cross. With a population of 775 health workers, obtained a total sample of 124. The data collection technique used was the survey and the instrument used was the questionnaire applied. Results: The 100 per cent (124) of the sample, the 23.4 per cent of health workers obtained a higher level of knowledge, the 41.1 per cent had a medium level of knowledge and the 35.5 per cent had a low level of knowledge about the post handling exposure to sharps. Regarding the attitudinal area, the 54 per cent of our presented positive attitudes and the 46 per cent had negative attitudes. Also it obtained significant difference between the level of knowledge and attitudes: "Health workers with a low level of knowledge about post exposure to sharps management have 2.6 times more likely to have negative attitudes when facing an accident sharps, regard to obtained the level of knowledge high-middle. The 53.2 per cent of the sample reported not knowing the protocol handling sharps accidents. The 53.2 per cent of the sample believes that there is little training on post exposure to sharps handling. Conclusion: The low level of knowledge of health workers on post exposure to sharps management relates to present a negative attitude towards a needle stick accident.

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Existe una prevalencia de trastornos oclusales en gran medida relacionados con la presencia de disfunción temporomandibular. Objetivo: determinar el grado de disfunción temporomandibular según el Índice de Maglione en correspondencia con la prevalencia de maloclusiones en el área de salud del policlínico "Turcios Lima". Métodos: se realizó un estudio observacional descriptivo, de corte transversal, en la consulta de ortodoncia, de junio del 2008 a junio del 2009. De un universo constituido por los 280 pacientes que acudieron al servicio de ortodoncia en el período señalado con presencia de maloclusiones, se seleccionó una muestra de 84 pacientes por muestreo aleatorio simple, teniendo en cuenta los criterios de inclusión y exclusión realizados por criterios de expertos. Resultados: presentaban disfunción temporomandibular 74 pacientes y dentro de ellos 44 (52,4 por ciento) tenían disfunción grado II (Moderada). El 97 por ciento de los pacientes con relación molar de clase II, presentaban disfunción temporomandibular. El 42,9 por ciento de los pacientes con una maloclusión, presentaban disfunción grado I. El 60 por ciento de los pacientes con dos maloclusiones presentaban disfunción grado II y el 66,7 por ciento de los pacientes con tres maloclusiones, presentaban disfunción grado III. La mayor cantidad de pacientes tuvieron disfunción grado II (Moderada). Conclusiones: el mayor por ciento de los pacientes con disfunciones presentó una clase II molar y a medida que aumentó el número de maloclusiones aumentó también la severidad de la disfunción(AU)

Prevalence of occlusal disorders are mostly related with temperomandibular dysfunction. Objective: to determine the level of temperomandibular dysfunction according to Maglione's index in correspondence with prevalence of malocclusions in the health area under Turcios Lima polyclinics. Methods: cross-sectional. observational and descriptive study was conducted in the orthodontics service from June 2008 to June 2009. Of a universe of 280 patients that went to the orthodontics service with maloclussions, a sample of 84 patients was randomly selected according to the inclusion and exclusion criteria set by experts. Results: seventy four patients presented with temporomandibular joint dysfunction and 44 of them (52.4 percent) had moderate dysfunction (Grade II). Ninety seven percent of the patients with Class II molar relationship, also presented temporomandibular joint dysfunction whereas 42.9 percent with malocclusion presented Grade I dysfunction; 60 percent of patients with two malocclusions presented Grade II dysfunction and 66.7 percent with three malocclusions, presented Grade III dysfunction. The majority of patients had Grade II dysfunction (moderate). Conclusions: the highest percent of patients with dysfunctions presented a Class II molar relation and the severity of dysfunction increased as the number of malocclusions increased(AU)

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Introducción: las fuerzas anormales que ejercen el violín y la viola sobre la rama mandibular, así como la boquilla de los instrumentos de viento sobre los dientes, producen una serie de alteraciones bucomaxilofaciales, pues cada instrumento requiere una técnica específica, una posición concreta y el movimiento de determinados músculos. Objetivo: se propuso como objetivo identificar la relación entre tocar violín, viola e instrumentos de viento con la presencia de maloclusión y signos clínicos de Trastornos Temporomandibulares (TTM). Método: se realizó un estudio descriptivo inferencial, de corte transversal en el Conservatorio de Música Amadeo Roldán, de enero a febrero del 2011. De un universo de 130 estudiantes que tocan instrumentos de viento, violín y viola, se seleccionó una muestra conformada por 52 estudiantes, mediante un muestreo aleatorio simple. Se utilizó el Estadístico X2, con la corrección de Yates para continuidad, con una p < 0.005 (probabiblidad de error) y se aplicó el Indicador de Riesgo OR. Resultados: presentaban resalte aumentado 25 pacientes (48.1%), y ruidos articulares 42 pacientes (80.8%); 27 pacientes que tocaban instrumentos de viento (51.9%) presentaban maloclusión; 21 pacientes que tocaban violín y viola (40.4%), presentaban signos clínicos de trastornos temporomandibulares. El Chi Cuadrado para determinar la asociación entre instrumentos musicales y la maloclusión es X² =22.36, y entre instrumentos musicales y los signos clínicos de trastorno temporomandibular es X² =18.39, con p< 0.005. Conclusiones: los estudiantes que tocaban instrumentos de viento fueron más propensos a presentar maloclusiones, mientras que los estudiantes que tocaban violín y viola, fueron más propensos a presentar signos clínicos de trastornos temporomandibulares.

Introduction: the violin and the viola cause an abnormal force upon the jaw and wind instruments upon teeth. Because instruments require a specific technique, a concrete position and the abnormal movement of some muscles. Objective: this investigation proposes to identify the relation among play the violin, viola and instruments of wind with malocclusions and clinic signs of temporomandiblular joint disorders (TMJ). Method: this investigation was descriptive and inferencial. The study was at the Academy of Music: Amadeo Roldan, since January until February of the 2011. It used X² p < 0.005 and OR , with 50 patients. Results: 42 patients (80, 8 %) showed noises in the temporomandiblular joint (TMJ); 27 patients play instruments of wind (51, 9 %) and they showed malocclusions. 21 patients play the violin and viola (40, 4 %), and they showed clinic signs of temporomandiblular joint (TMJ) disorders. The association among to play musical instruments and the maloclusión was: X² =22.36 and among to play musical instruments and clinic signs of temporomandiblular joint (TMJ) disorders was: X²= 18.39, with p<0,005. Conclusions: the students that were touching instruments of wind, were prone to show malocclusions, while the students that were playing violin and viola, were prone to show clinical signs of temporomandibular disorders.

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We discuss the importance of small solar observatories for EPO (Education and Public Outreach), mentioning why they are relevant and what kind of equipment and software require. We stress the fact that technological advances have made them affordable and that they should be widely available. This work is a result of our experience with one: The Carl Sagan Solar Observatory (CSSO). We briefly describe its status and the solar data obtained daily with students participation. We present examples of the data obtained in the visible, Ca II and two in Hα. Data which is widely used for education. Finally we talk about the capability for remote operation as an open invitation for collaboration in educational and scientific projects.

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Muchos pacientes acuden a consulta externa con un conjunto inespecífico de síntomas y signos que sugieren el diagnóstico de astenia, sin encontrarse una causa orgánica que explique dichos síntomas. Se realizó un estudio prospectivo a nivel nacional para diagnosticar y cuantificar la intensidad de la astenia en estos pacientes y medir la eficacia de la sulbutiamina 400 mg/día como tratamiento farmacológicoa corto plazo de primera línea. Se realizó un estudio abierto, prospectivo y multicéntrico,en el cual se ingresaron 341 pacientes, que consultaron ambulatoriamente y que presentaban síntomas de astenia. A través de la escala de Intensidad de Fatiga (por sus siglas en inglés: Fatigue Severity Scale - FSS) se determinó la presencia de astenia en estos pacientes y se evaluó la eficacia de la sulbutiamina 400 mg/día de Laboratorios Leti S.A.V., Venezuela (Tekron®). El estudio tuvo una duración de 15 días, en los cuales el paciente fue evaluado tres veces: día 1 (inicio), día 7 y día 15. Si el paciente presentaba astenia (puntuación ≥ 36 puntos en la FSS), se le indicaba sulbutiamina400 mg/día con el desayuno por 15 días. El 74,7% de los pacientes evaluados fueron del sexo femenino, con una edad media de 43,7 ± 12,5 años y el 25,3% del sexo masculino con una edad media de 41,7 ± 13,5 años. Al inicio del estudio la media de la puntuación de la FSS fue de 49,7 ± 7,3 puntos; a los 7 días de tratamiento con 400 mg/día de sulbutiamina fue de 37,2 ± 8,8 puntos con una disminucióndel 25,2% y al día 15 fue de 28,0 ± 9,8 puntos con una disminución de 43,7% con respecto al inicio del tratamiento, resultando estadísticamente significativo (p< 0,0001 y p< 0,0001 al día 7 y día 15 vs inicio, respectivamente). El 77,7% de los pacientes respondieron al tratamiento al día 15. La sulbutiamina resultó ser un tratamiento muy bien tolerado, se reportaron eventos adversos leves en 132 pacientes (38,7%) al día 7 y en 115 pacientes(33,7%) al día 15...

Many patients attending out patient clinics with a set of nonspecific symptoms and signs that suggest the diagnosis asthenia, without organic cause to explain the symptoms. In order to determine which of was these patients confirmed the diagnosis of functional asthenia, was performed a prospective nation wide, study to diagnose and quantify the intensity of fatigue in these patients and measure the effectiveness of sulbutiamine 400 mg/day treatment short-term drug frontline. Was realized an open, prospective, multicenter study, which entered 341 outpatient patients which showed signs of fati gue. The Fatigue Severity Scale (FSS) was used as a tool for the diagnosis and evaluation of severity of fatigue and was evaluated the effectiveness of sulbutiamine 400 mg/day to Leti Laboratories, S.A.V. (Tekron®), as first line treatment.The duration of the study was 15 days, with 3 evaluations (day 1 or baseline, day 7 and day 15). The score of the FSS had to be ≥ 36 points to be enrolled. 74,7% of patients were females with a mean age of 43,7 ± 12,5 years old and 25,3% were males with a mean age of 41,7 ± 13,5 years old. At baseline, the FSS score was 49,7 ± 7,3 points; at day 7 was 37,2 ± 8,8 points with a decrease of 25,2% and at day 15 was 28,0 ± 9,8 points, with a decrease of 43,7% respective to baseline, being statistically significant (p< 0,0001 and p< 0,0001 at day 7 and day 15, respectively). The percentage of response to treatment was 77,7% at day 15. Sulbutiamine was a very well tolerated treatment, there were reported mild adverse events in 132 patients (38,7%) at day 7 and in 115 patients (33,7%) at day 15. Sulbutiamine 400 mg/day is a secure treatment, it is well tolerated and effective in improving the asthenia symptoms, as demonstrated in this clinical trial by the significant decrease in the FSS mean score and the percentage of patients with asthenia at day 15 of treatment

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The essential oils from two native species from Guatemala were studied for their chemical composition and the dichloromethane and methanol extracts for their biological activity. A GC-MS analysis of the essential oil from Piper jacquemontianum Kunth, Piperaceae, showed 34 constituents, consisting mainly of linalool (69.4 percent), while Piper variabile C. DC. essential oil had 36 constituents, camphor (28.4 percent), camphene (16.6 percent) and limonene (13.9 percent) being the major components. Dichloromethane extracts of both species were cytotoxic against MCF-7, H-460 and SF-268 cell lines (<7 µg/mL). Dichloromethane extract of P. jacquemontianum was slightly active against bacteria (0.5 mg/mL), was active against promastigotes of Leishmania (20.4-61.0 µg/mL), and epimastigotes of Trypanosoma cruzi (51.9 µg/mL). The methanol extract of P. variabile showed antimalarial activity against Plasmodium falciparum F32 (4.5 µg/mL), and the dichloromethane extract against Leishmania (55.8-76.3 µg/mL) and T. cruzi (45.8 µg/mL). None of the extracts from the two species was active against Aedes aegypti larvae and Artemia salina nauplii.

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BACKGROUND: The best approach to determine the burden of neurological disorders in developing countries is to perform population-based studies. Our objectives were to determine the prevalence of neurological disorders in a Mexican rural community and assess the usefulness of a household screening questionnaire. METHODS: The survey took place in a Mexican rural community of Puebla State in Mexico. This was a cross-sectional, population-based, 2-phase study including a comparison of the usefulness levels of the individual (IQ) and household (HQ) questionnaires. RESULTS: A total of 4,008 individuals participated in the prevalence study using the IQ; of these, 280 neurological examinations allowed to identify 127 individuals suffering from at least 1 neurological disease. The most frequent ailments were headache (22.4/1,000, 95% confidence interval, CI: 17.7-28.2), neuropathy (7.1/1,000, CI 95%: 4.4-11.3) and epilepsy (3.9/1,000, CI 95%: 2.3-6.5). The HQ, used in parallel with the IQ, detected significantly fewer neurological cases. This result was mainly due to the low capacity of the HQ to detect headache. CONCLUSIONS: Results of the prevalence study are discussed emphasizing their relevance in adequately allocating resources. The usefulness of the HQ for screening neurological disorders in general was low, but could be adequate for specific neurological disorders.

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This paper provides macroscopic and histological evidence on the statistically significant protective effects of S3Pvac-phage vaccination against porcine cysticercosis and hydatidosis. The study included 391 rustically bred pigs (187 vaccinated and 204 controls). Vaccination significantly reduced the prevalence of cysticercosis by 61.7%. Vaccination also significantly reduced by 56.1% the prevalence of hydatidosis caused by Echinococcus granulosus in pigs. The presence of the vaccine epitopes in both cestodes is probably involved in the cross-protection observed. Increased inflammation was found in 5% of cysticerci recovered from controls, versus 24% from vaccinated pigs (P<0.01). Hydatid cysts were non-inflammatory in either group. Vaccination was effective to prevent one single disease, but it failed to prevent the simultaneous infections with both parasites in a same pig. The widening of the S3Pvac-phage vaccine protective repertoire to include hydatidosis is a convenient feature that should reduce the prevalence of two frequent zoonoses that affect rustic porcine breading with a single action. Thus, the costs of two different vaccination programs would be reduced to a single one with significant reduction in both zoonoses.

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This study was designed to explore if each individual case of naturally acquired porcine cysticercosis, living in different geographic rural areas of central Mexico, is caused by one or more different specimens of Taenia solium tapeworm. The genetic variability among cysticerci from the same pig and that from different pigs was assessed by random amplified polymorphic DNA markers (RAPDs), through the percentage of polymorphic loci, the number of effective alleles, the expected heterozygosity and the Shannon index. The parasite population's reproductive structure was estimated through the association index (I(A)), and the degree of genetic differentiation and variation was determined using AMOVA. Using six different random primers, and a total of 181 cysticerci from 14 pigs, 88 different loci were amplified: 85% were polymorphic between pigs and 24% within pigs. The phenogram grouped the cysticerci into eight major clusters, with differences in the genetic distances among all cysticerci from 14 pigs ranging from 0.78 to 1. Most of the cysticerci grouped in accord with their different geographical origin and with their pig of origin. The similarity matrix produced from the phenogram (obtained by UPGMA) and the original similarity matrix yielded a good cophenetic correlation (r=0.82317, P=0.0004), which suggests that the phenogram accurately represents the original genetic similarities between isolates. The combination of I(A) (0.0-0.089) with the genetic diversity index (0.009-0.073) supports the idea that DNA diversity in T. solium cysticerci of naturally infected pigs is within the range expected from a recombination process occurring during sexual reproduction. The small genetic diversity found within the cysticerci of each pig (33.81%), when compared with that between pigs (66.19%), indicates that pigs are rarely infected by different tapeworms. It would then appear that porcine cysticercosis courses with effective concomitant immunity, as occurs in ovine cysticercosis.

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Numerous efforts for the development of basic and clinical research in obesity are being made by the National Institutes of Health and Federal Reference Hospitals in Mexico. However, greater interaction among researchers and stronger efforts towards the dissemination of the results are needed. The document outlines the general ideas and proposals of the Academic Group for the Study, Prevention and Treatment of Obesity and Metabolic Syndrome of the Coordinating Committee of the National Institutes of Health and High Specialty Hospitals (CCINSHAE). This is the first step in developing common objectives, with the aim of understanding the effect of these entities in public health and to establish guidelines to limit and eventually overcome them. We discuss the appropriateness of analyzing obesity and the metabolic syndrome together, and the current management of these entities at the National Institutes of Health in Mexico. The problems that arise in clinical practice lead to the need to generate a new model of medical care, including a new health worker and a new patient. It is imperative to establish permanent lines of communication and education with health personnel and with patients. The group proposes an integrated approach for research in these areas. Finally, a master plan that links the National Institutes of Health, particularly in the areas of research and programs within the institutions, is required as a first step in seeking answers useful in solving the problem. The second step would be linking the first and second levels of care through concrete actions needed to limit and reduce obesity and metabolic syndrome in the population.

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