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Humpback whales (Megaptera novaeangliae) are a cosmopolitan species and perform long annual migrations between low-latitude breeding areas and high-latitude feeding areas. Their breeding populations appear to be spatially and genetically segregated due to long-term, maternally inherited fidelity to natal breeding areas. In the Southern Hemisphere, some humpback whale breeding populations mix in Southern Ocean waters in summer, but very little movement between Pacific and Atlantic waters has been identified to date, suggesting these waters constituted an oceanic boundary between genetically distinct populations. Here, we present new evidence of summer co-occurrence in the West Antarctic Peninsula feeding area of two recovering humpback whale breeding populations from the Atlantic (Brazil) and Pacific (Central and South America). As humpback whale populations recover, observations like this point to the need to revise our perceptions of boundaries between stocks, particularly on high latitude feeding grounds. We suggest that this "Southern Ocean Exchange" may become more frequent as populations recover from commercial whaling and climate change modifies environmental dynamics and humpback whale prey availability.

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Resumen Introducción: Existe una tendencia global al envejecimiento y con ello un aumento de patologías asociadas. En Chile la prevalencia de la colelitiasis o colecistolitiasis aumenta con la edad, siendo la cole-cistectomía una de las cirugías más frecuentes. Existen escasos estudios latinoamericanos referentes a la realidad de la población octogenaria expuesta a este problema. Objetivo: Estudiar la morbimortalidad posoperatoria en pacientes octogenarios operados de colecistectomía. Definir la precisión de distintas herramientas diagnósticas preoperatorias, estudiar variables operatorias y precisar costos hospitalarios. Materiales y Método: Estudio observacional retrospectivo de la ficha clínica electrónica del Hospital Clínico de la Universidad de Chile, entre enero de 2012 y mayo de 2017. Se incluyeron pacientes con edad igual o mayor a 80 años, en quienes se realizó una colecistectomía electiva o de urgencia por patología benigna. Resultados: Se incluyeron 145 pacientes, 51,7% fueron mujeres, el promedio de edad fue de 84,1 años y un 74,5% presentaba comorbilidades. El 62,1% de los casos ingresó por urgencia. 26,2% de toda la muestra presentó coledocolitiasis. La colecistectomía fue laparoscópica en 73,8% de la muestra global, la tasa de conversión fue de 14,5% en población de urgencia y 1,8% en población electiva (p = 0,009). La población operada totalmente por vía laparoscópica con coledocolitiasis fue resuelta en un 95,2% a través de Rendez-vous, con una tasa de éxito del 100%. La tasa de complicaciones fue de 17,9% siendo en su mayoría médicas, la mortalidad quirúrgica fue de 2,1%, siendo todos casos de urgencia. El costo promedio de atención en salud hospitalaria fue de $5.888.104 pesos chilenos (U$9.000). Conclusión: El paciente octogenario con colecistolitiasis representa un desafío quirúrgico, dado un mayor número de comorbilidades, un cuadro clínico más agresivo y una elevada tasa de coledocolitiasis. Es aconsejable valorar el abordaje mínimamente invasivo y realizar una colangiografía intraoperatoria de rutina.

Introduction: There is a global tendency to aging and associated pathologies. In Chile, the prevalence of cholecystolithiasis increases with age, cholecystectomy is one of the most frequent surgeries in the contry. There are few latinamerican studies regarding the reality of the elderly exposed to this problem. Objective: Study postoperative morbimortality in octogenarian patients undergoing cholecystectomy. Define the accuracy of different preoperative diagnostic tools, study operative variables and specify hospital costs. Materials and Method: Retrospective observational study of the Clinical Hospital of the University of Chile, between January 2012 and May 2017. Patients with age equal to or greater than 80 years were included, in whom an elective or emergency cholecystectomy was performed for benign pathology. Results: A total of 145 patients were included, 51.7% were women, the average age was 84.1 years, and 74.5% had comorbidities. The admission was throw the emergency department in 62.1% of the cases. Choledocholithiasis was diagnosed in 26.2% of the entire sample. Cholecystectomy was fully laparoscopic in 73.8% of the overall sample, the conversion rate was 14.5% in the emergency population and 1.8% in the elective population (p = 0.009). The population operated fully laparoscopically, that had choledocholithiasis, was resolved in 95.2% through Rendezvous technique, with a 100% clearance rate of common bile duct. The complication rate was 17.9%, most being medical. The surgical mortality was 2.1%, all cases operated from emergency. The average cost of hospital health care was $5,888,104.3 Chilean pesos (U$9.000). Conclusion: The octogenarian patient with cholecystolithiasis represents a surgical challenge, given a greater number of comorbidities, a more aggressive clinical setting and a high rate of choledocolithiasis. It is advisable to assess the minimally invasive approach and perform routine intraoperative cholangiography. In the postoperative period, the cardiopulmonary status and the infectious complications of the surgical site should be monitored closely.

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BACKGROUND: There is a limited functional reserve in patients over 65 years of age which is conducive to more frequent postoperative complications. Disease extension at the time of diagnosis (clinical stage) and complete tumor resection are two independent risk factors that have a direct influence on survival. AIMS: To describe the factors that influence morbidity and mortality in patients over 65 years of age after colorectal surgery. MATERIAL AND METHODS: A retrospective, observational, descriptive study was carried out within the time frame of January 2004 and December 2009 on 105 colon cancer patients after colorectal surgery. They were divided into two groups, one under 65 years of age and the other over 65 years of age, in order to compare preoperative comorbidity, as well as morbidity and mortality 30 days after surgery. RESULTS: Of the 105 patient total (53,3%), 56 were ≤ 65 years of age. There were complications in 42,8% of the patients, and those of early and less severe presentation were the most frequent; late complications were more frequent in patients ≤ 65 vs > 65 years of age (16,0% vs 10,2%). Overweight (BMI > 25 kg/m(2)) was observed in 35,0% of the study population. Patients > 65 years of age had fewer comorbidities. The most common causes of reintervention were anastomosis dehiscence and postoperative hemorrhage. Mortality in the group was 6,6% and sepsis was the most frequent cause of death. CONCLUSIONS: Colorectal surgery in patients over 65 years of age has an acceptable complication frequency and a low mortality rate. Our results suggest that patients older than 65 years of age be treated with the same prospects for cure as younger patients.

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Se presentan los resultados de la evaluación auditiva de 74 niños de 0 a 6 meses de edad procedentes de la Unidad de Terapia Intensiva Neonatal (UTIN) y del Reten de Alto Riesgo (RAR) del Hospital Luís Ortega de Porlamar Estado Nueva Esparta Venezuela; mediante evaluaciones electrofisiológicas (Emisiones Otacústicas y Potenciales Evocados Auditivos de Tallo Cerebral) repetidas trimestralmente durante 02 años, obteniéndose los siguientes resultados: 14 niños con hipoacusias neurosensoriales (18.91 por ciento), 12 niños con hipoacusia neurosensorial bilateral y dos niños con hipoacusia unilateral.

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La patología gástrica inflamatoria es una causa importante de morbilidad en nuestro medio. Condiciones específicas como la gastritis crónica atrófica multifocal, la metaplasia intestinal y la displasia gástrica se encuentran asociadas con el proceso de múltiples pasos en el desarrollo del adenocarcinoma gástrico de tipo intestinal. En este estudio, descriptivo retrospectivo, se revisó el archivo de quirúrgicos del Hospital San Juan de Dios y de la Clínica Carlos Lleras Restrepo de Bogotá, en el periodo comprendido entre el 1 de enero de 1.999 y el 31 de Mayo de 2.000, encontrando 9.349 casos. Dentro de éstos, la patología gástrica correspondió a 18,6 por ciento (1.742), de los cuales 1585 casos ( 90 por ciento) correspondieron a patología no tumoral Se seleccionaron 1.387 casos de los diferentes tipos de gastritis, los cuales fueron clasificados de acuerdo al sistema Sydney modificado del consenso internacional de Houston de 1994. Se encontró una asociación de gastritis crónica y H. pylori del 74,62 por ciento. La gastritis crónica no atrófica se presentó más frecuentemente (73,46 por ciento), afectando personas entre los 40 y 60 años y su asociación con H. pylori fue del 80 por ciento. La gastritis crónica atrófica ocupó el segundo lugar en frecuencia (26,46 por ciento), predominando en mujeres, y con una asociación significativa a infección por H. Pylori (63,31 por ciento).Todos los casos de displasia se presentaron asociados con gastritis crónica atrófica multifocal. Además, se encontró que la presencia de gastritis crónica atrófica multifocal y displasia representan un mayor riesgo relativo (2,2) de desarrollo de adenocarcinoma gástrico

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En una serie de 898 colecistectomias laparoscopicas se presentaron 4 casos de carcinoma de vesicula biliar (0.5 por ciento), y 2 de estos pacientes recidivaron como metastasis en el sitio del puerto laparoscopico umbilical. Un paciente con una lesion T2 recidivo a los 8 meses y su sobrevida fue de 11 meses. Este paciente presento recidiva en el bilio hepático. El segundo paciente presento un tumor T3, recidivo a los 10 meses y su sobrevida fue de 30 meses. Ambas neoplasias fueron insospechadas, por lo tanto no se protegio el puerto durante la extraccion. Ninguno recibio tratamiento adyuvante. Al primer paciente se le realizó una laparotomia sin tratamiento curativo y el segundo paciente no recibio tratamiento.

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A multicenter randomized study was performed. One hundred and seventy patients were selected. The patients were 18 years and older. They presented signs and symptoms of genital candidiasis and had positive smear culture for Candida. Eighty five patients were assigned to receive Cicloprox olamine 1%, and eighty five patients were assigned to receive Terconazol 0.8%. The treatment lasted six days with the objective to compare the clinical and antifungal efficiency and safety with both treatments. The result of mixed efficiency (clinical and microbiology) for Cicloprox olamine was 48 cases (62.3%) at the end of the treatment were cured--day 7-; and at the continuation--day 21-42 of them had the same result (55.3%); improvement was seen at the end in 25 cases (32.5%) and at the continuation 21 cases had the same result (27.6%). For Terconazol the result was 45 cases (61.6%) were cured at the end of the treatment, and at the continuation 39 had the same result (57.4%); improvement was seen at the end in 23 cases (31.5%) and at the continuation 22 cases had the same result (32.4%). We conclude that both treatments are effective and well tolerated for genital candidiasis treatment.

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The plaque reduction neutralization assay was standardized to differentiate an infection caused by dengue from another infection produced by yellow fever. Serum samples from Cuban donors were used to this end. Information on previous vaccination against yellow fever was available. Samples from Costa Rican patients with a clinical picture of dengue and with no antecedents of vaccination against yellow fever were also utilized. The optimal plaque staining day was the fifth day and the smallest serum dilution capable of differentiating an infection resulting from dengue from another infection caused by yellow fever was of 1/5. According to the high specificity of the standardized technique, risk factor studies of dengue hemorrhagic fever could be made among individuals vaccinated against yellow fever, which is a present and important topic.

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