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Objetivo: Analizar la percepción de la imagen corporal y su impacto en la función sexual orgásmica en mujeres estudiantes de la educación superior de Chillán, 2021. Métodos: Estudio cuantitativo, analítico, de corte transversal. Se evaluaron cuatro variables: datos demográficos, imagen corporal, orgasmo y función sexual. Se utilizó un Google Formulario a mujeres estudiantes entre 18 y 44 años de edad, de la educación superior en la ciudad de Chillán. Posterior a ello, los datos obtenidos se recopilaron y tabularon en el programa estadísticos SPSS 23. Resultados: Las dimensiones del índice de función sexual femenino alteradas con mayor frecuencia fueron: satisfacción (80,6 %), excitación (73,8 %) y orgasmo (51,5 %). El 99,0 % de las encuestadas presentaron disfunción sexual. Con respecto a la relación entre la dimensión de excitación y la pobre imagen corporal producida por el propio cuerpo (p = 0,019 r = -0,223) presentó correlación estadísticamente significativa, no así entre los puntajes totales de ambos instrumentos (p = 0,34; r = 0,09). Finalmente, las correlaciones entre la dimensión de dolor al momento de tener relaciones sexuales y la autodesvalorización por la apariencia física correlacionaron positivamente (p = 0,049; r = 0,196). Conclusión: Se observó alterado el orgasmo por la percepción de cómo se sienten con su propio cuerpo las encuestadas, lo que crearía una imagen corporal negativa llevando a una insatisfacción corporal(AU)

Objective: Analyze the perception of body image and its impact on orgasmic sexual function in female higher education students in Chillán, 2021. Methods: Quantitative, analytical, cross-sectional study. Four variables were evaluated: demographic data, body image, orgasm and sexual function. A Google Form was used for female students between 18 and 44 years of age, from higher education in the city of Chillán. Subsequently, the data obtained were compiled and tabulated in the statistical program SPSS 23. Results: The most frequently altered dimensions of the female sexual function index were: satisfaction (80.6%), arousal (73.8%), and orgasm (51.5%). 99.0% of the respondents had sexual dysfunction. Regarding the relationship between the arousal dimension and the poor body image produced by one's own body (p = 0.019; r = -0.223), there was a statistically significant correlation, but not between the total scores of both instruments (p = 0.34; r = 0.09). Finally, the correlations between the dimension of pain at the time of sexual intercourse and self-depreciation due to physical appearance were positively correlated (p = 0.049; r = 0.196). Conclusion: The orgasm was observed to be altered by the perception of how the respondents felt about their own body, which would create a negative body image leading to body dissatisfaction(AU)

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The hematophagous bats are usually the main reservoir of sylvatic rabies, being one of the most important viral zoonoses affecting humans and livestock in Latin America. Despite the most countries have already studied spatio-temporal distribution of bovine rabies, however, in Ecuador, little has been reported about the state of rabies in the country. Aiming to this objective, a descriptive observational study was realized from 2007 to 2020 based on the formal reports by WAHI-OIE and surveillance of bovine rabies retrieved from its official website. During the study period in Ecuador, some 895 cases of rabies were confirmed in cattle. In addition, in the total of bovine rabies cases seen in Andean and Coast regions (185 effected bovines), Loja and Esmeraldas had 95 (6.16% cases per 10,000 animals) and 51 (1.7% cases per 10,000 animals), respectively. Furthermore, the Amazon region indicated higher rabies cases in cattle than to the observed in other regions (710 rabies cases) while it was highly fluctuating with respect to the years (9.74 to 42.82% cases per 10,000 animals). However, Zamora (292 rabies cases), Orellana (115 rabies cases) and Sucumbíos (113 rabies cases) yielded the highest incidence rates than other provinces (9 to 42% cases per 10,000 animals). Based on this evidence, it has been fundamental to assess the current national program for preventing and control of the sylvatic rabies, being also necessary to include concept of the ecology of the vampire bat. Regardless of these results, vaccination is vital for control programs to prevent rabies in livestock and need to be widely increased for limiting their geographic and temporal spread.

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The effective relief of postsurgical pain in patients undergoing knee arthroscopy is important to allow the initiation of activities of daily living. The objective of this study is to demonstrate the analgesic efficacy of dexmedetomidine as an adjuvant added to ropivacaine by the intra-articular route. METHOD: Seventy patients underwent knee arthroscopy which were randomly assigned into two groups (n=35). The RD group received ropivacaine 1.5mg/kg plus dexmedetomidine 1µg/kg intra-articularly. Group R received ropivacaine 1.5mg/kg intra-articularly. The analgesic effect was evaluated by measuring the intensity of pain (VAS score) and the duration of analgesia. RESULTS: A longer duration of the analgesic effect was observed in the RD group (655min) compared to the R group (318min) being statistically significant (p=0.03). CONCLUSION: Dexmedetomidine as an adjuvant to intra-articular ropivacaine improves the quality and duration of postoperative analgesia in patients undergoing knee arthroscopy.

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The aim of this work was associate the presence of the virulence factors of Helicobacter pylori, cagA/cagE, with gastric illness. We found evidence that indicate the contribution of these genotypes with the severity of gastric lesions in patients infected, principally in histological subtypes as atrophic gastritis, and metaplasia.

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Cattle raising is a crucial element of production systems in the tropics and subtropics. However, in recent years, global public health security has been threatened by disease emergence. In Orellana Province, livestock is the most important activity to generate economic income. Nevertheless, there is no available data about Animal Health status. With this objective, a study was performed to describe the major Bovine diseases recorded between 2011 to 2019, and the main Risk factors associated. Data on main Bovine diseases were retrieved from the World Animal Health Information System database. Whereas Bovine population data used to calculate the prevalence rates and confidence intervals were obtained from Ecuador's Ministry of Agriculture. By contrast, the Risk factors identified with an epidemiological questionnaire were applied to 300 livestock farmers. As a result, from 2011 to 2019 in Orellana has been confirmed: 90 cases of Infectious Bovine Rhinotracheitis (31.58%), Bovine Rabies by hematophagous bats (Desmodus rotundus), 83 cases (29.12%), Bovine viral diarrhea with 43 cases (15.10%), Brucellosis by Brucella abortus 35 cases, which was (12.28%), and 34 cases related to Enzootic bovine leukosis (11.92%). Overall, the prevalence rates ranged from (0.24 to 15.37%). In addition, farm size, presence of forest, herd, and paddock sizes, cutting frequency of forages, and other animal species were involved as Risk factors (OR = 3.15 to 11.75; 95% CI, 0.01 to 0.69). In conclusion, there are animal diseases with reproductive and neurologic symptomology and high-Risk factors implicated in the transmission. Consequently, space-temporal and seroprevalence epidemiological studies should be performed in Orellana.

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Cattle raising is a crucial element of production systems in the tropics and subtropics. However, in recent years, global public health security has been threatened by disease emergence. In Orellana Province, livestock is the most important activity to generate economic income. Nevertheless, there is no available data about Animal Health status. With this objective, a study was performed to describe the major Bovine diseases recorded between 2011 to 2019, and the main Risk factors associated. Data on main Bovine diseases were retrieved from the World Animal Health Information System database. Whereas Bovine population data used to calculate the prevalence rates and confidence intervals were obtained from Ecuador's Ministry of Agriculture. By contrast, the Risk factors identified with an epidemiological questionnaire were applied to 300 livestock farmers. As a result, from 2011 to 2019 in Orellana has been confirmed: 90 cases of Infectious Bovine Rhinotracheitis (31.58%), Bovine Rabies by hematophagous bats (Desmodus rotundus), 83 cases (29.12%), Bovine viral diarrhea with 43 cases (15.10%), Brucellosis by Brucella abortus 35 cases, which was (12.28%), and 34 cases related to Enzootic bovine leukosis (11.92%). Overall, the prevalence rates ranged from (0.24 to 15.37%). In addition, farm size, presence of forest, herd, and paddock sizes, cutting frequency of forages, and other animal species were involved as Risk factors (OR = 3.15 to 11.75; 95% CI, 0.01 to 0.69). In conclusion, there are animal diseases with reproductive and neurologic symptomology and high-Risk factors implicated in the transmission. Consequently, space-temporal and seroprevalence epidemiological studies should be performed in Orellana.

A criação de gado é um elemento crucial dos sistemas de produção nos trópicos e subtrópicos. No entanto, nos últimos anos, a segurança da saúde pública global tem sido ameaçada pelo surgimento de doenças. Na província de Orellana, a pecuária é a atividade mais importante para gerar renda econômica. Contudo, não há dados disponíveis sobre o estado de saúde animal. Com este objetivo, foi realizado um estudo para descrever as principais doenças dos bovinos registradas entre 2011 e 2019, além dos principais fatores de risco associados. Os dados sobre as principais doenças bovinas foram recuperados do banco de dados do World Animal Health Information System. Os dados da população bovina usados para calcular as taxas de prevalência e os intervalos de confiança foram obtidos do Ministério da Agricultura do Equador. Por outro lado, os fatores de risco identificados com um questionário epidemiológico foram aplicados a 300 criadores de gado. Como resultado, de 2011 a 2019 em Orellana foram confirmados: 90 casos (31,58%) de rinotraqueíte infecciosa bovina, 83 casos (29,12%) de raiva bovina por morcegos hematófagos (Desmodus rotundus), 43 casos (15,10%) de diarreia viral bovina, 35 casos (12,28%) de brucelose por Brucella abortus e 34 casos relacionados à leucose enzoótica bovina (11,92%). No geral, as taxas de prevalência variaram de 0,24 a 15,37%. Além disso, tamanho da fazenda, presença de floresta, tamanho do rebanho e dos piquetes, frequência de corte de forragens e outras espécies animais estiveram envolvidos como fatores de risco (OR = 3,15-11,75; IC 95% 0,01-0,69). Em conclusão, existem doenças animais com sintomatologia reprodutiva e neurológica e fatores de alto risco implicados na transmissão. Portanto, estudos epidemiológicos espaço-temporais e de soroprevalência devem ser realizados em Orellana.

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La osteoporosis es una enfermedad sistémica esquelética, cuyas manifestaciones más comunes son las fracturas vertebrales y de cadera. En relación con el oído, se han realizado algunos estudios controversiales que sugieren el aumento de riesgo de pérdida auditiva en pacientes con osteoporosis, mientras otros indican que no hay relación alguna con esta enfermedad. Se realizó un reporte de caso donde se describen los hallazgos en el oído medio y oído interno, tras la valoración bajo microscopía de luz, en un espécimen de hueso temporal con antecedente de osteoporosis. Se evidencia desmineralización, porosidad y disminución cualitativa del tejido óseo, así como disminución del espacio incudomaleolar.

Osteoporosis is a skeletal systemic disease, commonly known for its affection on hips and spine. In relation to the ear, several controversial studies have documented an increased risk for hearing loss in patients with osteoporosis, while others do not find any association with these disorders. A case report was carried out which describes the findings in the middle ear and inner ear, after evaluation under light microscopy, in a temporary bone specimen with a history of osteoporosis. Demineralization, porosity and qualitative diminished bone tissue are found, as well as a decrease in the incudomallear joint.

A osteoporose é uma doença esquelética sistêmica, cujas manifestações mais comuns são as fraturas vertebrais e de quadril. Em relação ao ouvido, foram realizados alguns estudos controversos que sugerem um risco aumentado de perda auditiva em pacientes com osteoporose, enquanto outros indicam que não há relação com essa doença. Foi feito um relato de caso descrevendo os achados em ouvido médio e ouvido interno, após avaliação sob microscopia de luz, em espécime de osso temporal com histórico de osteoporose. Há evidências de desmineralização, porosidade e diminuição qualitativa do tecido ósseo, bem como diminuição do espaço incudomaleolar.

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In this study a microbial consortium, dominated by members of the genera Marinobacter and Alcanivorax (Gammaproteobacteria) isolated from marine sediments of Southern Gulf of Mexico, was assessed to grow in a bubble column bioreactor using 13 g L-1 of diesel (aliphatic and aromatic hydrocarbons mix including nonane and hexadecane) as the sole carbon source. The consortium was able to produce 3.3 g L-1 of biomass, measured as suspended solids. Microbial growth was detectable, even substrate depletion, after 8 days of cultivation. The emulsifier activity and its influence on the droplet size were also evaluated: it was observed that droplet diameter decreases as emulsifier activity increases. The bubble column bioreactor system proposed in this research could be used as a biotechnological process for the remediation of a contaminated body in important petrochemical regions, for example, Veracruz, México, where some points of sea and fresh-water bodies were analysed to find nonane and hexadecane in all sample water. It is important due to a lack of information, regarding hydrocarbon pollution in this port area, is filled.

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Introducción Es reconocido que el personal de enfermería es quien tiene mayor interacción con el paciente, por lo que se ve obligado a contar con conocimientos y experiencia suficiente que permita identificar y atender las necesidades de individuos que sufren de enfermedad cerebrovascular. Esta condición de salud puede ser secundaria a la ruptura de un aneurisma, lo que conduce al paciente a un estado crítico; además, puede traducirse en riesgo para el equilibrio financiero de la familia y el Sistema Sanitario. Métodos: Se desarrollaron las etapas del proceso de cuidado de enfermería centradas en una situación real de la práctica clínica durante el periodo postoperatorio de una paciente sometida a clipaje de aneurisma. Se utilizó el modelo de patrones funcionales de Marjory Gordon para la recolección de los datos; además de la taxonomía NANDA-NIC-NOC. Resultados: Se presentan los planes de cuidado en los que se centró la intervención de enfermería en la paciente valorada. Así como la evaluación del proceso en las dimensiones de estructura, proceso y resultado. Discusión/conclusiones: El EVC secundario a ruptura de aneurisma cerebral es una situación grave y devastadora para la familia y el sistema sanitario. Por tanto, una adecuada atención de enfermería a este problema es de la mayor importancia.

Introduction: It is well acknowledged that nursing staff have the greatest interaction with patients and thus, nurses need to have sufficient knowledge and experience to identify the diverse needs, for example of those patients suffering from cerebrovascular disease. This condition can be a consequence of a ruptured aneurysm, which can in turn lead the patient to a critical status jeopardizing the financial equilibrium of his/her family and the health system. Methods: The nursing process stages were developed during the postsurgical period of a patient who underwent an aneurysm clipping. The Gordon's functional health patterns model was used to collect data, in addition to the NANDA/NIC/NOC taxonomy. Results: Care plans derived from the nursing intervention were presented, as well as the related assessment in terms of the structure, process, and results dimensions. Discussion/Conclusion: The CVE secondary to the rupture of an aneurysm is a serious and devastating situation for the patient, his/her family, and the health system, therefore, an adequate related nursing attention becomes of the most importance.

Introdução: Reconhece-se que os enfermeiros têm maior interação com o paciente, sendo obrigados a ter conhecimento e experiência suficientes para identificar e atender às necessidades dos indivíduos portadores de doença cerebrovascular. Essa condição de saúde pode ser secundária à ruptura de um aneurisma, que leva o paciente a um estado crítico; além disso, pode ser traduzido em risco para o equilíbrio financeiro da família e do Sistema de Saúde. Métodos: Desenvolveram-se as etapas do processo de cuidar em enfermagem, enfocando uma situação real da prática clínica no pós-operatório de um paciente submetido a clipagem de aneurisma. O modelo de padrões funcionais de Marjory Gordon foi utilizado para coleta de dados; além da taxonomia NANDA-NIC-NOC. Resultados: São apresentados planos de cuidados em que a intervenção de enfermagem foi focada no paciente valorizado. Assim como a avaliação do processo nas dimensões de estrutura, processo e resultado. Discussão / conclusões: A EVC secundária a um aneurisma cerebral roto é uma situação grave e devastadora para a família e o sistema de saúde. Portanto, cuidados de enfermagem adequados para este problema são de extrema importância.

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AIMS: Ruthenium (II) complexes are promising anticancer molecules due its pharmacological properties and selectivity to cells tumor. The aim of this work was to study the cytotoxic activity, and apoptosis induction of two new ruthenium complexes on a human gastric cancer cell line. MAIN METHODS: Two ruthenium(II) complexes were synthesized: [(H2pbbzim)Ru(tpy-Ph-COOCH3)](Cl)2 (Ru-UCN1), and [(tpy)Ru(tpy-Ph-bzH)](Cl)2 (Ru-UCN3), and their anticancer capacity determined by cytotoxic assays, gene expression analysis, caspase activation and confocal microscopy. KEY FINDINGS: Ru-UCN3 is more notably cytotoxic than cisplatin in human gastric cancer cells AGS at 24 h, while Ru-UCN1 is more active against gastric cancer cells than cisplatin at 48 h. The complexes induce apoptosis as shown by RT-qPCR, protease activity, and confocal microscopy. Ru-UCN1 induces the overexpression of pro-apoptotic genes at 3 and 6 h, whereas Ru-UCN3 induces overexpression of these genes at 12 and 24 h. Ru-UCN1 treatment shows a strong activation of caspases 3/7 at 24 h, which was not observed for Ru-UCN3 treatment in the same timeframe. SIGNIFICANCE: Taken together, this data suggests that Ru-UCN1 and to a lesser extent, Ru-UCN3, may be interesting anticancer agents for gastric cancer.

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Chronic kidney disease (CKD) affects the kidneys, and in severe cases is considered as end-stage renal disease which can only be treated by dialysis and transplantation. Tierra Blanca city has a higher CKD rate compared to other Mexican cities, but its principal cause has not been found yet. Main factors related to CKD are carbonated beverage consumption, diabetes, obesity, hypertension, heat stress, dehydration, and intoxication by pesticides, heavy metals, and/or hydrocarbons. The aim of this work was to evaluate hydrocarbon pollution in Tierra Blanca domestic fresh-water related to CKD and to integrate this information with other main factors in order to suggest precautionary actions taking account of key actors. We found hydrocarbons in the water wells of the city and the presence of other risk factors, which creates a perfect storm for CKD. Additionally, key actors were identified in order to follow precautionary principles related to CKD cases in Tierra Blanca.

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INTRODUCTION AND AIMS: Esophagectomy is a highly invasive surgery and one of its postoperative complications is anastomotic leakage, occurring in 53% of cases. The aim of the present study was to determine the sensitivity of the contrast-enhanced swallow study as a method for diagnosing anastomotic leak in patients that underwent esophagectomy. MATERIAL AND METHODS: The present retrospective study included the case records of patients that underwent esophagectomy with reconstruction and cervical anastomosis at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán within the time frame of January 1, 2000 and May 31, 2016. Demographic, clinical, and laboratory data emphasizing clinical and radiographic anastomotic leak detection were identified. Descriptive statistics were carried out and contrast-enhanced swallow study sensitivity for diagnosing leakage was calculated. RESULTS: Seventy patients were included in the analysis. The mean age of the patients was 50.6 years, 51 of the patients were men (72.86%), and 19 were women (27.14%). Indications for surgery were benign lesion in 29 patients (41.4%) and malignant lesion in 41 (58.6%). A total of 44.3% of the patients presented with a comorbidity, with diabetes mellitus and high blood pressure standing out. Thirty patients (42.85%) presented with anastomotic leak. Contrast-enhanced swallow study sensitivity for leak detection was 43.33%. CONCLUSIONS: The diagnostic sensitivity of the contrast-enhanced swallow study was very low. Therefore, we recommend the discontinuation of its routine use as a method for diagnosing anastomotic leaks.

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En la patogénesis de la mastitis estafilocócica, el biofilm se considera un marcador de virulencia que permite la adherencia del microorganismo al epitelio mamario. Con la finalidad de determinar la producción de biofilm y detectar la presencia de genes icaABCD, se analizaron 30 cepas de S. aureus aisladas de leche cruda obtenida de vacas con mastitis subclínica. El biofilm se determinó por el método cuantitativo sobre microplacas de cultivo celular y los genes icaABCD por reacción en cadena de la polimerasa. En 96,67% de las cepas de S. aureus se observó producción de biofilm. De éstas 43,34% fueron fuertes productoras, 30,00% moderadas productoras, 23,33% débiles productoras y 3,33% no productoras de biofilm. La totalidad de los genes icaADCD se obtuvo en 6,66% de los aislamientos. Todas las cepas, excepto una, presentaron icaA o icaD. En 56,66% de los aislamientos se identificaron genes icaA/icaD. En todas las cepas productoras de biofilm se identificaron genes del operón icaABCD, lo cual evidencia que poseen un factor de virulencia que facilita su persistencia en el tejido mamario. Además, el biofilm constituye una fuente de contaminación microbiana que puede conducir a fallas en los procesos de producción que generen problemas de inocuidad de los alimentos.

In the pathogenesis of staphylococcal mastitis the biofilm is considered a marker of virulence that allows the adhesion of the microorganism to the mammary epithelium. In order to determine the production of biofilm and the presence of icaABCD gene, 30 S. aureus strains isolated from raw milk obtained from cows with subclinical mastitis were analyzed. Biofilm production was determined by the quantitative method on microplates for cell culture and the presence of genes icaABCD by polymerase chain reaction. Biofilm production was observed in 96.67% of strains of S. aureus. These 43.34% were strong producers, 30.00% producing moderate, 23.33% weak producers and 3.33% non producing biofilm. All of the icaABCD genes was obtained at 6.66% of the isolates. All strains, except one, presented icaA or icaD. 56,66% of isolates identified genes icaA/icaD. The icaABCD operon genes were identified in all biofilm-producing strains, which demonstrates that they possess a virulence factor that facilitates its persistence in the breast tissue. In addition, the biofilm is a source of microbial contamination which can lead to failures in production processes that generate problems of food safety.

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Resumen: La infección ósea y la seudoartrosis son las principales complicaciones ortopédicas en cuyo tratamiento intervienen múltiples factores en la tasa de falla al tratar de corregirlas. Conocer estos factores fue el problema que originó la investigación a través de un estudio longitudinal y prospectivo de una cohorte histórica de 83 pacientes de 43.3 ± 16.1 años de edad tratados por seudoartrosis asépticas y sépticas, osteomielitis, osteítis, consolidación viciosa o prótesis infectadas, el desenlace se relacionó con los factores pronósticos sistémicos y locales tomados del modelo de Cierny-Mader como factores que afectan la vigilancia inmunológica, el metabolismo y la vascularización local. Para el análisis bivariado se aplicó χ2 o el test exacto de Fisher; para el análisis multivariado se aplicó el modelo de regresión logística binaria no condicional con método de Wald hacia atrás para seleccionar los factores pronósticos significativos. El error alfa se fijó ≤ 0.05. Las complicaciones se presentaron en 51.8% de los casos. Los factores locales (linfedema, arteritis, insuficiencia venosa y pérdida de piel) con una OR de 5.0 (IC 95% 1.0-24.9, p = 0.03), las seudoartrosis sépticas con OR de 5.0 (IC 95% 1.9-13.0, p = 0.001) y fracturas segmentarias con OR de 3.2 (IC 95% 0.8-13.0, p = 0.07) fueron los factores pronósticos identificados en el análisis bivariado; sin embargo, la regresión logística sólo seleccionó como factor significativo a las seudoartrosis sépticas. Es necesario detectar y en su caso controlar o eliminar dichos factores que pueden incidir directamente en malos resultados postquirúrgicos.

Abstract: Bone infection and nonunion are the main orthopedic and traumatic complications whose treatment remains a challenge because multiple factors are involved in the rate of failures when you try to correct them. Knowing these factors were the problem that caused the research through a prospective longitudinal study of 83 patients of 43.3 ± 16.1 years old. They were treated for aseptic and septic nonunion, osteomyelitis, osteitis, malunion or infected joint replacement. The cases were classified with or without postoperative complications and outcome related to systemic and local factors taken prognostic model Cierny-Mader as factors affecting immune surveillance, metabolism and local vascularization. For bivariate analysis of data χ2 it was applied or where appropriate Fisher's exact test; for multivariate analysis model not conditional binary logistic regression method was applied Wald backward to select the significant prognostic factors. The alpha error was set ≤ 0.05. General complications occurred in 51.8% of cases. Local factors (lymphedema, arteritis, venous insufficiency, loss of skin) with an OR of 5.0 (95% CI 1.0-24.9, p = 0.03), septic nonunion with OR of 5.0 (95% CI 1.9-13.0, p = 0.001) and segmental fractures with an OR of 3.2 (95% CI 0.8-13.0, p = 0.07) were the prognostic factors identified in the bivariate analysis; however, the logistic regression only selected as the septic pseudoarthrosis as a significant factor. It is necessary to detect and if necessary control or eliminate those factors that can directly affect poor postoperative results.

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Mercury contamination in the River Beni basin is an important health risk factor, primarily for indigenous communities that live along the river. Among them are the Tacana, living in their original territory with sustainable use of their natural resources, consuming fish, Caiman yacare, and other riverine resources as their main source of protein. To assess mercury exposure to Tacana people, total mercury (THg) was evaluated in the muscle of seven commercial fish, and Caiman yacare (yacare caiman) during 2007 and 2008. THg was extracted by acid digestion and concentrations were determined by atomic absorption spectrometry. Mean mercury concentrations in C. yacare was 0.21 ± 0.22 µg g-1Hg w.w. (wet weight), which is lower than expected given its high trophic level, and its long life-span. It is possible that mercury in C. yacare is accumulated in other organs, not included in this study; but it is also possible that physiological mechanisms are involved that help caimans get rid of ingested mercury, or simply that C. yacare's diverse diet reduces THg accumulation. Carnivorous fishes (Pygocentrus nattereri, Pseudoplatystoma tigrinum, Zungaro zungaro, Plagioscion squamosissimus, and Leiarius marmoratus) had the highest total mercury concentrations, ranging from 0.35 to 1.27 µg g-1Hg w.w. moreover, most were above the limit recommended by WHO (0.5 µg g-1Hg w.w.); except for Leiarius marmuratus, which presented a mean of 0.353 ± 0.322 µg g-1Hg w.w. The two non-carnivorous fish species (Prochilodus nigricans, and Piaractus brachypomus) present mean concentrations of 0.099 ± 0.027, and 0.041 ± 0.019 µg g-1Hg w.w., respectively. Finally, recommendations on the consumption habits of Tacana communities are discussed.

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Introducción: El síndrome de hipoplasia femoral y facies inusual es una enfermedad rara con expresividad hereditaria variable, aunque se han reportado casos con un patrón autosómico dominante. Afecta particularmente las estructuras de la cara asociado a hipoplasia de fémur. Si bien su etiología no ha sido bien identificada, se ha asociado con diabetes materna, exposición a drogas, infecciones virales, radiaciones y oligohidramnios. Objetivo: Presentar el caso de una recién nacida con este síndrome. Caso clínico: Recién nacida de 41 semanas de gestación con nariz pequeña, labio superior delgado, micrognatia, filtrum largo, implantación baja de orejas, epicanto, cadera displásica con flexión y aducción de miembro inferior derecho y acortamiento del mismo a expensas del muslo. En la imagen radiográfica se encontró hipoplasia de fémur derecho con techo acetabular ipsilateral displásico. Se realizó una evaluación completa por distintos especialistas que descartaron otras malformaciones asociadas. Se programó el alargamiento quirúrgico de miembros inferiores a la edad de 5 meses con la finalidad de que deambule con sus propios pies; paralelamente se inició apoyo con kinesiterapia. Conclusiones: El síndrome de hipoplasia femoral y facies inusual es un padecimiento poco frecuente, que implica la participación de un equipo médico multidisciplinario para su manejo.

Introduction: Femoral hypoplasia-unusual facies syndrome is a rare disease with variable expressivity, although cases have been reported with an autosomal dominant pattern. It particularly affects the structures of the face associated with hypoplasia of the femur. Its aetiology is relatively unknown. However, this syndrome has been associated with maternal diabetes, drug exposure, viral infections, radiation, and oligohydramnios. Objective: The case of a newborn with this syndrome is presented. Clinical case: Newborn of 41 weeks gestation with small nose, thin upper lip, micrognathia, long philtrum, low set ears, epicanthal folds, dysplastic hips showing flexion, and adduction of the right leg, and shortening at the expense of the thigh. X-ray images revealed femoral hypoplasia and dysplastic acetabular roof. Different physicians from other specialties who excluded other associated malformations performed a complete evaluation. Surgical bone lengthening of lower limb is scheduled at 5 months of age, with the purpose that she walks with her own feet; at the same time she began management with kinesiotherapy. Conclusions: Femoral hypoplasia-unusual facies syndrome is a rare condition. A multidisciplinary health care team must treat individuals with femoral hypoplasia-unusual facies syndrome.

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Bone infection and nonunion are the main orthopedic and traumatic complications whose treatment remains a challenge because multiple factors are involved in the rate of failures when you try to correct them. Knowing these factors were the problem that caused the research through a prospective longitudinal study of 83 patients of 43.3 ± 16.1 years old. They were treated for aseptic and septic nonunion, osteomyelitis, osteitis, malunion or infected joint replacement. The cases were classified with or without postoperative complications and outcome related to systemic and local factors taken prognostic model Cierny-Mader as factors affecting immune surveillance, metabolism and local vascularization. For bivariate analysis of data Χ² it was applied or where appropriate Fishers exact test; for multivariate analysis model not conditional binary logistic regression method was applied Wald backward to select the significant prognostic factors. The alpha error was set 0.05. General complications occurred in 51.8% of cases. Local factors (lymphedema, arteritis, venous insufficiency, loss of skin) with an OR of 5.0 (95% CI 1.0-24.9, p = 0.03), septic nonunion with OR of 5.0 (95% CI 1.9-13.0, p = 0.001) and segmental fractures with an OR of 3.2 (95% CI 0.8-13.0, p = 0.07) were the prognostic factors identified in the bivariate analysis; however, the logistic regression only selected as the septic pseudoarthrosis as a significant factor. It is necessary to detect and if necessary control or eliminate those factors that can directly affect poor postoperative results.

La infección ósea y la seudoartrosis son las principales complicaciones ortopédicas en cuyo tratamiento intervienen múltiples factores en la tasa de falla al tratar de corregirlas. Conocer estos factores fue el problema que originó la investigación a través de un estudio longitudinal y prospectivo de una cohorte histórica de 83 pacientes de 43.3 ± 16.1 años de edad tratados por seudoartrosis asépticas y sépticas, osteomielitis, osteítis, consolidación viciosa o prótesis infectadas, el desenlace se relacionó con los factores pronósticos sistémicos y locales tomados del modelo de Cierny-Mader como factores que afectan la vigilancia inmunológica, el metabolismo y la vascularización local. Para el análisis bivariado se aplicó Χ² o el test exacto de Fisher; para el análisis multivariado se aplicó el modelo de regresión logística binaria no condicional con método de Wald hacia atrás para seleccionar los factores pronósticos significativos. El error alfa se fijó 0.05. Las complicaciones se presentaron en 51.8% de los casos. Los factores locales (linfedema, arteritis, insuficiencia venosa y pérdida de piel) con una OR de 5.0 (IC 95% 1.0-24.9, p = 0.03), las seudoartrosis sépticas con OR de 5.0 (IC 95% 1.9-13.0, p = 0.001) y fracturas segmentarias con OR de 3.2 (IC 95% 0.8-13.0, p = 0.07) fueron los factores pronósticos identificados en el análisis bivariado; sin embargo, la regresión logística sólo seleccionó como factor significativo a las seudoartrosis sépticas. Es necesario detectar y en su caso controlar o eliminar dichos factores que pueden incidir directamente en malos resultados postquirúrgicos.

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INTRODUCTION: Femoral hypoplasia-unusual facies syndrome is a rare disease with variable expressivity, although cases have been reported with an autosomal dominant pattern. It particularly affects the structures of the face associated with hypoplasia of the femur. Its aetiology is relatively unknown. However, this syndrome has been associated with maternal diabetes, drug exposure, viral infections, radiation, and oligohydramnios. OBJECTIVE: The case of a newborn with this syndrome is presented. CLINICAL CASE: Newborn of 41 weeks gestation with small nose, thin upper lip, micrognathia, long philtrum, low set ears, epicanthal folds, dysplastic hips showing flexion, and adduction of the right leg, and shortening at the expense of the thigh. X-ray images revealed femoral hypoplasia and dysplastic acetabular roof. Different physicians from other specialties who excluded other associated malformations performed a complete evaluation. Surgical bone lengthening of lower limb is scheduled at 5 months of age, with the purpose that she walks with her own feet; at the same time she began management with kinesiotherapy. CONCLUSIONS: Femoral hypoplasia-unusual facies syndrome is a rare condition. A multidisciplinary health care team must treat individuals with femoral hypoplasia-unusual facies syndrome.

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Age is an important feature at the time of early breast cancer diagnosis. Radiotherapy is a mandatory component of treatment for breast-conserving strategies in early disease stages. Breast radiotherapy has rapidly evolved in the last 20 years. A tendency to less treatment volume (partial-breast irradiation) and less treatment time (hypofractionation) is consolidated in modern radiation oncology practice. Age and risk for local recurrence guide the decision-making process to electro-optimal treatment. Radiotherapy technological versatility offers multiple options for individualized (risk-age adapted) recommendations.

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El sarcoma de Kaposi (SK) es un cáncer que se desarrolla a partir de las células de los vasos sanguíneos o linfáticos. Fue descrito, en 1872, por Moriz Kaposi, y por muchos años se consideró una neoplasia de curso poco agresivo, lo cual cambió con la epidemia del sida. Se han descrito clásicamente cuatro grupos de SK: clásico, endémico, iatrogénico y epidémico. El SK clásico, aparece con mayor frecuencia en pacientes de 60 a 70 años y de origen mediterráneo. Se presenta el caso de un paciente joven de 27 años, inmunocompetente que desarrolla un SK clásico con inicio inusual.

Kaposi's sarcoma is a type of cancer that develops from blood cells or lymphatic vessels. It was described in 1872 by Moriz Kaposi, and for many years was considered an aggressive neoplasm, which changed with the AlDS epidemic. lt has been classically described into four groups of Kaposi's sarcoma: classic, endemic, iatrogenic and epidemic. The classic Kaposi sarcoma occurs more frequent in patients from 60 to 70 years old and Mediterranean origin. We report the case of a young patient of 27 years old, immunocompetent who developed classic Kaposi sarcoma with an un usual start.

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