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Relative to the numerous studies focused on mammalian schistosomes, fewer include avian schistosomatids particularly in the southern hemisphere. This is changing and current research emerging from the Neotropics shows a remarkable diversity of endemic taxa. To contribute to this effort, nine ducks (Spatula cyanoptera, S.versicolor, Netta peposaca), 12 swans (Cygnus melancoryphus) and 1,400 Physa spp. snails from Chile and Argentina were collected for adults and larval schistosomatids, respectively. Isolated schistosomatids were preserved for morphological and molecular analyses (28S and COI genes). Four different schistosomatid taxa were retrieved from birds: Trichobilharzia sp. in N. peposaca and S. cyanoptera that formed a clade; S.cyanoptera and S. versicolor hosted Trichobilharzia querquedulae; Cygnus melancoryphus hosted the nasal schistosomatid, Nasusbilharzia melancorhypha; and one visceral, Schistosomatidae gen. sp., which formed a clade with furcocercariae from Argentina and Chile from previous work. Of the physid snails, only one from Argentina had schistosomatid furcocercariae that based on molecular analyses grouped with T. querquedulae. This study represents the first description of adult schistosomatids from Chile as well as the elucidation of the life cycles of N.melancorhypha and T. querquedulae in Chile and Neotropics, respectively. Without well-preserved adults, the putative new genus Schistosomatidae gen. sp. could not be described, but its life cycle involves Chilina spp. and C. melancoryphus. Scanning electron microscopy of T. querquedulae revealed additional, undescribed morphological traits, highlighting its diagnostic importance. Authors stress the need for additional surveys of avian schistosomatids from the Neotropics to better understand their evolutionary history.

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Mesocestoides is a controversial tapeworm with significant lack of data related to systematics and life cycles. This helminth has an indirect life cycle with vertebrates, mostly carnivorous mammals, as definitive hosts. Theoretically, a coprophagous arthropod would be the first intermediate host, and herptiles, mammals, and birds, which prey on these insects, would represent the second intermediate hosts. However, recent evidence suggests that this life cycle would require only two hosts, with no arthropods involved. In the Neotropics, although there are records of mammals and reptiles as hosts for Mescocestoides, no molecular analyses have been performed. This work aimed to record an additional intermediate host and molecularly characterize the isolated larvae. Thus, 18 braided tree iguanas (Liolaemus platei) from Northern Chile were collected and dissected during 2019. One lizard was parasitized by three morphotypes of larvae compatible with tetrathyridia of Mescocestoides. To achieve its specific identity, a molecular approach was performed: 18S rRNA and 12S rRNA loci were amplified through cPCR. The inferred phylogenies confirmed the morphological diagnosis and stated that all morphotypes were conspecifics. The sequences for both loci formed a monophyletic clade with high nodal support, representing a sister taxon to Mescocestoides clade C. This study represents the first molecular characterization of any taxon of Mescocestoides from the Neotropics. Future surveys from potential definitive hosts would help to elucidate its life cycle. Furthermore, an integrative taxonomic approach is required in additional studies from the Neotropical region, which would contribute to a better understanding of the evolutionary relationships of this genus.

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BACKGROUND AND PURPOSE: The carotid stent placement as a therapeutic option for carotid stenosis has been increasing among years; therefore, studies are required to evaluate the security and efficacy of its materials. The purpose of this study was to evaluate the distal filter and the proximal balloon-guided catheter with flow inversion as protection devices during carotid angioplasty and stenting. METHODS: This is a retrospective, observational study of patients diagnosed with carotid stenosis treated with angioplasty between January 1, 2014, and June 30, 2020; we analyzed a radiology service database to compare the distal filter and the proximal balloon-guided catheter as protection devices during angioplasty. RESULTS: One hundred seventy-five angioplasties were performed, the distal filter was the most prevalent embolic protection device used (66%), patients baseline characteristics did not differ between groups with different embolic protection devices, except for history of dyslipidemia (p < 0.000). As well, we did not find any significant differences between the groups in the device related complications, intervention time (p = 0.140), unrelated complications (p = 0.693) and functional independence at 90 days (p = 0.096). CONCLUSIONS: In our study the proximal balloon-guided catheter and the distal filter protection device as protection devices during the carotid stenting didn't show significant differences regarding complications related to the system.

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Introducción: el consumo de estimulantes de tipo anfetamínico (ETA) y sus derivados está cada vez más presente en los estudiantes universitarios y, en particular, en los programas de medicina. El objetivo principal de este estudio fue revisar la literatura sobre el uso de ETA y sus derivados en estudiantes de medicina latinoamericanos. Materiales y método: se realizó una revisión de la literatura disponible, utilizando las bases de datos PubMed, SciELO y LILACS. Se encontraron un total de 1.054 artículos, de los cuales 17 fueron seleccionados para esta revisión. Resultados: la revisión muestra, en general, una mayor frecuencia de uso de ETA en estudiantes de medicina de América Latina en comparación con la población general y estudiantes de otras carreras universitarias. También existe una tendencia a un mayor uso en hombres, de mayor nivel socioeconómico y en cursos posteriores del programa. La razón más informada para usar ETA fue aumentar el rendimiento académico. Como factor protector se destacaron los deportes, el tiempo en familia y la profesión de alguna creencia religiosa. De los artículos seleccionados, no se encontraron estudios sobre las consecuencias a largo plazo del uso de ETA en estudiantes de medicina. Discusión: en resumen, los estudiantes de medicina latinoamericanos tienen un alto consumo de ETA, por lo que es evidente la necesidad de nuevos estudios para mejorar la precisión estadística, determinar factores de riesgo específicos, estudiar las consecuencias a largo plazo y establecer políticas de prevención y tratamiento.

Introduction: the consumption of amphetamine-type stimulants (ATS) and their derivatives are increasingly present in university students and in particular in medical programs. The main objective of this study was to review the literature on the use of ATS and their derivatives in Latin American medical students. Materials and method: a review of the literature available was performed, using PubMed, SciELO, and LILACS databases. A total of 1054 articles were found, of which 17 were selected for this review. Results: the review generally shows a higher frequency of use of ATS in medical students of Latin America compared to the general population and students from other university degrees. There is also a tendency of a higher use in men, from higher socioeconomic status, and in later courses of the program. The most reported reason for using ATS was to increase the academic performance. As a protective factor, sports, family time and professing some religious belief stood out. Of the selected articles, no studies were found on the long-term consequences of the use of ATS in medical students. Discussion: in summary, Latin American medical students have a high consumption of ATS, and therefore there is an evident need for new studies to improve statistical precision, to determine specific risk factors, to study long-term consequences, and to stablish prevention policies and treatment.

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INTRODUCTION: Expansive intra-spinal processes usually have an insidious course that makes their early diagnosis difficult. Intra-spinal tumors are classified according to their location in the spinal canal: extradural and intradural, and these are classified as extramedullary and intramedullary. At the beginning, they can cause non-specific pain conditions and, sometimes, root-type pain. The patient may have symptoms such as: loss of strength, loss of balance, loss of sensation, sphincter disorders. Intra-spinal neoplasms, when diagnosed, have an indication for surgical treatment. MATERIAL AND METHODS: The clinical case of a 14-year-old male adolescent is described, pain in the lumbar region for four years, of insidious onset, intermittent, progressive, exacerbated six months ago, with radiation to the lower extremities, which is accompanied by progressive paresthesia and paresis predominantly in the lower right limb. RESULTS: Bilateral L4 and L5 laminotomy is performed, exploration and resection of the tumor and release of nerve roots. Tumor with characteristics similar to adipose tissue is obtained, where a wide vascular network is observed inside, with an approximate size of 14 × 10 × 4 mm, ovoid in shape, flattened with a smooth and shiny surface. CONCLUSION: Spinal tumors are relatively rare tumors, however, of these tumors, the extradural intraspinal location accounts for half of the cases. In our patient, the diagnosis of lipoma of the filum terminale was integrated, which corresponds to less than 1% of all tumors of the spine.

INTRODUCCIÓN: Los procesos expansivos intrarraquídeos suelen tener una evolución insidiosa que dificultan su diagnóstico precoz. Los tumores intrarraquídeos son clasificados de acuerdo con su localización en el conducto raquídeo: extradural e intradural, y éstos se clasifican en extramedular e intramedular. Al comienzo, pueden provocar cuadros de dolor poco específicos y, a veces, dolores de tipo radicular. El paciente podrá tener síntomas como: pérdida de fuerza, pérdida de equilibrio, pérdida de sensibilidad y disturbios esfinterianos. Las neoplasias intrarraquídeas, cuando son diagnosticadas, tienen indicación de tratamiento quirúrgico. MATERIAL Y MÉTODOS: Se describe el caso clínico de adolescente masculino de 14 años, dolor en región lumbar desde hace cuatro años, de inicio insidioso, intermitente, progresivo, que se exacerba hace seis meses, con irradiación a extremidades inferiores, que se acompaña de parestesias y paresias progresivas de predominio en extremidad inferior derecha. RESULTADOS: Se realiza laminotomía L4 y L5 bilateral, exploración y resección de tumoración y liberación de raíces nerviosas. Se obtiene tumor de características similares a tejido adiposo en donde se observa amplia red vascular en su interior, con tamaño aproximado de 14 × 10 × 4 mm de forma ovoide, aplanada con superficie lisa y brillante. CONCLUSIÓN: Los tumores raquimedulares son tumores relativamente raros; sin embargo, de estos tumores, la localización intrarraquídea extradural corresponde a la mitad de los casos. En nuestro paciente, se integró el diagnóstico de lipoma del filum terminale, el cual corresponde a menos de 1% de todos los tumores de la columna vertebral.

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OBJETIVO: La mastitis granulomatosa es una patología mamaria benigna y crónica de baja incidencia, cuyo diagnóstico es complejo y su tratamiento no está del todo establecido. Se presenta un caso clínico con el objetivo de hacer una revisión de la bibliografía sobre esta patología, su diagnóstico y tratamiento. MATERIAL Y MÉTODOS: Se presenta el caso de una paciente de 30 años con una mastitis refractaria a tratamiento antibiótico a la que finalmente se diagnosticó una mastitis granulomatosa idiopática gracias a la biopsia excisional. El tratamiento con corticoides a dosis altas tuvo buenos resultados en este caso. Se realizó una búsqueda bibliográfica en las bases de datos Medline vía PubMed, EMBASE y SciELO y también en libros de texto en papel. RESULTADOS: Se hallaron 598 referencias, la mayoría de ellas revisiones sistemáticas y casos clínicos. CONCLUSIONES: La mastitis granulomatosa es una patología poco frecuente cuyo diagnóstico se logra mediante estudio histológico de la misma. No hay consenso sobre cuál es el tratamiento óptimo, pero la tendencia actual es el tratamiento conservador con corticoides a altas dosis. Cada vez es más frecuente el uso de metotrexato cuando no hay buena respuesta con el tratamiento con corticoides.

OBJECTIVE: Granulomatous mastitis is a benign and chronic breast pathology with a low incidence, whose diagnosis is complex and its treatment is not fully established. A case report is presented with the aim of reviewing the literature on this pathology, its diagnosis and its treatment. MATERIAL AND METHODS: The patient is a 30-year-old woman with a mastitis refractory to antibiotic treatment. Finally, idiopathic granulomatous mastitis was diagnosed through excisional biopsy. Treatment with high-dose corticosteroids had good results in this patient. A literature search was performed in the Medline databases via PubMed, EMBASE and SciELO and also in paper textbooks. RESULTS: 598 references were found, most of them systematic reviews and case reports. CONCLUSIONS: Granulomatous mastitis is an uncommon pathology whose definitive diagnosis is achieved by histological study. Treatment is not fully established, but conservative treatment with high-dose corticosteroids is the current trend. The use of methotrexate has risen when there is no good evolution with corticosteroid treatment.

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OBJETIVOS: reportar el caso de una paciente con gestación gemelar monocorial-biamniótica complicada por secuencia TRAP que dio lugar al nacimiento de un feto bomba de 1932 gramos sin malformaciones anatómicas y de un feto acardio anceps de 1800 gramos, y realizar una revisión sobre esta patología y la importancia de su diagnóstico y tratamiento precoces. MATERIALES Y MÉTODOS: se presenta el caso de un feto acardio en una gestante con embarazo sin control estricto en el Hospital San Pedro de Logroño en el año 2019, de interés por su diagnóstico tardío y elevado peso al nacimiento del feto acardio. Se realizó una búsqueda de la literatura en las bases de datos Medline vía PubMed, OVID, Embase y SciE-LO con las palabras clave DeCS y términos MeSH. Como criterios de inclusión se consideraron artículos tipo series y reportes de casos y artículos de revisión desde enero de 1950 hasta enero de 2020. RESULTADOS: la búsqueda incluyó 39 referencias bibliográficas sobre las que se repasaron las principales cuestiones teóricas a exponer. El peso del feto acardio de nuestro caso fue muy elevado sin provocar repercusión en el feto sano, en comparación con la bibliografía, lo que aporta singularidad al caso, siendo sólo equiparable la serie de casos de Brassard et al (1999), con pesos de los fetos acardio por encima de 1700 gramos y diferenciándose en 100 gramos del feto bomba. CONCLUSIONES: el feto acardio es una complicación infrecuente de embarazos gemelares monocoriales. Se requiere la presencia de anastomosis vasculares placentarias entre ambas circulaciones. El diagnóstico precoz es importante para disminuir la morbilidad y usar, en la medida de lo posible, técnicas terapéuticas no invasivas.

OBJECTIVES: to report the case of a patient with a monochorionic-biamniotic twin gestation complicated by TRAP sequence that gave rise to the birth of a pump fetus without anatomical malformations (1932 g) and an acardiac anceps fetus (1800 g), and to review this pathology and the importance of its early diagnosis and management. MATERIAL AND METHODS: the case of an acardiac fetus is presented in a pregnant woman without strict control at the Hospital San Pedro de Logroño in 2019, worthwhile because of its late diagnosis and high birth weight. A search of the literature was carried out in the Medline databases via PubMed, OVID, Embase and SciELO with the MeSH terms. As inclusion criteria, we considered series-type articles and case reports, cohorts and review articles from January 1950 to January 2020. RESULTS: 39 bibliographic references were included with the main theoretical questions to be reviewed. Our acardiac fetus weight was very high comparing with the bibiography and without causing repercussion in the healthy fetus, which contributes to the uniqueness of the case, only the series report by Brassard et al (1999) is comparable, with weights of the acardiac fetus above 1700 grams and differing by 100 grams from the pump fetus. CONCLUSIONS: the acardiac fetus is an infrequent complication of monochorionic twin pregnancies. The presence of placental vascular anastomoses between both circulations is required. Early diagnosis is important to decrease morbidity and to use, as far as possible, non-invasive therapeutic techniques.

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RESUMEN La investigación y el interés por el virus influenza aviar han aumentado considerablemente en las últimas décadas en respuesta a los brotes de influenza aviar de alta patogenicidad en aves de corral y a su potencial zoonótico. Las aves silvestres acuáticas son el principal reservorio del virus en la naturaleza, por lo tanto, la comprensión de la dinámica de infección del virus influenza A (VIA) en estas poblaciones es fundamental para entender su potencial de persistencia en el ambiente y sus posibilidades de transmisión hacia aves domésticas y humanos. Se ha identificado que factores ambientales (como temperatura, precipitaciones, vegetación y características del paisaje, entre otros) pueden tener un importante rol en el mantenimiento y diseminación del virus en las zonas de concentración de aves silvestres. Sin embargo, los estudios que incluyen aspectos ecológicos del virus y que exploran la interacción entre la prevalencia del VIA en aves silvestres y el ambiente, continúan siendo escasos. En esta revisión se resumen los esfuerzos de investigación que se han realizado para identificar a los factores ambientales involucrados en la persistencia y transmisión del VIA en lugares de concentración de aves silvestres y cómo estos factores pueden incidir en la prevalencia del virus en estas poblaciones, generando diferencias en la presentación de la infección entre distintas zonas geográficas.

ABSTRACT Research and interest in avian influenza virus have increased considerably in recent decades in response to highly pathogenic avian influenza outbreaks in poultry and its zoonotic potential. Wild waterfowl are the main reservoir of the virus, therefore studying the dynamics of influenza A virus (IAV) infection in these populations is essential in order to understand its potential persistence in the environment and transmission to poultry and humans. It has been identified that environmental factors (such as temperature, rainfall, vegetation and landscape characteristics, among others) can play an important role in the maintenance and dissemination of the virus in the areas of concentration of wild birds. However, studies that include ecological aspects of the virus and explore the interaction between the prevalence of IAV in wild birds and environmental factors remain scarce. This review summarizes research efforts that have been made to identify the environmental factors involved in the persistence and transmission of IAV in areas of wild bird concentration and how these factors may influence the prevalence of the virus in these populations, generating differences in the presentation of the infection among different geographical areas.

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RESUMEN La Insuficiencia Ovárica Primaria se define por una amenorrea secundaria de al menos cuatro meses de duración, deficiencia de esteroides sexuales (estradiol) y altas concentraciones séricas de hormona folículoestimulante (FSH) con al menos un mes de diferencia entre estas determinaciones, en mujeres menores de 40 años. Es una causa insidiosa de infertilidad pero en algunas ocasiones es transitoria y permite una gestación espontánea. El Síndrome de Turner es un trastorno genético caracterizado por la pérdida o anomalías estructurales de un cromosoma X y que afecta a 1 de cada 2.500 mujeres nacidas vivas. Las manifestaciones clínicas varían entre pacientes, pero generalmente se relaciona con talla baja, coartación aórtica, disgenesia gonadal e insuficiencia ovárica primaria. Las técnicas de reproducción asistida como la criopreservación de ovocitos y de tejido ovárico, la maduración in vitro o la donación de ovocitos ofrecen opciones reproductivas en aquellos casos en los que no se produzca un embarazo espontáneo.

ABSTRACT Primary Ovarian Insufficiency is considered a secondary amenorrhea of at least four months duration, sex steroid deficiency (estradiol) and high serum concentrations of follicle stimulating hormone (FSH) with at least one month difference between these determinations, in women under 40 years. It is an insidious cause of infertility but sometimes it is transient and allows a spontaneous pregnancy. Turner syndrome is a genetic disorder characterized by the loss or structural abnormalities of an X chromosome that affects 1 in 2,500 women born alive. Clinical manifestations vary among patients, but it is usually associated with short stature, aortic coarctation, gonadal dysgenesis, and primary ovarian failure. Assisted reproduction techniques such as cryopreservation of oocytes and ovarian tissue, in vitro maturation or oocyte donation offer reproductive options in those cases in which there is no spontaneous pregnancy.

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RESUMEN El dolor abdominal en gestantes supone un diagnóstico complejo por el múltiple diagnóstico diferencial que existe. Es necesaria la realización de un diagnóstico precoz para reducir el número de complicaciones. Para ello, nos apoyamos no sólo en criterios clínicos si no en pruebas de imagen como la resonanacia magnética nuclear. Nuestro objetivo es la realización de una revisión bibliográfica sobre el dolor abdominal en gestantes, centrándonos en la obstrucción intestinal, a propósito de un caso de una gestante con dolor abdominal agudo a la que se le diagnosticó de isquemia intestinal secundaria a obstrucción intestinal por brida postquirúrgica. La obstrucción intestinal es una causa infrecuente y potencialmente grave de dolor abdominal agudo en gestantes, que cursa con clínica insidiosa y que precisa cirugía como tratamiento.

ABSTRACT Abdominal pain in the pregnant woman is complex to diagnose because of the multiple differential diagnosis that exists. It is necessary to perform an early diagnosis to reduce the number of complications. For this, we rely not only on clinical criteria but on imaging tests such as nuclear magnetic resonance. Our objective is to review the literature on abdominal pain in pregnant women, focusing on intestinal obstruction, and with regard to the case of a pregnant woman with acute abdominal pain who was diagnosed of intestinal ischemia due to intestinal obstruction by post-surgical bridle. Intestinal obstruction is an infrequent and potentially serious cause of acute abdominal pain in the pregnant woman, which is insidious and requires surgery as a treatment.

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The discoloration of methylene blue in aqueous solution was studied under illumination by a fluorescent lamp, LEDs of red, green, and blue light, and a UV-A black light bulb. Overall results showed that methylene blue was discolored with and without the presence of any photoactive semiconductor. Outcomes depended on the combination substrate-light source employed. Photosensitization was assumed as the discoloration mechanism followed upon visible light irradiation. Fluorescence spectroscopy and high-performance liquid chromatography were used to investigate the possible intermediates formed in the irradiated solutions. The detailed nature of formed species was not stablished, but it was proved that the dye molecule photo-bleached and partially defragmented in several intermediates including leuco dyes, demethylated phenothiazine dyes, and probably humic substances. Since the fluorescence intermediates found were similar for most of the irradiated solutions, it was assumed that comparable reactive species were responsible for the discoloration of the molecule in solution. Results proved the misconception of discoloration experiments found in the literature when employing visible light near the absorption region of the dye.

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RESUMEN Antecedentes: La comunidad ecuatoriana es la tercera comunidad extranjera más numerosa en España. Sin embargo, es poco lo que se conoce acerca de su estado de salud cardiovascular (CV) y si los efectos de la migración han causado un detrimento en dicho estado. Métodos: Con el objetivo de conocer la salud CV en una población ecuatoriana de migrantes en Madrid, se realizó un estudio transversal no aleatorizado en el que se incluyeron personas de nacionalidad ecuatoriana, mayores de 25 años, residentes en Madrid desde hace un año o más. Se realizaron encuestas, mediante el uso de cuestionarios previamente validados, para determinar el estado de salud CV de la población, así como el grado de distress psicológico. Resultados: Se incluyeron 165 participantes (68,5% mujeres), con edad promedio de 49 años. El 86,1% de la población estudiada presentó salud cardiovascular pobre y 13,9% intermedia, sin diferencias significativas según el sexo. No hubo individuos que cumplan las 7 variables con valores ideales. Las mujeres presentaron puntuaciones más altas en el cuestionario DASS-21 en comparación a los hombres (p<0,05). Conclusión: En la población migrante ecuatoriana residente en Madrid, más del 85% presentó una salud CV pobre, y ninguno presentó una salud CV ideal. Los factores de riesgo más prevalentes en dicha población fueron pobre actividad física, sobrepeso/obesidad y malos hábitos dietéticos. Se requieren más estudios para identificar la situación real de riesgo CV de la población migrante ecuatoriana. Probablemente, a medio-largo plazo, será necesario implementar políticas de salud especialmente dirigidas a los migrantes.

ABSTRACT Background: The Ecuadorian community is the third largest foreign community in Spain. However, little is known about their cardiovascular (CV) health status and whether the effects of migration have caused a detriment in that state. Methods: With the aim of knowing the CV health in an Ecuadorian population of migrants in Madrid, a non-randomized, cross-sectional study was carried out, which included people of Ecuadorian nationality, older than 25 years, living in Madrid for a year or more. Surveys were conducted through the use of previously validated questionnaires, to determine the health status of the population, as well as the degree of neuro-physiological distress. Results: We included 165 participants (68.5% women), with an average age of 49 years. Of these, 86.1% presented poor cardiovascular health and 13.9% intermediate, without significant differences according to sex. There were no individuals that met the 7 variables consistent with and ideal CV status. Women had higher scores on the DASS-21 questionnaire compared to men (p <0.05). Conclusion: In the Ecuadorian migrant population living in Madrid, more than 85% had poor CV health, and none had an ideal CV health. Most prevalent risk factors in this population were poor physical activity, overweight/obesity and poor dietary habits. More studies are required to identify the real situation of CV risk in the Ecuadorian migrant population. Probably, in the medium-long term, it will be necessary to implement health policies especially addressed to migrants.

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Introducción: La obesidad y la salud mental (SM) pueden interactuar de forma compleja y bidireccionalmente. Entre los tratamientos para la obesidad, la cirugía de pérdida de peso (WLS por sus siglas en inglés) es una alternativa para un número creciente de pacientes. El objetivo de este trabajo es realizar una revisión actualizada de los diversos aspectos que relacionan la SM y la WLS. Métodos: Se realizó una búsqueda en PubMed, utilizando los términos MeSH «mental health¼, «obesity¼,«surgery¼, «weight loss surgery¼, y «weight loss surgery¼ y «suicide¼, obteniéndose 532 resultados. Resultados: Los principales resultados fueron: a) Diversos equipos evalúan la SM de candidatos pre-WLS con diferentes procedimientos y protocolos. b) Hasta el 50% de los pacientes en evaluación pre-WLS tiene una enfermedad mental activa. c) La evidencia de que la presencia de alteraciones de la SM afecta el peso post-WLS no es concluyente. d) La investigación de pacientes con trastornos psiquiátricos severos sometidos a WLS es muy escasa y suele considerarse incluso un criterio de exclusión. e) La WLS se asoció a un impacto positivo en SM, ya sea por mejoría en la calidad de vida, por reducción en la severidad de trastornos mentales o por mejoría en las funciones cognitivas. Conclusiones: Los pacientes candidatos a WLS suelen sufrir de patología mental. La WLS se asocia a la mejoría de diversos resultados en SM. Nuevos estudios deben determinar si la presencia de algunos trastornos mentales y/o deterioro cognitivo podrían convertirse en criterios para la indicación de WLS.

Introduction: A complex interaction exists between mental health (MH) and obesity. Weight loss surgery (WLS) is currently an alternative for a growing number of patients. Hence, the aim of this study is to do an up-to-date review of the several aspects on the relationship between WLS and MH. Methods: A comprehensive PubMed search was done, using the MeSH terms ‘mental health’, ‘obesity’, ‘surgery’, and ‘weight loss surgery’ and ‘weight loss surgery’ and ‘suicide’. A total of 532 papers were found. Results: The main results were: a) Teams across the world evaluate MH of WLS candidates with different methods and protocols. b) Up to 50% of the patients in evaluation for WLS have an active mental disorder. c) The evidence that MH affects the final weight outcome in WLS subjects is not conclusive. d) The research in severe psychiatric patients and WLS is scarce and is often considered as an exclusion criterion. e) WLS is associated with a positive impact on MH, either due to a better quality of life, to reductions on the severity of mental disorders or improvements in cognitive functions. Conclusions: WLS seems to be associated with several positive outcomes of MH. Future studies should explore the questions yet not answered on this relationship, and investigate if the presence of some mental disorders and/or cognitive impairment might become criteria for the indication of WLS.

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Resumen El virus de chikunguña se manifiesta en los seres humanos como una tríada de síntomas: fiebre, erupción cutánea y artralgias. El nombre de chikunguña se derivó del debilitante dolor en las articulaciones en las poblaciones africanas durante un brote en 1952-1953, en lo que ahora se conoce como Tanzania. La palabra local chikunguña significa lo que dobla hacia arriba, como resultado de la postura encorvada causada por el dolor que causa la enfermedad. La infección por el virus de chikunguña normalmente es una enfermedad de alivio espontáneo y puede manifestarse como encefalopatía, encefalitis, miocarditis, hepatitis e insuficiencia multiorgánica; sin embargo, se han reportado pocos casos con afección del sistema nervioso central, con mortalidad de 10% en este grupo de pacientes. Entre las complicaciones neurológicas reportadas están las encefalitis, miopatías, neuropatías y polineuropatía.

Abstract Chikungunya virus is presented as a triad of symptoms: fever, rash and joint pain in humans. Chikungunya name was derived from debilitating joint pain in African populations during an outbreak in 1952-1953, in what is now known as Tanzania. The local word chikungunya means that which bends up as a result of the stooped posture secondary to pain caused by the disease. Infection due to chikungunya virus is usually a self-limiting disease. It may manifest as encephalopathy, encephalitis, myocarditis, hepatitis and multiple organ failure, but few cases have been reported with the central nervous system disease with a mortality of 10% in this group of patients. The neurological complications reported include encephalitis, myopathy, neuropathy and polyneuropathy.

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Resumen La enfermedad de Goodpasture es una entidad clínica con una base fisiopatológica inmunológica como punto de partida, en la que la unión al dominio terminal NC1 afecta principalmente en la zona glomerular y pulmonar, con lo que su diagnóstico está orientado hacia estas insuficiencias orgánicas; su incidencia varía de 0.5 a 1 casos por millón de habitantes, por lo que se considera una enfermedad poco frecuente y de mortalidad elevada debido a las complicaciones derivadas del mecanismo inmunológico. La manifestación pulmonar de manera aislada representa un porcentaje aún menor; la hemoptisis es, incluso en 66% de los casos, la forma más frecuente de expresión clínica. El pronóstico de estos pacientes se asocia con la forma de manifestación de la enfermedad y la calidad en la atención recibida. El diagnóstico definitivo se realiza mediante toma de biopsia; sin embargo, la existencia de anticuerpos anti-MBG (antimembrana basal glomerular) mediante la prueba ELISA puede manejarse en el diagnóstico con buena sensibilidad.

Abstract Goodpasture's disease is a clinical entity with an immunological pathophysiological basis, where the union to terminal NC1 domain mainly affects glomerular and lungs; thus, its diagnosis is oriented to such organ failure; its incidence varies from 0.5 to 1 cases per million population, for this reason it is considered a rare disease with high mortality due to complications from immune mechanism. Isolated lung presentation accounts for an even fewer percentage; in two thirds of cases hemoptysis is the most common clinical expression of the disease. Prognosis of these patients is associated to the presentation of the disease and the quality of care provided during the same. The definitive diagnosis is made by biopsy; however, the presence of antiGBM antibodies (glomerular basement membrane) by ELISA can be handled in the diagnosis with good sensitivity.

RESUMO

Resumen La linfohistiocitosis hemofagocítica es un síndrome hiperinflamatorio y no una enfermedad independiente. Representa una reacción hiperinflamatoria terminal que puede ocurrir en diferentes condiciones. Las formas genéticas de la linfohistiocitosis hemofagocítica se deben a un defecto en el transporte y el funcionamiento de los gránulos citotóxicos de las células NK y de los linfocitos T citotóxicos y no sólo están restringidas durante la niñez. Las formas adquiridas de esta enfermedad se encuentran en infecciones, enfermedades autoinflamatorias y autoinmunitarias, neoplasias malignas e insuficiencias inmunológicas adquiridas. El tratamiento está dirigido a suprimir la actividad de las citocinas y eliminar las células activadas e infectadas.

Abstract Hemophagocytic lymphohistiocytosis is a hyperinflammatory syndrome and not an independent disease. Hemophagocytic lymphohistiocytosis is a terminal hyperinflammatory reaction that can occur in different conditions. The hemophagocytic lymphohistiocytosis genetic forms are due to a defect in the transport and operation of the cytotoxic granules of NK cells and cytotoxic T lymphocytes and are not only restricted in childhood. Acquired forms of hemophagocytic lymphohistiocytosis are found in infections, auto-inflammatory and autoimmune diseases, cancers and acquired immune deficiencies. The treatment is aimed at suppressing the activity of cytokines and eliminate infected and activated cells.

RESUMO

OBJECTIVE: To develop an objective method for visualizing and measuring the fetal optic chiasm (OC) using transvaginal two-dimensional (2D) ultrasound in the coronal plane and to report measurements in fetuses with agenesis of the septum pellucidum (SP). METHODS: This was a prospective cross-sectional study of 115 morphologically normal fetuses in low-risk pregnancies, between 21 and 30 weeks' gestation. The OC was measured in a coronal plane at the level of the third ventricle and was seen as a horizontally aligned dumbbell-shaped structure of moderate echogenicity. In addition, OC measurements from eight fetuses with agenesis of the SP and complete follow-up were compared with the reference range. RESULTS: OC measurements were obtained in 110/115 normal fetuses and showed that OC increases linearly with gestational age. Our method of measurement demonstrated good intraobserver repeatability and excellent interobserver reproducibility. Among the eight fetuses with agenesis of the SP, five had normal OC measurements and five had normal vision postnatally. Pregnancy continued to term in all cases and the follow-up period varied from 6 months to 7 years. CONCLUSION: Our study demonstrates that it is possible to visualize and measure the OC directly on a 2D ultrasound coronal plane. In fetuses with agenesis of the SP, the morphology and width of the OC visual pathway could prove a relevant tool for assessing its development. It would also help in the difficult task of providing antenatal counseling when faced with the diagnosis of agenesis of the SP. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

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