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The annular pancreas (AP) is an uncommon congenital anomaly, characterised by a circumferential envelope in the second portion of the duodenum. In recent years, some genetic component has been found in the etiology. A newborn full-term male, weighing at 1910 g at birth, had a history of intrauterine growth restriction and diagnosis of tetralogy of Fallot, Down syndrome and congenital hypothyroidism. Duodenal membrane is suspected after persistent postprandial vomiting and abdominal distension; his abdomen was distended, hyperresonant and soft. The gastroduodenal series showed data compatible with a duodenal membrane so exploratory laparotomy was performed, finding the pancreas completely wrapping the second portion of the duodenum, so a diamond-shaped-duodenoduodenostomy anastomosis was performed. The AP should be considered, especially in male neonates with postprandial vomiting, abdominal distension, who show some other congenital anomaly, and in the abdominal X-ray, the sign of the double bubble is observed.

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This data article describes the connected pore cluster data from segmented nano-images of rocks related to a geothermal system. The collected samples include two (2) vesicle-amygdaloidal basalt (host rock) and four (4) horizons collected from a siliceous sinter mound (rock precipitated from hot waters). All the samples have undergone computed tomography scanning using a SkyScan 2211 multiscale X-ray nano-CT system (Bruker®), and the slices were analyzed using the Digital Rock Physics (DRP) approach. Pore volume and fluid permeability in the three directions were calculated with scripts of Python (v.3.9) and the visualizations of the 3D models were run with Paraview (v.5.10) software. The petrophysical properties, diagrams, and figures were produced by stacking the 2D projections (8-bit grayscale *.png images format) from the scanning. Raw data (images) were deposited in a repository, which has granted a persistent identifier (Mendeley Data: https://data.mendeley.com/datasets/srpxhpd37p/2). This article provides a study case to handle the data that test the interconnectivity and ability to transport fluids and/or exogenous matter carried during high-flow events in rocks outcropping at the surface level of a geothermal system.

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No disponible.

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Epignathus is a rare congenital orofacial teratoma that arises from the sphenoid region of the palate or the pharynx. It occurs in approximately 1:35,000 to 1:200,000 live births representing 2% to 9% of all teratomas. We present the case of a newborn of 39.4 weeks of gestation with a tumor that occupied the entire oral cavity. The patient was delivered by cesarean section. Oral resection was managed by pediatric surgery. Plastic surgery used virtual 3-dimensional models to establish the extension, and depth of the tumor. Bloc resection and reconstruction of the epignathus were performed. The mass was diagnosed as a mature teratoma associated with cleft lip and palate, nasoethmoidal meningocele that conditions hypertelorism, and a pseudomacrostoma. Tridimensional technology was applied to plan the surgical intervention. It contributed to a better understanding of the relationships between the tumor and the adjacent structures. This optimized the surgical approach and outcome.

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From samples of the Paleozoic Tamatán Group (Huizachal-Peregrina Anticlinorium, Tamaulipas, Mexico), petrographic (qualitative and modal) and geochemical analyses (major, trace, and rare earth elements) were conducted. The first U-Pb geochronological data on detrital zircons of the Tamatán Group were generated using four samples. The data presented here contains a broad overview of photomicrography, recalculated modal point-count data, raw geochemical data, and simple statistics of selected geochemical parameters. The data presented in this article are interpreted and discussed in the research article titled "Provenance and tectonic setting of the Tamatán Paleozoic sequence, NE Mexico: Implications for the closure of the Rheic Ocean at the northwestern part of Gondwana" [1].

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El pectus excavatum es la deformidad de la caja torácica frecuente, siendo el sexo masculino el mayormente afectado. Presentamos el caso de un varón de 16 años con pectus excavatum e índice de Haller de 4, a quien se somete a cirugía de pectus up con sistema de tracción esternal externa y fijación con tornillos. Se obtuvo una muy buena respuesta funcional y estética en su posoperatorio. La cirugía de pectus up como método poco invasivo da buenos resultados posoperatorios.The pectus excavatum is the most frequent deformity of the rib cage, with the male sex being the most affected. We present the case of a 16-year-old male with the presence of pectus excavatum with a Haller's index of 4 who undergoes pectus up surgery with an external sternal traction system and screw fixation. A very good functional and aesthetic response was obtained. The pectus up surgery as a less invasive technique has good postoperative results.

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Objective: Hormones produced by fat tissue, adipokines, produced during intrauterine life have recently been implicated in fetal growth. Vaspin is an adipokine expressed in visceral adipose tissue and has insulin-sensitizing effects. Elevated serum vaspin concentrations are associated with alterations in insulin sensitivity. We aimed to determine if vaspin concentrations in cord blood from healthy, term newborns differ among those born small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). A secondary objective was to determine whether an association existed between vaspin and anthropometric measurements, glucose and insulin levels in the newborn. Methods: The study population included healthy term newborns, 30 subjects in the SGA, 12 in the AGA, and 34 in the LGA group. Anthropometry was documented in all subjects. Blood was taken from the umbilical cord vein from each child for later analysis for vaspin, insulin and glucose concentrations. Results: Cord blood vaspin, insulin and glucose concentrations were not different between the three study groups. A negative correlation between vaspin and glucose concentrations was demonstrated in the whole cohort (r=-0.364, p=0.001). This correlation was also observed in the LGA group (r=-0.482, p=0.004). Glucose concentrations significantly predicted vaspin concentrations (r2=0.132, p=0.001). Conclusion: We found a negative association between glucose and vaspin concentrations in umbilical cord blood. In addition there was a predictive association between blood glucose and resulting vaspin concentration, suggesting that vaspin can be used as a predictor of alterations in the insulin-glucose metabolism from birth.

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The association of morphological divergence with ecological segregation among closely related species could be considered as a signal of divergent selection in ecological speciation processes. Environmental signals such as diet can trigger phenotypic evolution, making polymorphic species valuable systems for studying the evolution of trophic-related traits. The main goal of this study was to analyze the association between morphological differences in trophic-related traits and ecological divergence in two sympatric species, Astyanax aeneus and A. caballeroi, inhabiting Lake Catemaco, Mexico. The trophic differences of a total of 70 individuals (35 A. aeneus and 35 A. caballeroi) were examined using stable isotopes and gut content analysis; a subset of the sample was used to characterize six trophic and six ecomorphological variables. In our results, we recovered significant differences between both species in the values of stable isotopes, with higher values of δ15N for A. caballeroi than for A. aeneus. Gut content results were consistent with the stable isotope data, with a higher proportion of invertebrates in A. caballeroi (a consumption of invertebrates ten times higher than that of A. aeneus, which in turn consumed three times more vegetal material than A. caballeroi). Finally, we found significant relationship between ecomorphology and stable isotopes (r = .24, p < .01), hence, head length, preorbital length, eye diameter, and δ15N were all positively correlated; these characteristics correspond to A. caballeroi. While longer gut and gill rakers, deeper bodies, and vegetal material consumption were positively correlated and corresponded to A. aeneus. Our results are consistent with the hypothesis that morphological divergence in trophic-related traits could be associated with niche partitioning, allowing the coexistence of closely related species and reducing interspecific competition.

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Objetivos: Estimar la frecuencia de tendencias suicidas (suicidalidad) y explorar su relación con diversas variables en mujeres atendidas en un hospital público peruano durante el primer año del periodo posparto. Material y Métodos: Se realizó un análisis secundario de datos de un trabajo de investigación realizado en el Hospital Cayetano Heredia (Lima, Perú) que incluía 321 mujeres durante el primer año posparto, con registros de variables sociodemográficas, ginecológicas, clínico-psiquiátricas y de suicidalidad definida como la presencia del síntoma 9 del criterio A de Episodio Depresivo Mayor evaluado mediante la Entrevista Clínica Estructurada para el DSM-IV (Structured Clinical Interview for DSM-IV Disorders, SCID). Resultados: Se encontró una frecuencia de 15,58 % (IC 95%: 11,79-20,01%) de suicidalidad en mujeres durante el primer año posparto. El análisis bivariado mostró relación significativa entre la presencia de suicidalidad y depresión mayor (OR = 14,52; p <0,001), trastorno obsesivo-compulsivo (OR = 3,96; p= 0,001), trastorno disfórico premenstrual (OR=3,25; p=0,002) y episodio maniaco o hipomaniaco previo (OR=2,12; p=0,025). Asimismo, el análisis multivariado encontró relación significativa con status de separada/divorciada (OR = 6,96; p = 0,027), abortos previos (OR = 2,92; p = 0,006), sueño menor de 6 horas (OR=5,34; p=0,003) y lactancia materna (OR=0,15; p=0,004). Conclusiones: Las tendencias suicidas en mujeres con menos de un año posparto fueron detectadas en 15,58% de la muestra y se relacionaron con una serie de variables de diversa índole, las cuales deben ser tenidas en cuenta para eventuales intervenciones preventivas y/o de atención clínica focalizada.

Objectives: To estimate the frequency of suicidality and to explore its relation with different variables in women seen in a Peruvian public hospital during their first year of their postpartum period. Material and Methods: A secondary data analysis of a research study carried out in the Hospital Cayetano Heredia (Lima, Peru) was conducted on 321 women seen during their first postpartum year, with focus on sociodemographic, psychiatric, gynecological and suicidality variables. Suicidality was defined as the presence of symptom 9 of criterion A of a Major Depressive Episode assessed through the Structured Clinical Interview for DSM-IV Disorders (SCID). Results: Suicidality was found in 15.58% (95% CI: 11.79-20.01%) of the sample. Bivariate analyses showed a significant relationship between suicidality and major depression (OR = 14.52, p <0.001), obsessive-compulsive disorder (OR = 3.96, p = 0.001), premenstrual dysphoric disorder (OR=3.25, p = 0.002) and previous manic or hypomanic episode (OR = 2.12, p = 0.025). In addition, multivariate analysis found a significant relationship with being separated / divorced (OR = 6.96, p = 0.027), previous abortions (OR = 2.92, p = 0.006), sleep of less than 6 hours (5.34, p = 0.003) and breastfeeding (OR = 0.15, p = 0.004). Conclusions: The suicidality in women with less than one year postpartum had a frequency of 15.58% and was related to a series of variables to be taken into account for eventual preventive and/or focused clinical interventions.

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Introducción. La intolerancia a la lactosa es una afección frecuente en pediatría, cuyo diagnóstico erróneo conlleva morbilidad. El objetivo primario del estudio fue evaluar la utilidad del incremento del perímetro abdominal durante la prueba de hidrógeno espirado como predictor de intolerancia a la lactosa. El objetivo secundario fue analizar la influencia del índice de masa corporal, de la medida de la cintura y de la edad en la distensión abdominal de pacientes intolerantes a la lactosa. Población y métodos. Se incluyó a 138 sujetos de entre 3 y 15 años de edad a los cuales se les realizaron mediciones seriadas del perímetro abdominal y determinaciones de hidrógeno espirado cada 30 minutos por 3 horas, durante la prueba de hidrógeno espirado. Resultados. Del total de la muestra, 35 (25,4%) resultaron intolerantes a la lactosa. El incremento de 0,85 cm en el perímetro abdominal comparado con el perímetro abdominal basal tiene sensibilidad del 88% y especificidad del 85% para predecir intolerancia a la lactosa (OR 42,14; IC 95%: 13,08-135,75; p <0,001). El índice de masa corporal y la medida de la cintura no afectaron la distensibilidad del abdomen (p= NS); sin embargo, la edad modificó el momento de la distensión. Conclusiones. El incremento del perímetro abdominal de 0,85 cm en relación con el perímetro abdominal basal durante la prueba de hidrógeno espirado es un parámetro útil para diagnosticar la intolerancia a la lactosa en pediatría. Las variaciones en relación con el índice de masa corporal y la cintura no modificaron la utilidad del incremento del perímetro abdominal a diferencia de la edad.

Introduction. Lactose intolerance is a common disease in pediatrics, and its wrong diagnosis will lead to morbidity. The primary objective of this study was to assess the usefulness of an increased waist circumference during the hydrogen breath test as a predictor of lactose intolerance. The secondary objective was to analyze the impact of body mass index, waist circumference measurement, and age on the abdominal distension of patients with lactose intolerance. Population and methods. A total of 138 subjects aged 3 to 15 years were included. They underwent serial measurements of the waist circumference and hydrogen levels in the breath every 30 minutes over 3 hours during the hydrogen breath test. Results. Out of the entire sample, 35 (25.4%) patients had lactose intolerance. An increase of 0.85 cm in waist circumference compared to the baseline waist circumference results in a sensitivity of 88% and a specificity of 85% to predict lactose intolerance (odds ratio: 42.14, 95% confidence interval: 13.08-135.75, p < 0.001). The body mass index and waist circumference measurement did not affect abdominal distension (p= not significant); however, age modified the time of distension. Conclusions. A 0.85 cm increase in waist circumference compared to the baseline waist circumference during the hydrogen breath test is a useful parameter for the diagnosis of lactose intolerance in pediatrics. Variations in relation to body mass index and waist circumference did not affect the usefulness of an increased waist circumference, unlike age.

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INTRODUCTION: Lactose intolerance is a common disease in pediatrics, and its wrong diagnosis will lead to morbidity. The primary objective of this study was to assess the usefulness of an increased waist circumference during the hydrogen breath test as a predictor of lactose intolerance. The secondary objective was to analyze the impact of body mass index, waist circumference measurement, and age on the abdominal distension of patients with lactose intolerance. POPULATION AND METHODS: A total of 138 subjects aged 3 to 15 years were included. They underwent serial measurements of the waist circumference and hydrogen levels in the breath every 30 minutes over 3 hours during the hydrogen breath test. RESULTS: Out of the entire sample, 35 (25.4%) patients had lactose intolerance. An increase of 0.85 cm in waist circumference compared to the baseline waist circumference results in a sensitivity of 88% and a specificity of 85% to predict lactose intolerance (odds ratio: 42.14, 95% confidence interval: 13.08-135.75, p ≤ 0.001). The body mass index and waist circumference measurement did not affect abdominal distension (p= not significant); however, age modified the time of distension. CONCLUSIONS: A 0.85 cm increase in waist circumference compared to the baseline waist circumference during the hydrogen breath test is a useful parameter for the diagnosis of lactose intolerance in pediatrics. Variations in relation to body mass index and waist circumference did not affect the usefulness of an increased waist circumference, unlike age.

La intolerancia a la lactosa es una afección frecuente en pediatría, cuyo diagnóstico erróneo conlleva morbilidad. El objetivo primario del estudio fue evaluar la utilidad del incremento del perímetro abdominal durante la prueba de hidrógeno espirado como predictor de intolerancia a la lactosa. El objetivo secundario fue analizar la influencia del índice de masa corporal, de la medida de la cintura y de la edad en la distensión abdominal de pacientes intolerantes a la lactosa.

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La caracterización de los rasgos funcionales de las especies es un paso importante en la comprensión y descripción de las comunidades en hábitats naturales. La clasificación de especies en grupos funcionales es una herramienta útil para identificar la redundancia y la especialización. Se estudió la comunidad de peces de un humedal prístino de agua dulce en la Reserva de la Biosfera de Sian Ka'an, analizando dos funciones multidimensionales: adquisición de alimento y la locomoción. Analizamos los cambios en la estructura de los grupos funcional entre hábitats (permanentes y temporales) y temporadas (lluvias y secas). Seis grupos funcionales con características ecológicas distintas fueron detectados, dos de los cuales presentaron una alta redundancia funcional y tres de ellos están representados únicamente por una especie con una función ecológica particular. En las pozas permanentes durante la temporada de secas, la riqueza y diversidad de grupos funcionales fueron menores; mientras que la equitatividad de grupos funcionales fue mayor. Durante la temporada de lluvias se detectaron todos los grupos funcionales y la estructura de los grupos fue similar entre los hábitat. Estos resultados sugieren que los filtros ambientales tienen un efecto durante la temporada de secas y la complementariedad de nicho durante la temporada de lluvias.

The characterization of species' functional traits is a major step in the understanding and description of communities in natural habitats. The classification of species into functional groups is a useful tool to identify redundancy and uniqueness. We studied the fish community of a pristine freshwater wetland in the Sian Ka'an Biosphere Reserve by analysing two multidimensional functions: food acquisition and locomotion. We investigated changes in the functional group structure between habitats (permanent and temporary pools) and seasons (dry and wet). Six functional groups with different ecological characteristics were detected, two of which had high functional redundancy and three of them were represented by single species with unique ecological functions. In permanent pools during the dry season, functional group richness and diversity were lower, while evenness was higher. During the wet season, all functional groups were detected and similar functional group structure was found between habitats. These results suggest an effect of environmental filtering during the dry season and niche complementarity during the wet season.

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La caracterización de los rasgos funcionales de las especies es un paso importante en la comprensión y descripción de las comunidades en hábitats naturales. La clasificación de especies en grupos funcionales es una herramienta útil para identificar la redundancia y la especialización. Se estudió la comunidad de peces de un humedal prístino de agua dulce en la Reserva de la Biosfera de Sian Ka'an, analizando dos funciones multidimensionales: adquisición de alimento y la locomoción. Analizamos los cambios en la estructura de los grupos funcional entre hábitats (permanentes y temporales) y temporadas (lluvias y secas). Seis grupos funcionales con características ecológicas distintas fueron detectados, dos de los cuales presentaron una alta redundancia funcional y tres de ellos están representados únicamente por una especie con una función ecológica particular. En las pozas permanentes durante la temporada de secas, la riqueza y diversidad de grupos funcionales fueron menores; mientras que la equitatividad de grupos funcionales fue mayor. Durante la temporada de lluvias se detectaron todos los grupos funcionales y la estructura de los grupos fue similar entre los hábitat. Estos resultados sugieren que los filtros ambientales tienen un efecto durante la temporada de secas y la complementariedad de nicho durante la temporada de lluvias.(AU)

The characterization of species' functional traits is a major step in the understanding and description of communities in natural habitats. The classification of species into functional groups is a useful tool to identify redundancy and uniqueness. We studied the fish community of a pristine freshwater wetland in the Sian Ka'an Biosphere Reserve by analysing two multidimensional functions: food acquisition and locomotion. We investigated changes in the functional group structure between habitats (permanent and temporary pools) and seasons (dry and wet). Six functional groups with different ecological characteristics were detected, two of which had high functional redundancy and three of them were represented by single species with unique ecological functions. In permanent pools during the dry season, functional group richness and diversity were lower, while evenness was higher. During the wet season, all functional groups were detected and similar functional group structure was found between habitats. These results suggest an effect of environmental filtering during the dry season and niche complementarity during the wet season.(AU)

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OBJECTIVE: To determine the noise levels of different areas responsible for newborn care, develop intervention strategies to decrease the noise, and evaluate its effectiveness. METHODS: Prospective, observational and longitudinal study carried out using a sonometer, measuring sound levels for three weeks in the neonatal intensive care unit (NICU), neonatal intermediate care unit (UCIREN), delivery (TOCO QX) and nursery (CUNERO) units. We implemented an intervention program and subsequent measurements were performed under the same initial conditions. RESULTS: When comparing the decibel levels in different areas during the three weeks, pre- and post-intervention, we found at the neonatal intensive care unit 59.9±4.8 vs. 56.4±4.7 dB (p<0.001), neonatal intermediate care unit 55.3±3.9 vs. 51.3±4.4 dB (p<0.001), delivery unit 57.3±4.6 vs. 57.3±5.5 dB (NS), and nursery unit 57.6±5.8 vs. 53.9±5.8 dB (p<0.001). CONCLUSIONS: There was a significant reduction in noise levels of 3.5 dB at the NICU, 4 dB at UCIREN and 3.7 dB at TOCO QX, so the intervention program was effective in these areas; however, the decibel levels registered continue above those recommended by international standards.

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INTRODUCTION: The ability to handle and adapt to the visual perspectives generated by angled laparoscopes is crucial for skilled laparoscopic surgery. However, the control of the visual work space depends on the ability of the operator of the camera, who is often not the most experienced member of the surgical team. Here, we present a simple, low-cost option for surgical training that challenges the learner with static and dynamic visual perspectives at 30 degrees using a system that emulates the angled laparoscope. METHODS: A system was developed using a low-cost camera and readily available materials to emulate the angled laparoscope. Nine participants undertook 3 tasks to test spatial adaptation to the static and dynamic visual perspectives at 30 degrees. Completing each task to a predefined satisfactory level ensured precision of execution of the tasks. Associated metrics (time and error rate) were recorded, and the performance of participants were determined. RESULTS: A total of 450 repetitions were performed by 9 residents at various stages of training. All the tasks were performed with a visual perspective of 30 degrees using the system. Junior residents were more proficient than senior residents. CONCLUSIONS: This system is a viable and low-cost alternative for developing the basic psychomotor skills necessary for the handling and adaptation to visual perspectives of 30 degrees, without depending on a laparoscopic tower, in junior residents. More advanced skills may then be acquired by other means, such as in the operating theater or through clinical experience.

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The aim of this study was to identify and quantify the association between the amount of driving (km/year), traffic accidents, and other factors among university students in Guatemala. A cross-sectional study was performed during the 2010-2011 school year in a sample of 1,016 drivers who completed a self-administered questionnaire that assessed mobility patterns, use of safety accessories, driving style, and automobile crashes. The results showed a positive association between amount of driving and greater involvement in risky driving (adjusted regression coefficient 3.25, 95%CI: 2.23-4.27, for the highest level of exposure). More frequent involvement in risky driving and older age showed the strongest associations with traffic accidents. Although the amount of driving was positively associated with a higher accident rate, most of this association was found to be mediated by involvement in risky driving practices.

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