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Resumen (Introducción): La conservación y restauración del patrimonio ecológico y cultural es una necesidad ante la crisis ambiental, en particular ante los efectos del cambio climático. Lo anterior se puede lograr a través de investigación interdisciplinaria que permita generar estrategias para la restauración de paisajes bioculturales complejos. (Objetivo): Proponer estrategias de restauración ecológica ecocéntrica, biocultural y productiva en Tzintzuntzan (lugar de colibríes), un paisaje dominado por vestigios arqueológicos precolombinas en la ribera del Lago de Patzcuaro, México, ante los efectos esperados del cambio climático. (Metodología): Se elaboró un SIG con información de las condiciones socioambientales del área de estudio, y un modelo de cambio climático para el 2050 y se estimó la pérdida de nivel del lago. (Resultados): A partir de las condiciones actuales de la vegetación, la modelación climática y la presencia de vestigios arqueológicos, se obtuvo que para el 2050 la mayor parte (89 %) del área cubierta por bosques, actualmente dominados por especies de encino y pino, tendrán un clima propicio para especies de selva seca. Dada la distribución de los vestigios arqueológicos y la zona urbana, se proponen estrategias de restauración ecocéntricas, bioculturales y productivas (Conclusiones): Una aproximación biocultural a la restauración es deseable, porque permite la recuperación de elementos ambientales y culturales del socioecosistema, con énfasis en la adaptación al cambio climático y en la recuperación del hábitat de los colibríes, el vínculo más visible entre naturaleza y cultura en la región.

Abstract (Introduction): Conservation and restoration of the ecological and cultural heritage is a necessity given the current environmental crisis, when considering the effects of climate change. This can be achieved through interdisciplinary research that allows the creation of strategies for restoring complex biocultural landscapes. (Objective): To propose strategies for ecocentric, biocultural and productive ecological restoration in Tzintzuntzan (place of hummingbirds) a landscape dominated by precolumbian archaeological remains in the riverbanks of lake Paztcuaro, México, considering the expected effects of climate change. (Metodology): A GIS was created with information about the socio-environmental conditions of the study site, a climate change model was also elaborated for 2050 and the loss of water lake water level was estimated. (Results): From the present conditions of the vegetation, climatic modeling and the presence of archaeological remains we obtained that for 2050 most of the area (89 %) of forests, currently dominated by oaks and pines, will have a climate appropriate for dry tropical vegetation. Considering the distribution of archaeological remains and the urban area we propose ecocentric, biocultural and production restoration strategies. (Conclusions): A biocultural approach to restoration is desirable because it allows the recovery of ecological and cultural elements of the socioecosystem, with an emphasis in adaptation to climate change and the recovery of hummingbird habitat, being the hummingbirds the most important link between nature and culture in the region.

https://doi.org/10.15359/rca.57-2.3

Third National Registry of Cardiac Rehabilitation Programs in Mexico (RENAPREC III-2022)
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Lara-Vargas, Jorge A.

; Ilarraza-Lomelí, Hermes

; García-Saldivia, Marianna

; Pineda-García, Alfredo D.

; Leyva-Valadez, Eduardo A.

; Justiniano-Cordero, Samuel

; Sahagún-Olmos, Roberto

; Zavala-Ramírez, Juana

; Cassaigne-Guasco, María E.

; Sánchez-Limón, Edgar-F

; Castañeda-López, Javier

; Cerón-Enríquez, Norma

; Ku-González, Andrés

; Arteaga-Martínez, Rodolfo

; Hinojosa-López, Tania

; Vergara-Guzmán, Jéssica

; Pérez-Vázquez, Daniel I.

; Gasca-Zamudio, Pedro D.

; Aranda-Ayala, Zulema L.

; Vacío-Reyes, Martha E.

; Reza-Orozco, Marco

; Alcocer-Gamboa, Miguel A.

; Hernández-González, Pedro A.

; Pérez-Reyes, Angélica A.

; Núñez-Urquiza, Juan P.

; Alonso-Sánchez, Jesús

; Franco-Valles, Sarahí

; Romo-Escamilla, Ricardo E.

; Nuriulú-Escobar, Patricia

; Serna-Santamaría, Iván

; Avilés-González, Jorge

; Salgado-Solorio, María C.

; Muñoz-Gutiérrez, Luz M.

; Mendoza-Díaz, Pedro M.

; Ávila-Estrada, Ángel

; Morales-Medina, Carlos

; Lara-Vázquez, Eduardo

; Rodríguez-Herrera, Paulina

; Galván-López, María

; Segoviano-Mendoza, Georgina

; De-la-Torre-Cruz, Fabiola

; Jiménez-Campos, Cecilia

; Ramírez-Meléndez, Alejandra

; Almaraz-Ríos, Alejandro

; González-Bonilla, Mezthly

; Rojano-Castillo, Jessica

; Rius-Suarez, María D.

Archivos de cardiología de México

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dec 2023, Volume 93 N. 4 Pages 405 - 416

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

resumen está disponible en el texto completo

Abstract Introduction: In Mexico, cardiac rehabilitation (CR) as an interdisciplinary intervention with therapeutic impact in patients with heart disease is growing. There is the need to know actual conditions of CR in our country. Objectives: The objective of this National Registry is to follow-up those existing and new CR units in Mexico through the comparison between the two previous registries, RENAPREC-2009 and RENAPREC II-2015 studies. This is a descriptive study focused on diverse CR activities such as assistance training, and certification of health professionals, barriers, reference, population attended, interdisciplinarity, permanence over time, growth prospects, regulations, post-pandemic condition, integrative characteristics, and scientific research. Results: Data were collected from 45 CR centers in the 32 states, 75.5% are private practice units, 67% are new, 33% were part of RENAPREC II-2015, and 17 have continued since 2009. With a better distribution of CR units along the territory, the median reference of candidates for CR programs is 9% with a significant reduction into tiempo of enrollment to Phase II admission (19 ± 11 days). Regarding to previous registries, the coverance of Phases I, II, and III is 71%, 100%, and 93%, respectively; and a coverance increases in evaluation, risk stratification, and prescription, more comprehensive attendance and prevention strategies. Conclusions: CR in Mexico has grown in the past 7 years. Even there is still low reference and heterogeneity in specific processes, there are strengths such as interdisciplinarity, scientific professionalization of specialists, national diversification, and an official society that are consolidated over time.

https://doi.org/10.24875/acm.22000235

Registro español de intervencionismo en cardiopatías congénitas. II informe oficial de la ACI-SEC y el GTH-SECPCC (2021)
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Ballesteros Tejerizo, Fernando

; Coserría Sánchez, Félix

; Freixa, Xavier

; Amat-Santos, Ignacio J

; Balbacid Domingo, Enrique

; Betrián Blasco, Pedro

; Blanco Mata, Roberto

; Carrasco, José Ignacio

; del Cerro Marín, María Jesús

; Flores Fernández, Marta

; Gómez Jaume, Alfredo

; Insa Albert, Beatriz

; Navalón Pérez, Miguel José

; Ojeda Pineda, Soledad

; Rueda Núñez, Fernando

; Sánchez Gila, Joaquín

; Sanz-Ruiz, Ricardo

; Zabala Argüelles, Juan Ignacio

REC: Interventional Cardiology

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sep 2023, Volume 5 N. 3 Pages 185 - 192

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

RESUMEN Introducción y objetivos: La Asociación de Cardiología Intervencionista de la Sociedad Española de Cardiología (ACI-SEC) y el Grupo de Trabajo de Hemodinámica de la Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas (GTH-SECPCC) presentan su informe anual de actividad hemodinámica en cardiopatías congénitas correspondiente al año 2021. Métodos: Se invitó a participar a los centros españoles con laboratorio de hemodinámica y actividad intervencionista en cardiopatías congénitas. La recogida de datos fue telemática y su análisis lo efectuó una empresa externa junto con miembros de la ACI-SEC y el GTH-SECPCC. Resultados: Participaron 16 centros (15 públicos y 1 privado) que acumulan 34 salas de hemodinámica con actividad en cardiopatías congénitas, 7 (20,5%) de ellas con dedicación exclusiva a pacientes pediátricos. Se registraron 1.094 estudios diagnósticos (5,1% más que en 2020) y 1.553 cateterismos intervencionistas (6,4% más que en 2020). Las técnicas más frecuentes fueron el cierre de comunicación interauricular (336 casos), la angioplastia de ramas pulmonares (231 casos) y el cierre de ductus (228 casos). Respecto al año anterior se incrementaron significativamente las técnicas de implantación de válvulas percutáneas (29,3%), cierre de ductus (20,6%) y angioplastia aórtica (12,8%). La tasa de éxito en los procedimientos intervencionistas fue del 95%, con una tasa de complicaciones mayores del 2,7% y una mortalidad intrahospitalaria del 0,2%. Conclusiones: Este trabajo es la segunda publicación del Registro Español de Intervencionismo en Cardiopatías Congénitas. Se ha constatado un aumento significativo de los procedimientos diagnósticos y terapéuticos, destacando el incremento en la implantación de válvulas percutáneas, el cierre de ductus y la angioplastia aórtica. La mayoría de las técnicas intervencionistas siguen demostrando excelentes datos de seguridad y eficacia.

ABSTRACT Introduction and objectives: This is the 2021 annual activity report from the Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC), and the Interventional Working Group of the Spanish Society of Pediatric Cardiology (GTH-SECPCC). Methods: All Spanish centers with cath lab capabilities and interventional activity in congenital heart diseases were invited to participate. Data were collected online, analyzed by an external company, and ACI-SEC and GTH-SECPCC members. Results: A total of 16 centers participated 15 public and 1 private including 34 cath labs with experience in congenital heart diseases, 7 of them (20.5%) exclusively dedicated to pediatric patients. A total of 1094 diagnostic studies (4.5% more than 2020) and 1553 interventional catheterizations (5.8% more than 2020) were registered. The most common procedures were atrial septal defect closure (336 cases), pulmonary branch artery angioplasty (231 cases), and percutaneous closure of the patent ductus arteriosus (228 cases). Interventional procedures were considered successful in 95% of the cases with rates of major procedural complication and in-hospital mortality of 2.7% and 0.2%, respectively. Conclusions: This is the second Spanish Cardiac Catheterization in Congenital Heart Diseases Registry report. A significant increase of diagnostic and interventional procedures was reported with a special increase of percutaneous valve implantation, ductus arteriosus closure, and aortic angioplasty. Most interventional techniques continue to demonstrate excellent safety and efficacy outcomes.

https://doi.org/10.24875/recic.m23000366

Clinical and histopathological features of follicular thyroid cancer in Chile
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Díaz, René

; Domínguez, José Miguel

; Tala, Hernán

; Olmos, Roberto

; Pineda, Pedro

; Olivarí, Daniela

; Jiménez, Marcela

; Mimica, Ximena

; Lanas, Alejandra

; Ocares, Gerson

; Sapunar, Jorge

Archives of Endocrinology and Metabolism

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jun 2023, Volume 67 N. 3 Pages 348 - 354

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: Follicular thyroid carcinoma (FTC) is less frequent but has a worse prognosis than papillary carcinoma. The available evidence on pre-operative characteristics of FTC is controversial. Our objective was to characterize the clinical, ultrasound and histopathological presentation of FTC patients treated Chile. Subjects and methods: Retrospective analysis of 97 patients treated for FTC in 6 large centers in Chile. We analyzed their ultrasonographic features and classified the nodules according to ATA risk of malignancy and TI-RADS score, as well as the cytological findings according to the Bethesda system. We described their clinical and histopathological findings at diagnosis and classified their risk of recurrence and mortality according to ATA 2015 recurrence risk category and the eighth edition of the AJCC/UICC staging system, respectively. Results: Median age was 48 years and 73.2% were females. The median diameter was 38.8 mm; only 9.5% of them were microtumors. According to ATA risk of malignancy, 86% of the nodules were low or intermediate suspicious, while 78% were category 3 or 4A nodules according to the TI-RADS. Regarding the Bethesda system, 65.9% had indeterminate cytology (20.6% category III and 45.3% category IV). At histological examination, most were minimally-invasive and angio-invasive tumors with less than 4 foci (54.7% and 28.4% respectively). More than 90% of FTC were unifocal and there was no lymphovascular or extrathyroidal invasion or lymph node involvement. Four patients (4.1%) had distant metastases at diagnosis. Most patients (95%) had stage I or II disease according to the AJCC/UICC staging system, while the risk of recurrence was low at 51.5% when using the ATA risk of recurrence scale. Conclusions: At diagnosis, most FTCs were nodules of low or intermediate suspicion at ultrasound, nearly two thirds had indeterminate cytology according to the Bethesda system, and nearly 50% of them were of low risk of recurrence.

https://doi.org/10.20945/2359-3997000000580

Interacciones biológicas en la restauración: el caso de Tecoma stans (Bignoniaceae) y hongos micorrícicos
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Becerril-Navarrete, Arubi Monserrat

; Gómez-Romero, Mariela

; Lindig-Cisneros, Roberto

; Blanco-García, José Arnulfo

; Villegas, Javier

; Pineda-García, Fernando

Acta botánica mexicana

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2022, N. 129 elocation e1937

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen: Antecedentes y Objetivos: Los disturbios antropogénicos o naturales pueden ser tan fuertes que para recuperar sitios degradados se requiere de intervención. Una forma de facilitar el proceso de recuperación es mediante el uso de especies nativas adaptadas al ambiente local, pero aún existe desconocimiento sobre su desempeño. Asimismo, el establecimiento de interacciones con hongos micorrícicos puede contribuir a tener un mayor éxito en supervivencia y crecimiento de especies empleadas en la restauración. El arbusto Tecoma stans es una especie nativa con potencial para restauración, ya que se considera que tiene resistencia al estrés. Por lo tanto, en el presente estudio se exploró si establece interacciones con hongos micorrícicos y una bacteria, y si esto tiene efectos sobre su crecimiento. Métodos: Se estableció un experimento en condiciones semicontroladas, para lo cual se germinaron sus semillas y las plántulas se inocularon con hongos micorrícicos (Rhizophagus intraradices, Pisolithus arhizus y Scleroderma verrucosum) y con una bacteria (Azospirillum brasilense). Después de seis meses de crecimiento en los tratamientos de inoculo se cuantificó la tasa relativa de crecimiento, se estimaron rasgos morfofuncionales de la raíz y la parte aérea, y se midió el grado infección en las raíces. Resultados clave: Detectamos que todos los hongos infectaron las plántulas y cada uno afectó de forma distinta el crecimiento y los rasgos morfofuncionales. En la inoculación con S. verrucosum las plántulas crecieron más, tuvieron más hojas, una mayor copa y un sistema radicular de mayor volumen y con raíces de mayor diámetro. Conclusiones: Los resultados indican que el uso de hongos micorrícicos contribuiría al éxito del establecimiento de T. stans en la restauración, ya que promueve su crecimiento y características que potencialmente permitirían a la especie una mayor capacidad de ganancia de recursos.

Abstract: Background and Aims: Anthropogenic or natural disturbances can be so strong that intervention is required to recover degraded sites. One way to facilitate the recovery is the use of native species adapted to the local environment; however, there is lack of knowledge about their performance. Additionally, the establishment of interactions with mycorrhizal fungi would contribute to greater success in survival and growth of plant species used in restoration efforts. Tecoma stans is a native shrub with potential for restoration as it is considered to be stress resistant. Therefore, in the present study we explored if the species sustained interactions with mycorrhizal fungi and a bacterium and if this impacts its growth. Methods: We established an experiment in a semi-controlled environment, seeds were germinated and the seedlings were inoculated with mycorrhizal fungi (Rhizophagus intraradices, Pisolithus arhizus and Scleroderma verrucosum) and a bacterium (Azospirillum brasilense). After six months of growth in the inoculum treatments we measured the seedling relative growth rate, we quantified root and leaf morphofunctional traits and we explored the degree of infection in the roots. Key results: We detected that all fungi infected the plants and each one had different effects in the seedling growth and in its morpho-functional traits. The inoculation with S. verrucosum had positive effects on growth, and the seedlings had larger leaves and a larger canopy, a root system of greater volume and roots of larger diameter. Conclusions: Our results indicate that the use of mycorrhizal fungi would contribute to the success of the establishment of T. stans in restoration plans, since they promote growth and characteristics that potentially allow the species to realize a greater resource capture.

https://doi.org/10.21829/abm129.2022.1937 48 downloads

Diversidad genética y factores de virulencia de cepas de Staphylococcus aureus aisladas de la piel de ubre bovina
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Adame-Gómez, Roberto

; Toribio-Jimenez, Jeiry

; Castro-Alarcón, Natividad

; Talavera-Alarcón, Karina

; Flores-Gavilan, Jacqueline

; Pineda-Rodríguez, Sandra-Alheli

; Ramírez-Peralta, Arturo

Revista mexicana de ciencias pecuarias

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sep 2021, Volume 12 N. 3 Pages 655 - 680

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Staphylococcus aureus is a pathogen recognized as a cause of mastitis in cattle worldwide, so the objective of this work was to determine the presence of Staphylococcus aureus in the teat skin of the bovine udder and relate it to the presence of mastitis, as well as to determine the virulence factors and genetic diversity of the strains. Samples of 250 milking cows were taken in three farms, in two seasons of the year, dry and rainy. In addition, the California test was performed. Staphylococcus aureus was isolated in salt agar and mannitol and biochemically identified and confirmed with amplification of the femA gene. For the identification of virulence factors, the genes hlB, mec, saK, pvL, tsst-1, seA, seB, seC, seD and seE were used by end-point PCR. For the typing of S. aureus, amplification and restriction of the coag gene was performed. The frequency of S. aureus was 13.4 %. No statistical relationship between the presence of S. aureus in the bovine udder skin and the development of subclinical mastitis was found. The most frequent enterotoxin gene in the strains was enterotoxin A. Although the percentage of typing is low, it was possible to identify two restrictotypes that group strains isolated from different cows, which shows the infectious and contagious capacity of the microorganism.

Resumen Staphylococcus aureus es un patógeno reconocido como causa de mastitis en bovinos a nivel mundial, por lo cual el objetivo de este trabajo fue determinar la presencia de Staphylococcus aureus en la piel de pezón de la ubre bovina y relacionarlo a la presencia de mastitis, así como determinar los factores de virulencia y la diversidad genética de las cepas. En tres establos se tomaron muestras de 250 vacas de ordeña en dos temporadas del año, estiaje y lluvias. Además, se realizó la prueba de California. Staphylococcus aureus fue aislado en agar sal y manitol e identificado bioquímicamente y confirmado con la amplificación del gen femA. Para la identificación de los factores de virulencia se usaron los genes hlB, mec, saK, pvL, tsst-1, seA, seB, seC, seD y seE por PCR en punto final. Para la tipificación de S. aureus, se realizó la amplificación y restricción del gen coag. La frecuencia de S. aureus fue 13.4 %. No se encontró una relación estadística entre la presencia de S. aureus en la piel de la ubre bovina y el desarrollo de mastitis subclínica. El gen de la enterotoxina más frecuente en las cepas fue el de la enterotoxina A. Aunque el porcentaje de tipificación es bajo, se lograron identificar dos restrictotipos que agrupan cepas aisladas de diferentes vacas, lo cual evidencia la capacidad infectocontagiosa del microorganismo.

https://doi.org/10.22319/rmcp.v12i3.5646 140 downloads

Análisis de resistencia a Candidatus Liberibacter solanacearum en genotipos de tomate
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Arellano-Aburto, Denisse A.

; López-Valenzuela, José Á.

; Gutierrez-Dorado, Roberto

; Pineda-Hidalgo, Karen V.

; Retes-Manjarrez, Jesús E.

; Garzón-Tiznado, José A.

Revista fitotecnia mexicana

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sep 2021, Volume 44 N. 3 Pages 425 - 433

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Summary Candidatus Liberibacter solanacearum (CLs) is a bacterium associated with the psyllid yellows disease in tomato (PY), that causes great damage to tomato (Solanum lycopersicum L.) production in México. The use of resistant genotypes is the most sustainable alternative for disease management in plants; however, there are currently no reports of commercial tomato cultivars resistant to CLs. Therefore, the objective of this study was to evaluate the response to infection with CLs in cultivars Rio Grande®, Moctezuma®, Marmande, DRK2180®, La Roca®, Bonny Best® and the advanced line UAS 2016. The evaluation was carried out in Culiacan, Sinaloa, Mexico, in greenhouse conditions through a randomized complete block design with four replications. Inoculation of CLs was carried out by means of its vector and the expression of the disease in the plant was recorded for seven weeks. Genetic variability of the genotypes was analyzed by using of 15 microsatellites (SSR). Results indicated that the damage by PY in UAS 2016 and Marmande was significantly lower than in Rio Grande® and Moctezuma® while DRK2180®, La Roca® and Bonny Best® showed significant difference in relation to the last cultivar. The total genetic diversity presented a value of 0.58 and a GST of 0.30, indicating that the genotypes presented similar genetic variability.

Resumen Candidatus Liberibacter solanacearum (CLs) es una bacteria asociada a la enfermedad “Permanente del Tomate” (PT) que ocasiona grandes daños a la producción de tomate (Solanum lycopersicum L.) en México. El uso de genotipos resistentes es la alternativa más sustentable para el manejo de enfermedades en plantas; sin embargo, actualmente no hay reportes de cultivares comerciales de tomate resistentes a CLs. Por lo anterior, el objetivo del presente estudio fue evaluar la respuesta a la infección con CLs en los cultivares Río Grande®, Moctezuma®, Marmande, DRK2180®, La Roca®, Bonny Best® y la línea avanzada UAS 2016. La evaluación se desarrolló en Culiacán, Sinaloa, México en condiciones de invernadero mediante un diseño de bloques completos al azar con cuatro repeticiones. La inoculación de CLs se llevó a cabo mediante su vector y la expresión de la enfermedad en la planta se registró durante siete semanas. La variabilidad genética de los genotipos fue analizada con el empleo de 15 microsatélites (SSR). Los resultados indicaron que la expresión de PT en UAS 2016 y Marmande fue significativamente menor que en Río Grande® y Moctezuma®, sin que DRK2180®, La Roca® y Bonny Best® mostraran diferencia significativa con respecto a esta última variedad. La diversidad genética total presentó un valor de 0.58 y un GST de 0.30, lo que indica que los genotipos presentaron variabilidad genética similar.

https://doi.org/10.35196/rfm.2021.3.425

Treatment strategy for bilateral severe subepithelial fibrosis after photorefractive keratectomy enhancement
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Pineda, Roberto

; Veloso, Artur William

; Zyl, Tavé van

Revista Brasileira de Oftalmologia

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apr 2021, Volume 80 N. 2 Pages 143 - 145

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Um homem saudável de 27 anos de idade com história de aprimoramento com ceratectomia fotorrefrativa (PRK) bilateral, após Ceratomileuse Assistida por Excimer Laser In Situ (LASIK) com laser de femtossegundos, apresentou diminuição da acuidade visual à distância não corrigida (AVNC) de 20/125 no olho direito (OD) e 20/300 no olho esquerdo (OE) seis meses após PRK. O exame revelou opacidades subepiteliais densas bilaterais. Ambos os olhos (AO) foram tratados com queratectomia superficial combinada com ceratectomia fototerapêutica (PTK) e aplicação adjuvante de mitomicina C a 0,02%. Aos três meses de acompanhamento, o AVNC foi de 20/30 OD e 20/25 OE. A ceratectomia superficial combinada com PTK parece ser uma técnica segura e eficiente para o tratamento da formação densa de cicatrizes subepiteliais após o aprimoramento com PRK pós-LASIK.

ABSTRACT A 27-year-old healthy man with a history of bilateral photorefractive keratectomy (PRK) enhancement after femtosecond laser in situ keratomileusis (LASIK) presented with decreased uncorrected distance visual acuity (UDVA) of 20/125 in the right eye (OD) and 20/300 in the left eye (OS) six months after PRK. Examination revealed bilateral dense subepithelial opacities. Both eyes (OU) were treated with superficial keratectomy combined with phototherapeutic keratectomy (PTK) and adjunctive application of mitomycin C 0.02%. At three months follow up UDVA was 20/30 OD and 20/25 OS. Superficial keratectomy combined with PTK seems to be a safe and efficient technique for treatment of dense subepithelial scar formation following PRK enhancement after LASIK.

https://doi.org/10.5935/0034-7280.20210027 91 downloads

Enfermedad de Rosai-Dorfman primaria ósea
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Padilla-Flores, Juan Roberto

; Victorio Avila, Cesar Antonio

; Latorre Zúñiga, Alan Jesús

; Romero Espinoza, Edgar Jesus

; Pineda Borja, Vanessa Irene

Anales de la Facultad de Medicina

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mar 2021, Volume 82 N. 1 Pages 66 - 70

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Rosai-Dorfman disease is a rare pathology that usually presents as painless cervical adenopathies. Bone compromise as an extra nodal presentation is even more uncommon. We present the case of a 38 years old woman with a 3 months history of pain and functional limitation of her right lower limb. X-ray and CT images showed a lytic bone lession at the distal metaphysis and epiphysis on her right femur. Histological and immunohistochemical study of the lession determined that it was a case of Rosai-Dorfman disease with bone involvement.

RESUMEN La enfermedad de Rosai-Dorfman es una patología poco común que suele presentarse con adenopatías cervicales indoloras. El compromiso óseo como presentación extraganglionar es aún menos frecuente. Se presenta el caso de una mujer de 38 años con 3 meses de dolor y limitación funcional en miembro inferior derecho. La radiografía simple y tomografía computarizada mostraron la presencia de una lesión ósea lítica en la metáfisis y epífisis distal del fémur derecho. Finalmente, el estudio histopatológico e inmunohistoquímico de la lesión determinó que se trataba de un caso de enfermedad de Rosai-Dorfman primaria ósea.

https://doi.org/10.15381/anales.v82i1.20785

10.

Femtosecond laser-assisted anterior lamellar keratoplasty with suboptimal outcomes: a case series
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Veloso, Artur William Caldeira Abreu

; van Zyl, Tavé

; Jurkunas, Ula

; Pineda, Roberto

Revista Brasileira de Oftalmologia

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2021, Volume 80 N. 6 elocation e0049

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo Identificar as características clínicas pré-operatórias de pacientes submetidos à ceratoplastia lamelar anterior assistida por laser de femtossegundo que não alcançaram resultados visuais pós-operatórios ideais. Métodos Nesta série de casos retrospectiva em um único centro, os pacientes submetidos à ceratoplastia lamelar anterior assistida por laser de femtossegundo entre 2013 e 2018 foram incluídos se precisassem de revisão do enxerto, procedimento corneano subsequente ou visitas pós-operatórias adicionais por uma intercorrência relacionada à ceratoplastia lamelar anterior assistida por laser de femtossegundo. Os resultados visuais avaliados incluíram melhor acuidade visual corrigida e astigmatismo pós-operatório da córnea. Resultados Oito olhos de oito pacientes que atenderam aos critérios descritos foram incluídos. A idade média dos pacientes foi de 64,5 anos (variação de 21 a 89). A melhor acuidade visual corrigida pré-operatória média foi de um logaritmo do mínimo ângulo de resolução (variação de 0,3 logaritmo do mínimo ângulo de resolução para contagem de dedos). As indicações para ceratoplastia lamelar anterior assistida por laser de femtossegundo incluíram cicatriz do estroma anterior devido à ceratite viral (dois casos), ceratite bacteriana (um caso), defeito epitelial crônico (um caso), distrofia de Avellino (um caso), trauma (um caso) e insuficiência endotelial crônica (dois casos). Seis pacientes tinham história de cirurgias intraoculares anteriores, incluindo facoemulsificação (quatro casos), vitrectomia via pars plana (um caso), ceratoplastia endotelial (dois casos) e trabeculectomia (um caso). O mínimo ângulo de resolução médio no acompanhamento mais recente foi de um logaritmo do mínimo ângulo de resolução (variação de zero logaritmo do mínimo ângulo de resolução para movimentos das mãos), representando melhora ou estabilidade em seis de oito pacientes. Astigmatismo corneano visualmente significativo estava presente em quatro de oito pacientes. Os procedimentos pós-ceratoplastia lamelar anterior assistida por laser de femtossegundo incluíram reposicionamento do enxerto, ceratotomia arqueada, facoemulsificação e enxerto. Conclusão Embora a ceratoplastia lamelar anterior assistida por laser de femtossegundo ofereça uma opção de tratamento menos invasiva em comparação com a ceratoplastia penetrante, o manejo intra e pós-operatório pode ser complexo. A ceratoplastia lamelar anterior assistida por laser de femtossegundo em pacientes com história de ceratoplastia endotelial anterior ou comorbidades oculares correntes deve ser avaliada com cautela.

ABSTRACT Objective To identify preoperative clinical characteristics of patients undergoing femtosecond laser-assisted anterior lamellar keratoplasty who failed to achieve optimal postoperative visual outcomes. Methods In this single-center, retrospective case series, patients who underwent femtosecond laser-assisted anterior lamellar keratoplasty between 2013 and 2018 were included if they required graft revision, subsequent corneal procedure, or additional postoperative visits for a femtosecond laser-assisted anterior lamellar keratoplasty-related issue. Visual outcomes assessed included best-corrected visual acuities and postoperative corneal astigmatism. Results Eight eyes of eight patients meeting the above criteria were included. Mean patient age was 64.5 years (range, 21 to 89 years). Mean included preoperative best-corrected visual acuities was one logarithm of the minimum angle of resolution (range, 0.3 logarithm of the minimum angle of resolution to counting fingers). Indications for femtosecond laser-assisted anterior lamellar keratoplasty included anterior stromal scarring due to viral keratitis (two cases), bacterial keratitis (one case), chronic epithelial defect (one case), Avellino dystrophy (one case), trauma (one case), and chronic endothelial failure (two cases). Six patients had history of prior intraocular surgeries including phacoemulsification (four cases), pars plana vitrectomy (one case), endothelial keratoplasty (two cases), and trabeculectomy (one case). Mean included best-corrected visual acuities at most recent follow-up was one logarithm of the minimum angle of resolution (range zero logarithm of the minimum angle of resolution to hand movements) representing improvement or stability in six of eight patients. Visually significant corneal astigmatism was present in four of eight patients. Post-femtosecond laser-assisted anterior lamellar keratoplasty procedures included graft repositioning, arcuate keratotomy, phacoemulsification, and regraft. Conclusion While femtosecond laser-assisted anterior lamellar keratoplasty offers a less-invasive treatment option compared to penetrating keratoplasty, intraoperative and postoperative management can be complex. Femtosecond laser-assisted anterior lamellar keratoplasty in patients with history of prior endothelial keratoplasty or ongoing ocular comorbidities should be pursued with caution.

https://doi.org/10.37039/1982.8551.20210049

11.

Taponamiento cardiaco en paciente embarazada que inicia con lupus eritematoso sistémico. Reporte de caso y revisión de la bibliografía
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Romero-Ohara, Luis G

; Alas-Pineda, César

; Morales, Roberto R

; Domínguez-Aguilar, Daniel E

; Hernández, Saúl

; Mendoza, Carla

Ginecología y obstetricia de México

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2021, Volume 89 N. 12 Pages 994 - 1001

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic, multisystemic disease of unknown etiology, whose clinical manifestations are heterogeneous. Pericardial involvement is the most common cardiac complication; however, the development of cardiac tamponade is rare, and even more so in pregnant patients presenting with SLE. OBJECTIVE: To present the clinical characteristics, diagnosis, treatment, and evolution of cardiac tamponade in a pregnant patient that presents with systemic lupus erythematosus. CLINICAL CASE: A 24-year-old patient, who is 27.5 weeks pregnant, presenting with anasarca, dyspnea that evolved to orthopnea and stabbing chest pain for three weeks. Her chest X-ray showed cardiomegaly grade II, congestive lung fields and pleural effusion at the level of cardiophrenic sinuses. The echocardiogram found a 500 mL pericardial effusion with evidence of cardiac tamponade. Progressive deterioration with compromised lung capacity, and the appearance of acute renal failure with progressive increases in creatinine; showing hemodynamic instability characterized by paradoxical pulse and hypotension. With positive Antinuclear Antibodies (ANA) and proteinuria, renal biopsy reports histopathological patterns corresponding to lupus nephritis, treated with steroid pulses and intravenous cyclophosphamide in a risk-benefit assessment, with subsequent satisfactory maternal-fetal evolution. CONCLUSION: Cardiac tamponade is not common in patients with SLE, and it is even rarer as the initial manifestation, even more so during pregnancy. It is a clinical emergency and requires multidisciplinary management since pregnancy in a patient with SLE implies an increased risk of systemic complications.

Resumen ANTECEDENTES: El lupus eritematoso sistémico es una enfermedad autoinmunitaria y multisistémica. El daño pericárdico es la complicación cardiaca más común y el taponamiento cardiaco es infrecuente, más aún en embarazadas y con lupus eritematoso sistémico. OBJETIVO: Exponer las características clínicas, diagnósticas, tratamiento y evolución del taponamiento cardiaco en una embarazada que inició con lupus eritematoso sistémico y valorar la información de la bibliografía a propósito de otros casos. CASO CLÍNICO: Paciente de 24 años, con 27.5 semanas de embarazo, con anasarca, disnea que evolucionó a ortopnea y dolor torácico punzante de tres semanas de evolución. La radiografía de tórax mostró cardiomegalia grado II, campos pulmonares congestivos y derrame pleural a la altura de los senos cardiofrénicos. En el ecocardiograma se encontró derrame pericárdico de 500 mL, con datos de taponamiento cardiaco. Tuvo deterioro progresivo con afectación de la capacidad pulmonar e insuficiencia renal aguda con aumentos progresivos de creatinina; se encontró hemodinámica inestable, con pulso paradójico e hipotensión. Anticuerpos antinucleares positivos y proteinuria. La biopsia renal reportó patrones histopatológicos correspondientes a nefritis lúpica. Se trató con pulsos esteroideos y ciclofosfamida por vía intravenosa. El derrame pericárdico desapareció por medio de una ventana subxifoidea y la extracción del líquido del pericardio. La evolución posterior fue satisfactoria para la madre y su hijo. CONCLUSIÓN: El taponamiento cardiaco es infrecuente en pacientes con lupus eritematoso sistémico y más raro aún durante el embarazo. Es una urgencia clínica que requiere atención multidisciplinaria porque el embarazo, en una paciente con lupus eritematoso sistémico, implica mayor riesgo de complicaciones sistémicas, como se señala en la bibliografía.

https://doi.org/10.24245/gom.v89i12.5711 58 downloads

12.

Brazil in the face of new SARS-CoV-2 variants: emergencies and challenges in public health
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Marquitti, Flavia Maria Darcie

; Coutinho, Renato Mendes

; Ferreira, Leonardo Souto

; Borges, Marcelo Eduardo

; Portella, Tatiana Pineda

; Silva, Rafael Lopes Paixão da

; Canton, Otavio

; Poloni, Silas

; Franco, Caroline

; Coelho, Verônica

; Barberia, Lorena

; Bolle, Monica de

; Boing, Alexandra Crispim

; Donalisio, Maria Rita

; Boing, Antonio Fernando

; Silva, Antônio Augusto Moura da

; Prado, Paulo Inácio

; Veras, Maria Amélia de Sousa Mascena

; Kraenkel, Roberto André

Revista Brasileira de Epidemiologia

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2021, Volume 24 elocation e210022

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO: Este artigo discute a situação epidêmica da COVID-19 no Brasil diante do aparecimento de uma nova linhagem, chamada P.1, mais transmissível e com possível reinfecção associada. Tendo em vista o colapso do atendimento hospitalar em Manaus em janeiro de 2021 e os resultados de três preprints recentes, dos quais todos encontraram maior transmissibilidade da variante P.1, propomos algumas ações urgentes: o estabelecimento de uma vigilância genômica baseada em diagnóstico em múltiplos passos, iniciando com os testes do tipo transcrição reversa seguida de reação em cadeia da polimerase (RT-PCR) até o sequenciamento; um esforço imediato na identificação de reinfecções associadas à nova variante, com a atualização dos protocolos de definição; e estudos sobre a eficácia das vacinas disponíveis no Brasil na vigência da nova variante. Propomos, ademais, o aprimoramento do sistema de vigilância em saúde brasileiro para que seja articulado com a vigilância genômica, de forma a responder mais oportunamente a emergências futuras. Chamamos os agentes públicos implicados na vigilância em saúde para que compartilhem dados e informações referentes à epidemia de forma clara, rápida e transparente. Finalmente propomos maior engajamento na cooperação interinstitucional de todos os envolvidos na resposta e produção de conhecimento sobre a pandemia em nosso país.

ABSTRACT: This article discusses the epidemic situation of Covid-19 in Brazil, in the face of the emergence of a new strain called P.1, which is more transmissible and may be associated with reinfection. Given the collapse of hospital care in Manaus in January 2021 and the results of three recent preprints, each that reports increased transmissibility of the P.1 variant, we propose some urgent measures. Genomic surveillance based on multi-step diagnostics, starting with RT-PCR type tests and up to sequencing, should be established. Efforts to identify reinfections associated with this variant and the update of its definition in protocols should be prioritized, and studies on the efficacy of currently available vaccines in Brazil concerning the new variant should be conducted. We also propose improving the Brazilian health surveillance system such that genomic surveillance is coordinated and thereby better able to respond to future emergencies in a more timely fashion. We call on the public agents involved in health surveillance to share data and information regarding the epidemic in a clear, fast and transparent way. Finally, we propose a greater engagement in inter-institutional cooperation of all those involved in the response and production of knowledge about the pandemic in our country.

https://doi.org/10.1590/1980-549720210022

13.

Brazil in the face of new SARS-CoV-2 variants: emergencies and challenges in public health
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Marquitti, Flavia Maria Darcie

; Coutinho, Renato Mendes

; Ferreira, Leonardo Souto

; Borges, Marcelo Eduardo

; Portella, Tatiana Pineda

; Silva, Rafael Lopes Paixão da

; Canton, Otavio

; Poloni, Silas

; Franco, Caroline

; Coelho, Verônica

; Barberia, Lorena

; Bolle, Monica de

; Boing, Alexandra Crispim

; Donalisio, Maria Rita

; Boing, Antonio Fernando

; Silva, Antônio Augusto Moura da

; Prado, Paulo Inácio

; Veras, Maria Amélia de Sousa Mascena

; Kraenkel, Roberto André

Revista Brasileira de Epidemiologia

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2021, Volume 24 elocation e210022

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1980-549720210022 1287 downloads

14.

Apego al cumplimiento de los indicadores de calidad en endoscopia del tracto gastrointestinal superior en el Hospital General Dr. Manuel Gea González
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Ramírez-Nava, José R.

; Délano-Alonso, Roberto

; Ávila-Langarica, María del C.

; Rentería-Palomo, Enrique

; Pineda-Leguízamo, Ricardo

; Valenzuela-Salazar, Carlos

; Herrera-Esquivel, José de J.

Endoscopia

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mar 2020, Volume 32 N. 1 Pages 2 - 6

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract The endoscopy of the upper digestive tract is used for the diagnosis and treatment of digestive disorders. The quality of health care can be measured by comparing the performance of an individual or group with a given benchmark. Material and methods: This is a descriptive study in which the database registry of the Endoscopy service of the Dr. Manuel Gea González General Hospital was taken as a reference. Results: 300 endoscopy reports were reviewed, of which 154 were men (51.3%) and 146 women (48.7%), with a median age of 56 years; of the 21 indicators of endoscopy of the upper gastrointestinal tract that could be evaluated, 12 (57.1%) are met. The American Society of Gastrointestinal Endoscopy and the American College of Gastroenterology published the first version of quality indicators for higher endoscopy, being updated with new relevant data in 2015, on which the results were based. Conclusions: We consider that having carried out this study is a watershed to know our deficiencies in terms of the quality of our procedures, evaluate the reasons for non-compliance with the indicators and thus implement improvement actions, which lead to the compliance suggested by the guidelines.

Resumen La endoscopia del tracto superior digestivo se utiliza para el diagnóstico y tratamiento de trastornos digestivos. La calidad de la atención sanitaria puede medirse comparando el desempeño de un individuo o grupo con un punto de referencia determinado. Material y métodos: Se trata de un estudio descriptivo en el que se tuvo como referencia el registro de base de datos del Servicio de endoscopia del Hospital General Dr. Manuel Gea González. Resultados: Se revisaron 300 reportes de endoscopia, de los cuales 154 eran hombres (51.3%) y 146 mujeres (48.7%), con una mediana edad 56 años; de los 21 indicadores de endoscopia del tracto gastrointestinal superior que se pudieron evaluar, se cumplen 12 (57.1%); La Sociedad Americana de Endoscopia Gastrointestinal y el Colegio Americano de Gastroenterología publicaron la primera versión de indicadores de calidad para endoscopia superior, actualizada con nuevos datos pertinentes en 2015, en los cuales se basaron los resultados. Conclusiones: Consideramos que el haber realizado este estudio es un parteaguas para conocer nuestras deficiencias en cuanto a la calidad de nuestros procedimientos, evaluar las razones del no cumplimiento de los indicadores y de esta manera implementar acciones de mejora, que lleven al cumplimiento sugerido por las guías.

https://doi.org/10.24875/end.19000029 51 downloads

15.

Métodos de diagnóstico en el estudio de las Miopatías Inflamatorias Autoinmunes: Datos del Registro Argentino de Miopatías Inflamatorias de la Sociedad Argentina de Reumatología
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Gómez, Graciela

; Gargiulo, María de los Ángeles

; Granel, Amelia

; Marcos, Ana

; Gómez, Ramiro Adrián

; Braillard Poccard, Andrea

; Costi, Carolina

; García, Mercedes

; Lojo, María Nieves

; Wernicke, Verónica

; Barrios, Belén

; Papasidero, Silvia

; Benítez, Alejandro

; Viola, Malena

; de La Vega, María Celina

; Aciar, Mariana

; Crespo Espíndola, Maria Elena

; Capelusnik, Dafne

; Schneerberger, Emilce

; Cosatti, Micaela

; Pisoni, Cecilia

; Ponce Delgado, Yessica

; Rillo, Oscar

; Pineda, Susana

; Duartes Noé, Damián

; Rivero, Mariano

; Girard Bosch, Paula

; García Salinas, Rodrigo

; Kisluk, Boris

; Berbotto, Guillermo

; Movia, Roberto

; Visentini, Susana

; Herrera, Gladys

; Lázaro, María Alicia

Revista argentina de reumatología

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mar 2020, Volume 31 N. 1 Pages 3 - 7

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

The Idiopathic Inflammatory Myopathies (IIM) comprise a heterogeneous group of acquired muscle diseases classified as polymyositis (PM), dermatomyositis (DM), Inclusion Body Myositis (IBM), Immuno Mediated Necrotizing Myopathies (IMNM), Overlap Myositis (OM), juvenile myositis, Antisynthethase Syndrome (ASS) and cancer related myositis (CAM). The presence of myositis specific antibodies in the serum and autoantibodies against target antigens and inflammatory infiltrates in muscle tissue suggests the autoimmune condition of the disease. The diagnosis of inflammatory myopathies is often a challenge and the disposal of diagnostic tools are not always available in daily practice. Information on the accessibility of these methods was obtained from the Argentine Register of Myopathies. The study of muscle enzymes, ANA, anti-Jo-1 antibodies and chest tomography were easy to get to most patients while muscle MRI, lung diffusion capacity for carbon monoxide (DLco) and muscle biopsy were performed in less than 50% of cases. Other myositis specific antibodies, necessary for disease diagnosis and prognosis, were mostly done through a subsidy from the Argentine Rheumatology Society.

Las Miopatías Inflamatorias Autoinmunes (MI) comprenden un grupo de enfermedades heterogéneas con presentación y características clínicas variables. Se distinguen subtipos clínicos como Polimiositis (PM), Dermatomiositis (DM), Miositis por cuerpos de Inclusión (MCI), Miopatía Necrotizante Inmunomediada (MNIM), Miositis de los Síndromes de Superposición, formas juveniles de MI (DMJ), Síndrome Antisintetasa (SAS) y Miopatía Asociada a Cáncer (MAC). La presencia de anticuerpos séricos y el infiltrado inflamatorio en la biopsia de músculo sugiere que se trata de una condición autoinmune. Realizar el diagnóstico de las MI suele ser un desafío y las herramientas diagnósticas no siempre están disponibles en la práctica diaria. Se obtuvo información sobre la disponibilidad de estos métodos del Registro Argentino de Miopatías Inflamatorias. El estudio de enzimas musculares, Anticuerpos Antinucleares (ANA), anticuerpo anti-Jo-1 y la tomografía computada de tórax, estuvieron disponibles para la mayoría de los pacientes mientras que la Resonancia Magnética de musculo (RM), el estudio de difusión de monóxido de carbono (DLco) y la biopsia muscular se realizaron en menos del 50% de los casos. La determinación de otros anticuerpos específicos de miositis, de importancia en el diagnóstico y pronóstico de la enfermedad se realizó, en mayor parte, a través de un subsidio de la SAR.

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