Semiología de ictericia

Cuando una persona adquiere una coloración amarilla, su aspecto no puede ser inadvertido y desde épocas muy antiguas se basó en este hallazgo el diagnóstico de una enfermedad: la ictericia. Investigaciones posteriores que han aclarado algunos hechos —no todos— sobre la fisiopatología de este fenómeno, autorizan a expresarlo como un síndrome caracterizado por: coloración amarilla de piel y mucosas acompañada de cambios en el color de la orina y de las heces, producida por aumento de la bilirrubina circulante

Rendimiento operativo de la tamizacion doble ajustada por raza para la deteccion de aneuploidias en poblacion colombiana

Actualmente, los algoritmos utilizados para la detección de alteraciones cromosómicas se han basado en los resultados obtenidos de poblaciones caucásicas, afrocaribeñas y asiáticas, las cuales, no tienen las mismas características de la raza mestiza. De allí, surgió el interés de realizar un estudio que permitiera determinar los valores de los marcadores serológicos, empleados en la tamización de aneuploidías, en población latina, para establecer un punto de corte ajustado a la raza mestiza. Se encuentra en desarrollo un estudio de validación de prueba diagnóstica, cuyos avances se presentan a continuación. En esta investigación, hasta el momento, se han incluido 1418 pacientes entre 11-13.6 semanas, sometidas a tamización combinada para la detección de aneuploidías. Se realizó un ajuste por raza de valores de medianas y sus múltiplos para los marcadores y se determinó el rendimiento operativo de la prueba luego de dicho ajuste. Posteriormente, se realizó una comparación entre ambas pruebas. Los niveles de B-hCG son 17.1 % más bajos en población mestiza colombiana, comparado con población caucásica y los niveles de PAPP-A son 19% inferiores. Las tasas de detección de la prueba, utilizando los valores convencionales, son del 60 % y, luego del ajuste por raza, es del 53 %. Haciendo el cálculo de riesgo, utilizando los nuevos múltiplos de mediana, no existen diferencias en aplicar la tamización con los valores convencionales entre las semanas 11 y 12 pero, en semana 13, los valores aplicados a población caucásica presentan una mejor tasa de detección que utilizar la prueba ajustada.Currently, the algorithms used for the detection of chromosomal alterations have been based on the results from Caucasian populations, Afro-Caribbean and Asian, which do not have the same characteristics of the mixed race. From there, we became interested to conduct a study to determine the values of biochemical markers, used in the screening for aneuploidy in Latino population, to establish a cutoff point set to the mixed race. Is developing a validation study of diagnostic tests, whose results are presented below. In this investigation, so far, 1418 patients were included between 11-13.6 weeks, subject to combined screening for the detection of aneuploidies. Were adjusted for race and median values for multiple markers and determined the operating performance of the test after the adjustment. Subsequently, a comparison was made between the two tests. The B-hCG levels are 17.1% lower in Colombian mestizo population, compared with Caucasians and PAPP-A levels are 19% lower. Detection rates of the test, using the conventional values, are 60% and, after adjusting for race, is 53%. Using the calculation of risk using the new multiple of median, no difference in applying the screening with conventional values between weeks 11 and 12 but in week 13, the values applied in the Caucasian population have a better detection rate using test set

Reduced calcification and lack of acclimatization by coral colonies growing in areas of persistent natural acidification

Author Posting. © The Author(s), 2013. This is the author's version of the work. It is posted here by permission of National Academy of Sciences for personal use, not for redistribution. The definitive version was published in Proceedings of the National Academy of Sciences of the United States of America 110 (2013):11044-11049, doi:10.1073/pnas.1301589110.As the surface ocean equilibrates with rising atmospheric CO2, the pH of surface seawater is decreasing with potentially negative impacts on coral calcification. A critical question is whether corals will be able to adapt or acclimate to these changes in seawater chemistry. We use high precision CT scanning of skeletal cores of Porites astreoides, an important Caribbean reef-building coral, to show that calcification rates decrease significantly along a natural gradient in pH and aragonite saturation (Ωarag). This decrease is accompanied by an increase in skeletal erosion and predation by boring organisms. The degree of sensitivity to reduced Ωarag measured on our field corals is consistent with that exhibited by the same species in laboratory CO2 manipulation experiments. We conclude that the Porites corals at our field site were not able to acclimatize enough to prevent the impacts of local ocean acidification on their skeletal growth and development, despite spending their entire lifespan in low pH, low Ωarag seawater.This research was funded by Na¬tional Science Foundation (NSF) OCE-1040952, a University of California Institute for Mexico and the United States (UC-Mexus) grant (to A.P.), and NSF OCE-1041106 (to A.L.C.). E.D.C. was funded through NSF-GFR and a EPA-STAR fellowships.2013-12-1

Azadirachtin effectivity in embryogenesis inhibition of Aegorhinus superciliosus (Guérin) (Coleoptera: Curculionidae)

Raspberry is cultivated in the southern part of Chile mainly for export. Its fruit is severely affected by the raspberry weevil (RW) Aegorhinus superciliosus (Guérin), a Curculionidae native of Chile. Little is known about the biology RW and control measures. Conventional insecticides have been tried against the adult, however, their use has been hindered in the practice by the coincidence of the presence of the mature insect with flowering and fructification periods. Entomopathogenic fungi are being incorporated lately, but still not massively used. This work aimed to evaluate azadirachtin, using the commercial product Neem as a growth regulator. Six doses of Neem, 0.5, 1, 2, 3, 4, and 5 ml/L of water, were applied under laboratory conditions, maintaining a check with no insecticide. RW adults stayed confined on the foliage of raspberry bushes treated with Neem during five days and in thirty days during egglaying. Number of eggs, number of emerged larva, percentage of born larva, effectiveness; effective half dose (DE50) and ninety effective dose (DE90) were determined. Neem treatments had significantly lower egg-laying amount, lower emergence of larvae and greater effectiveness, compared to the untreated check. The lowest egg-laying number was obtained with 2 ml of Neem, however, 5 ml of Neem resulted in the smallest number and percent of emerged larvae. DE50 and DE90 were found to be 0.0290 and 8.923 ml of Neem for liter of water, respectively. It was concluded that Neem can significantly alter egg-laying and embryogenesis of the RW.La frambuesa es una fruta de exportación, cuyo cultivo en el sur de Chile es afectado seriamente por el curculiónido Aegorhinus superciliosus (Guérin) o cabrito del frambueso (CF), insecto nativo de Chile. La biología del CF es poco conocida y también su control. Se ha intentado reducir al adulto con insecticidas convencionales; sin embargo, en la práctica se dificulta su uso por coincidir la presencia del insecto adulto con periodos de floración y cosecha de fruta. Recientemente se están incorporando hongos entomopatógenos, pero aún no se aplican masivamente. En este trabajo se experimentó con azadirachtina, utilizando el producto comercial Neem como regulador de crecimiento. Bajo condiciones de laboratorio se aplicaron seis dosis de Neem: 1 ml; 2 ml; 3 ml; 4 ml; 5 ml; 6 ml de Neem por litro de agua. Además, de un testigo sin insecticida. Los adultos del CF se mantuvieron confinados con follaje de frambueso tratados con Neem durante cinco días y en postura por treinta días. Durante este periodo se determinó: cantidad de huevos, cantidad de larvas emergidas, porcentaje de larvas nacidas, grado de eficacia, dosis media efectiva (DE50) y dosis noventa efectiva (DE90). Los tratamientos con Neem fueron significativamente diferentes al testigo, presentando menor postura, menor emergencia de larvas y mayor grado de efectividad. Con 2 ml de Neem se obtuvo la menor postura; sin embargo, la dosis de 5 ml de Neem presentó la menor cantidad de larvas emergidas y el menor porcentaje de emergencia de larvas. La DE50 se determinó en 0,0290 ml de Neem y la DE90 en 8,923 ml de Neem por litro de agua. Con los antecedentes expuestos se concluyó que el Neem tiene un efecto que altera la postura y la embriogénesis del CF

Abordaje interdisciplinario de lesión periapical confluyente que involucraba el seno maxilar: reporte de un caso

Interdisciplinarity in the diagnosis and treatment of large periapical lesions in the jaws is essential for a favorable prognosis and preservation of dental organs. This case presents apical granulomas as a consequence of chronic endo-periodontal diseases and inadequate and untimely diagnoses. This is how tools such as cone-Bean tomography, histopathology and immunohistochemistry were also applied, playing a fundamental role in their intervention for an accurate diagnosis. The objective of this case was to describe an interdisciplinary approach to a confluent periapical lesion involving the maxillary sinus, which evolved satisfactorily.La interdisciplinariedad en los diagnósticos y tratamientos de lesiones periapicales de gran tamaño en los maxilares es fundamental para el pronóstico favorable y conservación de órganos dentales. El presente caso exhibe a los granulomas apicales a consecuencia de enfermedades endo-periodontales crónicas y de inadecuados manejo e inoportunos diagnósticos. Es así como también fueron aplicadas herramientas como tomografía cone-Bean, histopatología e inmunohistoquímica jugando un rol fundamental en la intervención de las mismas para un diagnóstico certero. El objetivo del presente caso fue describir un abordaje interdisciplinario de lesión periapical confluyente que involucraba el seno maxilar, el cual evolucionó de manera satisfactoria

Importancia de la morfología de las ondas del ductus venoso en el diagnóstico de cardiopatía congénita

El ductus venoso refleja el ciclo cardiaco, pero actualmente no se conoce como se comporta cada onda del ductus venoso en los diferentes grupos de cardiopatías congénitas. Se pretende evaluar la importancia de la morfología de las ondas del ductus venoso en el diagnóstico de los diferentes tipos de cardiopatías congénita, teniendo en cuenta las pacientes atendidas en la Unidad De Medicina Materno Fetal de la clínica Colombia entre enero 2012 y julio de 2014.The ductus venosus reflects the cardiac cycle, but currently there is no information about the morphology of each wave with the different groups of cardiac congenital disease. It aims to evaluate the importance of the waveform morphology of the ductus venosus in the diagnosis of the different types of congenital heart disease, taking into account patients attended in maternal fetal medicine unit of clinical Colombia between January 2012 and July 2014

Joint IODP/ICDP Scientific Drilling of the Chicxulub Impact Crator

The Chicxulub impact crater in Mexico (Fig. 1) is unique in the terrestrial impact record. Its association with the Cretaceous–Paleocene (K-P) mass extinction has generated great interest, but the precise environmental effects and associated extinction mechanisms remain a matter of some debate over several decades. Chicxulub is also the best preserved large impact crater on Earth and is the only known terrestrial impact structure with a demonstrable topographicpeak ring (Figs. 2 and 3). Peak rings are common features of large craters on the terrestrial planets yet their process of formation is poorly understood. At all other large terrestrial craters, erosion and/or tectonic deformation have removed the evidence of a peak ring, should one have existed. Chicxulub is, thus, the only crater where the peak ring can be imaged and sampled

Dung Beetles of Chile, with Emphasis in La Araucania Region

Dung beetles are insects that provide a large-scale ecosystem service worldwide through their role in the decomposition of manure from livestock, thereby providing a series of environmental services, such as nutrients recycling, control of internal parasites of livestock whose eggs are in the feces, soil aeration, spreading of seeds and maintenance of ecological balance. Dung beetles are broadly classified according to their nesting behavior in three categories as telecoprids, paracoprids and endocoprids. Telecoprids are the rollers that make balls from feces and roll them into the ground; paracoprids are the tunnellers that bury the dung balls at different depths, forming galleries in the ground below or next to the food source and endocoprids, who are the dwellers that raise their larvae inside feces. There are 10 native species of dung beetles recorded in Chile, apart from 10 species of Aphodiinae, plus two introduced species, such as Onitis vanderkelleni and Onthophagus gazella. Dung beetles species were prospected in La Araucania Region and registered Homocopris torulosus, Frickius variolosus, Podotenus fulviventris and Aphodius pseudolividus. We found that species from genus Homocopris, Podotenus and Aphodius were distributed from 0 to 2000 m above sea level, while F. variolosus was distributed over an altitude of 350 m

Manejo médico expectante ambulatorio de pacientes con ruptura prematura de membranas. Experiencia de la Unidad de Medicina Materno Fetal de la Clínica Reina Sofía

ResumenObjetivo: Describir el manejo médico expectante ambulatorio en pacientes con ruptura  prematura de membranas  (RPM) entre las semanas  24 y 34 de edad gestacional.[Beltran MA, Rebolledo MA, Garvito A, Herrera M. Manejo médico expectante ambulatorio de pacientes con ruptura prematura de membranas. Experiencia de la Unidad de Medicina Materno Fetal de la Clínica Reina Sofía. MedUNAB 2005; 8:113-117].Palabras clave: Ruptura Prematura de membranas, parto pretérmino