Abstract: Introduction: Mayer-Rokitansky-Küster-Hauser syndrome (also known as müllerian aplasia) is a rare congenital anomaly of the tract genital, of unknown etiology, characterized by the congenital absence of the uterus, cervix and upper portion of the vagina. Clinical case: A 16-year-old female patient with primary amenorrhea, normal hormonal profile, adequate sexual development Tanner 5, 46 XX karyotype. A magnetic sound is performed where the absence of the uterus and the proximal two-thirds of the vagina are detected. Conclusion: Magnetic resonance is a diagnostic test that provides great anatomical detail of the uterus and vagina, allowing to correctly characterize and classify Müllerian anomalies.

Resumen: Introducción: El síndrome de Mayer-Rokitansky-Küster-Hauser (también conocido como aplasia mülleriana) es una rara anomalía congénita del tracto genital, de etiología desconocida, se caracteriza por la ausencia congénita del útero, cérvix y porción superior de la vagina. Caso clínico: Paciente femenino de 16 años de edad que presenta amenorrea primaria, perfil hormonal normal, desarrollo sexual adecuado Tanner 5, cariotipo 46 XX. Se realiza resonancia magnética, donde se detecta ausencia de útero y de los dos tercios proximales de la vagina. Conclusión: La resonancia magnética es una prueba diagnóstica que brinda gran detalle anatómico del útero y vagina, permitiendo caracterizar y clasificar correctamente a las anomalías müllerianas.

Resumen Introducción La prostatectomía es el tratamiento estándar para pacientes con cáncer de próstata localizado. Actualmente, la prostatectomía radical asistida por robot es ampliamente utilizada por sus ventajas en visualización, precisión y manipulación de los tejidos. Sin embargo, este abordaje requiere un manejo multidisciplinario, pues el enfoque analgésico y anestésico es fundamental para optimizar los desenlaces. Objetivo Describir los primeros casos de prostatectomía radical asistida por robot realizadas en un hospital universitario de cuarto nivel en Bogotá, Colombia. Metodología Estudio observacional en el cual se incluyeron todos los pacientes sometidos a prostatectomía radical asistida por robot (PRAR) en el hospital Fundación Santa Fe de Bogotá entre septiembre de 2015 y diciembre de 2019. Se excluyeron los pacientes con historia clínica incompleta. Se registraron los datos demográficos y se revisaron los eventos perioperatorios importantes. Resultados Se analizaron 301 pacientes. La edad media de pacientes sometidos a PRAR fue 61,4 ± 6,7 años. El tiempo quirúrgico promedio fue 205 ± 43 minutos y la pérdida sanguínea media fue 300 [200-400] mL. Solo 6 pacientes (2 %) requirieron transfusión. La edad y el IMC no mostraron una asociación relevante con los desenlaces clínicos. Conclusiones El adecuado abordaje perioperatorio en PRAR es importante para minimizar las complicaciones, las cuales en este estudio y en esta institución fueron infrecuentes.

Abstract Introduction Prostatectomy is the standard treatment for patients with clinically localized prostate cancer. Currently, robot-assisted radical prostatectomy (RARP) is widely used for its advantages, as it provides better visualization, precision, and reduced tissue manipulation. However, RARP requires a multidisciplinary approach in which anesthesia and analgesia management are especially important. Objective This study aims to describe our experience delivering anesthesia for the first cases of patients undergoing RARP in a teaching hospital in Bogotá, Colombia. Methodology An observational study was conducted. We included all patients undergoing RARP from September 2015 to December 2019 at Fundación Santa Fe de Bogotá. All patients with incomplete data were excluded. Patient demographics were recorded, and significant perioperative events were reviewed. Results A total of 301 patients were included. At our institution, the mean age for patients undergoing RARP was 61.4 ± 6.7 years. The mean operative time was 205 ± 43 min and mean blood loss was 300 [200400] mL. Only 6 (2%) patients required transfusion. Age and BMI were not associated with clinical outcomes. Conclusions An adequate perioperative approach in RARP is important to minimize complications, which in this study and in this institution were infrequent.

Resumen La neurotización es el fenómeno por medio del cual un brote axonal alcanza la estructura de un nervio periférico lesionado, coloniza el órgano o tejido blanco de dicho nervio y produce en este la función que tiene determinado el cuerpo celular al cual pertenece esta nueva prolongación axonal. Los tipos de neurotización dependen del tejido que se va a reinervar. Teóricamente, cualquier tejido podría ser reinervado o neurotizado. Este artículo de revisión tiene el objetivo de explicar el fenómeno de neurotización y los diferentes tipos que hasta el momento han tenido aplicación clínica. Conocerlo es importante para indicar su aplicación en diferentes técnicas quirúrgicas y lograr cada día mejores resultados en pacientes con lesiones del nervio periférico, por ejemplo, la recuperación de lesiones tanto sensitivas como motoras, lesiones producidas por objetos cortantes, aplastamientos, quemaduras, heridas por arma de fuego o síndromes de compresión crónicos.

Abstract Neurotization is the phenomenon by which an axonal sprout reaches the structure of an injured peripheral nerve, colonizes the organ or target tissue and produces in it, the function determined by the cell body to which this new axonal prolongation belongs. The types of neurotization depend on the tissue to be reinnervated, theoretically any tissue could be reinnervated or neurotized. This review article aims to explain the neurotization phenomenon and the different types that have had clinical application up to now, its knowledge being important to indicate its application in different surgical techniques and to achieve better results every day in patients with peripheral nerve injuries, achieving recovery from both sensory and motor injuries, injuries caused by sharp objects, crushing, burns, gunshot wounds or chronic compression syndromes.

Abstract: INTRODUCTION This work shows that 3% (v/v) human urine (HU) in semisolid Liver Infusion Tryptose (SSL) medium favors the growth of Trypanosoma cruzi and T. rangeli. METHODS Parasites were plated as individual or mixed strains on SSL medium and on SSL medium with 3% human urine (SSL-HU). Isolate DNA was analyzed using polymerase chain reaction (PCR) and pulsed-field gel electrophoresis (PFGE). RESULTS SSL-HU medium improved clone isolation. PCR revealed that T. cruzi strains predominate on mixed-strain plates. PFGE confirmed that isolated parasites share the same molecular karyotype as parental cell lines. CONCLUSIONS SSL-HU medium constitutes a novel tool for obtaining T. cruzi and T. rangeli clonal lineages.

Malignant tumors of tongue are a common pathology with high morbidity and mortality. Treatment requires surgical oncology and systemic management, with the respective reconstruction in order to achieve an adequate quality of life, due to the primary function of the tongue during feeding, communication, social and labor interaction. That is why the choice of donor tissue for reconstruction depends heavily on its characteris-tics and the type of defect, essential to obtain favorable results in the patients. A review of the classification of resulting defects after tongue's tumors resection is performed, and management algorithm and microvascular free flaps more frequently used in this type of reconstruction.

Los tumores malignos de lengua son una patología frecuente con alto grado de morbilidad y mortalidad. Su tratamiento requiere manejo quirúrgico y sistémico oncológico, con la respectiva reconstrucción, para lograr así una adecuada calidad de vida, debido a la función primordial de la lengua durante la alimentación, la comunicación, la interacción social y laboral. Es por esto que la elección de los tejidos donantes para ello depende en gran medida de sus características y del tipo de defecto, aspecto fundamental para obtener resultados favorables en los pacientes. Se realiza una revisión de la clasificación de los defectos resultantes después de la resección de tumores de lengua, un algoritmo de manejo y los colgajos libres microvasculares más utilizados en este tipo de reconstrucción.

Background and Objectives. The hand is part of not only the physical appearance of the individual but also of the most important evolutionary functions of human beings. The amputation of multiple fingers generates a major constraint affecting the quality of life of these patients. Patients and Methods. In this article we present the surgical technique performed by our team in cases of transfer from the second toe and of combined transfer from the secon and third toes for the treatment of the metacarpal hand. Results. We detail the results obtaniend in a group of 5 patients. Conclusions: Reconstruction of metacarpal hand by transferring toes becomes the best alternative to restore hand functionality and improve quality of life.

Antecedentes y Objetivos. La mano forma parte no solo de la apariencia física del individuo, sino también de las funciones evolutivas más importantes del ser humano. La amputación de múltiples dedos genera una importante limitación y afecta a la calidad de vida de estos pacientes. Pacientes y Método. Exponemos la técnica quirúrgica realizada por nuestro equipo en casos de transferencias del segundo artejo, así como la transferencia combinada del segundo y tercer dedos para el tratamiento de la denominada mano metacarpiana. Resultados. Detallamos los resultados obtenidos en una serie de 5 pacientes. Conclusiones. La reconstrucción de la mano metacarpiana mediante transferencia de dedos de los pies se convierte en la mejor alternativa para devolver la funcionalidad a la mano y mejorar la calidad de vida.

Los colgajos de perforantes se han constituido en el escalón reconstructivo de mayor refinamiento quirúrgico por sus beneficios al dejar mínima morbilidad en las áreas donantes y permitir el tallado de los tejidos más precisos a los defectos a reconstruir, permitiendo al mismo tiempo la transferencia de varios tipos de tejidos, constituyéndose así en una herramienta versátil para casos complejos, con defectos tridimensionales y necesidades tisulares específicas. El presente artículo realiza una revisión de los aspectos clínicos, así como la presentación de pacientes manejados con esta opción que dentro del campo de la microcirugía reconstructiva se posiciona como la primera elección al contemplar las diferentes posibilidades de tratamiento.

Perforator flaps have turned into the reconstructive step with the highest surgical refinement because of its benefits by limiting the donor site morbidity and allowing more accurate tissue graving in the defects to be reconstructed while allowing the transference of several types of tissues, thus becoming a versatile tool for complex cases with tridimensional defects and specific tissue needs. This article reviews the clinical features as well as the presentation of patients managed through this option, which, in the field of reconstructive microsurgery, has been positioned as the leading election when the different possibilities of treatment are considered.

Os retalhos de perfurantes constituemse no degrau reconstrutivo de maior refinamento cirúrgico por seus benefícios ao deixar mínima morbilidade nas áreas doadoras e permitir esculpir os tecidos de forma mais precisa no momento de corrigir defeitos e reconstruir, permitindo ao mesmo tempo a transferência de vários tipos de tecidos, constituindose assim em uma ferramenta versátil para casos complexos, com defeitos tridimensionais e necessidades tissulares específicas. O presente artigo faz uma revisão dos aspectos clínicos, bem como a apresentação de pacientes tratados com esta opção que dentro do campo da microcirurgia reconstrutiva se posiciona como a primeira escolha ao considerar as diferentes possibilidades de tratamento.

INTRODUÇÃO: Durante muito tempo, foi questionada a importância da doença de Chagas no México onde muitos a consideravam um padecimento exótico. Considerando a grande diversidade genética existente, entre os isolados de Trypanosoma cruzi, a importância da caracterização biológica desses e o escasso número de informações sobre os aspectos clínicos e biológicos da doença de Chagas no México, o objetivo deste trabalho foi realizar a caracterização biológica e molecular de isolados de Trypanosoma cruzi originários de diferentes áreas endêmicas deste país, principalmente do Estado de Jalisco. MÉTODOS: Oito cepas mexicanas de Trypanosoma cruzi foram caracterizadas biologicamente e geneticamente (PCR específica para Trypanosoma cruzi, PCR-multiplex, amplificação do espaço não transcrito dos genes do mini-exon, amplificação das regiões polimórficas do gene do mini-exon, classificação pela amplificação de regiões intergênicas dos genes do spliced leader, RAPD - random amplified polymorphic DNA). RESULTADOS: Foram observados dois tipos de parasitemia: patente com picos máximos de parasitemia entre 4,6x10(6) e 10(7) parasitas/mL e subpatente. Além disso, todos os isolados foram capazes de infectar 100% dos animais. Observou-se tropismo predominante pelo músculo estriado (cardíaco e esquelético). As técnicas de PCR do gene do mini-éxon classificaram as oito cepas como TcI e a técnica de RAPD mostrou variação intra-especifica das mesmas, separando as cepas isoladas de humanos daquelas de triatomíneos e por origem geográfica. CONCLUSÕES: As cepas mexicanas de Trypanosoma cruzi são miotrópicas e correspondem ao TcI.

INTRODUCTION: For a long time, the importance of Chagas disease in Mexico, where many regarded it as an exotic malady, was questioned. Considering the great genetic diversity among isolates of Trypanosoma cruzi, the importance of this biological characterization, and the paucity of information on the clinical and biological aspects of Chagas disease in Mexico, this study aimed to identify the molecular and biological characterization of Trypanosoma cruzi isolates from different endemic areas of this country, especially of the State of Jalisco. METHODS: Eight Mexican Trypanosoma cruzi strains were biologically and genetically characterized (PCR specific for Trypanosoma cruzi, multiplex-PCR, amplification of space no transcript of the genes of the mini-exon, amplification of polymorphic regions of the mini-exon, classification by amplification of intergenic regions of the spliced leader genes, RAPD - (random amplified polymorphic DNA). RESULTS: Two profiles of parasitaemia were observed, patent (peak parasitaemia of 4.6×10(6) to 10(7) parasites/mL) and subpatent. In addition, all isolates were able to infect 100% of the animals. The isolates mainly displayed tropism for striated (cardiac and skeletal) muscle. PCR amplification of the mini-exon gene classified the eight strains as TcI. The RAPD technique revealed intraspecies variation among isolates, distinguishing strains isolated from humans and triatomines and according to geographic origin. CONCLUSIONS: The Mexican T. cruzi strains are myotrophic and belong to group TcI.

Este trabalho avaliou a possibilidade da inoculação e reinoculação de um tripanossomatídeo isolado de morcego, morfológica, biológica e molecularmente semelhante ao Trypanosoma cruzi, na proteção contra a infecção por cepas virulentas. Camundongos não-isogênicos foram divididos em 24 grupos, que receberam de zero a três inóculos da cepa RM1 de Trypanosoma cruzi-like, na presença ou ausência de adjuvante de Freund e desafiados com as cepas de Trypanosoma cruzi VIC ou JG. Acompanhou-se a parasitemia e a sobrevida e os camundongos foram sacrificados para análise histopatológica. Os animais imunizados com a cepa RM1 de Trypanosoma cruzi-like apresentaram redução da parasitemia, independente do número de inóculos ou presença de adjuvante. Apesar dessa redução, os animais não apresentaram proteção contra lesões histopatológicas e observaram-se intensos infiltrados eosinofílicos que foram correlacionados com o número de inóculos da cepa RM1 de Trypanosoma cruzi-like. Sugere-se que a inoculação prévia dessa cepa, ao invés de proteger contra a infecção, agravou o processo inflamatório tecidual.

This study evaluated the possibility of inoculation and reinoculation with a trypanosomatid isolated from bats that is morphologically, biologically and molecularly similar to Trypanosoma cruzi, to protect against infection by virulent strains. Non-isogenic mice were divided into 24 groups that received from zero to three inoculations of Trypanosoma cruzi-like strain RM1, in the presence or absence of Freund's adjuvant, and were challenged with the VIC or JG strains of Trypanosoma cruzi. Parasitemia and survival were monitored and animals were sacrificed for histopathological analysis. Animals immunized with Trypanosoma cruzi-like strain RM1 presented decreased parasitemia, independently of the number of inoculations or the presence of adjuvant. In spite of this reduction, these animals did not present any protection against histopathological lesions. Severe eosinophilic infiltrate was observed and was correlated with the number of inoculations of Trypanosoma cruzi-like strain RM1. These findings suggest that prior inoculation with this strain did not protect against infection but, rather, aggravated the tissue inflammatory process.

Iniciando estudo de alterações patológicas crônicas no pâncreas de hamsters experimentalmente infectados com a cepa Vic de Trypanosoma cruzi, metaplasia oncocítica foi observada em um dos animais infectados. Este é o primeiro relato de oncocitos na doença de Chagas, que poderiam decorrer de resposta regenerativa aberrante ao processo inflamatório pancreático.

Beginning the study of chronic pathologic changes in pancreas of hamsters experimentally infected with Trypanosoma cruzi Vic strain, hepatocyte metaplasia was observed in one animal from infected group. This is the first report of oncocytes in Chagas' disease, which could be due to aberrant regenerative response to pancreas inflammatory process.

No presente trabalho, avalia-se a nova fixação de complemento, comparativamente à imunofluorescência indireta, para o diagnóstico da doença de Chagas crônica, utilizando um extrato aquoso de formas epimastigotas do Trypanosoma cruzi e três extratos etanólicos: um de epimastigotas, um de tripomastigotas e outro de amastigotas obtidas de cultura. Empregaram-se 236 amostras testadas por imunofluorescência indireta: 109 positivas (20 com diagnóstico parasitológico) e 127 amostras negativas (96 de doadores de sangue e 31 de portadores de outras patologias). Os resultados mostraram que é possível obter reação positiva em amostras diluídas até 1:16. Os melhores limiares de reatividade encontrados foram a diluição 1:4 para o extrato etanólico de amastigotas e 1:2 para os demais antígenos. Os índices de correlação entre a nova fixação de complemento e imunofluorescência indireta indicaram o extrato etanólico de epimastigotas como o antígeno mais adequado para fins de diagnóstico entre as preparações testadas, tendo apresentado índice de co-positividade com a imunofluorescência indireta de 0,92207 e índice de co-negatividade de 0,90000. Conclui-se que a nova fixação de complemento mostrou-se ser uma microtécnica semi-quantitativa rápida, sensível, barata e de fácil execução, aplicável ao diagnóstico da doença de Chagas crônica.

From this present data it has been evaluated a new complement fixation test, comparatively to indirect immunofluorescence to diagnose chronic Chagas' disease, utilizing one watery extract of epimastigotes of Trypanosoma cruzi and three other ethanolic extracts: one from epimastigotes, one from tripomastigotes and a third one of amastigotes obtained from cultures. Utilizing 236 serum samples indirect immunofluorescence test was performed: 109 positives (20 of them with positive parasitologic diagnostic) and 127 negatives (96 of healthy blood donors and 31 with other diseases). The results have showed that is possible a positive reaction in diluted samples up to 1:16. The best limits of reactivity found were the dilutions 1:4 for the ethanolic extract of amastigotes and 1:2 for the others antigens. The correlation index among the new complement fixation test and indirect immunofluorescence test showed that the ethanolic extract from epimastigotes was the best antigen to be utilized to diagnosis purposes. Its co-positivity index with indirect immunofluorescence was 0,92207 and the co-negative index was 0,90000. Concluding, the new complement fixation test showed itself as a fast, sensible, easily applicable semiquantitative microthecnique to the diagnosis of chronic Chagas' disease.

No presente trabalho avaliou-se a susceptibilidade do Triatoma infestans a sete cepas de Trypanosoma cruzi, isoladas e adaptadas em camundongos, provenientes de pacientes chagásicos do Triângulo Mineiro. Alimentou-se um total de 200 triatomíneos sobre camundongos infectados, na fase aguda, com as diferentes cepas e a cada 30 dias durante 5 meses, realizou-se as leituras pelos métodos da compressão e dejeção espontânea. A positividade do T. infestans frente as diferentes cepas foi de 62,08% acompanhado de uma elevada mortalidade (60%). Conclui-se que o T. infestans é pouco susceptível as cepas isoladas, fato que pode explicar a baixa postividade dos xenodiagnósticos realizados em pacientes chagásicos crônicos do Triângulo Mineiro

This data evaluated the susceptibility of T. infestans to seven different strains of T. cruzi from chagasic patients of the Triângulo Mineiro, isolated and adapted in Swiss mice. A total of 200 bugs were fed in mice in acute phase injected with the different strains of T. cruzi and at each 30 days, during 5 months, their feces were obtained by abdominal compression or spontaneous dejection. The overall positivity of T. infestans infection with these different strains of T. cruzi was 62.08%. There was a high mortality rate (60%) during the examination period. We conclude that T. infestans has a low susceptibility to these strains. This could explain the low rate of positivity in the xenodiagnosis in chagasic chronic patients of the Triângulo Mineiro.