ABSTRACT Creutzfeldt-Jakob disease is a rare neurodegenerative disease with a high incidence in Chile compared to the rest of the world. The condition is mainly characterized by the development of rapidly progressive dementia and various nonspecific neurological signs, the most common being myoclonus. The case that will be described below stands out for the atypical initial manifestations that the patient presented, such as sensory compromise in the cranio-cervico-dorsal region and peripheral polyneuropathy of the lower extremities, which meant a delay in the clinical diagnosis of the disease. It is important to know the different symptoms and signs that can be present in the clinical picture of CJD, both typical and those less frequent, in order to be able to diagnose the disease in earlier stages. Similarly, it is essential to have diagnostic tools such as the detection of 14-3-3 protein or Tau protein in health centers in our country. This would allow the health team to provide adequate and timely support management to these patients.

RESUMEN La enfermedad de Creutzfeldt-Jakob (ECJ) es una rara enfermedad neurodegenerativa con una alta incidencia en Chile respecto del resto del mundo. El cuadro se caracteriza principalmente por desarrollo de demencia rápidamente progresiva y diversos signos neurológicos inespecíficos, siendo el más frecuente la mioclonía. El caso que se describirá a continuación destaca por las manifestaciones iniciales atípicas que presentó el paciente, tales como compromiso sensitivo en región cráneo-cérvico-dorsal y polineuropatía periférica de extremidades inferiores (EEII), lo que significó un retraso en el diagnóstico clínico de la ECJ. Es importante conocer los diferentes síntomas y signos que pueden presentarse en el cuadro clínico de ECJ, tanto típicos como aquellos menos frecuentes, para así poder dar con el diagnóstico de la enfermedad en etapas más tempranas. De igual manera, es fundamental contar con herramientas diagnósticas como la detección de proteína 14-3-3 o proteína Tau en los centros de salud de nuestro país. Esto permitiría al equipo de salud, brindar un manejo de soporte adecuado y oportuno a estos pacientes.

Resumo A popularidade de coelhos como animais de estimação aumentou em muitos países. No entanto, a maioria dos perfis de laboratório em medicina de coelhos advém das observações de biomodelos animais ou da produção de carne. Assim, são necessárias pesquisas adicionais para obter valores de referência para hematologia e perfis bioquímicos em coelhos de estimação, e das diferentes raças, especialmente, em relação ao equilíbrio ácido-base. O objetivo deste relatório foi oferecer os valores médios dos principais parâmetros ligados ao perfil ácido-base na raça Anã Holandês. Trinta e cinco coelhos saudáveis (15 machos e 20 fêmeas) foram estudados. A amostra de sangue venoso da veia safena lateral foi analisada para mensuração: hematócrito, hemoglobina, nitrogênio ureico sanguíneo, glicose, pH sanguíneo, pressão parcial de CO2 (pCO2), CO2 total, íons bicarbonato, cloreto, sódio, potássio, excesso de base e ânion Gap. Os resultados apresentaram um intervalo menor do que aqueles relatados por diferentes pesquisadores. Além disso, as diferenças entre os gêneros foram mostradas na pCO2, seus valores foram maiores no sexo masculino. Pode estar associado a um maior metabolismo celular. Os valores obtidos nesta pesquisa devem ser levados em consideração pelos clínicos veterinários para esta raça em suas avaliações clínicas. Além disso, esses valores fornecem novos resultados em parâmetros com poucos valores de referencia.

Abstract Pet rabbits have increased their popularity in a lot of countries. However, most of the laboratory profiles in rabbit medicine come from the observations made in rabbit as biomodels or meat production. So that further researches are necessary to obtain reference values for hematology and biochemical profiles in pet rabbits and the different breeds, especially, in relation to acid-base balance. The aim of this report was to offer the mean values of the main parameters connected with acid-base profile in Netherland Dwarf breed. Thirty-five healthy rabbits (15 males and 20 females) were studied. Venous blood sample from lateral saphenous vein was analyzed to measure: haematocrit, haemoglobin, blood urea nitrogen, glucose, blood pH, partial pressure of CO2 (pCO2), total CO2, ions bicarbonate, chloride, sodium, potassium, base excess and anion Gap. Results showed a shorter range that those reported by different researchers. Moreover, differences between genders were showed in pCO2, its values were higher in males. It may be associated with a greater cellular metabolism. Values obtained in this research should be taken into account by veterinary clinicians for this breed in their clinical assessments. Besides, these values provide new results in parameters with few reference values.

Abstract: Introduction: The hypernatremic neonatal dehydration is a severe condition whose incidence has increased in recent years resulting in complications leading to the hospitalization of the newborn. Objective: Describe the clinical and laboratory characteristics of term-newborns with Hypernatremic Dehy dration diagnosis. Patients and Method: Descriptive observational study of hospitalized term- newborns due to hypernatremic dehydration between a period from 2014 to 2016. Term newborns over 37 weeks with clinical signs of dehydration (dry mucous membranes, depressed fontanel, tear less crying, signs of the cutaneous pleat), and/or excessive weight loss greater than 7% and serum sodium greater than 145 mEq/L were included. Sociodemographic and biochemical variables were recorded for analysis. Results: 43 neonates were included. 60.5 percent of their mothers were pri- miparous, 90 percent of neonates received exclusive breastfeeding, mothers reported breastfeeding problems in 76.7 percent. Incoming neonates reported weight loss compared to birth weight at 15.3% on average. 83.3% had public health insurance. 65.1% had dehydration clinical signs at entry and 83.5% transient neurological signs. The average sodium was 155 mEq/L at revenue. The sodium decrease in the first 24 hours of handling was 7.74 mEq/L (0.32mEq/L per hour). The correction of the hypernatremia was 55.8% by oral intake and 4 days hospital stay on average. Conclusions: The feeding's problems came up in a (76%), primiparous mothers in an (88.4%). 90.6 percent of this population administered exclusive breastfeeding, results that can help to alert the health professional to timely identification, warning signs, and early post-discharge control and preventive measures.

Resumen: Introducción: La deshidratación hipernatrémica neonatal es una condición grave y su incidencia se ha incre mentado en los últimos años, repercutiendo en complicaciones que llevan a la hospitalización del recién nacido. Objetivo: Describir las características clínicas y de laboratorio de recién nacidos a término con diagnóstico de deshidratación hipernatremica. Pacientes y Método: Estudio observacional descriptivo de recién nacidos a término que se hospitalizaron por deshidratación hiperna trémica entre los años 2014 y 2016. Se incluyeron recién nacidos a término mayores de 37 semanas con signos clínicos de deshidratación (mucosas secas, fontanela deprimida, llanto sin lágrimas, signos de pliegue cutáneo) y/o pérdida excesiva de peso mayor de 7% y sodio sérico mayor a 145 mEq/L. Se registraron variables sociodemográficas y bioquímicas para su análisis. Resultados: Se incluyeron 43 neonatos. El 60,5% de sus madres fueron primigestantes, el 90% de los neonatos recibieron lactancia materna exclusiva, las madres reportaron problemas en la lactancia materna en el 76,7%. La pérdida de peso al ingreso con respecto al peso de nacimiento fue de 15,3% en promedio. El 83,3% contaba con seguro de salud público. 65,1% presentó signos clínicos de deshidra tación al ingreso y 83,5% signos neurológicos transitorios. El promedio de sodio fue de 155 mEq/L al ingreso. El descenso de sodio en las primeras 24 horas de manejo fue 7,74 mEq/L (0,32mEq/L por hora). La corrección de la hipernatremia fue en el 55,8% por vía oral y la estancia hospitalaria de 4 días en promedio. Conclusiones: Los problemas de alimentación se presentaron en un (76%) madres primigestantes en un (88,4%). El 90,6% de esta población administraban lactancia materna exclusiva, resultados que pueden contribuir para alertar al profesional de la salud a identificar de forma oportuna, signos de alarma y un control precoz posterior al alta del puerperio y a la toma de medidas preventivas.

Abstract In this paper, the encryption improvement via modulation of the fractional-order chaotic oscillators state variables is presented. A network of N-coupled fractional-order Lü chaotic oscillators, is synchronized. A voice message is encrypted, via additive encryption, by using a state variable of the synchronized network. The selected state variable is modulated and used to encrypt the message again. The results are compared.

Resumen En este artículo, se presenta la mejora de la calidad de encriptado mediante la modulación de las variables de estado de osciladores caóticos de orden fraccionario. Se sincroniza una red de N osciladores caóticos Lü de orden fraccionarios acoplados. Se encripta un mensaje de voz mediante encriptado aditivo, utilizando una variable de estado de la red sincronizada. La variable de estado seleccionada se modula y se utiliza para cifrar el mensaje nuevamente. Se comparan los resultados.

Abstract It is well known that the genus of a strange attractor changes if the control parameters of the dynamical system are modified. It is shown that the genus of strange attractors may also depend on the order of the system and that such changes generate different strange attractors. In this work, low-dimensional topological tools are applied in order to know the genus of a strange attractor.

SUMMARY: In vitro modeling of neurodegenerative diseases is now possible by using patient-derived induced pluripotent stem cells (iPS). Through them, it is nowadays conceivable to obtain human neurons and glia, and study diseases cellular and molecular mechanisms, an attribute that was previously unavailable to any human condition. Amyotrophic lateral sclerosis (ALS) is one of the diseases that has gained a rapid advance with iPS technology. By differentiating motor neurons from iPS cells of ALS- patients, we are studying the mechanisms underlying ALS- disease onset and progression. Here, we introduce a cellular platform to help maintain longevity of ALS iPS-motor neurons, a cellular feature relevant for most late-onset human diseases. Long term cultures of patient-derived iPS cells might prove to be critical for the development of personalized-drugs.

RESUMEN: Actualmente es posible modelar in vitro enfermedades neurodegenerativas humanas mediante el uso de células madre pluripotentes inducidas (iPS) derivadas del paciente. A través de ellas, es hoy concebible obtener neuronas y glía humanas, y estudiar mecanismos celulares y moleculares de enfermedades, un atributo que anteriormente no era posible para ninguna condición humana. La esclerosis lateral amiotrófica (ELA) es una de las enfermedades que se ha beneficiado con la tecnología de iPS. Al diferenciar neuronas motoras de células iPS obtenidas de pacientes con ELA, hemos iniciado estudios sobre los mecanismos que subyacen a la aparición y progresión de la enfermedad. Aquí, presentamos el desarrollo de una plataforma celular que permite extender la longevidad de las neuronas motoras derivadas de iPS, una característica relevante para la mayoría de las enfermedades humanas de inicio tardío. Los cultivos a largo plazo de células iPS provenientes de pacientes pueden ser determinantes en el desarrollo de terapias asociadas a la medicina de precisión.

Background: Intravenous thrombolysis (IVT) with alteplase (tissue plasminogen activator) is the standard pharmacological treatment in acute ischemic stroke (AIS), reducing disability in patients. Aim: To report the results a thrombolysis protocol during four years in a regional public hospital. Material and Methods: Data from 106 consecutive patients aged 68 ± 13 years (57% men) who were treated with IVT, from May 2012 until April 2016, was analyzed. Results: The median door-to-needle time was 80 minutes (interquartile range = 57-113). The median National Institute of Health Stroke Scale (NIHSS) scores on admission and at discharge were was 11.5 and 5 points respectively. At discharge, 27% of hospitalized patients had a favorable outcome (n = 99), defined as having 0 to 1 points in the modified Rankin scale. Symptomatic intracerebral hemorrhage and mortality rates were 5.7 and 13.1%, respectively. The thrombolysis rate rose from 0.7% in 2012 to 6% in 2016. Conclusions: The implementation of 24/7 neurology shifts in the Emergency Department allowed us to increase the amount and quality of IVT in our hospital, as measured by the rate of thrombolysis and by process indicators such as door-to-needle time.

Objectives: We pretend to establish the utility of the ankle-ankle systolic pressure index (AAI) in patients with trauma in the inferior limbs and soft signs of vascular injury describing its sensitivity, specificity and predictive values according to the best cut-off point. Material and method: The cohort included 120 patients with trauma in the inferior limbs and soft signs of vascular injury who attended the University Hospital of Santander (Bucaramanga, Colombia) over a period of 4 years (2012-2015). Results: 21 (17.5%) patients had an ankle brachial pressure index (ABI) < .9 at the admission and they received immediately surgical management, finding vascular injury in the operating room; 2 (1.6%) patients had an ABI < .9 in the 6 h monitoring control and they also received surgical management finding vascular injury. Therefore, we found 23 patients with vascular injury. The ROC curves for the ABI and AAI show that they both have a good achievement for the diagnosis of vascular injury in patients with soft signs when they were used one time. In both cases, the traditionally point of .90 has a good discriminatory capacity with a sensitivity of 91% (95% CI: .71-.98), specificity of 100% (95% CI: .96-1.0), positive predictive value of 100% (95% CI: .83-1.0) and negative predictive value of 97% (95% CI: .92-.99). Conclusion. The ankle-ankle systolic pressure index (AAI) allows to rule out vascular injury in the patient with trauma in the inferior limbs and soft signs.

Objetivos: Establecer la utilidad del índice de presión arterial tobillo-tobillo (ITT) en los pacientes con trauma de extremidades inferiores y signos blandos de lesión vascular en términos de sensibilidad, especificidad y valores predictivos según el mejor punto de corte detectado. Material y método: Se incluyeron 120 pacientes con trauma en extremidades inferiores y signos blandos de lesión vascular que ingresaron al Hospital Universitario de Santander (Bucaramanga, Colombia) durante los años 2012 a 2015, a los cuales se les calculó el índice tobillo-brazo (ITB) e ITT. Resultados: Un total de 21 (17,5%) pacientes tuvieron ITB menor a 0,9 al ingreso, los cuales fueron llevados a intervención quirúrgica inmediata, encontrando lesión vascular; 2 (1,6%) pacientes tuvieron ITB menor a 0,9 en el control realizado a las 6 h, los cuales también fueron llevados a intervención quirúrgica, encontrando lesión vascular. Por tanto, se encontraron 23 pacientes con lesión vascular. Las curvas ROC tanto de ITB como de ITT señalan que ambas tienen un muy buen desempeño para diagnosticar las lesiones vasculares en pacientes con signos blandos cuando se emplean una única vez. En ambos casos, el punto de corte propuesto tradicionalmente de 0,90 tiene una capacidad discriminatoria adecuada, con sensibilidad de 91% (IC 95%: 0,71-0,98), especificidad de 100% (IC 95%: 0,96-1,0), valor predictivo positivo de 100% (IC 95%: 0,83-1,0) y valor predictivo negativo de 97% (IC 95%: 0,92-0,99). Conclusión. El índice tobillo-tobillo (ITT) permite descartar lesión vascular en el paciente con trauma en extremidades inferiores y signos blandos.

The main factors affecting the diversity of arbuscular mycorrhizal fungi (AMF) are host plant, environmental characteristics and geographical location. A better understanding of the influence of land use changes on AMF abundance will help in improving their management, leading to improved plant productivity in soils, and will also be useful in designing more sustainable agronomic management practices. The aim of this work was to document the occurrence and diversity of AMF species in the Southern Central zone of Chile. This information has been generated by seven separate studies which provide the basis for discussion of the AMF species found in this zone. The work includes a bibliographic review of the records from croplands, grasslands and forests generated by collections made during the period 2004-2014 in Chile. Overall we recorded 21 genera and 66 species of Glomeromycota. This represents 24% of species of AMF known so far. Acaulospora represents 23% of all species and Glomus 20%. It is concluded that more studies are needed in this and other regions of Chile for a more comprehensive knowledge of the AMF diversity in the country. These biodiversity studies will help to define the ecology of these important soil microbiological resources.

Gold nanoparticles (AuNPs) were deposited by DC-magnetron sputtering onto molybdenum trioxide (MoO3) thin films grown by Photochemical Metal-Organic Deposition (PMOD) on Si(100) and borosilicate glass substrates. The chemical, optical and morphology properties of the films were studied by UV/ Vis Spectroscopy, Scanning Electron Microscopy (SEM), X-Ray Photoelectron Spectroscopy (XPS), and X-Ray Diffraction (XRD). SEM revealed that AuNPs formed after 5 s of sputtering. AuNPs are spherical and have both an average diameter of 18 nm and a relatively narrow size distribution. As the deposition time increases, larger structures are formed by an aggregation of AuNPs. XPS studies of the AuNP/MoO3 films on Si(100) showed the presence of Mo(VI) and Mo(V), which indicated that the films were primarily non-stoichiometric molybdenum oxides. The occurrence of oxygen vacancies in the substrate play an important role to stabilize the AuNPs.

In this paper, a study on chaotic synchronization of an irregular network is made. Synchronization is achieved by using a modified Hamiltonian approach in a bidirectional irregular arrayed network made of 20 chaotic oscillators. The chaotic oscillator used as example is the Hysteretic circuit. Afterwards the concept is used in chaotic encryption to send secured confidential analog information. As a result, an image is encrypted using additive chaotic encrytion with two channels.

En este trabajo, un estudio de la sincronización caótica de una red irregular es realizada. La sincronización es alcanzada al usar una modificación al enfoque Hamiltoniano sobre una red bidireccional irregular creada por 20 osciladores caóticos. El oscilador caótico usado como ejemplo es el circuito de Histeresis. Después, este concepto es usado en encriptamiento caótico para enviar información análoga confidencial de manera segura. Como resultado, una imagen es encriptada usando encriptamiento caótico aditivo de dos canales.

Background: Angiomyolipomas associated with tuberous sclerosis may invade the renal vein and generate intramural thrombi. Case report: We report a 36-years-old woman, consulting for left flank pain. CT scan showed a large tumor in the left kidney consistent with the diagnosis of infiltrating renal angiomyolipoma with tumor invasion of the vein. Laparoscopic nephrectomy was performed, with removal of tumor thrombus. The operative time was 127 minutes and estimated bleeding 20 ml. There were no intraoperative or postoperative complications. The patient is currently asymptomatic after 12 months of follow up. The pathological study of the surgical piece showed a renal angiomyolipoma with invasion of the kidney and a solid tumor in the lumen of the renal vein.

Objetivo: Se presenta el caso clínico de un Angiomiolipoma renal con extensión a vena renal, patología de muy baja frecuencia. Caso clínico: Mujer de 36 años, quien consulta por dolor en flanco izquierdo. En una tomografía computada se encuentra una lesión tumoral extensa del riñón izquierdo compatible con un Angiomiolipoma renal infiltrante e invasión tumoral de la vena renal. Se realiza nefrectomía laparoscópica, con extirpación de trombo tumoral. El tiempo operatorio fue de 127 min y el sangrado estimado de 20 ml. No hubo complicaciones intra ni postoperatorias. La paciente se encuentra actualmente asintomática luego de 12 meses de seguimiento. La histología mostró un Angiomiolipoma renal con invasión del riñón y un tumor sólido en el lumen de la vena renal. Conclusión: La invasión de vena renal por un Angiomiolipoma es extremadamente raro. Su resolución laparoscópica es posible, con sólo una comunicación previa en la literatura.

Background: Agriculture workers and rural dwellers are exposed to pesticide products. Sanitation policies attempt to regulate their use, but studies demonstrate that a significant percentage of workers and residents who are close to the productive zones are exposed to these chemicals. Pregnant women are particularly vulnerable to pesticides. Aim: To identify the risk of exposure to pesticides and practices of pesticide handling in women under pregnancy control programs in Family Health Care Centers in two rural districts of the 5th Region. Method: Cross-sectional study, conducted during May 2013 and April 2014 on eighty women, who entered pregnancy control programs in either rural district. The health professionals of the Centers collected the data in a survey. Results: Most of the pregnant women declared having been in contact with pesticides at some point. Almost half of them had this contact in the same year of their interview, that is previous or during their pregnancy. The exposure to pesticides takes place in productive locations as well as residential areas. The preventive measures associated to the contact with pesticides are not sufficient. Rural populations are also exposed to aerial fumigations, which further limits preventive measures. Conclusion: Pregnant women living in a rural district may be permanently exposed to pesticides. Exposure to agrochemicals is not associated to safe prevention practices which increase the risk of exposure. Educational programs may aid to enhance safe pesticide use.

Antecedentes: Los trabajadores agrícolas y habitantes rurales están expuestos a productos plaguicidas. Aun cuando las políticas sanitarias se preocupan de normarlos, diversos estudios demuestran exposición en trabajadores y residentes cercanos a las zonas productivas. Entre ellos se encuentran mujeres gestantes, consideradas población particularmente vulnerable frente a plaguicidas. Objetivo: Identificar el contacto con plaguicidas, así como conductas asociadas a su uso, en mujeres gestantes de dos comunas agrícolas de la V Región en control prenatal en Centros de Salud Familiar. Método: Estudio observacional transversal, realizado en una muestra de ochenta gestantes que ingresaron a control entre mayo 2013 y abril 2014. El instrumento de recolección de datos fue una encuesta, aplicada por el equipo de salud al ingreso. Resultados: Las gestantes, en su gran mayoría, alguna vez han tenido contacto con plaguicidas, y cerca de la mitad lo tuvo en el mismo año en que se aplicó la encuesta. La exposición a plaguicidas se da tanto en los espacios productivos, como residenciales. Se observó que las medidas preventivas asociadas al contacto con agrotóxicos son insuficientes. A la vez, destaca la exposición a fumigaciones aéreas, frente a las cuales la posibilidad de prevención es aún menor. Conclusión: En comunas rurales puede existir un contacto permanente de la población femenina gestante con plaguicidas, lo cual sucede sin las medidas de protección adecuadas, incrementando el riesgo de exposición a estas sustancias. Es pertinente entonces, desarrollar una labor educativa activa para mejorar las prácticas de uso de plaguicidas.

Introduction: Self-concept is the set of ideas and attitudes that a person has about him/herself. Objective: To evaluate whether there are differences in the level of self-concept in children 8-12 years old with and without burns sequelae. To identify predictive variables of self-concept in children with sequelae. Patients and method: A comparative cross-sectional study of self-concept in 109 children with burns sequelae, from 8 to 12 years old, with 109 children without burns sequelae, and of the same age and socioeconomic status. The Piers-Harris self-concept scale is used, which provides a general measurement of self-concept and behavioural, intellectual and school status, appearance, and physical attributes, anxiety, popularity, happiness and satisfaction dimensions. Results: There were no significant differences in the level of general self-concept or their dimensions (P > .05). In the group with burns sequelae, the protective factor was the variable number of sequels was associated with the dimensions of anxiety, popularity, happiness-satisfaction and general self-concept. The location variable emerged as a risk factor for the behavioural dimension. Discussion: The absence of differences in self-concept between children with burns sequelae and children without them is similar to that reported in the literature. The finding in the risk and protective factors encourages to further research, and perhaps incorporating pre-morbidity and family background.

Introducción: Autoconcepto es el conjunto de ideas y actitudes que se tiene acerca de sí mismo. Nuestro objetivo fue evaluar si existen diferencias en el nivel de autoconcepto de niños de 8-12 años con y sin secuelas de quemaduras, e identificar variables predictoras del autoconcepto en los niños con secuelas. Pacientes y método: Estudio comparativo, transversal de 109 niños con secuelas de quemaduras de 8 a 12 años de edad, con 109 niños sin secuelas de quemaduras, del mismo grupo de edad y nivel socioeconómico. Se utilizó la escala de autoconcepto de Piers-Harris, que entrega medida de autoconcepto general y dimensiones: conductual, estatus intelectual y escolar, apariencia y atributos físicos, ansiedad, popularidad, felicidad y satisfacción. Resultados: No hubo diferencias significativas en el nivel de autoconcepto general ni en sus dimensiones al comparar ambos grupos (p > 0,05). Dentro del grupo con secuelas de quemaduras la variable número de secuelas resultó ser un factor protector para las dimensiones ansiedad, popularidad, felicidad-satisfacción y autoconcepto general. La variable localización surgió como factor de riesgo para la dimensión conductual. Discusión: La ausencia de diferencias en autoconcepto entre niños con secuelas de quemaduras y sin ellas es similar a lo reportado por la literatura. El hallazgo en factores de riesgo y protectores motiva a continuar investigando, incorporando antecedentes premórbidos y familiares.

Introduction: Ureteral trauma can result from various noxas the most frequent iatrogenic. Additional this, external causes: blunt trauma, sharp weapon and gunshot contributing to the overall incidence. Its early diagnosis although great importance to avoid complications is difficult so it is their suspect is essential when confronted with trauma patients. Case reports: We report five patients aged 15 to 46 years with ureteral trauma. Two patients had gross hematuria, one patient acute abdominal pain and two as hypovolemic shock. The lesions were found mainly to the left ureter and in smaller proportion in right ureter. Four patients the diagnosis was surgical exploration and one case was performed by scans. All were operated, had an uneventful postoperative period and are currently asymptomatic.

Introducción: El trauma de uréter puede ser resultado de diferentes noxas siendo la más frecuente la iatrogénica. Adicional a esto, las causas externas de trauma contuso, las causadas con arma cortopunzante y las realizadas por arma de fuego contribuyen a la incidencia global. Su diagnóstico temprano, aunque de gran importancia para evitar complicaciones, resulta difícil por lo que es primordial su sospecha cuando nos enfrentamos a pacientes politraumatizados. Casos clínicos: Se identificaron 5 casos de trauma ureteral en nuestro hospital desde septiembre de 2012 a agosto de 2013. La mediana de edad fue 24,5 años (15-46 años). Se manifestaron como hematuria macroscópica en dos casos, un caso como dolor abdominal agudo y dos como choque hipovolémico. Estas lesiones se encontraron principalmente localizadas hacia uréter izquierdo y en menor proporción en uréter derecho, todas de tipo penetrante, causadas por arma de fuego. En 4 pacientes el diagnóstico fue por exploración quirúrgica y un caso fue realizado a través de escanografía. Los pacientes fueron intervenidos quirúrgicamente, ninguno presentó complicaciones y se encuentran actualmente asintomáticos.