Abstract Impediment to local anesthetic solution in the epidural space results in unsatisfactory pain relief during labor epidural. Patients with a history of back trauma and spinal instrumentation have increased rates of epidural failure due to patchy spread of local anesthetic with obliterated epidural space. Dual Epidural Catheters (DEC) can be used in such clinical scenarios with complete labor analgesia and improved patient satisfaction. We present the successful management of a parturient with vertebral fracture at risk for epidural failure and neurologic injury due to bone fragments and inserted cranial and caudal to the fractured vertebra using ultrasound to avoid neurologic sequelae. DEC (DEC satisfaction sequelae

ABSTRACT When fnely analyzing complex decisions, it is necessary to use several methods of operational research, decision theory inparticular. However, these normally cannot handle election tie-breakers or disagreement in group decisions for certain reasons. In this article, we extend the range of the methodological scheme of the analytical hierarchy process (AHP) to address problems in reaching consensus among experts. First, we verify that it is a technique that guarantees the necessary set of preferences in an expert judgment; then we apply a prioritization procedure with the geometric mean to verify, reach and improve the level of consensus of the group via this technique. Finally, through a case of application in the industrial logistics sector, the scheme developed is illustrated, reaching positive results that indicate its effectiveness and applicability within the field of the Decision Theory.

RESUMEN Cuando se busca una mayor precisión en el análisis de decisiones complejas, se hace necesario recurrir a diferentes técnicas de la Investigación de Operaciones, particularmente en la Teoría de decisiones. Sin embargo, la mayoría de estas pueden ser inadecuadas para manejar desempates de elecciones o disparidad en decisiones grupales por determinadas razones. En este artículo ampliamos los casos de aplicación del esquema metodológico del Proceso de jerarquía analítica (AHP) para abordar problemas en consensos de expertos. Primero, se verifica que esta sea una técnica que garantice el conjunto de preferencias necesarias en un juicio de expertos, luego, aplicamos un procedimiento de priorización usando la media geométrica, para verificar, alcanzar y mejorar el nivel de consenso de grupo por medio de esta técnica de decisión. Finalmente, se ilustra el esquema desarrollado mediante un caso de aplicación en el sector de la logística industrial, llegando a resultados positivos que señalan su efectividad y aplicabilidad dentro del campo de la Teoría de decisiones.

In the present study the production of phenolic acids and flavonoid compounds by E. gracilis exposed to two cadmium concentrations (0.02 and 0.14 mM) was evaluated using high-performance liquid chromatography (HPLC). The results showed that E. gracilis exposed to 0.02 mM Cd+2 increased significantly the total content of phenolic compounds (798.46 ± 12.61 μg GA/g) and total flavonoids (241.34 ± 47.63 μg QE/g) with respect to the control (137.34 ± 19.80 μg QE/g DW and 549.00 ± 8.57 μg GA/g DW, respectively). However, no significant increase in the total content of phenolic compounds (568.54 ± 17.42 μg GA/g DW) and total flavonoids (141.11 ± 9.36 μg QE/g DW) were observed in E. gracilis exposed to 0.14 mM Cd+2. Further research is necessary to determine the specific role of flavonoids in E. gracilis exposed to high concentrations of Cd+2.

En el presente estudio la producción de compuestos fenolicos y flavonoides producidos por E. gracilis expuesto a dos concentraciones de cadmio fue evaluado usando cromatografía liquida de alta precisión (HPLC). Los resultados mostraron que 0.02 mM de Cd+2 incrementaba significativamente el contenido total de compuestos fenolicos (798.46 ± 12.61 μg GA/g) y flavonoides (241.34 ± 47.63 μg QE/g) con respecto al control (137.34 ± 19.80 μg QE/g DW y 549.00 ± 8.57 μg GA/g DW) respectivamente. Sin embargo, incrementos no significativos en el contenido de compuestos fenolicos (568.54 ± 17.42 μg GA/g DW) y flavonoides totales (141.11 ± 9.36 μg QE/g DW) fueron observados en E. gracilis expuestas a 0.14 mM de Cd+2. Futuros estudios son necesarios para determinar la función especifica de los flavonoides en E. gracilis expuesto a altas concentraciones de Cd+2.

The effect of the exposure to copper in metal bioaccumulation capacity in cells from Euglena gracilis was evaluated in this study. Metal accumulation measured with the X-ray fluorescence (XRF) technique showed that the accumulation of Cu+2 in E. gracilis was dose dependent and was significantly increased in cells treated with 0.4 and 0.8 mM of Cu+2 with respect to control. The presence of an accumulation strategy in E. gracilis that could involve the participation of a number of multiple processes, such as production of vacuoles, is not discarded. Future studies should be oriented to evaluate the potential for bioaccumulation of E. gracilis to be applied in bioremediation of aquatic systems programs.

En esta investigación se evaluó el efecto de la exposición de cobre en la capacidad de bioacumulación de metal en células de Euglena gracilis. La acumulación de metal medida con la técnica de fluorescencia de rayos X (XRF) mostró que la acumulación de Cu+2 en E. gracilis fue dosis dependiente y se incrementó significativamente en las células tratadas con 0.4 y 0.8 mM de Cu+2 con respecto al control. No se descarta la presencia de una estrategia de acumulación en E. gracilis que podría involucrar la participación de una serie de múltiples procesos, como producción de vacuolas. Futuros estudios al respecto deberán orientarse a evaluar la capacidad de bioacumulación de E. gracilis para su aplicación en programas de biorremediación de sistemas acuáticos.

Echinococcus granulosus, the etiologic agent of cystic echinococcosis (CE) in humans and other animal species, is distributed worldwide. Ten intra-specific variants, or genotypes (G1-G10), have been defined based on genetic diversity. To determine the genotypes present in endemic areas of Peru, samples were collected from cattle (44), sheep (41) and humans (14) from Junín, Puno Huancavelica, Cusco, Arequipa and Ayacucho. DNA was extracted from protoscolex and/or germinal layers derived from 99 E. granulosus isolates and used as templates to amplify the mitochondrial cytochrome C oxidase subunit 1 gene. The resulting polymerase chain reaction products were sequenced and further examined by sequence analysis. All isolates, independent of the host, exhibited the G1 genotype. Phylogenetic analysis showed that three isolates from Ayacucho shared the same cluster with microvariant G1(4). The G1 genotype is considered the most widespread and infectious form of E. granulosusworldwide and our results confirm that the same patterns apply to this country. Therefore, these findings should be taken into consideration in developing prevention strategies and control programs for CE in Peru.

Twenty three patients with Cutaneous Larva Migrans syndrome were prospectively treated with 400 mg/day of Albendazole for 3 consecutive days. Clinical response, compliance and tolerance was excellent. Patients were asymptomatic within the first 72 hours of treatment and recurrences did not occurred. Preliminary results with three additional patients suggest that a single oral 400 mg dose may be effective as well.

Veintitrés pacientes con el sindrome de Larva Cutanea Migratoria, fueron tratados prospectivamente con 400 mg/dia VO de albendazol por tres dias consecutivos. La respuesta clínica, aceptación y tolerancia del tratamiento fué excelente. Todos los pacientes se volvieron asintomáticos durante las primeras 72 horas de tratamiento y no se observaron recurrencias de lesiones. Los resultados preliminares obtenidos entres pacientes adicionales, sugieren que la dosis única de 400 mg puede ser igualmente efectiva.