RESUMEN Introducción: El tratamiento de los trastornos funcionales de la unidad anorrectal debe centrarse en la causa subyacente. La terapia de biorretroalimentación es un reentrenamiento funcional del suelo pélvico que ha demostrado su utilidad en el tratamiento del estreñimiento asociado a la disinergia y en el manejo de la incontinencia fecal. Este estudio describe las primeras experiencias con esta forma de terapia de biorretroalimentación en Colombia. Objetivo: Describir nuestra experiencia con la terapia de biorretroalimentación en la unidad de neurofisiología gastrointestinal. Materiales y métodos: Esta cohorte histórica incluyó pacientes con indicación de terapia de biorretroalimentación por estreñimiento o incontinenciafecalenlaunidaddeneurofisiologíagastrointestinalenelperiododerecolección de datos. Se describe la respuesta a la terapia comparando los hallazgos manométricos antes y después de 10 sesiones de biorretroalimentación. Resultados: Se incluyó a 21 pacientes (71,4% mujeres, el promedio de edad fue de 68, 9 con estreñimiento y 12 con incontinencia fecal. Entre los pacientes con estreñimiento hubo una mejoría significativa en el 71,4% de los que tenían hiposensibilidad rectal y en el 57,1% de los que tenían disinergia. La terapia de biorretroalimentación aumentó significativamente la tasa de expulsión del balón (11,1 frente a 66,7%, p=0,02). En pacientes con incontinencia fecal, hubo mejoría en el 50% de los que tenían hipotonía anal y en el 80% de los que tenían hiposensibilidad anal. Conclusiones: Este estudio demuestra que la terapia de biorretroalimentación tiene un impacto favorable en un alto número de pacientes con estreñimiento e incontinencia fecal, en nuestro centro, la respuesta es similar a la de la literatura mundial.

ABSTRACT Introduction: Treatment of functional disorders of the anorectal unit should focus on the underlying cause. Biofeedback therapy is a functional retraining of the pelvic floor that has proven useful in the treatment of constipation associated with dyssynergia and in the management of fecal incontinence. This study describes the first experiences with this form of biofeedback therapy in Colombia. Objective: Describe our experience with biofeedback therapy in the gastrointestinal neurophysiology unit. Materials and methods: This historical cohort included patients with an indication for biofeedback therapy for constipation or fecal incontinence in the gastrointestinal neurophysiology unit during the data collection period. The response to therapy is described by comparing manometric findings before and after 10 biofeedback sessions. Results: 21 patients were included (71.4% women, the average age was 68, 9 with constipation and 12 with fecal incontinence. Among the patients with constipation there was a significant improvement in 71.4% of those who had rectal hyposensitivity and in 57.1% of those with dyssynergia. Biofeedback therapy significantly increased the balloon expulsion rate (11.1 vs. 66.7%, p=0.02). In patients with fecal incontinence, there was improvement in 50% of those who had anal hypotonia and in 80% of those who had anal hyposensitivity. Conclusions: This study demonstrates that biofeedback therapy has a favorable impact on a high number of patients with constipation and fecal incontinence; in our center, the response is similar to that of the world literature.

Abstract Objective Few studies have addressed the use of sacral nerve stimulation (SNS) in the treatment of patients with multiple pelvic floor dysfunctions (PFD). So, we evaluated the functional outcomes and level of satisfaction with SNS in selected patients with one or multiples PFD. Methods A prospective database was used to collect information on eligible patients treated for PFD with SNS, and severity of symptoms was assessed with scores and satisfaction rates by visual analogue scale (VAS) at baseline and by the end of follow-up. Results We recruited 70 patients, 98.6% of whom responded positively during the evaluation period (Global Response Assessment ≥ 50% for at least one type of PFD), resulting in the implantation of a permanent SNS device. Additionally, 49 of the patients (71%) had a single PFD (fecal incontinence [FI] = 38; constipation/obstructed defecation syndrome [C/ODS] = 11), while 20 (29%) had more than one PFD (double incontinence/n = 12; double incontinence + C/ODS/n = 8). All scores improved significantly between baseline (pre-SNS) and the end of follow-up (post-SNS), as did VAS in all groups (single and multiple PFD). The pre-SNS scores were higher in patients with a single PFD, including FI (Cleveland clinic Florida incontinence score [CCF-FI]) and C/ODS (Cleveland clinic constipation score [C-CCF] and the Renzi ODS score). The pre-SNS impact of VAS scores was similar in all groups (single and multiple PFD), but the VAS (post-SNS) was significantly lower (better response) for FI alone compared with multiple PFD. Conclusion The SNS technique is an effective and safe option for patients with one or more PFD refractory to conservative measures. Response was positive for at least two PFD, based on reduced correspondent scores and satisfaction rate. (SNS . (PFD) So (VAS followup. followup follow up. up 7 986 98 6 98.6 Global 50 , PFD) device Additionally 4 71% 71 (71% fecal [FI 38 constipationobstructed obstructed CODS C [C/ODS 11, 11 11) 2 29% 29 (29% incontinencen n 12 CODSn 8. 8 8) preSNS pre (pre-SNS postSNS, postSNS post Cleveland CCFFI CCF [CCF-FI] CCCF [C-CCF score. score) (post-SNS better response measures rate (PFD 9 98. 5 (71 3 1 (29 [CCF-FI (7 (2 (

Abstract This study aimed to investigate the reproductive effects of adding monosodium glutamate (MSG) to the diet of goats. Eleven adult goats received synchronized estrus and follicular waves using three prostaglandin analog injections every seven days. Goats allocated to individual pens received 1 g/kg BW of MSG in their diet for 23 days (MOGLU group, n = 6), whereas the control group (n = 5) maintained the base diet. The supplemented animals showed an increase in dry matter intake (P < 0.0001) and a reduction in heart rate (P < 0.05), respiratory rate, and ruminal movement (P < 0.001). Surface and rectal temperatures were higher in the MOGLU group, (P < 0.0001) with a significant increase in the afternoon. There was an increase (P < 0.05) in the frequency of behaviors related to rumination, defecation, and urination in the MOGLU group, and a reduction in behaviors associated with stress (P < 0.05). No differences were observed in the plasma levels of proteins, albumin, urea, cholesterol, or triglycerides. Glucose levels were lower (P < 0.05) in the MOGLU group, which also showed increased glutathione peroxide levels during the induction of ovulation. Supplemented animals recorded a larger number (P < 0.05) of follicles throughout the experimental period and higher intraovarian blood perfusion (P < 0.05) during ovulation induction. We conclude that MSG exerts a positive effect on the reproductive response in goats and therefore represents an effective nutritional supplement. (MSG gkg g kg 2 6, 6 , 6) 5 P 0.0001 00001 0 0001 0.05, 005 0.05 05 0.001. 0.001 . 001 0.001) afternoon rumination defecation 0.05. proteins albumin urea cholesterol triglycerides supplement 0.000 0000 000 00 0.0 0.00 0.

RESUMEN El temazate rojo (Mazama temama) es uno de los cérvidos más abundantes y con más amplia distribución en los bosques neotropicales. Un método para estimar densidades poblacionales es mediante el conteo de heces, para lo cual es necesario conocer la tasa de defecación. Para obtener dicha tasa en este ungulado, se realizaron conteos de los eventos de defecación, durante cuatro días, en tres individuos adultos: dos hembras y un macho; alojados en cautiverio en el parque Xcaret, ubicado en el estado de Quintana Roo, México. La tasa de defecación promedio obtenida fue de 10 ± 3,33 (DE) grupos de excrementos/individuo/día. Este dato permitirá realizar estimaciones de densidad poblacional de esta especie en vida libre.

ABSTRACT The red brocket deer (Mazama temama) is one of the most abundant and widely distributed cervids in Neotropical forests. A method for estimating population densities is by counting pellets, for which is necessary to know their fecal rate. To estimate such rate in this ungulate, defecation events were counted during four days, in three adult individuals: two females and one male; hosted in captivity in the Xcaret park, located in Quintana Roo state, Mexico. The average defecation rate obtained was 10 ± 3.33 (SD) pellet groups / individual / day. This data will allow estimations of the population density of this species in free living.

ABSTRACT Objective: Describe the defecation pattern profile of patients hospitalized at Orthogeriatrics Unit of a tertiary Trauma Center, to evaluate defecation satisfaction during hospitalization and potential reasons for dissatisfaction. Methods: This is a cross-sectional descriptive study of 200 patients (> 65 years old) admitted to the Orthogeriatrics Unit of Hospital Vall d'Hebron. Evaluated variables incloude: sociodemographic date (age and sex), polypharmacy (>5 drugs), fiber intake, laxatives use before and during hospitalization, water intake, morphine intake during hospitalization, early mobilization, chronic constipation (Rome III scale), satisfaction of the evacuation pattern at home and during hospitalization, symptoms and trigger factors of their potential dissatisfaction. Results: Most of the patients were female (77%) with a mean (23%) age of 83.92 years. Among the enrolled patients, (63%) take more than (>5 drugs), 57.5% use opioid and 52.5% reported self-prescribed laxatives use 65% were dissatisfied with their evacuation pattern during admission compared to the previous one (38%). According to Rome III criteria, 25% suffer from chronic constipation. The most reported symptom was the excessive straining (60%) and the trigger factor for dissatisfaction was the delayed response to the call of sanitary teams (43.84%). We obtained eight factors that explain up to 61.25% of the total variance. Conclusion: Due to the high rate of dissatisfaction reported by patients while, we believe it is necessary to carry out further research on new tools that improve constipation diagnosis, including specific criteria. Moreover, we recommend the implementation of an action algorithm could diminish the variability of therapeutic approaches in our clinical practice.

RESUMEN Objetivos: Describir el perfil de los pacientes hospitalizados en la unidad de ortogeriatría de un hospital terciario en lo que respecta a su patrón evacuador e identificar la satisfacción de aquellos durante la hospitalización y los posibles motivos de insatisfacción. Metodología: Estudio descriptivo y transversal sobre 200 personas mayores de 65 años ingresadas en la Unidad de Ortogeriatría del Hospital Vall d'Hebron (Barcelona). Variables: sociodemográficas (edad y sexo), polifarmacia, consumo de fibra, consumo de laxantes previo y durante la hospitalización, ingesta hídrica, consumo de mórficos durante la hospitalización, movilización precoz, estreñimiento crónico (Escala Roma III), satisfacción del patrón evacuador tanto en domicilio como durante la hospitalización, principales síntomas y factores desencadenantes de la posible insatisfacción. Resultados: Predominio del sexo femenino (77%) frente al masculino (23%), edad media 83,92 años. Destaca polifarmacia (>5 fármacos) (63%), consumo de opiáceos (57,5%), automedicación de laxantes (52,5%), insatisfacción del patrón evacuador durante el ingreso (65%) respecto al previo (38%) y estreñimiento crónico (25%) según criterios Roma III. El síntoma más descrito por los pacientes es el esfuerzo excesivo para evacuar (60%) y la demora en la respuesta de la llamada (43,84%). Se identificaron 8 factores que explican hasta el 61,25% de la varianza total. Conclusión: El estudio ha permitido identificar los factores relacionados con el perfil de los pacientes hospitalizados en la Unidad de Ortogeriatría del Hospital Vall d'Hebron en lo que respecta a su patrón evacuador e identificar la satisfacción respecto al patrón de eliminación durante la hospitalización y los posibles motivos de insatisfacción.

Resumo Introdução A taxa de recorrência do prolapso de órgãos pélvicos é uma questão importante que afeta a qualidade de vida do paciente, resultando em um novo procedimento cirúrgico. Os autores adotaram uma nova técnica de suspensão laparoscópica de órgãos pélvicos (suspensão retal) no tratamento de prolapso de órgãos pélvicos. Os resultados dessa técnica foram avaliados três meses após a cirurgia e no momento do relato do estudo. Métodos Todos os pacientes com prolapso de órgão pélvico submetidos a suspensão laparoscópica foram avaliados. Os dados foram coletados do prontuário do paciente, na visita de acompanhamento três meses após a cirurgia e na última visita de acompanhamento. Os dados demográficos, histórico médico, avaliação física, escore de incontinência fecal de Wexner, escore da síndrome da defecação obstruída de Altomare, complicações pós-operatórias e satisfação do paciente foram analisados retrospectivamente. Resultados Todos os pacientes eram do sexo feminino, com média de idade de 57 ± 11,43 anos (variação de 32 a 86 anos). O índice de massa corporal médio foi de 26,1 ± 3,73. Nove (31%) pacientes apresentaram sangramento retal; 18 (62%), defecação prolongada ou difícil; 16 (55,2%), prolapso retal; 11 (37,9%), incontinência gasosa; nove (31%), incontinência fecal líquida, cinco (17,2%), incontinência fecal; nove (31%), prolapso vaginal; 23 (79,3%), constipação; nove (31%), queixa de dor pélvica; nove (31%), incontinência urinária de urgência ou esforço e 13 (44,8%), dispareunia. Conclusões Os autores acreditam que este procedimento apresenta bons resultados no seguimento de curto prazo (três meses após a cirurgia), mas uma alta taxa de recorrência no acompanhamento a médio prazo. Portanto, esse procedimento não é mais recomendado.

Abstract Background Pelvic organ prolapse recurrence rate is an important issue which impacts the patient's quality of life and results in a new surgical procedure. We use a new technique of laparoscopic pelvic organ suspension (rectal suspension) for pelvic organ prolapse treatment in our center. We evaluated the results of this technique, three months after surgery and at the time of study reporting. Methods All patients with pelvic organ prolapse for whom laparoscopic pelvic organ prolapse had been done were evaluated. Data were collected from the patient's charts and their short term follow up 3 months after the surgery and their last follow up visit. Demographic, history, physical examination, Wexner's fecal incontinence score and Altomare's Obstructed Defecation Syndrome score, post-operation complications and patient's satisfaction were analyzed, retrospectively. Results All patients were female with a mean age of 57 ± 11.43 years (range 32-86 years). Mean BMI was 26.1 ± 3.73. Nine patients had rectal bleeding (31%), 18 had prolonged or difficult defecation (62%), 16 had rectal prolapse (55.2%), 11 had gas incontinence (37.9%), 9 had liquid stool incontinence (31%), 5 had stool incontinence (17.2%), 9 had vaginal prolapse (31%), 23 had constipation (79.3%), 9 complaint of pelvic pain (31%), 9 had urge or stress urinary incontinence (31%) and 13 had dyspareunia (44.8%). Conclusions In conclusion, we believe this procedure has good results in short term follow up (3 months after surgery), but a high recurrence rate in the middle term follow up. Therefore, this procedure is no longer recommended.

ABSTRACT Pelvic organ prolapse is defined as the descent of the anterior and / or posterior wall of the vagina and / or the dome or uterus through the vagina. This pathology has been associated with urinary dysfunction, altered defecation and sexual dysfunction. Symptomatic prolapse of pelvic organs is a condition that negatively affects the quality of life of women, finding a prevalence of lifetime prevalence is 3-6%. Obliterative vaginal surgery, has a shorter surgical time, morbidity and blood loss rates are lower, recovery is faster, and anatomic success greater. Patients who are ideal candidates for colpocleisis usually present multiple medical comorbidities that discard them to lead to reconstructive surgery. With an efficiency of 90% in the literature, indicating that improvement of the quality of life and body image for the majority of patients. OBJECTIVE: To perform a review of the colpocleisis procedure regarding anatomical results, resolution of symptoms, satisfaction with surgical results and associated morbidity and mortality of patients who consulted a third-level private health care institution located in Medellín, (Colombia). METHODOLOGY: A retrospective cohort study was carried out in which all patients with grade III-IV prolapse who underwent colpocleisis were included in the period from 2013 to 2016, in a private health institution of III level in Medellín, Antioquia, that attends contributory regime of the social security system in Colombia and private patients. The Pelvic Organ Prolapse (POP-Q) scale was used to determine prolapse levels and what type of prolapse was identified before and after surgery. All preoperative multichannel urodynamic evaluations with prolapse reduction were requested to evaluate occult incontinence or micturition difficulties. And a subjective evaluation of the response to surgery was performed with the Global Impression of Patient Improvement (PGI-I) scale. RESULTS: Data were collected between January 2013 and December 2016. Thirty-three patients were submitted to colpocleisis, 27 of which 18.8 (%) were older than 80 years. 52 (36.3%) patients between 60-70 years, 62 (43.3%) between 70-80 years and <60 years 1 patient. The mean age of the age group was 75 years, range 58-94 years; the mean body mass index was 27, the average follow-up duration was 9 months, and the number of vaginal deliveries was 4. (97.9%) of the patients had medical comorbidities. With a cure rate of 97.9%. CONCLUSION: The cohort study describes our experience and adds to existing data that support the viability and safety of colpocleisis. We found high efficacy of cleisis in terms of patient satisfaction, improvement in quality of life, independent of age, with a low rate of complications and surgical failures. Colpocleisis is a good treatment option for prolapse of pelvic organs stage III-IV, in those who do not wish to preserve sexual functionality, however this concept must be individualized for each patient.

RESUMEN El prolapso de órganos pélvicos es definido como el descenso de la pared anterior y /o posterior de la vagina y/ o la cúpula o útero a través de la vagina. Esta patología se ha visto asociada a disfunción urinaria, alteración de la defecación y disfunción sexual. El prolapso sintomático de órganos pélvicos es una condición que afecta negativamente la calidad de vida de las mujeres, encontrando una prevalencia de 3-6%. La cirugía obliterativa de vagina, tiene un menor tiempo quirúrgico, las tasas de morbilidad y pérdida de sangre son más bajas, la recuperación es más rápida, y el éxito anatómico mayor. Las pacientes que son ideales candidatas a la colpocleisis suelen presentar múltiples comorbilidades médicas que las descartan para llevar a una cirugía reconstructiva con una eficiencia de 90% en la literatura, refiriendo que mejora de la calidad de vida y la imagen corporal para la mayoría de pacientes. OBJETIVO: Realizar una revisión sobre el procedimiento de colpocleisis referente a los resultados anatómicos, resolución de los síntomas, satisfacción con los resultados quirúrgicos y la morbimortalidad asociada de pacientes que consultaron a una institución prestadora de salud privada de tercer nivel, ubicada en Medellín, (Colombia). METODOLOGÍA: Se realizó un estudio de cohorte retrospectivo en el cual se incluyen todas las pacientes con prolapso grado 3-4 a quienes se les haya realizado colpocleisis en el periodo de tiempo comprendido entre 2013 al 2016, en una institución prestadora de salud privada de III nivel en Medellín, Antioquia, que atiende régimen contributivo del sistema seguridad social en Colombia y pacientes particulares. Se usó la escala de cuantificación del Prolapso del Órgano Pélvico (POP-Q) para determinar los niveles de prolapso y que tipo de prolapso se identificaba antes y después de la cirugía. Se les solicitó a todas evaluación urodinámica multicanal preoperatoria con reducción del prolapso para evaluar incontinencia oculta o dificultades de micción. Y se realizó una evaluación subjetiva de la respuesta a la cirugía con la escala de Impresión Global de Mejora del paciente (PGI-I). RESULTADOS: Se realizó una recolección de datos entre enero de 2013 a diciembre de 2016. Fueron sometidas a colpocleisis 143 pacientes, 27 de ellas (18.8 %) tenían más de 80 años. 52 pacientes (36.3%) entre 60-70 años, 62 pacientes (43.3%) entre 70-80 años y 1 pacientes <60 años. La edad media del grupo de edad fue de 75 años, rango 58-94 años; el índice de masa corporal promedio fue de 27, la duración del seguimiento promedio fue 9 meses, y el número de partos vaginales 4. El 97.9% de las pacientes presentaban comorbilidades médicas. Hubo una tasa de curación de 97.9%. CONCLUSIÓN: El estudio de cohorte describe nuestra experiencia y agrega a los datos existentes que apoyan la viabilidad y seguridad de la colpocleisis. Encontramos alta eficacia de las cleisis en cuanto a la satisfacción de las pacientes, en mejoría de calidad de vida, independiente de la edad, con una baja tasa de complicaciones y fallas quirúrgicas. La colpocleisis es una buena opción de tratamiento para prolapso de órganos pélvicos estadio 3-4, en quienes no deseen conservar la función sexual, sin embargo este concepto debe ser individualizado para cada paciente.

ABSTRACT This study aimed to evaluate the buriti oil (Mauritia flexuosa L.) inclusion levels (0, 15, 30, and 45 g kg−1 in dry matter) replacing ground corn on the feeding behavior, as well as physiological and hematological variables of crossbred lactating Anglo Nubian goats. Eight Anglo Nubian goats were used, which were distributed in a double 4 × 4 Latin square experimental design (four periods and four levels of buriti oil) replacing corn in the total dry matter. For the evaluation of feeding behavior, single animals were observed every ten minutes for 24 h on three days. Respiratory rate (RR), heart rate (HR), rectal temperature (RT), and sweating rate (SR) of the animals were evaluated in the morning (09:00 h) and in the afternoon (15:00 h). Blood samples were always taken in the morning, before feeding, by puncturing the jugular vein for the complete blood count and white blood cell count. The levels of buriti oil had no effect on feeding, rumination, idling time, water intake, defecation and urination, DM intake, feed efficiency, and rumination efficiency of DM and NDF, but had effects on NDF intake. Physiological variables (RT, SR, RR, and HR) in both periods of the day were not influenced by the inclusion of buriti oil. However, SR and RR were higher in the afternoon than in the morning. In erythrocyte, results showed that the hematocrit and mean corpuscular volume increased with the inclusion of buriti oil. Hemoglobin, red blood cell count, mean corpuscular hemoglobin concentration, and total plasma protein were not affected by the inclusion of buriti in the goat diet. The inclusion of buriti oil is recommended in up to 45 g kg−1 (DM basis) as a replacement for ground corn in diet of lactating goats without affecting the feeding behavior and physiological and hematological variables.

RESUMO Objetivo: As vantagens da terapia por biofeedback, juntamente com a dieta, em pacientes com constipação se situam entre os tópicos atualmente em discussão. O objetvo desse estudo foi avaliar os resultados, após 2 anos, da terapia por biofeedback associada à dieta em pacientes com síndrome da defecação obstruída (SDO) (Anismus). Metodologia: O enfoque desse estudo prospectivo é um grupo de 129 pacientes com constipação por SDO, encaminhados a dois centros acadêmicos de referência para atendimento terciário entre os anos de 2013 e 2016. Os pacientes receberam terapia por biofeedback em combinação com dieta apropriada no grupo de estudo (casos), e apenas dieta no grupo de controle. Boa resposta foi deinida como o paciente com pelo menos 50% de melhora desde antes até após a terapia por biofeedback, com o uso de um Sistema de Pontuação para Constipação do Centro Médico Cleveland Clinic Florida (CCF). Os fatores associados a melhor desfecho foram analisados com o uso do programa SPSS 20. Resultados: Dos 129 pacientes, 112 (86,8%) eram mulheres. A média de idade dos pacientes era de 4244 ± 15,05 years. O escore CCF médio dos pacientes antes e depois da terapia por biofeedback foi 12,41 ± 4,39 e 6,00 ± 3,28 respectivamente no grupo de casos (P < 0,001). Além disso, o escore CCF médio dos pacientes antes e depois da dietoterapia foi 12,82 ± 4,85 e 9,43 ± 3,79 respectivamente no grupo de controle (P < 0,001). Embora o escore CCF tanto no grupo de casos como no grupo de controle tenha apresentado redução significativa após a terapia, o grau dessa redução foi mais elevado no grupo de casos (P < 0,001). Conclusão: Nossos achados sugerem que a terapia por biofeedback em combinação com a dieta melhora o resultado para os pacientes apresentando constipação por SDO. Recomendamos a realização de estudos clínicos prospectivos com amostras mais expressivas, que permitam o estabelecimento de correlações causais.

ABSTRACT Object: The advantages of biofeedback therapy along with diet in patients with constipation are among the issues discussed nowadays. The aim of this study was to evaluate 2 years outcome of biofeedback therapy along with diet in patients with obstructed defecation syndrome (ODS) (Anismus). Methodology: The focus of this prospective study is a group of 129 patients with ODS constipation, who were referred to two tertiary-care referral academic centers from 2013 to 2016. Patients received biofeedback therapy combined with appropriate diet in cases group and received diet in controls group. Good response was defined as a subject with at least 50 percent improvement from before to after biofeedback therapy on a Cleveland Clinic Florida Constipation Scoring System (CCF). Factors associated with better outcome were analyzed using SPSS 20 software. Results: Out of the 129 patients, 112 patients (86.8%) were female. The mean age of patients was 42.44 ± 15.05 years. The mean CCF score of the patients before and after biofeedback therapy was 12.41 ± 4.39 and 6.00 ± 3.28 respectively in case group (p-value < 0.001). In addition, the mean CCF score of the patients before and after diet therapy was 12.82 ± 4.85 and 9.43 ± 3.79 respectively in control group (p-value < 0.001). While CCF score in both case and control groups reduced significantly after therapy, the rate of this reduction was higher in case group (p < 0.001). Conclusion: Our findings suggest that biofeedback therapy combined with diet will improve patients outcome in ODS constipation. Prospective clinical trials with larger sample sizes are recommend allowing for causal correlations.

Abstract: INTRODUCTION: Panstrongylus herreri is a main Chagas disease vector, and its success as a vector stems from its ability to establish domiciliated colonies; we aimed to explore its biology and reproduction. METHODS: The average amount of blood ingested and the time from the beginning of a blood meal to the production of feces were recorded. RESULTS: Females exhibited a higher blood ingestion rate than males, but similar defecation times and frequencies were observed. CONCLUSIONS: Despite the detected decrease in oviposition rates, P. herreri’s potential as a Chagas disease vector in environments other than the Amazon forest cannot be discounted.

Abstract Introduction Trypanosoma cruzi is the etiologic agent of Chagas disease. Transmission is through insects of the Triatominae subfamily, where Triatoma dimidiata is one of the main vectors in Mexico and Central America. This parasite transmission depends on factors such as the infection rate of the vector and its defecation time after feeding. Aim Evaluate the ability of five nymphal stages of T. dimidiata to cause infection of T. cruzi and determine the posprandial defecation time. Material and methods Thirty individuals of each stage of T. dimidiata were fed with blood infected with T. cruzi. A second feed was carried out after 20 days to evaluate the presence of the parasite in the feces and timing of postprandial defecation. Results The total number of individuals infected with T. cruzi was 99 (66 %). Differences statistically significant were not found among the nymphal stages (p> 0.05). Defecation time was lower in individuals of the fifth stage with difference statistically significant (p <0.05). Conclusions All stages of T. dimidiata were infected with T. cruzi, being the fifth stage the better vector in laboratory conditions.

Resumen Introducción El parásito Trypanosoma cruzi es el agente etiológico de la enfermedad de Chagas. Su transmisión es a través de insectos de la subfamilia Triatominae, donde Triatoma dimidiata es uno de los vectores principales en México y Centro América. La transmisión del parásito depende de factores como la tasa de infección de las distintas especies y el tiempo de defecación después de la alimentación. Objetivo Evaluar la infección con T. cruzi en los cinco estadios de T. dimidiata y determinar el tiempo de defecación postprandial. Material y métodos Treinta individuos de cada estadio de T. dimidiata fueron alimentados con sangre infectada con T. cruzi. Se llevó a cabo una segunda alimentación 20 días posteriores para evaluar la presencia del parásito en las heces y medir el tiempo de defecación postprandial. Resultados El número total de ejemplares infectados con T. cruzi fue de 99 (66 %). No se encontraron diferencias significativas en la tasa de infección por estadio ninfal (p>0.05). El tiempo de defecación fue menor en los individuos del quinto estadio en relación a los otros grupos (p<0.05). Conclusiones Todos los estadios de T. dimidiata se infectaron con T. cruzi, considerando al quinto instar como un mejor vector del parásito en condiciones de laboratorio.

This study aimed to estimate the frequency, associated factors, and molecular characterisation of Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, andEntamoeba hartmanni infections. We performed a survey (n = 213 subjects) to obtain parasitological, sanitation, and sociodemographic data. Faecal samples were processed through flotation and centrifugation methods.E. histolytica, E. dispar, E. moshkovskii, and E. hartmanni were identified by nested-polymerase chain reaction (PCR). The overall prevalence of infection was 22/213 (10.3%). The infection rate among subjects who drink rainwater collected from roofs in tanks was higher than the rate in subjects who drink desalinated water pumped from wells; similarly, the infection rate among subjects who practice open defecation was significantly higher than that of subjects with latrines. Out of the 22 samples positive for morphologically indistinguishableEntamoeba species, the differentiation by PCR was successful for 21. The species distribution was as follows: 57.1% to E. dispar, 23.8% to E. histolytica, 14.3% toE. histolytica and E. dispar, and 4.8% E. dispar and E. hartmanni. These data suggest a high prevalence of asymptomatic infection by the group of morphologically indistinguishable Entamoeba histolytica/dispar/moshkovskiicomplex and E. hartmanni species. In this context of water scarcity, the sanitary and socioenvironmental characteristics of the region appear to favour transmission.

Introducción. El Salvador no cuenta con datos actualizados de prevalencia en menores de 15 años de la infección por helmintos transmitidos por contacto con el suelo. Además, al ser uno de los países en las Américas que reporta un número bajo de casos de malaria, se considera que su eliminación allí es factible. Objetivo. Determinar la prevalencia y la intensidad de la infección por geohelmintos y la prevalencia de Plasmodium spp. en escolares de 8 a 10 años de El Salvador. Materiales y métodos. Se hizo un estudio de corte transversal en las cinco zonas eco-epidemiológicas del país (planicie costera, depresión central, cadena volcánica, cadena costera y zona montañosa). La presencia de geohelmintiasis se estudió en 1.325 estudiantes y, la de malaria, en 152. Se utilizó la técnica de Kato-Katz para la detección de geohelmintos, y para el diagnóstico de la malaria, una prueba rápida, el estudio mediante microscopía y la prueba de reacción en cadena de la polimerasa. Resultados. La prevalencia total de geohelmintiasis fue de 7,9 % (IC 95% 6,6-9,5). En la planicie costera fue de 14,9 % (IC 95% 10,9-19,7); en la depresión central, de 9,4 % (IC 95% 6,5-13,3); en la cadena volcánica, de 6,6 % (IC 95% 4,2-10,5); en la cadena costera, de 5,9 % (IC 95% 3,8-9,4), y en la cadena montañosa, de 2,6 % (IC 95% 1,4-5,7). La proporción de infección de gran intensidad debida a cualquiera de las especies de geohelmintos fue de 0,3 %. No se encontraron escolares infectados con Plasmodium spp. Conclusión. La prevalencia de geohelmintos fue baja y la especie más prevalente fue Trichuris trichiura . La intensidad de la infección debida a cualquiera de las especies de geohelmintos fue leve (<1 %). Los factores de riesgo asociados a la infección por geohelmintos fueron la defecación al aire libre, no usar calzado y vivir en la planicie costera.

Introduction: El Salvador does not have recent data on the prevalence of infection with soil-transmitted helminths among children aged under 15 years of age. As one of the countries in the Americas that reports few malaria cases, eradication of this disease from El Salvador is considered to be feasible. Objective: To determine the prevalence and intensity of infection by soil-transmitted helminths, as well as the prevalence of Plasmodium spp. in schoolchildren aged 8-10. Materials and methods: A cross-sectional study was carried out in each of the five eco-epidemiological zones of the country (coastal plain, central basin, volcanic range, coastal range and mountain zone). In all 1,325 students we studied the presence of geohelminthiasis, with 152 of them also being tested for malaria. The Kato-Katz technique was used to detect geohelminths while diagnosis of malaria was performed using the rapid diagnostic test, microscopy and polymerase chain reaction. Results: The overall prevalence of geohelminthiasis was 7.9% (95%CI 6.6-9.5%). Values for the five eco-epidemiological zones were as follows: coastal plain, 14.9% (95%CI 10.9-19.7%); central plateau, 9.4% (95%CI 6.5-13.3%); volcanic range, 6.6% (95%CI 4.2-10.5%); coastal range, 5.9% (95%CI 3.8-9.4%), and mountain zone, 2.6% (95%CI 1.4-5.7%). The overall rate of high intensity infection with any of the geohelminth species was 0.3%. No schoolchildren were found infected with Plasmodium spp. by any of the three diagnostic techniques used. Conclusion: Prevalence of geohelminths was low and Trichuris trichiura was the predominant species. Intensity of infection with any of the species of geohelminths was light (<1%). The risk factors associated with infection by soil-transmitted helminths were defecation in the open air, being barefoot and living in coastal areas.

The aim of this is study was to analyse perineal hernia's prevalence in the population, describe its characteristics and to evaluate different surgical techniques used and their results. The study design is a retrospective study of perineal hernia's cases in the Veterinary Teaching Hospital of the University of Extremadura. Perineal hernia cases are 0.96% of the population. Males and females represent 98.2% and 1.2%, respectively. Our population with perineal hernia has an average age of 8,69 years, and a standard deviation of 2.19 years. The average weight body was 16.4 kg ± 11.44 kg. We found 18 bilateral perineal hernias, 40 right unilateral hernias and 20 left unilateral; the total number was 96 perineal hernias. Sixty seven patients underwent surgery, and a total of 80 perineal hernias were repaired. The most frequent clinical signs were perineal bulge and defecation difficulty. Bladder retroflexion appeared in 13.6% of the cases and the prostate was affected in the 21%. It was noted that bilateral perineal hernia patients had increased susceptibility to bladder retroflexion. The techniques used were as follows: anatomical or conventional (7.55%), transposition of the internal obturator muscle (67.92%), anatomical with polypropylene mesh (11.32%), transposition of the internal obturator muscle with polypropylene mesh (13.22%). The transposition of the internal obturator muscle obtained a recurrence's rate of 2.8%. Complications's rate and recurrence's rate on perineal herniorraphy were 9.84% and 14.8%, respectively.

Este estudio se llevó a cabo con el fin de analizar la prevalencia de la hernia perineal en la población, describir las características de la misma y evaluar las distintas técnicas empleadas para la herniorrafia y sus resultados. Se realizó un estudio retrospectivo de los casos de hernia perineal en el Hospital Clínico Veterinario de la Universidad de Extremadura. Los casos de hernia perineal representan 0,96% de la población. Los machos constituyen un 98,2% y las hembras 1,2%. Los pacientes tienen una edad media de 8,69 años, y una desviación típica de 2,19 años. El peso fue de 16,4 kg ± 11,44 kg (media ± desviación típica). Se encontraron 18 hernias perineales bilaterales, 40 unilaterales derechas y 20 unilaterales izquierdas, con 96 hernias perineales. Fueron intervenidos 67 pacientes, sumando 80 hernias perineales operadas. Presentaron retroflexión de vejiga el 13,6% de los casos y afectación de la próstata el 21%. Se observó que los pacientes con hernia perineal bilateral tenían mayor predisposición a tener la vejiga en retroflexión. Las técnicas empleadas fueron las siguientes: anatómica o convencional (7,55%), transposición del obturador interno (67,92%), anatómica con malla (11,32%), transposición del obturador interno con malla (13,22%). La técnica de transposición del obturador interno obtuvo 2,8% de recidivas. La tasa de complicaciones y de recidiva tras la herniorrafia perineal se eleva al 9,84% y 14,8%, respectivamente.

Compararam-se a motilidade intestinal, a frequência de defecação, a umidade e o aspecto das fezes, o tempo médio de retenção (TMR) e a taxa de passagem (TxP) da ingesta no intestino grosso (ig), em cinco éguas hígidas tratadas com: polietilenoglicol 3350, na dose única de 1,5g kg-1, em bolus, por via enteral (PEG); ou por polietilenoglicol 3350, na dose única de 1,5g kg-1, em bolus, por via enteral, associado ao Ringer lactato, 15mL kg-1 h-1 por fluxo contínuo de 12h, via intravenosa (PEG+RL); ou por solução isotônica poliônica enteral, 15mL kg-1 h-1 em fluxo contínuo de 12h (SIPE); ou por solução isotônica poliônica enteral, 7,5mL kg-1 h-1 por fluxo contínuo de 12h, via enteral, associada ao Ringer lactato, 7,5mL kg-1 h-1 por fluxo contínuo de 12h, via intravenosa (SIPE+RL); ou por cloreto de sódio 0,9%, 15mL kg-1 h-1 por fluxo contínuo de 12h, via intravenosa (NaCl 0,9%). O PEG apenas amoleceu discretamente as fezes. O PEG+RL, o SIPE+RL e o NaCl 0,9% foram mais eficazes em amolecer as fezes e aumentar a frequência de defecação do que o PEG. O SIPE foi o único tratamento que aumentou a motilidade intestinal, e foi o melhor em aumentar a frequência de defecações, amolecer as fezes e diminuir o TMRig, aumentando a TxPig. Conclui-se que os cinco tratamentos demonstraram efeito laxativo, sendo o SIPE o mais eficaz.

The intestinal motility, frequency of defecation, moisture and appearance of feces, mean retention time (MRT) and passage rate (RP) of ingesta in the large intestine (li) were compared in five healthy mares treated with: polyethylene glycol 3350 in a single dose of 1.5g kg-1, in bolus, administered enterally (PEG); or for polyethylene glycol 3350 in a single dose of 1.5g kg-1, in bolus, enterally, associated to the Ringer lactate, 15ml kg-1 h-1 by continuous flow of 12 hours, intravenously (PEG+RL); or for enteral isotonic polionic solution, 15ml kg-1 h-1 by continuous flow of 12 hours, enterally (SIPE); or for enteral isotonic polionic solution, 7,5ml kg-1 h-1 by continuous flow of 12 hours, enterally, associated to the Ringer lactate, 7.5mL kg-1 h-1 by continuous flow of 12 hours, intravenously (SIPE+RL); or sodium chloride 0.9 %, 15ml kg-1 h-1 by continuous flow of 12 hours, intravenously (NaCl 0.9%). PEG treatment only slightly softened feces. PEG+RL, SIPE+RL and NaCl 0.9% were more effective in softening the feces and increasing the frequency of defecation than PEG. SIPE was the best to increase the frequency of defecation, to soften the feces, and reduce the TMRli, increasing RPli. It is concluded that the five treatments demonstrated a laxative effect, but SIPE was the most effective.