ABSTRACT Objective: After initial treatment, up to 30% of patients with papillary thyroid cancer (PTC) have incomplete response, mainly cervical lymph node (LN) disease. Previous studies have suggested that active surveillance (AS) is a possible option for these patients. Our aim was to report the results of AS in patients with PTC and cervical LN disease. Materials and methods: In this retrospective observational study, we included adult patients treated and followed for PTC, who presented with cervical LN disease and were managed with AS. Growth was defined as an increase ≥ 3mm in either diameter. Results: We included 32 patients: 27 (84.4%) women, age of 39 ± 14 years, all initially treated with total thyroidectomy, and 22 (69%) with therapeutic neck dissection. Cervical LN disease was diagnosed 1 year (0.3-12.6) after initial management, with a diameter of 9.0 mm (6.0-19.0). After a median AS of 4.3 years (0.6-14.1), 4 (12.5%) patients had LN growth: 2 (50%) of whom were surgically removed, 1 (25%) was effectively treated with radiotherapy, and 1 (25%) had a scheduled surgery. Tg increase was the only predictive factor of LN growth evaluated as both the delta Tg (p < 0.0366) and percentage of Tg change (p < 0.0140). None of the included patients died, had local complications due to LN growth or salvage therapy, or developed distant metastases during follow-up. Conclusions: In selected patients with PTC and suspicious cervical LNs diagnosed after initial treatment, AS is a feasible and safe strategy as it allows effective identification and treatment of the minority of patients who progress. Objective 30 (PTC response (LN (AS methods study Results 3 84.4% 844 84 (84.4% women thyroidectomy 69% 69 (69% dissection 0.312.6 03126 0.3 12.6 0 12 6 (0.3-12.6 management 90 9 9. 6.019.0. 60190 6.0 19.0 . 19 (6.0-19.0) 43 4. 0.614.1, 06141 0.6 14.1 , (0.6-14.1) 12.5% 125 5 (12.5% 50% 50 (50% removed 25% 25 (25% radiotherapy surgery p 0.0366 00366 0366 0.0140. 00140 0.0140 0140 0.0140) died therapy followup. followup follow up. follow-up Conclusions progress 84.4 8 (84.4 (69 312 0.312. 0312 03 0. 126 12. (0.3-12. 019 6.019.0 6019 60 6. 190 19. (6.0-19.0 614 0.614.1 0614 06 141 14. (0.6-14.1 12.5 (12.5 (50 (25 0.036 0036 036 0014 0.014 014 84. (84. (6 31 0.312 031 (0.3-12 01 6.019. 601 (6.0-19. 61 0.614. 061 (0.6-14. (12. (5 (2 0.03 003 001 0.01 (84 ( 0.31 (0.3-1 6.019 (6.0-19 0.614 (0.6-14 (12 0.0 00 (8 (0.3- 6.01 (6.0-1 0.61 (0.6-1 (1 (0.3 (6.0- (0.6- (0. (6.0 (0.6 (0 (6.

ABSTRACT Purpose: Kidney stones are one of the most common urological diseases worldwide. The size and location of the stone are the most important factors in determining the most suitable treatment options. The aim of this review was to evaluate the displacement of lower pole stones. Methods: Three studies assessing the efficacy of translocating kidney stones from the lower pole of the kidney to other locations during retrograde intrarenal surgery published in the last 20 years were included. A systematic search was conducted in the PubMed, Embase, Latin American and Caribbean Health Sciences Literature (LILACS), and Web of Science databases using the following search terms: “Lower pole,” “Lithotripsy.” Meta-analysis was performed using Review Manager version 5.4. Results: Stone-free rates were improved through displacement (odds ratio – OR = -0.15; 95% confidence interval–95%CI -0.24–-0.05; p = 0.002; I2 = 21%), but at the cost of increased surgical duration (mean difference = -12.50; 95%CI -24.06–-0.95; p = 0.03; I2 = 94%). Although this represents a potentially negative outcome, the improvement in clearance rates justifies the additional investment of time and effort. Conclusions: Displacement of lower pole kidney stones for subsequent lithotripsy brings significant benefits in terms of stone-free rate, with no difference in laser energy usage. However, it results in increased surgical time. Despite these factors, the benefits to patients undergoing the procedure are substantial. Purpose worldwide options Methods 2 included PubMed Embase LILACS, LILACS , (LILACS) Lower pole, Lithotripsy. Lithotripsy “Lithotripsy. Metaanalysis Meta analysis 54 5 4 5.4 Results Stonefree Stone free odds 0.15 015 0 15 -0.15 95 interval95CI intervalCI interval CI 0.24–0.05 024005 0.24– 0.05 24 05 -0.24–-0.05 0.002 0002 002 I 21%, 21 21% 21%) mean 12.50 1250 12 50 -12.50 95CI 24.06–0.95 2406095 24.06– 0.95 06 -24.06–-0.95 0.03 003 03 94%. 94 94% . 94%) outcome effort Conclusions stonefree rate usage However substantial (LILACS “Lithotripsy 5. 0.1 01 1 -0.1 9 0.24–0.0 02400 024 0.24 005 0.0 -0.24–-0.0 0.00 000 00 12.5 125 -12.5 24.06–0.9 240609 2406 24.06 095 0.9 -24.06–-0.9 0. -0. 0.24–0. 0240 02 0.2 -0.24–-0. 12. -12. 24.06–0. 24060 240 24.0 09 -24.06–-0. -0 0.24–0 -0.24–-0 -12 24.06–0 24. -24.06–-0 - -0.24–- -1 -24.06–- -0.24– -24.06– -0.24 -24.06 -0.2 -24.0 -24. -24 -2

The aim of this paper is enhancing current evidence about factors that impact the income of university graduates who have joined the labor market recently. For that purpose, it uses data about incomes obtained by graduates from a non traditional private university, considering a wide range of degrees in different areas. Using multilevel models, main fndings show the effect of variables related to disciplines themselves affecting the income of graduates who studied those disciplines. In this sense, it is possible to see a wage punishment for graduates of female dominated disciplines- which is observable in the case of both women and men-, a positive effect of selectivity, beyond academic records of graduates, and also a wage recognition to programs that take more time to be completed, although students get their degree much later.

El propósito del trabajo es ampliar la evidencia respecto de los factores que inciden en las remuneraciones de universitarios recién incorporados al mercado del trabajo, a partir de los salarios percibidos por titulados de una universidad privada no tradicional en un conjunto amplio de carreras en distintas áreas del conocimiento. Usando modelos multinivel, los principales resultados indican el efecto de variables propias de las carreras afectando las remuneraciones de los titulados. Así, se aprecia una penalización salarial a las carreras feminizadas -que opera sobre hombres y mujeres-, un efecto positivo de la selectividad -más allá del rendimiento universitario observado- y un premio salarial a las carreras largas -más allá del retraso del estudiante en titularse-.

We report a 60 years oíd female admitted for pain in the right upper quadrant of the abdomen, vomiting and fever. Initial laboratory showed leukocytosis with 56% of eosinophils. An abdominal CAT sean showed a subcapsular fluid collection in the liver. The patient was operated and the presence of a subcapsular hematoma was confirmed. Blood serological tests were positive for Fasciola hepática. The patient was treated with tricabendazole and after one year of follow up, is in good conditions.

Presentamos el caso de una paciente de sexo femenino de 60 años de edad, ingresada en nuestro centro hospitalario por cuadro agudo de dolor abdominal en hipocondrio derecho asociado a vómitos y fiebre. Destaca la presencia de leucocitosis con eosinofilia de 56%. La tomografía computanzada abdominal muestra una colección subcapsular hepática. Durante su evolución presenta abdomen agudo, realizándose una laparoscopía exploratoria que confirma un hematoma subcapsular con presencia de hemopentoneo de escasa cuantía. La serología confirma infección por fasciola hepática. Se realizó su tratamiento con triclabendazol en monodosis. Además, realizamos una revisión de la literatura nacional e internacional sobre el tema, sus manifestaciones clínicas, métodos diagnósticos y tratamiento.

Streptococcus mutans and Streptococcus sobrinus are the main causative organisms of dental caries. Nevertheless, the microbiological and biochemical methods, available at the moment in Chile, do not allow to the fast detection and identification of these bacteria. The aim of this investigation is implement the polymerase chain reaction (PCR) technique to detect the presence of S. mutans and S. sobrinus in saliva. A total of 51 schoolchildren (5 to 17 years oíd) from five different schools from Temuco city (Chile) participated in this study. The presence of salivary mutans streptococci was determined by microbiological method, and the species differentiation was assessed using PCR technique. The sensitivity for the PCR technique was 1000 cfu/mL of saliva, ten times superior to the sensitivity of the microbiological method used (10,000 cfu/mL). In addition, the analysis of the specificity of the amplification, evaluated by enzymatic restriction, confirmed the presence of the investigated bacteria. The prevalence of S. mutans was of 88.2% and for 5. sobrinus was 11.8%. The combined presence of both bacteria was observedin 7.8% of the individuáis. In conclusión, theobtained results indícate that the implemented methodology is useful for the rapid detection of S. mutans and S. sobrinus in saliva.

Streptococcus mutans y Streptococcus sobrinus han sido indicados como los principales agentes etiológicos de la caries dental. Sin embargo, los métodos microbiológicos y bioquímicos, disponibles actualmente en Chile, no permiten la rápida detección e identificación de estas bacterias. El objetivo de este trabajo fue implementar la metodología de reacción en cadena de la polimerasa (PCR) para detectar la presencia de S. mutans y S. sobrinus en saliva. Participaron de este estudio 51 escolares (5 a 17 años), provenientes de cinco diferentes colegios de la ciudad de Temuco; a los cuales se les realizó recuento de estreptococos del grupo mutans en saliva por método microbiológico y la diferenciación de especies por la técnica de PCR. Los resultados mostraron que la sensibilidad para la técnica de PCR fue 1000 UFC/mL de saliva, diez veces superior a la sensibilidad del método microbiológico utilizado (10.000 UFC/mL). Además, el análisis de la especificidad de la amplificación, evaluada por restricción enzimática, confirmó la presencia de las bacterias investigadas. La prevalencia de S. mutans fue de 88.2% y para S. sobrinus de 11.8%. La presencia conjunta de ambas bacterias fue observada en 7.8% de los individuos. En conclusión, podemos señalar que la metodología implementada es útil para la detección rápida de S. mutans y S. sobrinus en saliva.

The case of a 2-year-old patient that after a splenectomy developed sudden fever, vomits and diarrhea, together with shock, disseminated intravascular coagulation and acute respiratory insufficiency that needed mechanical ventilation, was presented. She also had acute oliguria and late squamous lesions in the palms of the hands and in the soles. Therapeutical measures of vital support were used and a complete recovery was attained.

Se presentó una paciente que 2 años después de una esplenectomía desarrolló un cuadro súbito de fiebre, vómitos y diarreas, acompañado de shock, coagulación intravascular diseminada e insuficiencia respiratoria aguda, que precisó ventilación mecánica, fracaso renal agudo oligúrico y lesiones tardías decamativas en palmas y plantas. Se emplearon medidas terapéuticas de soporte vital y se obtuvo una recuperación completa.

A review of the nutrition of the ventilated patient was performed taking into account the great number of patients who are admitted to the Intensive Care Unit presenting with a very critical status and need mechanical ventilation. A proper nutritional evaluation contributes to an early weaning and to a favourable evolution of these patients. Readjustments which should be done regarding the supply of proteins an calories, as well as the provision of vitamins and trace elements for those patients. The characteristics of nutrition are assessed and iatrogenies which may occur if physiological changes related to age and the occurrence of chronic related to age and the occurrence of chronic underlying diseases are not taken into account are also pointed out. Differences concerning the utilization of diverse types of nutrition modalities are reported.

Se realizó una revisión de la nutrición en el paciente ventilado teniendo en cuenta el gran número de pacientes que ingresa en la UCI en estado crítico que necesitan ventilación mecánica. Una correcta evaluación nutricional contribuye el destete precoz y a la evolución favorable de estos enfermos. Se analizaron los reajustes que deben hacerse en cuanto al aporte protéico-calórico, así como el aporte vitamínico y de oligoelementos de este tipo de paciente. Se evalúan las características de la nutrición y se plantean las yatrogenias que pueden ocurrir de no tenerse en cuenta los cambios fisiológicos relacionados con la edad y enfermedades crónicas sobreañadidas. Se señalan las diferencias en cuanto a la utilización de distintas vías de nutrición.