Resumen. Trichoderma spp., es un antagonista muy eficiente de patógenos de las raíces de papa. Rhizoctonia solani, causa pérdidas en varios cultivos agrícolas. El objetivo de este trabajo, fue evaluar in vitro la capacidad antagónica de T. viridie; T. koningii; T. harzanium y Trichoderma spp. frente a R. solani proveniente de un cultivo de papa. En las pruebas de confrontación, todos los aislamientos de Trichoderma se ubicaron en la clase 2 de antagonismo de la escala de Bell, donde T. harzianum y T. koningii mostraron más de 60% de inhibición del crecimiento radial de R. solani a las 120 h. En la interacción de T. harzianum y Trichoderma spp. con R. solani, como estrategia de micoparasitismo, se observó vacuolización, lisis, enrollamiento y penetración; las dos últimas presentes en todos los aislados evaluados de Trichoderma.

Abstract. Trichoderma spp., is a highly efficient antagonist of root pathogens, such as Rhizoctonia solani, which causes loss in many crops. The aim of this research was to evaluate in vitro the antagonistic capacity of T. viride, T. koningii, T. harzianum and Trichoderma spp. isolates against R. solani from a potato crop. In confrontation tests, all Trichoderma isolates were classified as antagonists class 2 according to Bell scale, where T. harzianum and T. koningii showed more than 60% inhibition of the radial growth of R. solani at 120 h. In the interaction between T. harzianum and Trichoderma spp. with R. solani, as mycoparasitism strategy, vacuolization, lysis, coiling, and penetration were demonstrated, the last two were present in all Trichoderma isolates evaluated.

Abstract Background: Tagetes contains about 55 species, its largest center of diversification is in Mexico with 35. Nearly 10 % of the species have cultural and economic importance. To date, anatomical studies are lacking in most of its species. Question: Are there foliar anatomical characters with diagnostic value that allow discriminating between the nine species of Tagetes studied? Study species: T. lacera, T. lemmonii, T. linifolia, T. lucida, T. lunulata, T. micrantha, T. parryi, T. stenophylla, T. zypaquirensis. Study site and date: Natural distribution areas in the Mexican Highlands, Trans-Mexican Volcanic Belt and the Genetics Experimental Field, Chapingo Autonomous University, Texcoco, State of Mexico, during 2017. Methods: Botanical specimens were collected. Leaves were fixed and subjected to conventional anatomical techniques, as clearing and embedding in paraffin for their observation and analysis. Results: Tagetes species develop entire and pinnatisect leaves, secondary venation pattern was eucamptodromous becoming reticulodromous distally and simple and festooned brochidodromous. The marginal ultimate venation was incomplete except for T. lunulata. Abundant and diverse trichomes, dorsiventral and isolateral mesophyll, collateral vascular bundles with sheath, and ducts in mesophyll and midvein were observed. Conclusions: The leaf architecture and anatomy of the studied species reveals common characters in Asteraceae. However, in Tagetes the type of trichomes, mesophyll, size of ducts, and sclerenchyma associated to vascular bundles are important.

Resumen Antecedentes: Tagetes contiene cerca de 55 especies, su mayor centro de diversificación se encuentra en México con 35. Cerca del 10 % de las especies tienen importancia en el ámbito cultural y económico. A la fecha, se carece de estudios anatómicos en la mayoría de ellas. Pregunta: ¿Existen caracteres anatómicos foliares de valor diagnóstico que permitan discriminar entre las nueve especies de Tagetes estudiadas? Especies de estudio: Tagetes lacera, T. lemmonii, T. linifolia, T. lucida, T. lunulata, T. micrantha, T. parryi, T. stenophylla, T. zypaquirensis. Sitio de estudio y fecha: Áreas de distribución natural en el Altiplano Mexicano, Faja Volcánica Transmexicana y Campo Experimental de Fitotecnia, Universidad Autónoma Chapingo, Texcoco, Estado de México, durante el 2017. Métodos: Se recolectaron ejemplares botánicos. Sus hojas fueron fijadas y sometidas a técnicas convencionales de anatomía vegetal, se diafanizaron e incluyeron en parafina para su observación y análisis. Resultados: Las especies de Tagetes desarrollan hojas enteras y pinnatisectas, el patrón de venación secundaria fue eucamptódromo tornándose reticulódromo distalmente y broquidódromo simple y festoneado. La venación última marginal fue incompleta excepto de T. lunulata. Se observaron abundantes y diversos tricomas, mesofilo dorsiventral e isolateral, haces colaterales con vaina y canales en el mesofilo y en la vena media. Conclusiones: La arquitectura y la anatomía foliar de las especies estudiadas revela caracteres comunes en Asteraceae. Sin embargo, en Tagetes el tipo de tricomas, mesofilo, tamaño de los canales y esclerénquima asociada a los haces vasculares son importantes.

Resumen La enfermedad de Chagas afecta a millones de personas en América. La enfermedad está globalizada y en franca expansión, esto debido a la acelerada urbanización y a la expansión geográfica de chinches vectores (triatominos). La riqueza de de triatominos en México es alta (33 especies) pero varía por regiones. En Morelos, ubicado en el centro de México, se han reportado las especies Meccus pallidipennis, Triatoma barberi y T. dimidiata, con una prevalencia de infección alta. En este trabajo se describe el incremento de incidencia en ambiente intradomiciliar y el porcentaje de infección natural de triatominos en la zona oriente de Morelos. Se realizaron colectas activas intra y peri domiciliares de triatominos y se evaluó la presencia de T. cruzi en heces. Los resultados muestran que los casos de la enfermedad han ido en aumento con incremento en la preferencia intradomiciliar del triatomino. El índice de infección natural con Trypanosoma fue de 79.7 % para M. pallidipennis y del 49 % para T. barberi (no se detectó la presencia de T. dimidiata). Los resultados muestran que es necesario un incremento en los recursos económicos y humanos para generar estrategias de controles eficientes y sustentables de la enfermedad.

Abstract Chagas disease affects millions of people in the Americas. Due to rapid urbanization and the geographic expansion of vectors, the disease is considered to be globalized and expanding. The diversity of triatomine in Mexico is high, with 33 species, but varies by region. In Morelos (Central Mexico), Meccus pallidipennis, Triatoma barberi and Triatoma dimidiata, have been reported, however, the infection rate is high. In this work, we describe the increased incidence in the intradomiciliary environment and the percentage of natural infection in the eastern zone of Morelos. Intra- and peri-domiciliary collections were performed. The presence of Trypanosoma cruzi was detected in M. pallidipennis and T. barberi collected individuals with a natural infection rate of 79.7% and 49% respectively (individuals of T. dimidiata were not collected). Results show that the reported cases of the disease have been increasing, as well as the intradomiciliary preference of the vectors. Economic and human resources are necessary to generate efficient and sustainable control strategies.

Abstract Background and Aims: Thunbergia alata is one of the ten most problematic invasive plant species in Colombia. Its rapid colonization and adaptation to Andean forests have affected the composition and structure of indigenous plant communities. In this research, analysis of functional traits was carried out, generating new information that could explain the rapid colonization, adaptation and invasive potential of T. alata in this type of Andean environment. Methods: To obtain this information, a series of observations were made on the morphology and anatomy of roots, stems, leaves, flowers, fruits and seeds. Likewise, a characterization of its floral visitors and symbiotic relationships with soil microorganisms was carried out. Key results: We determined that both morphological traits and interaction phenomena favour the adaptability of T. alata in Andean forests and could contribute to a greater extent to its active colonization in this type of environment. An active association of T. alata was found with different species of native and introduced floral visitors, with a total of 2266 floral visits made during our study by seven species of insects belonging to the orders Coleoptera and Hymenoptera. Mycorrhizal fungal spores associated with T. alata populations were found at all sampling sites. The number of spores per 100 g of soil varied between 300 and 424. All the roots of T. alata, without exception, had high colonization by arbuscular mycorrhizal fungi. Conclusions: We believe that the information obtained in this research will contribute to the generation of comprehensive and effective strategies for the control of this species in Andean forests.

Resumen Antecedentes y Objetivos: Thunbergia alata es una de las diez especies de plantas invasoras más problemáticas de Colombia. Su rápida colonización y adaptación a los bosques andinos ha afectado la composición y estructura de las comunidades vegetales nativas. En esta investigación se realizó un análisis de rasgos funcionales, generando nueva información que podría explicar la rápida colonización, adaptación y potencial invasor de T. alata en este tipo de ambientes andinos. Métodos: Para obtener esta información se realizó una serie de observaciones sobre la morfología y anatomía de raíces, tallos, hojas, flores, frutos y semillas. Asimismo, se realizó una caracterización de sus visitantes florales y de las relaciones simbióticas con los microorganismos del suelo. Resultados clave: Se determinó que tanto los rasgos morfológicos como los fenómenos de interacción favorecen la adaptabilidad de T. alata en los bosques andinos y podrían contribuir en mayor medida a su colonización activa en este tipo de ambientes. Se encontró una asociación activa de T. alata con diferentes especies de visitantes florales nativos e introducidos, con un total de 2266 visitas florales realizadas durante nuestro estudio por siete especies de insectos pertenecientes a los órdenes Coleoptera e Hymenoptera. En todos los sitios de muestreo se encontraron esporas de hongos micorrizógenos asociadas a las poblaciones de T. alata. El número de esporas por 100 g de suelo variaba entre 300 y 424. Todas las raíces de T. alata, sin excepción, presentaban una alta colonización por hongos micorrizógenos arbusculares. Conclusiones: Creemos que la información obtenida en esta investigación contribuirá a la generación de estrategias integrales y efectivas para el control de esta especie en los bosques andinos.

Abstract Introduction and objectives: In some centers the pulse oximetry is not performed with the justification of lack of the adequate oximeter. We compared the effectiveness of two brands of oximeters to perform it. Methods: In neonates a term of the joint housing service of a Hospital General de Occidente in Zapopan Jalisco Mexico from May-November 2018, an examination of the characteristics of the American Academy of Pediatrics with both oximeters (ChoiceMMed and Masimo SET) was carried out, comparing the detection of critical congenital heart disease (CCC), time of intake and false positives. Results: In each group 1,022 patients were analyzed; with the Masimo SET oximeter 83 positive tests were obtained (8.12%), of which 22 cases had some heart disease (26.5%), which represents a sensitivity of 100%, specificity of 93.9%, positive predictive value of 26.5% and negative predictive value of 100% (OR: 0.73; 95% CI: 0.6-0.8). With the ChoiceMMed oximeter, 168 positive tests were obtained (16.4%), of which 22 cases had some heart disease (13.09%), with a sensitivity of 100%, specificity of 85.4%, positive predictive value of 13.09% and negative predictive value 100% (OR: 0.86; 95% CI: 0.8-0.92). Regarding the time to perform the cardiac sieve, the mean in minutes of the Masimo SET oximeter was 5.38 and the ChoiceMMed oximeter was 9.7 minutes. Conclusions: The ChoiceMMed oximeter contains a large number of false positives and a greater number of echocardiograms and comparatively longer cardiac screen printing with Masimo SET, however, both with a negative predictive value of 100% eliminating such excuses.

Resumen Introducción y objetivos: En algunos centros el tamiz cardíaco no se realiza con la justificación de no tener el oxímetro adecuado. Comparamos la efectividad de dos marcas de oxímetros para realizarlo. Métodos: En los neonatos a término del Servicio de alojamiento conjunto del Hospital General de Occidente en Zapopan Jalisco México de mayo a noviembre del 2018 se realizó tamiz cardíaco según las guías de la Academia Americana de Pediatría con dos oxímetros, el Masimo SET (aprobado por la FDA) y el ChoiceMMed, comparando su efectividad para la detección de cardiopatías congénitas críticas, el tiempo de toma y los falsos positivos. Resultados: En cada grupo se analizaron 1,022 pacientes; con el oxímetro Massimo SET se obtuvieron 83 pruebas positivas (8.12%) de las cuales 22 casos presentaron alguna cardiopatía (26.5%), lo que representa una sensibilidad del 100%, una especificidad del 93.9%, un valor predictivo positivo del 26.5% y un valor predictivo negativo del 100% (Odd Ratio [OR]: 0.73; IC 95%: 0.6-0.8). Con el oxímetro ChoiceMMed se obtuvieron 168 pruebas positivas (16.4%), de las cuales 22 casos presentaron alguna cardiopatía (13.09%), con una sensibilidad del 100%, una especificidad del 85.4%, un valor predictivo positivo del 13.09% y un valor predictivo negativo del 100% (OR: 0.86; IC 95%: 0.8-0.92). En cuanto al tiempo para realizar el tamiz cardíaco, la media en minutos del oxímetro Masimo SET fue 5.38 y del oxímetro ChoiceMMed fue 9.7 minutos. Conclusiones: El oxímetro ChoiceMMed presentó mayor cantidad de falsos positivos y mayor tiempo de realización del tamiz cardíaco en comparación al Masimo SET, sin embargo, ambos presentan un valor predictivo negativo del 100%, siendo igualmente útiles como método de detección de cardiopatías críticas.

Abstract The uniformity of water application is an important factor in the evaluation of sprinkler irrigation systems. This uniformity depends on the type of sprinkler and its operating conditions, such as the arrangement and spacing between the sprinklers in the area; velocity and wind direction during the period of water application and the pressure variation of the irrigation system. The objective of this study was to model, analyze and compare the structure of spatial dependence, as well as the spatial variability of the water depths applied by a sprinkler irrigation system with compensating and non-compensating sprinklers, using geostatistical methods and measurements of accuracy or similarity between the applied water depth maps. The experiment was carried out in an agricultural area, in the city of Cascavel-Paraná-Brazil. A total area of 10 × 10 m was used, with 04 compensating and 04 non-compensating sprinklers installed at a height of 1.5 m. For each type of sprinkler, water levels were measured in 100 collectors spaced 1 × 1 m in the study area in 32 trials. On each test sprinkling was carried out for one hour. The conditions of wind, temperature and air humidity were evaluated at the beginning of each test and at 10-minute intervals with a climatological station. As the geostatistical analysis showed the existence of directional trends, the coordinates were incorporated as covariates to the linear spatial model in the study of the spatial dependence of the average depth of the irrigation water for the two types of sprinklers. The spatial dependence structure that best fits the data when using the compensating sprinklers was the Gaussian model and when the non-compensating sprinklers were used, it was the exponential model. The spatial variability maps of average irrigation water depth (mm) of the trials, obtained by universal kriging, revealed that for both sprinklers there was an increase in the mean level average values in the northwest-southeast direction (135° in the azimuth system) in the area under study, influenced by wind direction and velocity during the execution of the experiment.

Abstract The incidence of root diseases was estimated in apple orchards from Chihuahua, Mexico. Three hundred isolates (fungi and Oomycetes) were identified in samples of root tissue and soil of trees with infectious damage symptoms and disease symptom-free trees. At the same time, putatively antagonistic agents were isolated and subsequently identified. The pathogenicity of fifteen selected isolates (eight fungi and seven Oomycetes), was tested in twelve apple rootstocks under greenhouse conditions. In addition, the in vitro antagonistic activity of Trichoderma and Bacillus species was evaluated against seven of the selected Oomycetes. The incidence of infection damage of roots in 20 tested orchards was 17% (1-40%). Fusarium was the most widely distributed fungi (67.8%). The distribution of the other organisms was variable. Four species of Trichoderma were identified, with T. gamsii being the most widely distributed (72.5%). Bacillus spp. substantially reduced the radial growth (>90%, p=0.05) of Phytophthora cactorum. Eleven rootstocks were susceptible to Pythium ultimum y Phytophthora cactorum C3. The G.935, Standard and M.25 rootstocks were the most resistant with 0% incidence. The antagonistic species of both genera inhibited the in vitro growth of P. cactorum (86.4-93.8%, p= 0.05), respect to Pythium species, and therefore, they might be used as biological control agents.

Resumen Se estimó la incidencia de enfermedades de raíz en manzanos de Chihuahua, México, y se identificaron trescientos aislados (hongos y Oomicetos) tomados del tejido de raíz y suelo de la rizosfera de árboles con síntomas de infección y libres de síntomas de enfermedad. Paralelamente, se aislaron e identificaron hongos putativamente antagonistas. Se determinó la patogenicidad de quince aislados seleccionados (ocho hongos y siete Oomicetos) sobre doce portainjertos de manzano bajo condiciones de invernadero. Adicionalmente, se evaluó la actividad antagónica in vitro de especies de Trichoderma y Bacillus contra siete de los Oomicetos seleccionados. La incidencia de daños infecciosos en raíz en 20 huertos analizados fue del 17% (1-40%). Fusarium fue el hongo más ampliamente distribuido (67.8%). La distribución del resto de los organismos fue variable. Se identificaron cuatro especies de Trichoderma, siendo T. gamsii la más ampliamente distribuida (72.5%). Bacillus spp., redujo sustancialmente el crecimiento radial (>90%, p=0.05) de Phytophthora cactorum. Once portainjertos fueron susceptibles al menos a Pythium ultimum y Phytophthora cactorum C3. Los portainjertos G.935, Standard y M.25 fueron los más resistentes con 0% de incidencia. Las especies antagonistas de ambos géneros inhibieron in vitro significativamente el crecimiento de P. cactorum (86.4-93.8%, p= 0.05), respecto a especies de Pythium, por lo que podrían ser utilizados como agentes de control biológico.

We evaluate the elimination of the microscopic stage of conventional xenodiagnosis (XD) to optimize the parasitological diagnosis of Trypanosoma cruzi in chronic Chagas disease. To this purpose we applied under informed consent two XD cages to 150 Chilean chronic chagasic patients. The fecal samples (FS) of the triatomines at 30, 60 and 90 days post feeding were divided into two parts: in one a microscopic search for mobile trypomastigote and/or epimastigote forms was performed. In the other part, DNA extraction-purification for PCR directed to the conserved region of kDNA minicircles of trypanosomes (PCR-XD), without previous microscopic observation was done. An XD was considered positive when at least one mobile T. cruzi parasite in any one of three periods of incubation was observed, whereas PCR-XD was considered positive when the 330 bp band specific for T. cruzi was detected. 25 of 26 cases with positive conventional XD were PCR-XD positive (concordance 96.2%), whereas 85 of 124 cases with negative conventional XD were positive by PCR-XD (68.5%). Human chromosome 12 detected by Real-time PCR used as exogenous internal control of PCR-XD reaction allowed to discounting of PCR inhibition and false negative in 40 cases with negative PCR-XD. Conclusion: PCR-XD performed without previous microscopic observation is a useful tool for detection of viable parasites with higher efficiency then conventional XD.

Introducción. En México, la enfermedad de Chagas es un problema de salud pública. Se han registrado, al menos, 30 especies de triatominos vectores, la mayoría con hábitos domésticos y tendencia a invadir las viviendas humanas. Objetivo. Evaluar la utilidad de gallineros en la vigilancia de la presencia de triatominos peridomésticos y conocer su situación en el área de estudio. Materiales y métodos. Se realizó un estudio de campo, experimental, longitudinal, por un año. Se instalaron 50 gallineros en 50 viviendas de tres localidades del municipio de Teocuitatlán de Corona, en el estado de Jalisco, México. Se inspeccionaron los gallineros y las viviendas para saber si aquéllos podían detectar la presencia de triatominos, para estimar la situación vectorial en el área. Resultados. Se recolectaron significativamente (p<0,05) más especímenes de Meccus longipennis (93%) que de Triatoma barberi (7%). Aproximadamente, un tercio (31,3%) de los especímenes de M. longipennis y ninguno de T. barberi se recolectó en los gallineros. M. longipennis tuvo un porcentaje de infección por Trypanosoma cruzi de 25,7%, y T. barberi, de 53,2%. Los meses de primavera y verano fueron en los que se recolectaron más ejemplares de triatominos. Conclusiones. Los gallineros se consideran una herramienta útil para detectar la presencia de ejemplares de M. longipennis, aunque no funcionaron para T. barberi. Se confirma la importancia de M. longipennis y se establece el posible rol primario de T. barberi como vector en el área de estudio.

Introduction. Chagas disease is an important public health problem in Mexico. At least 30 Triatominae species, vectors of that disease have been recorded, most with domiciliary habits and tendency to invade human dwellings. Objective. The usefulness of using chicken coops was evaluated for monitoring peridomestic triatomine presence, identity and infection with Trypanosoma cruzi. Materials and methods. A year-long, longitudinal field study was designed. Fifty chicken coops were placed in 50 human dwellings on three localities in Teocuitatlán de Corona County, Jalisco State, Mexico. The coops and human dwellings were routinely inspected to determine if the coops alone can monitor for the presence of triatomines. Results. Significantly (p<0.05) more Meccus longipennis specimens (93.0%) than of Triatoma barberi (7.0%) were collected. Almost a third (31.3%) of M. longipennis and none of T. barberi specimens were collected in the coops. Meccus longipennis was found with infections of Trypanosoma cruzi of 25.7%, and T. barberi of 53.2%. Most triatomines were collected in spring and summer months. Conclusions. Chicken coops proved useful tools to detect presence of M. longipennis; however, they were not effective for T. barberi. The importance of M. longipennis as a potential vector was confirmed, and the possible primary vector role of T. barberi was established as well.

Objective: We report two cases of primary testicular lymphoma and performed a bibliography review about this pathology. Methods/Results: We describe two cases of primary testicular lymphoma in two male patients 69 and 61 yr. old respectively. In both cases, reason for consultation was increase of the right testicular size. After inguinal orchyectomy the diagnosis for the first case was large and medium T cell diffuse lymphoma, stage I (E)-A; three years after chemotherapy (R-CHOP) the patient is in complete remission. In the second case, the diagnosis was diffuse large B-cell lymphoma, and after receiving various chemotherapy regimens died 14 months after diagnosis. Conclusions: Testicular lymphoma is a very rare entity, despite being considered the most common testicular tumor in patients over the age of 60 years. Most of them are non-Hodgkin diffuse, intermediate or high grade of malignancy , B-cell immunophenotype, being T-cell exceptional. Prognosis is poor due to their high tendency to systemic dissemination. The treatment is based on orchiectomy, chemotherapy and radiotherapy, although there is not a standardized regimen.

Objetivo: Comunicación de dos casos clínicos con diagnóstico de linfoma testicular primario y revisión de la literatura existente sobre esta patología. Métodos/ Resultados: Descripción de dos casos de linfoma testicular primario en dos varones de 69 y 61 años. En ambos casos su motivo de consulta fue un aumento de volumen testicular derecho. Tras practicar una orquiectomía inguinal se diagnóstico, en el primer caso, un linfoma difuso tipo T de células grandes y medianas, estadio I (E)-A, que tras seguir tratamiento con quimioterapia (R-CHOP) se mantiene en remisión a los tres años. En el segundo caso, el diagnóstico fue de linfoma difuso de células grandes tipo B, que tras recibir distintas pautas de quimioterapia, falleció a los 14 meses del diagnóstico. Conclusiones: El linfoma testicular es una entidad muy poco frecuente, a pesar de ser considerado el tumor testicular más común en mayores de 60 años. En su mayoría se trata de linfomas no Hodgkin difusos de grado intermedio alto de malignidad e inmunofenotipo B, considerando como excepcionales los de tipo T. Su pronóstico es pobre debido a su gran tendencia a la propagación sistémica. Su tratamiento se basa en orquiectomía, quimioterapia y radioterapia, si bien no existe una pauta estandarizada del mismo.

Background Some studies have reported that off-pump coronary artery bypass graft surgery is cost-saving when compared to conventional coronary surgery. Cost differences may be attributable to lower incidence of postoperative complications in off-pump group. However, it is still unknown the validity of this cost-effectiveness in Argentina, specially because of local higher costs with respect to operating materials and resources, and less costly bed occupancy. Study objective To perform a medical cost study of off-pump coronary artery bypass surgery, and to estimate its cost-effectiveness when compared with on-pump surgery. Research design and methods A retrospective cost analysis was carried over a series of 200 on- and off-pump coronary surgeries, performed during 2004 and 2005. Operating-room costs were determined directly, and length of stay cost was extrapolated from bed occupancy cost, exclusively for non complicated surgeries (base case). Postoperative complications influence on total cost was indirectly estimated through complication rates reported on clinical trials and its corresponding incremental cost, according to a previously communicated stochastic model. Finally a sensitivity analysis was done by means of a computer-aided dynamic simulation, taking into account two predictive parameters: coronary stabilizer reuse (OCTOPUS ®) and off-pump surgery use rate. Results Cost of non complicated coronary surgery oscillated between $9,340 and $12,540 (median = $10,750) for on-pump method, and between $10,100 and $15,300 (median = $12,100) for off-pump surgery. This higher cost was related to disposable coronary stabilizer price, comparatively more expensive than a membrane oxygenator used for extracorporeal circulation. Proportionally, operating-room total cost for off-pump surgery was between 15 and 39% more costly than conventional surgery. On the other hand, influence of postoperative complications on total cost showed values between $11,978 and $18,145 (median= $14,350) for off-pump surgery, and between $12,303 and $16,518 (median = $13,377) for on-pump method. Conclusions In this local study it was not possible to demonstrate a cost reduction with off-pump coronary artery surgery, with respect to on-pump procedure. Operating-room cost (disposable coronary stabilizer) seems to be the principal determinant for higher costs of off-pump in Argentina. Legal measures to allow reuse of "single use" medical devices, or an economical policy to reduce cost of surgical resources, could enhance costeffectiveness of off-pump surgery in our country.

Antecedentes Algunos estudios han sugerido que la cirugía coronaria "sin bomba" disminuiría la morbimortalidad posoperatoria y reduciría los costos al compararlos con la cirugía tradicional. Una característica regional importante para la Argentina es el alto costo de los insumos, en su mayoría importados, y el relativo bajo costo de internación, lo cual crea condiciones locales diferentes al pretender comparar la relación costo-efectividad de la cirugía sin circulación extracorpórea (CEC). Objetivos Realizar una evaluación de los costos médicos y los resultados de la cirugía coronaria sin CEC en comparación con la técnica tradicional y estimar a la vez su relación costo-eficacia. Material y métodos El análisis retrospectivo de costos se realizó a partir de una serie de 200 cirugías coronarias con CEC y sin CEC, efectuadas entre 2004 y 2005. Se empleó la técnica de microcosteo directo para determinar los costos de quirófano y se extrapoló el valor día/cama de la internación, de acuerdo con los datos suministrados por el prestador, para el caso de cirugías sin complicaciones (caso base). La influencia de las complicaciones en el costo final se estimó en forma indirecta mediante el uso de las tasas de complicaciones publicadas en ensayos clínicos controlados y su correspondiente costo incremental por evento, según modelos probabilísticos publicados previamente. Por tratarse de un modelo parcialmente estocástico, se informan sólo los costos netos con uno y otro procedimiento, a fin de obtener la diferencia o beneficio neto entre el uso de cirugía con CEC y sin CEC. Finalmente, se realizó un análisis de sensibilidad de costos por medio de una simulación dinámica computarizada (parámetros predictores: número de usos del estabilizador y tasa de uso de cirugía sin CEC). Resultados En una cirugía coronaria que evoluciona sin complicaciones, el costo se halló entre $9.340 y $12.540 (mediana = $10.750) para el procedimiento con CEC, y entre $10.100 y $15.300 (mediana = $12.100) para la cirugía "sin bomba". Este costo mayor estuvo relacionado con el precio del estabilizador descartable, que es comparativamente más caro que el de un oxigenador. Así, proporcionalmente, el costo total de quirófano de una cirugía sin CEC fue el 15% a 39% más caro que la cirugía convencional. Por su parte, el análisis del costo de una cirugía, teniendo en cuenta las tasas de complicaciones, mostró valores entre $11.978 y $18.145 (mediana: $14.350) para la cirugía sin CEC, y entre $12.303 y $16.518 (mediana: $13.377) para el procedimiento "con bomba". Conclusiones En el presente estudio no se ha podido demostrar una reducción del costo de la cirugía coronaria con el empleo de la técnica de revascularización sin CEC, al compararla con el procedimiento convencional. El precio de los insumos de quirófano (estabilizador coronario) parece ser el factor determinante del alto costo de la cirugía sin CEC en la Argentina. Medidas regulativas que contemplen la reutilización de los estabilizadores coronarios descartables o una política que favorezca la reducción del costo de los insumos quirúrgicos podrían mejorar la relación costo-eficacia de la cirugía "sin bomba" en nuestro medio.

No estudo avaliou-se o efeito da temperatura, concentração e tempo de contato na atividade antifúngica do óleo essencial do cravo disperso em solução concentrada de açúcar. Os ensaios foram feitos a 21ºC e a 37ºC, utilizando suspensão de óleo essencial de 0.2 a 0.8% v/v. Os microorganismos utilizados foram Candida albicans, Penicillium citrinum, Aspergillus niger e Trichophyton mentagrophytes. A melhor atividade fungicida ocorreu a 37ºC, onde um minuto de contato foi suficiente para matar uma população de 10(6) u.f.c./ml de Candida albicans. Não obstante, P. citrinum, A. niger, T. mentagrophytes foram mais resistentes, embora uma importante ação letal da essência tenha sido observada. Em 60 minutos, o óleo essencial de cravo (0,4% v.v.) em solução concentrada de açúcar reduziu em 99,6% um inóculo de 10(6) u.f.c./ml de T. mentagrophytes. O efeito letal do óleo essencial de cravo sobre C. albicans, após 2 minutos de contato, foi semelhante ao de desinfectantes comumente usados em hospitais, como povidona-iodo e cloroxilenol.

The effect of temperature, concentration and contact time on the fungicidal effect of clove oleoresin dispersed in a concentrated sugar solution at 21 and 37ºC, and clove oleoresin at 0.2 to 0.8% (v/v) was studied. The test microorganisms were Candida albicans, Penicillium citrinum, Aspergillus niger and Trichophyton mentagrophytes. The fungicidal effect was enhanced at 37ºC; at this temperature short contact times (e.g. 1 min.) were enough to eliminate a microbial inoculum of 10(6) c.f.u./ml of C. albicans. Although clove oleoresin caused important lethal effect, P. citrinum and A. niger were more resistant. After 60 minutes, clove oleoresin dispersed (0.4% v/v) in concentrated sugar solution caused a 99.6% reduction of the initial population (10(6) c.f.u./ml) of Trichophyton mentagrophytes. The fungicidal activity of clove-sugar on C. albicans, after 2 min contact, was similar to that presented by disinfectants commonly used in hospitals, such as povidone-iodine and chloroxylenol.

Relata-se o caso de um acidente ofídico por Crotalus durissus que apresentou como complicação abscesso no local da picada. Abscessos são uma complicação rara deste tipo de acidente, possivelmente porque o veneno de serpentes da espécie Crotalus durissus não apresenta uma forte ação citotóxica.

The case of a man bitten by a South American rattlesnake (Crotalus durissus) and who developed an abscess at the site of the bite is reported. Abcesses are a rare complication of this type of envenoming, possibly due to the lack of a strong cytotoxic action of Crotalus durissus venom.

O presente trabalho é um estudo da incidência dos acidentes por serpentes peçonhentas nos 12 municípios do Vale do Ribeira, Estado de São Paulo, baseado na avaliação de 840 casos que ocorreram de janeiro de 1985 a dezembro de 1989. A incidência global no Vale mostrou-se muito maior (68,7 a 84,2/100.000 habitantes) do que a conhecida para o Estado de São Paulo (6,8 a 7,4/100.000 habitantes). Maior ocorrência foi observada nos primeiros e nos últimos meses do ano, e os municípios de maior incidência foram os de Juquiá (159,4/100.000 habitantes) e Eldorado (131,4/100.000 habitantes). As pessoas do sexo masculino foram mais acometidas (79%) assim como os lavradores (52,5%). A maioria dos casos foi atendida precocemente (57,7% dentro de duas horas após o acidente). À semelhança do que ocorre em todo o Estado de São Paulo, o quadro clínico provocado pelo envenenamento foi, em geral, leve e a letalidade foi baixa (0,2%).

This study reports on the incidence of snakebites from January 1985 to December 1989 in Vale do Ribeira, São Paulo, Brazil. Overall incidence ranged from 68.7 to 84.2/100,000. There were 840 snakebites during this period, with higher frequency from October to May. The highest incidence rates were observed in the districts of Juguiá and Eldorado (159.4 and 131.4/100,000, respectively). Most of the patients were male. Agricultural workers were the most heavily affected. Most of the patients received treatment within 2 hours after the bite. Morbidity was not severe and lethality was 0.2%.

O presente trabalho é um estudo da incidência dos acidentes por serpentes peçonhentas nos 12 municípios do Vale do Ribeira, Estado de São Paulo, baseado na avaliação de 840 casos que ocorreram de janeiro de 1985 a dezembro de 1989. A incidência global no Vale mostrou-se muito maior (68,7 a 84,2/100.000 habitantes) do que a conhecida para o Estado de São Paulo (6,8 a 7,4/100.000 habitantes). Maior ocorrência foi observada nos primeiros e nos últimos meses do ano, e os municípios de maior incidência foram os de Juquiá (159,4/100.000 habitantes) e Eldorado (131,4/100.000 habitantes). As pessoas do sexo masculino foram mais acometidas (79%) assim como os lavradores (52,5%). A maioria dos casos foi atendida precocemente (57,7% dentro de duas horas após o acidente). À semelhança do que ocorre em todo o Estado de São Paulo, o quadro clínico provocado pelo envenenamento foi, em geral, leve e a letalidade foi baixa (0,2%).

This study reports on the incidence of snakebites from January 1985 to December 1989 in Vale do Ribeira, São Paulo, Brazil. Overall incidence ranged from 68.7 to 84.2/100,000. There were 840 snakebites during this period, with higher frequency from October to May. The highest incidence rates were observed in the districts of Juguiá and Eldorado (159.4 and 131.4/100,000, respectively). Most of the patients were male. Agricultural workers were the most heavily affected. Most of the patients received treatment within 2 hours after the bite. Morbidity was not severe and lethality was 0.2%.