ABSTRACT Introduction: Face transplantation has gained recognition, changing the clinicalsurgical scenario for restoring complex facial defects, as it attributes functional and aesthetic recovery to patients who have suffered serious accidents. At the time of writing this article, in official publications, 43 patients had already undergone facial transplantation worldwide. Face transplantation has numerous pieces of evidence that can irrefutably provide improvements to the patient. For this, preoperative care for the patient must be carefully established so that there is good surgical performance. Case Report: Male patient, 46 years old, reports that, at the age of 6, he had burns due to exposure to gasoline, with 72% of his body surface burned, showing sequelae of burns and surgical reconstructions on the face, with redundant and ptotic skin flap on the left cheek, absence of upper and lower lip and exposure of lower teeth. Conclusion: It is important to publicize this innovative procedure in different medical specialties and preoperative care through a thorough investigation, which attributes better surgical effectiveness, allowing the rescue of their facial identity, once stigmatized.

RESUMO Introdução: O transplante de face adquiriu reconhecimento, alterando o panorama clínico-cirúrgico para a restauração de defeitos faciais complexos, visto que atribui recuperação funcional e estética a pacientes que sofreram acidentes graves. Até o momento da redação deste artigo, em publicações oficiais, 43 pacientes já haviam realizado o transplante facial em todo mundo. O transplante de face possui inúmeras evidências que podem fornecer melhorias ao paciente de forma irrefutável. Para isso, cuidados pré-operatórios ao paciente devem ser cuidadosamente estabelecidos para que haja um bom desempenho cirúrgico. Relato de Caso: Paciente sexo masculino, 46 anos, relata que, aos 6 anos de idade, teve queimadura por exposição à gasolina, com 72% de superfície corporal queimada, apresentando sequelas de queimaduras e reconstruções cirúrgicas na face, com retalho cutâneo redundante e ptótico em bochecha esquerda, ausência de lábio superior e inferior e exposição dos dentes inferiores. Conclusão: Ressalta-se a importância da divulgação desse procedimento inovador em diferentes especialidades médicas e dos cuidados pré-operatórios através de uma investigação minuciosa, que atribuem uma melhor eficácia cirúrgica, possibilitando o resgate de sua identidade facial, uma vez estigmatizada.

Abstract The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the disease COVID-19, represents one of the most deleterious health emergencies of the last two decades; of which there are still innumerable unknowns about the course and handling of atypical presentations. Therefore, it is important to publish clinical cases of interest in a special population, such as kidney transplant recipients, who may have a greater risk of contracting the disease due to their immunosuppression and frequent contact with the medical care system. Co-infection with other respiratory viruses is not uncommon in the transplanted population with COVID-19, and the association with opportunistic germs such as Mycobacteria, Cytomegalovirus, Pneumocystis jirovecii and fungi, such as Cryptococcus neoformans, is unknown, yet it is possible that this association could worsen the severity of the systemic and pulmonary involvement. We present the case of a 45-year-old deceased-donor kidney transplant recipient man who was admitted to the emergency service; he presented acute respiratory difficulty syndrome (ARDS) and ventilatory failure due to infection by SARS-CoV-2. It was also confirmed that he had systemic infection by Cryptococcus neoformans without compromise of the central nervous system. It was necessary to use invasive mechanical ventilation, glucocorticoid, liposomal amphotericin B; he died 12 days after admission.

Resumen La infección por el síndrome respiratorio agudo severo por coronavirus 2 (SARS-CoV-2), causante de la enfermedad COVID-19, representa una de las emergencias sanitarias más deletéreas de las últimas dos décadas; de la que aún existen innumerables incógnitas acerca del curso y manejo de presentaciones atípicas. Por lo anterior, resulta importante publicar casos clínicos de interés en población especial como lo son los pacientes receptores de trasplante renal, quienes pueden tener un mayor riesgo de contraer la enfermedad dado su estado de inmunosupresión, así como por el contacto frecuente con el sistema de atención médica. La coinfección con otros virus respiratorios no es infrecuente en población trasplantada con COVID-19, y la asociación con gérmenes oportunistas como Micobacterias, Citomegalovirus, Pneumocystis jirovecii y hongos, tal como el Cryptococcus neoformans es desconocida, pero es posible que dicha asociación pudiese empeorar la severidad del compromiso sistémico y pulmonar. Se presenta el caso de un hombre de 45 años, con antecedentes de trasplante renal de donante cadavérico, que ingresó al servicio de urgencias del Hospital de San José; el presentó síndrome de dificultad respiratoria aguda (SDRA) y falla ventilatoria por infección por SARS-CoV-2. Además, se confirmó infección sistémica por Cryptococcus neoformans sin compromiso del sistema nervioso central. Se inició manejo con ventilación mecánica invasiva, glucocorticoide, anfotericina B liposomal; fallece a los 12 días de su ingreso.

Parece que esquemos que o mundo já enfrentara outras pandemias e, commaior ênfase, necessita combater outra pandemia, de natura diferente, representada pela inatividade física e hábito sedentário. De acordo com a OMS, somente no Brasil, doenças relacionadas ao sedentarismo matam 300 mil pessoas por ano e, no mundo, são aproximadamente 3,2 milhões de mortes anuais em decorrência desse comportamento prejudicial à saúde e qualidade de vida da população. Nesse sentido, questiona-se o porquê que, em alguns países do mundo, os centros de atividades físicas continuam fechados? Quando a própria OMS incentiva a manutenção da prática regular de atividades físicas como estratégia de promoção de saúde. Dessa forma, o referido ponto de vista tem como objetivo principal elucidar, através de evidências científicas, a importância e possibilidades de reabertura de centros de atividades físicas outdoor e indoor, visando à melhoria e manutenção da saúde e da qualidade de vida da população.

Resumo Introdução: Os procedimentos de transposição muscular são utilizados quando não há rotação ocular em nenhuma direção determinada devido a alterações dos músculos extraoculares, como paralisia, agenesia ou anomalias congênitas. O objetivo deste estudo é caracterizar os pacientes tratados com este procedimento e determinar a porcentagem de correção do ângulo de desvio obtida após a cirurgia na Unidade Pediátrica de Oftalmologia, Estrabismo e Neuro-Oftalmologia. “Dra. Ana María Illescas Putzeys”, Hospital de ojos y oídos “Dr. Rodolfo Robles V. Métodos: Foi realizado um estudo retrospectivo, descritivo, observacional, com revisão dos registros de pacientes operados para transposição muscular nos anos de 1999 a 2016. Resultados: Foram realizados vinte e três procedimentos de transposição do músculo reto. Treze pacientes eram homens (56,5%). A idade média foi de 42 anos. Em nossa série, foi obtida uma correção média de 42 PD (82%), independente do tipo de paralisia ou do procedimento cirúrgico realizado. Conclusão: Em casos selecionados de estrabismo paralítico, a principal abordagem pode ser apenas a transposição muscular com aumento (sutura de fixação intermuscular posterior), com bons resultados semelhantes aos obtidos com a transposição muscular com a utilização de adjuvantes como o tratamento com toxina botulínica.

Abstract Introduction: Muscular transposition procedures are used when there is no ocular rotation in a particular direction due to alterations of the extraocular muscles such as paralysis, agenesis or congenital anomalies. The objective of this study is to characterize the patients treated with this procedure and determine the percentage of correction of the deviation angle obtained after surgery in the Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology Unit. “Dra. Ana María Illescas Putzeys”, Hospital de ojos y oídos “Dr. Rodolfo Robles V. Methods: A retrospective, descriptive, observational study was conducted with review of records of patients operated on muscle transposition during the years 1999 to 2016. Results: Twenty-three rectus muscle transposition procedures were performed. Thirteen were male (56.5%). The mean age was 42 years. In our series, an average correction of 42 PD (82%) was obtained regardless of the type of paralysis or the surgical procedure performed. Conclusion: In selected cases of paralytic strabismus, the main approach may be only muscle transposition with augmentation (posterior intermuscular fixation suture), with good results, similar to those obtained with muscle transposition using adjuvants such as botulinum toxin treatment.

SUMMARY: The aim of the study was to evaluate the morphometric parameters of the axis vértebra (C2) in the Mexican population involved in the performance of surgical procedures in order to provide essential quantitative data in their surgical approach. A total of 576 axis vertebrae (C2) of contemporary Mexican population were used for this study. The measurements of the vertebrae were made bilaterally using a millimeter digital vernier with an accuracy of 0.01 millimeters (Mitutoyo Digimatic w / Absolute Encoders - Series 500). A total of 576 axis vertebrae (C2) were measured bilaterally, all our measurements were reported in millimeters. The average width of the pedicle was 8.96 mm with a SD ± 2.11 mm. The average height of the pedicle was 10.82 mm with a SD of ± 1.89 mm. The average height of the odontoid process was 16.90 mm with a SD of ± 2.99 mm. The average width of the odontoid process was 9.99 mm with a SD of ± 0.80 mm. The average diameter of the articular facet was 8.44 mm with a SD of ± 1.04 mm. The average diameter of the AP of the vertebral body was 15.11 mm with a SD of ± 1.88 mm. The average transverse diameter of the vertebral body was 17.93 mm with a SD of ± 2.22 mm. The average height of the vertebral body was 18.54 mm with a SD of 2.38 mm. The average height of the lamina was 11.53 mm with a SD of ± 1.39 mm. The average width of the lamina was 6.10 mm with a SD of ± 1.44 mm. The results obtained in our measurements show a variation with the results of other authors in different studies of osteological pieces and studies of the axis image (C2), which suggests the use of techniques and special measures for the atlantoaxial stabilization of the Mexican population in order to reduce the risk of damage to neurovascular structures.

RESUMEN: El objetivo de este estudio fue evaluar de manera integral los parámetros morfométricos de la vértebra axis (C2) en la población mexicana involucrados en la realización de procedimientos quirúrgicos con el fin de proveer datos cuantitativos indispensables en su abordaje quirúrgico. Para este estudio se utilizaron un total de 576 vértebras axis (C2) de población mexicana contemporánea. Las mediciones de las vértebras se efectuaron bilateralmente utilizando un vernier digital milimétrico con una precisión de 0.01 mm (Mitutoyo Digimatic w/Absolute Encoders- Series 500). Un total de 576 vértebras axis (C2), fueron medidas de manera bilateral, todas nuestras mediciones se reportaron en mm. El promedio del ancho del pedículo fue de 8,96 mm con una DE ± 2,11 mm. El promedio de la altura del pedículo fue de 10,82 mm con una DE de ± 1,89 mm. El promedio de la altura del proceso odontoideo fue de 16,90 mm con una DE de ± 2,99 mm. El promedio del ancho del proceso odontoideo fue de 9,99 mm con una de DE de ± 0,80 mm. El promedio del diámetro de la faceta articular fue de 8,44 mm con una DE de ± 1,04 mm. El promedio del diámetro AP del cuerpo vertebral fue de 15,11 mm con una DE de ± 1,88 mm. El promedio del diámetro trasverso del cuerpo vertebral fue de 17,93 mm con una DE de ± 2,22 mm. El promedio de la altura del cuerpo vertebral fue de 18,54 mm con una DE de 2,38 mm. El promedio de la altura de las láminas fue de 11,53 mm con una DE de ± 1,39 mm. El promedio del ancho de las láminas fue de 6,10 mm con una DE de ± 1,44 mm. Los resultados obtenidos en nuestras mediciones demuestran una variación con los resultados de otros autores en diferentes estudios de piezas osteológicas y de estudios de imagen del axis (C2), lo que sugiere, con el fin de reducir los riesgo de daño a estructuras neurovasculares, utilizar técnicas y medidas especiales para la estabilización atlantoaxial de la población mexicana.

Ocular trauma is a significant problem worldwide. The obj ective of this study was to determine the characteristics of patients younger than 14 years who underwent traumatic cataract surgery at the Unit of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology "Dra. Ana María Illescas Putzeys" of Hospital de Ojos y Oídos "Dr. Rodolfo Robles V." A retrospective, descriptive, and observational study was carried out to review the medical records of patients who underwent cataract surgery between 2010 and 2015. A total of 54 children underwent traumatic cataract surgery; 75% were boys; 68% were in the 6-11-year-old age range. Blunt force trauma was observed in 57.4%. A visual acuity of 20/70 or better was achieved by 68.2% of patients.

El trauma ocular es un problema significativo en todo el mundo. El objetivo de este estudio fue determinar las características de los pacientes menores de 14 años operados de catarata traumática en la Unidad de Oftalmología Pediátrica, Estrabismo y Neurooftalmología "Dra. Ana María Illescas Putzeys", Hospital de Ojos y Oídos "Dr. Rodolfo Robles V.". Se realizó un estudio retrospectivo, descriptivo, observacional, en el que se revisaron expedientes de pacientes operados de catarata de 2010 a 2015. Se operaron 54 niños por catarata traumática, de los cuales 75% eran hombres. El 68% pertenecían al rango de edad de 6-11 años. El tipo de trauma fue cerrado en un 57,4%. Los pacientes que lograron una agudeza visual igual a 20/70 o mayor fueron el 68,2%.

RESUMO Introdução: O envelhecimento leva ao declínio de múltiplos sistemas de órgãos associado a alterações hormonais e perda de massa e força muscular. Objetivo: Avaliar os efeitos do treinamento de força no meio terrestre e aquático sobre a força muscular e os níveis séricos basais de GH, IGF-1 e IGFBP3 em mulheres idosas. Métodos: Os indivíduos foram distribuídos em três grupos: treinamento de força no meio terrestre (TFT; n = 10; idade: 66,10 ± 2,77 anos), treinamento de força na água (TFA; n = 10; idade: 67,10 ± 3,54 anos) e grupo controle (GC; n = 10; idade: 68,80 ± 5,41 anos). A força muscular foi avaliada pelo teste de 1-RM nos exercícios supino reto (SR) e leg press (LP). Os níveis séricos de GH, IGF-1 e IGFBP3 foram analisados por quimioluminescência. Resultados: O teste ANOVA com medidas repetidas mostrou aumento da força muscular no SR só no TFT (∆% = 60,2%; p = 0,0001) quando comparado ao GC (∆% = 46,73%, p = 0,0001) e TFA (∆% = 32,49%, p=0,004). TFT e TFA aumentaram a força muscular no LP (∆% TFT = 57,14%; p = 0,004; ∆% TFA = 42,3%; p = 0,033). Houve um aumento no TFT e TFA no LP em comparação com o GC (∆% = 45,59%, p = 0,019; ∆% = 43,97%, p = 0,026, respectivamente). IGF-1 aumentou só no TFT (∆% = 49,72%, p = 0,004) do pré para o pós-teste e quando comparado ao TFA (∆% = 56,76%, p = 0,002) e ao GC (∆% = 74,63%, p = 0,0001). Os níveis de IGFBP3 mostraram aumento apenas no TFA (∆% = 26,79%, p = 0,044) do pré para o pós-teste. A razão IGF-1/IGFBP3 demonstrou que TFT atingiu elevação intragrupo (∆% = 52,66%, p = 0,002) e quando comparado ao TFA (∆% = 94,11%, p = 0,0001) e CG (∆% = 73,45%, p = 0,0001). Não foram verificadas diferenças significativas no GH. Conclusão: O treinamento de força no meio terrestre produziu maior efeito anabólico nas idosas.

ABSTRACT Introduction: Aging leads to decline in multiple organ systems associated to hormone alterations and loss of muscle mass and strength. Objective: To evaluate the effects of land and water resistance training on muscle strength, basal serum levels of GH, IGF-1, and IGFBP3 in elderly women. Methods: Subjects were distributed in three groups: land resistance training (LRT; n=10; age: 66.10±2.77 years), water resistance training (WRT; n=10; age: 67.10±3.54 years) and control (CG; n=10; age: 68.80±5.41 years). Muscle strength was assessed with the 1-RM test in bench press (BP) and leg press (LP) exercises. Serum levels of GH, IGF-1, and IGFBP3 were analyzed by chemiluminescence. Results: Repeated measures ANOVA showed elevated muscle strength in the BP only in LRT (D%=60.2%; p=0.0001) when compared to the CG (D%=46.73%, p=0.0001) and WRT (D%=32.49%, p=0.004). LRT and WRT increased muscle strength in LP (D%LRT=57.14%; p=0.004; D%WRT=42.3%; p=0.033). There was an increase in LRT and WRT in the LP when compared to CG (D%=45.59%, p=0.019; D%=43.97%, p=0.026, respectively). IGF-1 was elevated only in LRT (D%=49.72%, p=0.004) from pre- to post-test and when compared to WRT (D%=56.76%, p=0.002) and CG (D%=74.63%, p=0.0001). IGFBP3 levels showed that only WRT increased (D%=26.79%, p=0.044) from pre- to post-test. The IGF-1/IGFBP3 ratio demonstrated that LRT reached intragroup elevation (D%=52.66%, p=0.002) and when compared to WRT (D%=94.11%, p=0.0001) and CG (D%=73.45%, p=0.0001). There was no significant difference in GH. Conclusion: Land resistance training may provide better anabolic effects in elderly women.

RESUMEN Introducción: El envejecimiento lleva al declive de múltiples sistemas de órganos, asociado a cambios hormonales y pérdida de masa y fuerza muscular. Objetivo: Evaluar los efectos del entrenamiento de fuerza en el medio terrestre y acuático sobre la fuerza muscular y los niveles séricos basales de GH, IGF-1 e IGFBP3 en mujeres mayores. Métodos: Los individuos fueron distribuidos en tres grupos: entrenamiento de fuerza en medio terrestre (EFT; n = 10; edad: 66,10 ± 2,77 años), entrenamiento de fuerza en medio acuático (EFA; n = 10; edad: 67,10 ± 3,54 años) y grupo control (GC, n = 10; edad = 68,80 ± 5,41 años). La fuerza muscular se evaluó por la prueba de 1-RM en los ejercicios de press de banca (PB) y prensa de pierna (PP). Los niveles séricos de GH, IGF-1 e IGFBP3 se analizaron por quimioluminiscencia. Resultados: La prueba ANOVA con medidas repetidas mostró aumento de la fuerza muscular en el PB sólo en el EFS (∆% = 60,2%; p = 0,0001) en comparación al GC (∆% = 46,73%, p = 0,0001) y EFA (∆% = 32,49%, p = 0,004). EFS y EFA aumentaron la fuerza muscular en la PP (∆%EFS = 57,14%; p = 0,004; ∆%EFA = 42,3%; p = 0,033). Se observó un aumento en el EFS y EFA en la PP en comparación con el GC (∆% = 45,59%, p = 0,019; ∆% = 43,97%, p = 0,026, respectivamente). IGF-1 aumentó sólo en el EFS (∆% = 49,72%; p = 0,004) del pre para el post-test y en comparación con el EFA (∆% = 56,76%; p = 0,002) y al GC (∆% = 74,63%; p = 0,0001). Los niveles de IGFBP3 mostraron aumento sólo en el EFS (∆% = 26,79%; p = 0,044) del pre para el post-test. La razón IGF-1/IGFBP3 demostró que EFS alcanzó elevación intragrupo (∆% = 52,66%; p = 0,002) y en comparación al EFA (∆% = 94,11%, p = 0,0001) y GC (∆% = 73,45%; p = 0,0001). No se observaron diferencias significativas en el GH. Conclusión: El entrenamiento de fuerza en el medio terrestre produjo un mayor efecto anabólico en las mujeres mayores.

A descriptive study was conducted in the service of Allergy and Immunology of the Mary Immaculate Clinic, the World Trade Center in Mexico and the Previsora Clinic from Camagüey, Cuba to evaluate the prevalence of cow’s milk allergy (CMA). The universe was 3221 subjects referred to these services from January 2010 to December 2015. The sample was 650 children from 0 to 9 years old with probable symptoms of CMA. Prick test was carried out with cow’s milk and industrial extracts, oral challenge test was carried out, and specific IgE to α-lactoalbumin, ß-lactoglobulina and casein. The age variable was correlated with the presence of atopic dermatitis, allergic rhinitis, allergic rhinitis/asthma, hives and digestive symptoms. Diagnoses by age group and positive tests were added to calculate the percentage of CMA and Chi-square test was applied. The general prevalence of CMA was 4.9%; prevalence by study groups was higher in Mexicans with 5.1% than in Cubans (4.5%) (p=0,036). Patients diagnosed with CMA corresponded to children under 3 years old. Children under one year old with atopic dermatitis were associated with CMA cases to 1.8% prevalence. It can be concluded that the diagnosis of CMA in children with clinical suspicion is done at early ages.

Con el propósito de evaluar la prevalencia de alergia a proteína de la leche de vaca (APLV) se hizo un estudio descriptivo en los servicios de Alergología e Inmunología de la clínica María Inmaculada de la Salud, del World Trade Center en México y en el policlínico Previsora de Camagüey, Cuba. El universo de estudio fueron 3221 individuos derivados a dichos servicios desde enero del 2010 a diciembre 2015. La muestra fue de 650 niños con sintomatología probable de APLV de las edades 0 a 9 años. Se realizó Prick test con leche de vaca y extractos industriales, así como prueba de reto oral e IgE específica a α-lactoalbúmina, ß-lactoglobulina y caseína. La variable edad se correlacionó con la presencia de dermatitis atópica, rinitis alérgica, rinitis alérgica/asma bronquial, urticaria y sintomatología digestiva. Se sumaron los diagnósticos según grupo etario y pruebas positivas para calcular el porcentaje de APLV y se aplicó la prueba de Chi-cuadrado. La prevalencia general de APLV en la muestra fue de 4,9%. En relación a la prevalencia por grupos de estudio fue mayor en los mexicanos con 5,1 % que en los cubanos (4,5%) (p=0,036). Los pacientes con diagnóstico definitivo de APLV correspondieron a los niños menores de 3 años. Los niños menores de un año con dermatitis atópica se asociaron a APLV en 1,8%. Se concluye que en los niños con sospecha clínica de APLV el diagnóstico definitivo se hace en las primeras edades de la vida.

In areas of the National Institute of Agricultural Sciences (INCA) an experiment was conducted with crop wheat in order to assess their physiological response to water stress by default, for which the effect of two irrigation treatments on soil moisturecontent, development variables, water relations, yield and water use efficiency (WUE) in culturewere evaluated. The INCA TH 4 cultivar was grown at double row in concrete containers of 1,56 m ². The two irrigation treatments T 100 and T 50, they consisted of applying 50 to 100 % of standard crop evapotranspiration (ETc.), respectively.Background fertilization was performed before planting with complete formula NPK (9-13-17) and urea (46-0-0) applied to each container 0,1 and 0,04 kg., respectively. Irrigation was applied using an automated system micro sprinkler and water delivery was controlled by valves placed in each treatment. The results showed a significant effect of treatments on soil water content and T 50 at 52 and 67 days after sowing (DDS) that dropped below 15 %, something that was confirmed with the values of potential deficit soil moisture (Dp) which was 178 in T 50 and 77 mm in T 100, respectively. Also the results of leaf water potential (Yfoliar) showed that T 50 plants were exposed to severe water deficit at 41 and 62 DDS, with lower values of -1.5 MPa and T 100 at 62 DDS. Stomatal conductance (gs) showed greater sensitivity to water stress than the remaining variables of water relations. Studied treatments hardly exerted any effect on growth variables, mainly in the accumulation of dry matter and leaf area. In T 50 plants had a lower yield and water use efficiency (WUE) was slightly higher than the T 100

En áreas del Instituto Nacional de Ciencias Agrícolas (INCA) se realizó un experimento en el cultivo de trigo con el objetivo de evaluar su respuesta fisiológica al estrés hídrico por defecto, para lo cual, se evaluó el efecto de dos tratamientos de riego en el contenido de humedad del suelo, variables del desarrollo, las relaciones hídricas, el rendimiento y el uso eficiente del agua (WUE) en el cultivo. El cultivar empleado fue el INCA TH 4 cultivado en doble hilera en contenedores de hormigón de 1,56 m ². Los dos tratamientos de riego T 100 y T 50, consistieron en aplicar el 50 y el 100 % de la evapotranspiración estándar del cultivo (ETc), respectivamente. Se realizó una fertilización de fondo antes de la siembra con fórmula completa NPK (9-13-17) y urea (46-0-0) aplicando a cada canaleta 0,1 y 0,04 kg, respectivamente. El riego se aplicó mediante un sistema automatizado de micro aspersión y la entrega del agua se controló mediante válvulas colocadas en cada tratamiento. Los resultados mostraron un efecto importante de los tratamientos en el contenido hídrico del suelo y en T 50 a los 52 y 67 días después de la siembra (DDS) este descendió por debajo del 15 %, aspecto que se corroboró con los valores del déficit potencial de humedad del suelo (Dp) que en T 50 fue de 178 y en T 100 de 77 mm, respectivamente. También los resultados del potencial hídrico foliar (Yfoliar) evidenciaron que las plantas de T 50 estuvieron expuestas a déficit hídrico severo a los 41 y 62 DDS, con valores menores de -1,5 MPa y las de T 100 a los 62 DDS. La conductancia estomática (gs) reflejó una sensibilidad mayor a la deficiencia hídrica que las restantes variables de las relaciones hídricas. Los tratamientos estudiados prácticamente no ejercieron efecto alguno en las variables del crecimiento, principalmente en la acumulación de materia seca y el área foliar. En T 50 las plantas tuvieron un rendimiento menor y su uso eficiente del agua (WUE) fue ligeramente mayor que las de T 100

RESUMO Objetivo: Tumores do tecido conjuntival tem uma apresentação variada. Poucas séries de pacientes pediátricos foram publicadas. O objetivo deste trabalho é apresentar os diagnósticos histopatológicos de tumores conjuntivais em crianças com menos de 14 anos de idade, obtidas durante um período de 25 anos. Métodos: Estudo retrospectivo, descritivo e observacional foi realizado. Nós revisamos o banco de dados de todas as crianças em quem um tumor conjuntival foi removido cirurgicamente no Hospital de Ojos y oidos "Dr. Rodolfo Robles V.," Benemérito Comité Pro Ciegos y Sordos de Guatemala. Sexo, idade e diagnóstico histopatológico de todos os casos foram compilados. O mesmo patologista ocular fez todos os diagnósticos. Resultados: Cento e sessenta e cinco casos foram encontrados, com média de 7,88 anos, sendo 91 (55,15%) do sexo masculino. Lesões melanocíticas foram as mais frequentes (30,91% dos casos). Apenas um caso (0,60%) era maligno. Conclusões: Lesões melanocíticas foram as mais frequentes. Do total, apenas uma lesão era maligna, o que correspondeu a um paciente com xeroderma pigmentoso. Estes resultados são consistentes com o relatado em outros estudos quanto à frequência de diagnóstico histopatológico de tumores da conjuntiva na população pediátrica.

ABSTRACT Purpose: Conjunctival tissue tumors have a varied presentation, and few series studies on pediatric patients have been published. The objective of this paper is to report the histopathologic diagnoses (spanning over 1988-2013) of conjunctival tumors in children younger than 14 years. Methods: We conducted a retrospective, descriptive, and observational study by reviewing the database of all children in whom a conjunctival tumor was surgically removed at Hospital de Ojos y Oídos "Dr. Rodolfo Robles V.," Benemérito Comité Pro Ciegos y Sordos de Guatemala. The data pertaining to gender, age, and histopathologic diagnosis of all cases was collected. The same ocular pathologist made all diagnoses. Results: One hundred sixty-five cases were found, with a mean age of 7.88 years, being 91 (55.15%) male subjects. Melanocytic lesions were the most common tumors found (30.91% of cases), with only one case (0.60%) being malignant. Conclusions: Melanocytic lesions were the most common tumors found, and of all the cases, only one was malignant; this was in a patient with xeroderma pigmentosum. These findings are consistent with those reported in other studies regarding the frequencies of the histopathology of conjunctival tumors in the pediatric population.

Pediatric ocular trauma is common and the leading cause of non congenital unilateral blindness. The information in developing countries is scarce. The objective of this case series is to describe clinical and epidemiological characteristics of ocular trauma in children under 14 years of age who visited Hospital Dr. Rodolfo Robles Valverde in Guatemala City in 2010. In this study 119 patients were included. School-aged (7-9 years) male gender was the most affected. Closed globe injury was the commonest. The most frequent objects causing the lesions were: wooden objects, toys and chemicals. Trauma occurred most frequently at home. Twenty one of the patients were surgically intervened. Education and prevention programs for pediatric ocular trauma are necessary.

El trauma ocular pediátrico es frecuente y es la principal causa de ceguera unilateral no congénita. La información en países en vías de desarrollo es escasa. El objetivo de esta serie de casos es describir las características clínicas y epidemiológicas del trauma ocular en niños menores de 14 años que consultaron al Hospital Dr. Rodolfo Robles Val verde en la Ciudad de Guatemala durante el año 2010. Se incluyeron 119 pacientes en el estudio. El género masculino en edad escolar (7-9 años) fue el más comprometido. El trauma más común fue el de globo cerrado. Los objetos más frecuentes causantes de la lesión fueron madera, juguetes y químicos. La vivienda fue el lugar donde más ocurrió el trauma. Se intervinieron 21 pacientes. Son necesarios programas de educación y prevención.

The records of patients from the Allergology Service in the Previsora Policlinic, Camagüey were revised to evaluate benefits and risks of the subcutaneous immunotherapy (ITSC) with extracts of acari. The study was observational, analytic and retrospective of cases and controls in allergic rhinoconjunctivitis and bronchial asthma. A total of 160 subjects, older than 18 years old, were chosen. Eighty out of them had already received ITSC with dose increase during 13 weeks and maintenance with monthly injections during 18 months. A total of 80 patients who only received prevention measures and medications during the crises were paired. Questionnaires were applied for quality of rhinoconjunctivitis life and asthma, about the consumption of medications and the frequency of the crises. The adverse events were measured, as they were local and systemic to the cutaneous tests, to the ITSC and the different pharmacological treatments. There was a significant increase of the punctuation of life quality questionnaires, (p=0.011). The consumption of medications decreased in both the cases and the controls, without significant differences (p=0.083). The frequency of the rhinitis and asthma crises decrease in the group of ITSC (p=0.029). Slight local and systemic reactions were reported in both groups with Odds ratio (OR)=2.029 in the ITSC group, with a 95% confidence interval of 1.114–3.967 (p=0.019). The results show that the subcutaneous immunotherapy with acari offers benefits and few risks to patients with allergic rhinoconjunctivitis and asthma.

Para evaluar beneficios y riesgos de la inmunoterapia subcutánea (ITSC) con extractos de ácaros se revisó el registro de pacientes del servicio de alergología en el policlínico de Previsora, Camagüey. El estudio fue observacional analítico retrospectivo de casos y controles en rinoconjuntivitis alérgica y asma bronquial. Se seleccionaron 160 individuos mayores de 18 años, de ellos 80 ya habían recibido ITSC con incremento de dosis durante 13 semanas y mantenimiento con inyecciones mensuales durante 18 meses. Fueron apareados 80 pacientes que sólo recibieron medidas de prevención y fármacos en las crisis. Se aplicaron cuestionarios para calidad de vida de rinoconjuntivitis y asma, acerca del consumo de medicamentos y de la frecuencia de las crisis. Los eventos adversos se midieron según fueran locales y sistémicos a las pruebas cutáneas, a la ITSC y a los diferentes tratamientos farmacológicos. Hubo incremento de la puntuación de los cuestionarios de calidad de vida, significativo a favor de los casos (p=0,011). El consumo de medicamentos descendió en los casos y en los controles, sin diferencias significativas (p=0,083). La frecuencia de las crisis de rinitis y asma disminuyó en el grupo de ITSC (p=0,029). Se reportaron reacciones locales y sistémicas ligeras en ambos grupos con valores de Odds ratio de 2,029 en la ITSC; con un intervalo de confianza al 95,0% de 1,114 - 3,967 (p= 0,019). Los resultados revelan que la inmunoterapia subcutánea con ácaros aporta beneficios y pocos riesgos en pacientes con rinoconjuntivitis alérgica y asma.