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Resumen El cultivo de cacao (Theobroma cacao L.) para el departamento de Nariño representa una alternativa productiva frente a la sustitución de cultivos ilícitos, del cual dependen pequeños y medianos productores; sin embargo, la alta humedad relativa, temperatura y precipitaciones, así como el manejo inadecuado fitosanitario, provocan alta incidencia de enfermedades como Moniliophthora roreri y Phytophthora sp. y limitando rendimiento productivo. En este sentido, es necesario la identificación de clones de cacao adaptados a las condiciones de la zona y tolerantes a las principales enfermedades. El objetivo de este estudio fue evaluar el potencial productivo y sanitario en etapas iniciales de desarrollo de cuatro clones de cacao; TCS 01, TCS 06, TCS 13 y TCS 19 bajo condiciones ambientales del Pacífico Nariñense. Para el análisis estadístico se utilizó el software SAS 9.4, empleando el procedimiento Glimminx para analizar las variables y se ajustó el análisis a la distribución de Poisson. Además, se utilizó pruebas de Tukey cuando se presentaron diferencias significativas. El Clon TCS 19, presentó los mejores resultados en producción (1.44 kg grano seco árbol-1) superando al testigo comercial ICS 95 (0.6 kg grano seco árbol-1). En tema sanitario, M. roreri fue la enfermedad con mayor incidencia, especialmente en los genotipos TCS 01 (38.67%) y TCS 13 (25.85%). Los rendimientos de los materiales evaluados superaron el promedio de producción nacional (460 kg ha-1) y regional (560 kg ha-1). Según estos resultados, TCS 19 podría potencialmente considerarse como recurso genético promisorio para el desarrollo de la cacaocultura de la Costa Pacífica Nariñense.

Abstract The cacao (Theobroma cacao L.) crop for the department of Nariño represents a productive alternative to the substitution of illicit crops, on which small and medium producers depend; nevertheless, high relative humidity, temperature, and rainfall, as well as inadequate phytosanitary management, cause a high incidence of diseases such as Moniliophthora roreri and Phytophthora sp., limiting productive yield. In this sense, it is necessary to identify cacao clones adapted to the conditions of the area and tolerant to the main diseases. This study aimed to assess the productive and sanitary potential in the initial stages of development of four cacao clones, TCS 01, TCS 06, TCS 13, and TCS 19, under environmental conditions of the Nariño Pacific. The SAS 9.4 software was used for the statistical analysis, employing the Glimmix procedure to analyze the variables, and the analysis was adjusted to the Poisson distribution. In addition, Tukey’s tests were used when there were significant differences. The clone TCS 19 presented the best results in production (1.44 kg dried bean tree-1), surpassing the commercial control ICS 95 (0.6 kg dried bean tree-1). In terms of health, M. roreri was the disease with the highest incidence, especially in the genotypes TCS 01 (38.67%) and TCS 13 (25.85%). The yields of the materials evaluated exceeded the average national (460 kg ha-1) and regional (560 kg ha-1) production. According to these results, TCS 19 could potentially be considered a promising genetic resource for the development of cacao farming on the Pacific Coast of Nariño.

https://doi.org/10.29312/remexca.v14i7.3331

Frecuencia de eventos cardiovasculares en pacientes con lupus eritematoso sistémico.
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García, Lucila

; Gobbi, Carla

; Quintana, Rosana

; Alba, Paula

; Roverano, Susana

; Álvarez, Analía

; Graf, César

; Pisoni, Cecilia

; Spindler, Alberto

; Gómez, Catalina

; Figueredo, Heber Matías

; Papasidero, Silvia

; Paniego, Raúl

; de la Vega, María Celina

; Civit, Emma

; González Lucero, Luciana

; Martire, María Victoria

; Maldonado Aguila, Rodrigo

; Gordon, Sergio

; Micelli, Marina

; Nieto, Romina

; Rausch, Gretel

; Gongora, Vanina

; Damico, Agustina

; Dubinsky, Diana

; Orden, Alberto

; Zacariaz, Johana

; Romero, Julia

; Pera, Mariana

; Goñi, Mario

; Rillo, Oscar

; Báez, Roberto

; Arturi, Valeria

; González, Andrea

; Vivero, Florencia

; Bedoya, María Eugenia

; Shmid, Marcela

; Caputo, Víctor

; Larroude, María Silvia

; Domínguez, Nadia

; Gómez, Graciela

; Rodríguez, Graciela

; Marín, Josefina

; Collado, Victoria

; Jorfen, Marisa

; Bedran, Zaida

; Curti, Ana

; Gazzoni, María Victoria

; Sarano, Judith

; Finucci Curi, Pablo

; Rojas Tessel, Romina

; Arias Saavedra, Maira

; Sattler, María Emilia

; Machado Escobar, Maximiliano

; Astesana, Pablo

; París, Úrsula

; Vandale, Juan Manuel

; Santa Cruz, María Julia

; Pons-Estel, Bernardo

; García, Mercedes

Revista argentina de reumatología

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oct 2023, Volume 34 N. 2 Pages 43 - 50

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Introducción: el progreso en los tratamientos para el lupus eritematoso sistémico (LES) resultó en una disminución de la mortalidad; sin embargo, la enfermedad cardiovascular y las complicaciones infecciosas aún son las principales causas de muerte. La evidencia apoya la participación del sistema inmunológico en la generación de la placa aterosclerótica, así como su conexión con las enfermedades autoinmunes. Objetivos: describir la frecuencia de eventos cardiovasculares (ECV) en el Registro de Lupus Eritematoso Sistémico de la Sociedad Argentina de Reumatología (RELESSAR) transversal, así como sus principales factores de riesgo asociados. Materiales y métodos: estudio descriptivo y transversal para el cual se tomaron los pacientes ingresados en el registro RELESSAR transversal. Se describieron las variables sociodemográficas y clínicas, las comorbilidades, score de actividad y daño. ECV se definió como la presencia de al menos una de las siguientes patologías: enfermedad arterial periférica, cardiopatía isquémica o accidente cerebrovascular. El evento clasificado para el análisis fue aquel posterior al diagnóstico del LES. Se conformaron dos grupos macheados por edad y sexo 1:2. Resultados: 1515 pacientes mayores de 18 años participaron del registro. Se describieron 80 pacientes con ECV (5,3%). En este análisis se incluyeron 240 pacientes conformando dos grupos. La edad media fue de 47,8 (14,4) y 47,6 (14,2) en el grupo con y sin ECV respectivamente. Los pacientes con ECV tuvieron mayor duración del LES en meses, mayor índice de Charlson, mayor SLICC (Systemic Lupus International Collaborating Clinics/American College of Rheumatology), mayor frecuencia de manifestaciones neurológicas, síndrome antifosfolípido, hospitalizaciones y uso de ciclofosfamida. Las únicas variables asociadas en el análisis multivariado fueron el índice de Charlson (p=0,004) y el SLICC (p<0,001). Conclusiones: los ECV influyen significativamente en nuestros pacientes, y se asocian a mayor posibilidad de daño irreversible y comorbilidades.

Abstract Introduction: progress in treatments for systemic lupus erythematosus (SLE) has resulted in a decrease in mortality; however, cardiovascular and infectious diseases remain the leading causes of death. Evidence supports the involvement of the immune system in the generation of atherosclerotic plaque, as well as its connection to autoimmune diseases. Objectives: to describe the frequency of cardiovascular disease (CVD) in the cross-sectional RELESSAR registry, as well as its associated variables. Materials and methods: a descriptive and cross-sectional study was performed using patients admitted to the cross-sectional RELESSAR registry. Sociodemographic variables, clinical variables, comorbidities, activity and damage scores were described. CVD was defined as at least one of the following: peripheral arterial disease, ischemic heart disease, or cerebrovascular accident. All patients with at least one CVD were included in our analysis (heart attack, central nervous system vascular disease, and peripheral arteries atherosclerotic disease). The event classified for the analysis was that after the diagnosis of SLE. SLE diagnosis was previous to CVD. Two groups matched by age and sex, 1:2 were formed. Results: a total of 1515 patients older than 18 years participated in the registry. Eighty patients with CVD (5.3%) were described in the registry. Two-hundred and forty patients were included, according to two groups. The mean age was 47.8 (SD 14.4) and 47.6 (SD 14.2) in patients with and without CVD, respectively. Patients with CVD had a longer duration of SLE in months, a higher Charlson index, a higher SLICC, increased frequency of neurological manifestations, antiphospholipid syndrome, hospitalizations, and use of cyclophosphamide. The associated variables in the multivariate were the Charlson Index (p=0.004) and the SLICC (p<0.001). Conclusions: CVDs have a significant influence on our patients, being associated with a greater possibility of damage and comorbidities.

https://doi.org/10.47196/rar.v34i2.747

El hábito de fumar y su relación con afecciones bucales en adolescentes
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Valdés Sardiñas, Sonia Amalia

; Hernández Gutiérrez, Daymi

; Fernández González, Roberto

; Broche Pombo, Ada

; Romero Flores, Dayani

; Fernández Hernández, Roberto Alfredo

Medicentro Electrónica

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mar 2022, Volume 26 N. 1 Pages 1 - 14

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Introduction: smoking is associated with a wide variety of harmful changes in the oral cavity, since it alters its microenvironment and predisposes it to the occurrence of various conditions. Objective: to determine the possible relationship between smoking and oral conditions in adolescents. Method: an observational study was carried out in adolescents from "Pepito Tey" Mixed Center, in San Diego del Valle, Cifuentes between September 2016 and October 2018. The study population, made up of 208 adolescents, was organized into two strata: study group and control ones. Two probabilistic samples were selected by simple random sampling (60 adolescents in each group). Results: 12-year-old male light smokers, who started smoking between 14 and 15 years of age and practiced this habit for less than 6 months, predominated. Dental caries, periodontal disease, dental stains, oral mucosal lesions and halitosis were associated with smoking. Conclusions: 12-year-old male adolescent smokers predominated. Most smokers were classified as light, started smoking between 14 and 15 years of age and practiced this habit for less than 6 months. There was a significant association between smoking and oral conditions (periodontal disease, dental caries, dental stains, halitosis and oral mucosal lesions).

RESUMEN Introducción: El hábito de fumar está asociado a una gran variedad de cambios perjudiciales en la cavidad bucal, pues altera su microambiente y lo predispone para que se presenten diversas afecciones. Objetivo: Determinar la posible relación del hábito de fumar con las afecciones bucales en adolescentes. Método: Se realizó un estudio observacional en adolescentes del Centro Mixto «Pepito Tey» de San Diego del Valle, Cifuentes, en el período comprendido entre septiembre de 2016 y octubre de 2018. La población de estudio, conformada por 208 adolescentes, se organizó en dos estratos: grupo estudio y grupo control. Se seleccionaron dos muestras probabilísticas por muestreo aleatorio simple (60 adolescentes en cada grupo). Resultados: Predominaron adolescentes de 12 años, fumadores leves, del sexo masculino, con inicio del hábito entre 14-15 años y práctica de este hábito de menos de 6 meses. Se asociaron al hábito de fumar: la caries dental, la enfermedad periodontal, las manchas dentales, las lesiones de la mucosa bucal y la halitosis. Conclusiones: Predominaron adolescentes fumadores masculinos de 12 años. La gran mayoría de los fumadores fueron clasificados como leves, con inicio del hábito entre los 14-15 años de edad, y con práctica desde hace menos de seis meses. Existió asociación significativa entre el hábito de fumar y las afecciones bucales (enfermedad periodontal, caries dental, mancha dental, halitosis y lesión de la mucosa bucal).

Lupus en Argentina. .
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Quintana, Rosana

; García, Lucila

; Gobbi, Carla

; Alba, Paula

; Roverano, Susana

; Álvarez, Analia Patricia

; Graf, César Enrique

; Pisoni, Cecilia

; Spindler, Alberto

; Gómez, Catalina

; Figueredo, Heber Matías

; Papasidero, Silvia

; Paniego, Raúl

; de la Vega, María Celina

; Civit, Emma

; González Lucero, Luciana

; Martire, María Victoria

; Aguila Maldonado, Rodrigo

; Gordon, Sergio

; Micelli, Marina

; Nieto, Romina

; Rausch, Gretel

; Gongora, Vanina

; Damico, Agustina

; Rodríguez Gil, Gustavo

; Dubinsky, Diana

; Orden, Alberto

; Zacariaz, Johana

; Romero, Julia

; Pera, Mariana

; Goñi, Mario

; Rillo, Oscar

; Báez, Roberto

; Arturi, Valeria

; González, Andrea

; Vivero, Florencia

; Bedoya, María Eugenia

; Shmid, María Marcela

; Caputo, Víctor

; Larroude, Maria Silvia

; Domínguez, Nadia

; Gómez, Graciela Noemí

; Rodríguez, Graciela Nora

; Marín, Josefina

; Collado, Victoria

; Jorfen, Marisa

; Bedran, Zaida

; Curti, Ana

; Gazzoni, María Victoria

; Sarano, Judith

; Zelaya, Marcos

; Sacnun, Mónica

; Finucci Curi, Pablo

; Rojas Tessel, Romina

; Arias Saavedra, Maira

; Sattler, María Emilia

; Machado Escobar, Maximiliano Augusto

; Astesana, Pablo

; Paris, Úrsula

; Virasoro, Belén María

; Santa Cruz, María Julia

; Allievi, Alberto

; Vandale, Juan Manuel

; Hojberg, Noelia Giselle

; Pons-Estel, Bernardo

; Pons-Estel, Guillermo

; García, Mercedes Argentina

Revista argentina de reumatología

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mar 2022, Volume 33 N. 1 Pages 14 - 25

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

resumen está disponible en el texto completo

Abstract Introduction: lupus is a complex disease and often difficult to approach. Achieving remission is one of the objectives, incorporating therapeutic options. Objectives: to describe the characteristics of the patients and the use of belimumab, according to the status of the disease. Materials and methods: cross-sectional study. Patients of the RELESSAR registry. Stratification: Remission: SLEDAI=0 and without corticosteroids. Low disease activity SLEDAI> 0 and ≤4 and without corticosteroids and non-optimal control: SLEDAI> 4 and any dose of corticosteroids. Results: a total of 1,277 patients were included, 23.4% in remission, 12.6% in low disease activity and 63.8% in non-optimal control. The last group was younger and had a shorter duration of the disease. They had higher activity and chronicity indices and greater use of immunosuppressants. Only 22.3% of the patients with potential criteria for the use of belimumab (activity disease despite standard treatment) were receiving it. The variables associated with hospitalizations were: corticosteroids, cyclophosphamide and higher SLICC. Those associated with severe infection: mycophenolate mofetil, azathioprine, corticosteroids, and higher SLICC. Conclusions: the complexity of the management of these patients is reflected, visualizing structural aspects such as inequality. The use of belimumab could be beneficial in selected patients.

https://doi.org/10.47196/rar.v33i1.602 101 downloads

Colleters in Cephalanthus (Rubiaceae) and reevaluation of occurrence of corolline colleters in Angiosperms
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ROMERO, MARÍA FLORENCIA

; SALAS, ROBERTO MANUEL

; GONZALEZ, ANA MARIA

Anais da Academia Brasileira de Ciências

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2022, Volume 94 N. 2 elocation e20201975

Abstract: En | Text: En | PDF: En

Abstract Colleters are glandular structures related to young shoots protection. In several Angiosperm families, as in Rubiaceae colleters are taxonomically important. This study reports presence, location, morpho-anatomical structure, ontogeny and histochemistry of colleters in vegetative and reproductive organs in 6 species of Cephalanthus and 20 species representatives of the tribe Naucleeae. Primarily based on their color and their secretion color, they were classified into light (LC) and dark (DC) colleters. The LC are exclusive to the inner side of the stipule, while the DC are found in several vegetative and reproductive organs. Histochemical studies revealed that higher mucilage and phenol content in DC could explain the dark color secretion. Results were analyzed at genus, tribe and subtribe levels, evidencing the taxonomic relevance in the family. Finally, the presence of corolline colleters in angiosperm flowers was reviewed. It was confirmed that, besides Cephalanthus, they are only present in Adenoa (Passifloraceae) and Chamaecrista (Fabaceae). Therefore, structures described as colleters in Nerium (Apocynaceae) and Cuscuta (Cuscutaceae) corollas do not correspond to colleters. This proves that corolline colleter is a rare character in Angiosperms. To conclude we provide a record of presence/absence, type and distribution of corolline colleters in an Angiosperm phylogenetic tree.

https://doi.org/10.1590/0001-3765202220201975

Evaluación del disbalance autonómico en el paciente con serología positiva para enfermedad de Chagas: Score de diagnóstico y tratamiento
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Giménez, Luisa J.

; Mitelman, Jorge E.

; Sabra, Ahmad H.

; Encina, Juan Justiniano

; Uriona Villarroel, Juan

; Maldonado, Ninoska

; Fernández Chamorro, Felipe Nery Gervacio

; Luces León, Raquel M.

; Aguirre, Fernando

; Mendoza, Iván

; Macedo Linares, Ana María

; Bonilla, Rafael

; Blandón Calderón, Roberto

; Linarez Ochoa, Nery E.

; Reyes López, Pedro A.

; Gutiérrez Perucho, Ernesto

; Melnikov, Valery

; Romero, Analía

; González, Marcos E.

Insuficiencia cardíaca

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jun 2021, Volume 16 N. 2 Pages 52 - 59

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

A doença de Chagas é uma doença parasitária (Trypanosoma cruzi), endêmica em 21 países da América e que as migrações a dispersaram em diferentes continentes. Uma das primeiras manifestações desta doença são as alterações disautonômicas ou disfunção autonômica. A gravidade desse funcionamento inadequado do sistema nervoso autônomo é mensurável, de modo que a evolução e/ou progressão da doença pode ser verificada alterando os estudos clínicos e detectando anticorpos antimuscarínicos. Esses anticorpos estão presentes em 30% dos infectados e aparecem muito cedo, uma vez instalada a parasitose; Além disso, outros estudos, como a dispersão do QT (> 65 mseg) e a variabilidade da freqüência cardíaca (<100 mseg), mostram valores anormais. A utilização de novos paradigmas de atendimento, diagnóstico e tratamentos adequados são essenciais para prevenir o desenvolvimento desta doença cardíaca.

Chagas disease is a parasitic disease (Trypanosoma cruzi), endemic in 21 countries of America and that migrations have dispersed it in different continents. One of the earliest manifestations of this disease is dysautonomic alterations or autonomic dysfunction. The severity of this inadequate functioning of the autonomic nervous system is measurable, so that the evolution and/or progression of the disease can be verified by altering clinical studies and detecting antimuscarinic antibodies. These antibodies are present in 30% of those infected and appear very early once the parasitosis is installed; In addition, other studies, such as QT dispersion (> 65 ms) and heart rate variability (<100 ms) show abnormal values. The use of new paradigms of care, diagnosis and appropriate treatments are essential to prevent the development of this heart disease.

La enfermedad de Chagas es una enfermedad parasitaria (Trypanosoma cruzi), endémica en 21 países de América y que las migraciones la han dispersado en distintos continentes. Una de las manifestaciones más precoces de esta enfermedad son las alteraciones disautonómicas o disfunción autonómica. La severidad de este inadecuado funcionamiento del sistema nervioso autónomo resulta mensurable, de modo que la evolución y/o progresión de la enfermedad puede constatarse mediante la alteración de estudios clínicos y detección de anticuerpos antimuscarínicos. Estos anticuerpos están presentes en un 30% de los infectados y aparecen muy precozmente una vez instalada la parasitosis; además otros estudios, como la dispersión del QT (>65 mseg) y la variabilidad de la frecuencia cardíaca (<100 mseg) presentan valores anormales. La utilización de nuevos paradigmas de atención, diagnóstico y tratamientos adecuados son imprescindibles para prevenir el desarrollo de esta cardiopatía.

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Lectotypification, geographic distribution and conservation status of Cephalanthus glabratus (Naucleeae-Rubiaceae)
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Romero, María Florencia

; Salas, Roberto Manuel

; Gonzalez, Ana María

Rodriguésia

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2021, Volume 72 elocation e01452019

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Cephalanthus glabratus é uma espécie imperfeitamente conhecida da família Rubiaceae. Esta é uma planta medicinal muito utilizada pelos habitantes locais em sua área de distribuição, porém até agora tem recebido escassa atenção da comunidade científica, o qual é evidenciado na escassa literatura que trata do táxon. A espécie é um arbusto muito ramificado, com folhas verticiladas, inflorescências em glomérulos, fruto esquizocárpico, uma semente por mericarpo, e sementes com um estrofiolo proeminente e esponjoso. A espécie cresce somente em vegetação de áreas baixas alagáveis e está sempre relacionada às bacias dos principais rios da região, Paraguai, Paraná, Uruguai e Rio da Prata, e, portanto, é fortemente ameaçada pelas atividades humanas ao longo delas (hidrelétricas, desmatamento, avanços das áreas urbanas, redução das zonas úmidas etc.). Seguindo as diretrizes da IUCN e baseado em todos os dados disponíveis de distribuição, classificamos como NT (Near Threatened, quase ameaçada). Apesar de que gênero foi taxonomicamente revisado, a nomenclatura do tipo de Cephalanthus glabratus não foi por enquanto corretamente estudada, portanto, é revisada aqui. Uma descrição detalhada, dados ecológicos e de distribuição são adicionalmente fornecidos.

Abstract Cephalanthus glabratus is an imperfectly known species of the family Rubiaceae. It is a medicinal plant widely used by the locals in its area of distribution, however until now it has received little attention from the scientific community, which is evidenced in the few articles treating the species. The species is a much-branched shrub, with whorled leaves, glomeriform inflorescences, schizocarpic fruits with 1-seeded mericarps, and seeds with a large spongy strophiole. It grows only in the vegetation of the lowlands and is always related to the basins of the main rivers of the region, Paraguay, Paraná, Uruguay and Río de la Plata, and therefore is strongly threatened by the human activities along them (hydroelectric dams, deforestation, advances of urban areas, reduction of the wetlands, etc.). Following IUCN guidelines and all available distributional data, we rated it NT (Near Threatened). Despite the fact that the genus was taxonomically revised, the nomenclatural type of Cephalanthus glabratus was not correctly clarified, so we have done so here. A detailed description, ecological and distributional data are provided.

https://doi.org/10.1590/2175-7860202172045 162 downloads

Relación Dosis de oxígeno-Celeridad en la oxigenación hiperbárica para intoxicación con monóxido de carbono
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Ferreyra, Fernando Ramiro Martinel

; Mastroianni, Clara Isabel

; Sánchez, Verónica Arredondo

; Sánchez, Roberto Sebastián

; Alterini, Pablo

; González, Mauro

; Romero, Feris Delfina

; Arredondo, Carlos Félix

Acta toxicológica argentina

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dec 2020, Volume 28 N. 3 Pages 1 - 10

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract A narrative review that raises a reflection about the role of hyperbaric oxygenation in the recovery of monoxide carbon (CO) poisoning is carried out. A description of the relationship of the pressure of hyperbaric oxygen therapy (HBOT), oxygen dosage, and the delay in its implementation was done. Nine cases of intoxications treated with HBOT at 1.45 ATA due to lack of access to high-pressure HBOT were presented. While additional research is necessary, we suggest that this therapeutic modality at 1.45 ATA (Absolute Atmospheres) should be chosen instead of normobaric oxygen therapy for CO poisoning, and considered when high pressure facilities are not available at reasonable distances.

Resumen Se realiza una revisión narrativa que plantea una reflexión acerca del rol de la oxigenación hiperbárica en la recuperación de los intoxicados con monóxido de carbono (ICO). La relación presión de tratamiento de oxigenación hiperbárica (TOHB), o sea dosis de oxígeno, y demora en su implementación son descriptas en esta revisión. Se presentan 9 casos de pacientes con ICO tratados con TOHB a 1,45 ATA (Atmósferas absolutas) por falta de acceso a TOHB de alta presión. Si bien es necesario investigación adicional, sugerimos que esta modalidad terapéutica a 1,45 ATA para ICO debe ser elegida frente al oxígeno normobárico, y considerada cuando las instalaciones de alta presión no están disponibles a distancias razonables.

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Guía de recomendaciones para el manejo de pacientes pediátricos con enfermedad severa por SARS-CoV-2
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Scheu Goncalves, Christian

; Diettes González, Adriana

; Wegner Araya, Adriana

; Bravo Figueroa, Pablo

; Drago Thibaut, Michelle

; Nalegach Romero, María Elisa

; Castillo Moya, Andrés

; Verscheure Peralta, Felipe

; Acuña Aguirre, Carlos

; Díaz Rubio, Franco

; Ortiz, Paula

; Cordero, Jaime

; Dalmazzo Álvarez, Roberto

; Valverde Goñi, Cristian

; Yunge Bertini, Mauricio

Revista chilena de pediatría

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sep 2020, Volume 91 N. 7 Pages 60 - 74

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract: The appearance of SARS-CoV-2 from December 2019 and its rapid expansion in the world reaching Pandemic status, has become a great challenge for health teams. Although the evidence of infection in children is still scarce compared to that of adults, it has become evident that at the pediatric po pulation level, most of the time the infection is asymptomatic or mild, but not all the patients have this evolution, which has motivated the discussion in the Pediatric Critical Care teams regarding how to face these patients with a more serious disease. This consensus is the result of the work of the Pediatric Intensive Care Branch of the Chilean Society of Pediatrics, collecting the evidence available at the time of the review plus the opinion of national experts in Pediatric Intensive Care. The purpose of these recommendations is to offer teams that care for critically ill pediatric patients a guide for the diagnosis and treatment of patients who evolve with severe COVID 19, which can be applied in all Pediatric UPCs in our country, with special emphasis in those measures that have shown greater effectiveness at the level of diagnostic studies, treatment and care of health personnel.

Resumen: La aparición del SARS-CoV-2 a partir de diciembre de 2019 y su rápida expansión en el mundo alcanzando el estatus de Pandemia, se ha convertido en un gran desafío para los equipos de salud. Aunque la evidencia de la infección en niños aún es escasa comparada a la de los adultos, se ha hecho evidente que a nivel de la población pediátrica, la mayor parte de las veces la infección es asintomática o de curso leve, sin embargo no todos los pacientes tienen esta evolución, lo que ha motivado la discusión en los equipos de Cuidados Criticos Pediátricos respecto a cómo enfrentar estos pacientes con enfermedad grave. Este consenso es fruto del trabajo de la Rama de Cuidados Intensivos Pe diátricos de la Sociedad Chilena de Pediatría, recogiendo la evidencia disponible al momento de la revisión más la opinión de expertos nacionales en Cuidados Intensivos Pediátricos. El propósito de estas recomendaciones, es ofrecer a los equipos que atienden a pacientes críticos pediátricos, una guía para el diagnóstico y tratamiento de pacientes que evolucionen con COVID 19 grave, que puedan ser aplicadas en todas las UPC Pediátricas de nuestro país, haciendo especial énfasis en aquellas medidas que han demostrado mayor efectividad a nivel de estudios diagnósticos, tratamiento y cuidados del personal de salud.

https://doi.org/10.32641/rchped.vi91i7.2550 2119 downloads

10.

Actualización de diagnóstico y tratamiento de la insuficiencia cardíaca de etiología chagásica
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Giménez, Luisa J.

; Mitelman, Jorge E.

; Piñeiro, Daniel J.

; Núñez Burgos, Federico

; Sabra, Ahmad

; Feitosa, Gilson

; de Oliveira Junior, Wilson

; Fernández Chamorro, Felipe Nery Gervacio

; Blandón Calderón, Roberto

; Aguirre, Fernando

; Rosas Andrade, Fernando

; Uriona Villarroel, Juan

; Bulla Fernández, Daniel

; Linárez Ochoa, Nery E.

; Barisani, José Luis

; Romero, Analía

; González, Marcos

; Melnikov, Valery

; Macedo Linares, Ana María

; Buitrago Rodríguez, María Fernanda

; Gutiérrez Perucho, Ernesto

; Justiniano Encina, Juan

; Gutiérrez Sotelo, Oswaldo

; Bonilla, Rafael

; Guzmán Melgar, Ismael

; Almonte, Claudia

; Echeverría Frías, Carlos

; Mendoza, Iván

; Newton-Sánchez, Oscar

; Dones Figueroa, Wistremundo

; Simeone, Andrea

Insuficiencia cardíaca

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sep 2019, Volume 14 N. 3 Pages 96 - 110

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

A doença de Chagas é um importante problema de saúde pública nas Américas, amplamente disseminado em todo o mundo, tanto por migrações externas quanto internas, sendo a insuficiência cardíaca uma das complicações mais graves da cardiomiopatia chagásica, com um impacto severo em ambos os casos. individual como em sua família, não apenas com afetação na qualidade de vida, mas com um número significativo de complicações cardiológicas, como arritmias severas e complexas, acidentes vasculares cerebrais e até mesmo a morte súbita. Também é de alto custo em tratamentos médicos, hospitalizações, uso de dispositivos eletrônicos; transplantes, etc. Um grupo de especialistas latino-americanos realizou uma atualização com base em sua experiência, acompanhada de uma importante revisão bibliográfica, a fim de atualizar os diagnósticos clínicos e complementares usuais e de alta complexidade, bem como os tratamentos atualmente disponíveis para essa complicação, e deve adaptar os mesmos para a disponibilidade de centros de saúde.

Chagas disease is a important public health problem throughout America, extended worldwide, both by external and internal migrations, with heart failure being one of the most serious complications of chagasic cardiomyopathy, with severe repercussions on both the individual and his family, not only with involvement in the quality of life, but with a significant number of cardiological complications such as severe and complex arrhythmias, strokes and even sudden death. As well, It is expensive in medical treatments, hospitalizations, use of electronic devices; transplants, etc. A group of Latin American experts have made an update based on their experience accompanied by an important bibliographic review in order to update the usual clinical and complementary diagnoses and of high complexity, as well as the treatments currently available for this complication, and they must be adapted to the availability of health care centers.

La enfermedad de Chagas es un importante problema de salud pública en toda América, extendida a nivel mundial, tanto por las migraciones externas como las internas, siendo la insuficiencia cardíaca una de las complicaciones más graves de la miocardiopatía chagásica, con severa repercusión tanto en el individuo como en su familia, no sólo con afectación en la calidad de vida, sino con un número importante de complicaciones cardiológicas como las arritmias severas y complejas, los accidentes cerebrovasculares y aun la muerte súbita. También es de alto costo en tratamientos médicos, internaciones, utilización de dispositivos electrónicos; trasplantes, etc. Un grupo de expertos latinoamericanos han realizado una actualización basada en la experiencia del mismo acompañado de una importante revisión bibliográfica con la finalidad de actualizar los diagnósticos clínicos y complementarios habituales y de alta complejidad, así como los tratamientos disponibles actualmente para esta complicación, debiéndose adecuar los mismos a la disponibilidad de los centros de atención sanitaria.

831 downloads

11.

Avaliação do tratamento dos nódulos do hepatocarcinoma nos pacientes em lista de espera para transplante hepático
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Sá, Gustavo Pilotto Domingues

; Carlotto, Jorge Roberto Marcante

; Vicentine, Fernando Pompeu Piza

; Romero, Luiz

; Tejada, Dario Fernandes Perdomo

; Salzedas Netto, Alcides Augusto

; Lopes Filho, Gaspar de Jesus

; Gonzalez, Adriano Miziara

Revista do Colégio Brasileiro de Cirurgiões

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aug 2017, Volume 44 N. 4 Pages 360 - 366

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: comparar o resultado do transplante de fígado por hepatocarcinoma em pacientes submetidos ou não ao tratamento loco-regional e downstaging, em relação à sobrevida e risco de recidiva na fila de transplante. Métodos: estudo retrospectivo dos pacientes portadores de hepatocarcinoma submetidos a transplante hepático na região metropolitana de São Paulo, entre janeiro de 2007 e dezembro de 2011, a partir de doador falecido. A amostra foi constituída de 414 pacientes. Destes, 29 foram incluídos na lista por downstaging. Os demais 385 foram submetidos ou não ao tratamento loco-regional. Resultados: as análises dos 414 prontuários demonstraram um predomínio de pacientes do sexo masculino (79,5%) e com média de idade de 56 anos. O tratamento dos nódulos foi realizado em 56,4% dos pacientes em fila de espera para o transplante. O método mais utilizado foi a quimio-embolização (79%). Os pacientes submetidos ao tratamento loco-regional tiveram redução significativa no tamanho do maior nódulo (p<0,001). Não houve diferença estatística entre grupos com e sem tratamento loco-regional (p=0,744) e em relação à mortalidade entre pacientes incluídos no Critério de Milão ou ao downstaging (p=0,494). Conclusões: não houve diferença na sobrevida e ocorrência de recidiva associadas ao tratamento loco-regional. Os pacientes incluídos através do processo de downstaging apresentaram resultados de sobrevida comparáveis àqueles previamente classificados como Critério de Milão/Brasil.

ABSTRACT Objective: to compare the outcome of liver transplantation for hepatocarcinoma in submitted or not to locoregional treatment and downstaging regarding survival and risk of recurrence in transplant waiting list patients. Methods: retrospective study of patients with hepatocarcinoma undergoing liver transplantation in the metropolitan region of São Paulo, between January 2007 and December 2011, from a deceased donor. The sample consisted of 414 patients. Of these, 29 patients were included in the list by downstaging. The other 385 were submitted or not to locoregional treatment. Results: the analysis of 414 medical records showed a predominance of male patients (79.5%) with average age of 56 years. Treatment of the lesions was performed in 56.4% of patients on the waiting list for transplant. The most commonly used method was chemoembolization (79%). The locoregional patients undergoing treatment had a significant reduction in nodule size greater (p<0.001). There was no statistical difference between groups with and without locoregional treatment (p=0.744) and on mortality among patients enrolled in the Milan criteria or downstaging (p=0.494). Conclusion: there was no difference in survival and recurrence rate associated with locoregional treatment. Patients included by downstaging process had comparable survival results to those previously classified as Milan/Brazil criteria.

https://doi.org/10.1590/0100-69912017004010 2565 downloads

12.

El aprendizaje a través del juego como herramienta en el diseño de actividades de valor añadido en un currículo integrador de Ciencias Biomédicas Básicas
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Rodríguez, Iván

; González, Rocío

; Morales, Gracia

; Azpeleta, Clara

; Monreal, Domingo

; Fernández, Roberto

; Fernández-Santander, Ana

; Palau, Luisa

; Rodríguez-Learte, Ana I

; Romero-Lorca, Alicia

; Santos, Pablo

; Sánchez, Ana

; Gal-Iglesias, Beatriz

FEM: Revista de la Fundación Educación Médica

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feb 2017, Volume 20 N. 1 Pages 23 - 28

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Introduction: The Department of Basic Biomedical Sciences at the Universidad Europea de Madrid is committed to design activities that foster an environment of active and inclusive student-centered learning and contextualized in a professional environment. The aim is to ensure, through an integrated assimilation of fundamental concepts, the student motivation to learn and facilitate the extracurricular knowledge. Subjects and methods: Within our added-value activities, we have designed a play-based activity with students from the first course of the degrees of Medicine, Pharmacy and the double degree Pharmacy-Biotechnology. Using a clinical case related to a cardiovascular disease as a thread, a gymkhana was designed following a workstations working model. The correct resolution of all tasks included in each workstation without delay was finally rewarded. Results: Respondents found the integrated sessions more useful than the traditional seminars and also remarked that they bring up a variety of contents from different subjects successfully (54% positive answers). 58% of the survey participants expressed that the activity approached them new content not covered through the traditional master class. Conclusions: We have ensured that students develop skills required to take their future roles as members of multidisciplinary teams, thanks to the participation of students from different degrees. Moreover, the activity managed to increase motivation and the interest for the most basic concepts of Biomedical Sciences through real integration and direct application to a real clinical case. The experience was evaluated as very positive by all participants.

Introducción: Desde el Departamento de Ciencias Biomédicas Básicas de la Universidad Europea de Madrid optamos por el diseño de actividades que fomenten un entorno de aprendizaje activo e integrador, centrado en el alumno y contextualizado en un entorno profesional. El objetivo es favorecer la asimilación de conceptos fundamentales, motivando al alumno y facilitando el aprendizaje extracurricular. Sujetos y métodos: Dentro de nuestras actividades de valor añadido hemos diseñado una dinámica a través del juego con estudiantes de los primeros cursos de los grados de Medicina, Farmacia y la doble titulación de Farmacia-Biotecnología. Utilizando como hilo conductor un caso clínico relacionado con una enfermedad cardiovascular, se diseñó una yincana con un carácter integrador de disciplinas básicas con diferentes estaciones de trabajo. Se premió la correcta resolución de las tareas incluidas en las estaciones de trabajo en un tiempo establecido. Resultados: Los estudiantes encuestados mostraron su satisfacción con la utilidad de estas sesiones integradas frente a las no integradas, así como con la inclusión de contenidos de diferentes materias (el 54% respondió favorablemente). El 58% de los grupos participantes afirmó que la actividad les acercó a contenidos nuevos. Conclusiones: Con esta actividad se ha aumentado el interés y la motivación de los alumnos por los conceptos más básicos de las ciencias biomédicas, a través de la integración real y la aplicación directa a un caso clínico auténtico. Asimismo, hemos conseguido que los alumnos trabajen competencias necesarias para asumir sus futuros roles como integrantes de equipos multidisciplinares, gracias a la participación de alumnos de grados distintos.

https://doi.org/10.33588/fem.201.871 1210 downloads

13.

Caracterización de pacientes con litiasis vesicular operados por mínimo acceso
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Oliu Lambert, Hernán

; de la Cruz Castillo, Natalia Altagracia

; Piña Prieto, Luis Roberto

; Domínguez González, Erian Jesús

; Romero García, Lázaro Ibrahim

MEDISAN

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sep 2016, Volume 20 N. 9 Pages 2069 - 2076

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Introduction: vesicular lithiasis is the disease of the alimentary tract mostly requiring hospitalization. Objective: to characterize the patients with vesicular lithiasis treated with minimal access surgery. Method: a descriptive and retrospective observational study of 1 271 patients with vesicular lithiasis treated with minimal access surgery at the General Surgery Service from "Saturnino Lora Torres" Teaching Provincial Clinical Surgical Hospital in Santiago de Cuba was carried out from January, 2011 to September, 2014. Results: the female sex (84.1%), the age group 45-65 years (47.7%), as well as the choleperitoneum as iatrogenic lesion of the biliary pathways as main complication and most frequent cause of reintervention prevailed in the series; also, the presence of the chronic vesicular abscess turned out to be the reason of change to open surgery (25.0%) and only 0.2% of the affected patients died. The hospital stay was shorter than 24 hours in 96.6% of the total of patients and 93.8% of the members of the study were operated with a surgical time of 60 minutes or less. Conclusions: there was low incidence of complications, conversions and reinterventions, without prolonged surgical times and a short hospital stay

Introducción: la litiasis vesicular es la enfermedad del tracto alimentario que más requiere de hospitalización. Objetivo: caracterizar a los pacientes operados por litiasis vesicular mediante cirugía de mínimo acceso. Método: se realizó un estudio observacional descriptivo y retrospectivo de 1 271 pacientes con litiasis vesicular operados por mínimo acceso en el Servicio de Cirugía General del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, desde enero de 2011 hasta septiembre de 2014. Resultados: en la serie predominaron el sexo femenino (84,1 %), el grupo etario de 45-65 años (47,7 %), así como el coleperitoneo por lesión iatrogénica de la vía biliar como principal complicación y causa de reintervención más frecuente; asimismo, la presencia del plastrón vesicular crónico resultó ser el motivo de las conversiones a cirugía abierta (25,0 %) y solo falleció 0,2 % de los afectados. La estadía hospitalaria fue menor de 24 horas en 96,6 % del total de pacientes y 93,8 % de los integrantes del estudio fueron operados con un tiempo quirúrgico de 60 minutos o menos. Conclusiones: existió baja incidencia de complicaciones, conversiones y reintervenciones, sin tiempos quirúrgicos prolongados y una corta estadía hospitalaria

14.

Mineral metabolism disorders, vertebral fractures and aortic calcifications in stable kidney transplant recipients: The role of gender (EMITRAL study)
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Torres, Armando

; Torregrosa, Vicens

; Marcen, Roberto

; Campistol, Josep María

; Arias, Manuel

; Hernández, Domingo

; Fernández, Constantino

; Esforzado, Nuria

; Paschoalin, Raphael

; Pérez, Nuria

; García, Ana Isabel

; Amo, Montserrat del

; Pomés, Jaume

; González Rinne, Ana

; Marrero, Domingo

; Pérez, Estefanía

; Henríquez, Fernando

; Díaz, Juan Manuel

; Silva, Irene

; López, Verónica

; Perello, Manuel

; Ramos, David

; Beneyto, Isabel

; Cruzado, José María

; Martínez Castelao, Alberto

; Bravo, Juan

; Rodríguez, Minerva

; Díaz, Carmen

; Crespo, Josep

; Anaya, Fernando

; Rodríguez, María Luisa

; Cubero, Juan José

; Pascual, Pilar

; Romero, Rafael

; Andrés Belmonte, Amado

; Checa, María Dolores

; Jiménez, Carlos

; Escuin, Fernando

; Crespo, Marta

; Mir, Marisa

; Gómez, Gonzalo

; Bayes, Beatriz

; González, María José

; Gutiérrez, Alex

; Cuberes, Marta

; Rodríguez Benoit, Alberto

; García, Teresa

; Llamas, Francisco

; Ortega, Agustín

; Conde, José Luis

; Gómez Alamillo, Carlos

Nefrología (Madrid)

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jun 2016, Volume 36 N. 3 Pages 255 - 267

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Background and objectives: The relationship between mineral metabolism disorders, bone fractures and vascular calcifications in kidney transplant recipients has not been established. Method: We performed a cross-sectional study in 727 stable recipients from 28 Spanish transplant clinics. Mineral metabolism parameters, the semi-quantification of vertebral fractures and abdominal aortic calcifications were determined centrally. Results: Vitamin D deficiency (25OHD3 < 15 ng/ml) was more common in female recipients at CKD-T stages I-III (29.6% vs 44.4%; p = 0.003). The inverse and significant correlation between 25OHD3 and PTH was gender-specific and women exhibited a steeper slope than men (p = 0.01). Vertebral fractures (VFx) with deformity grade ≥2 were observed in 15% of recipients. Factors related to VFx differed by gender; in males, age (OR 1.04; 95% CI 1.01-1.06) and CsA treatment (OR: 3.2; 95% CI: 1.6-6.3); in females, age (OR 1.07; 95% CI: 1.03-1.12) and PTH levels (OR per 100 pg/ml increase: 1.27; 95% CI: 1.043-1.542). Abdominal aortic calcifications were common (67.2%) and related to classical risk factors but not to mineral metabolism parameters. Conclusions: Vitamin D deficiency is more common among female kidney transplant recipients at earlier CKD-T stages, and it contributes to secondary hyperparathyroidism. Prevalent vertebral fractures are only related to high serum PTH levels in female recipients.

resumen está disponible en el texto completo

https://doi.org/10.1016/j.nefro.2016.03.004 345 downloads

15.

Estudios morfo-anatómicos dedomacios foliares en Rubiáceas Argentinas
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Romero, María Florencia

; Salas, Roberto

; Gonzalez, Ana Maria

Boletín de la Sociedad Argentina de Botánica

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dec 2015, Volume 50 N. 4 Pages 493 - 514

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

This paper deals with the study of leaf domatia in Argentine Rubiaceae, which are common morphogenetic structures on the underside of the leaves of woody plants, which can establish mutual relations with mites or ants. Tufts of hair, pockets, cavities and crypts: many families are classified into types common relatively well preserved. Around 290 families of “dicots” have domatia, Rubiaceae being the best represented with all known and transitional types. Domestic classification by molecular data, Rubiaceae divided into three subfamilies: Rubioideae, Ixorideae and Cinchonoideae. In Argentina inhabit 41 genera and 132 species of Rubiaceae, of which 34 are woody (27%). As result, tree domatia types were found: tuft of hair, pockets and crypt, present in 14 species of Rubiaceace. It is mentioned for the first time a domatia in a vine species of Manettia. The results were compared with recent molecular studies; this confirmed the plesiomorphic condition thereof, since different types are common to the three subfamilies almost all the tribes of the family. Based on this sampling, the following tribes completely lack domatia: Anthospermeae, Rubieae, Paederieae and Pavetteae.

Este trabajo estudia los domacios foliares en Rubiáceas argentinas, los cuales son estructuras morfogenéticas frecuentes en el envés de las hojas de plantas leñosas, que permiten establecer relaciones mutualistas con ácaros u hormigas. Se clasifican en tipos relativamente bien conservados comunes a numerosas familias: mechones de pelos, bolsillos, cavidades y criptas. Alrededor de 290 familias de “dicotiledóneas” tienen domacios, siendo Rubiaceae la mejor representada con todos los tipos conocidos y transicionales. La clasificación intrafamiliar según datos moleculares, divide a Rubiaceae en tres subfamilias: Rubioideae, Ixorideae y Cinchonoideae. En Argentina viven 41 géneros y 132 especies de Rubiáceas, de las cuales 34 son leñosas (27%). Como resultado se encontraron tres tipos de domacios: mechón de pelos, bolsillos y en cripta en 14 especies de Rubiáceas. Se menciona por primera vez domacios en una enredadera sufrútice de la familia, en el género Manettia. Los resultados obtenidos fueron contrastados con estudios moleculares recientes, lo que permitió confirmar la condición plesiomórfica de los mismos, ya que los diferentes tipos son comunes a las tres subfamilias y a casi todas las tribus de la familia. Basado en el presente muestreo, las tribus Anthospermeae, Rubieae, Paederieae y Pavetteae carecen completamente de domacios.

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