Abstract Aim The aim of this study was to investigate the isotopic signature of P. brasiliana captured in three different points along the river flow toward the sea of the Prumirim River, northern coast of the state of São Paulo/Brazil in order to test the hypothesis of similarity between isotopic signature of individuals living in separated areas of the river. Methods We used stable isotope analyses (δ13C and δ15N) at three points of the river and ANOVA and Bayesian Ellipses analyses were performed. Results Our results showed that are a differential isotopic enrichment along the river course in 13C, providing important results on the environmental condition and anthropogenic impacts in the region. In addition, the food biology of P. brasiliana was characterized as a primary consumer corroborating with the detritivores feeding habit observed in previous studies of stomach content analysis. Conclusions Our research, limited to a single area along the northern coast of the state of São Paulo, uncovers intriguing findings that merit replication in other areas within the region. This is particularly crucial given the rising number of anthropogenic influences resulting from urban development, underscoring the need for improved monitoring of these areas. P River PauloBrazil Paulo Brazil δ13C δC δ C δ15N δN N performed 13C region addition analysis research development

Resumo Objetivo O objetivo deste estudo foi investigar a assinatura isotópica de P. brasiliana capturada em três diferentes pontos ao longo do fluxo fluvial em direção ao mar do rio Prumirim com a finalidade de testar a hipótese de similaridade entre a assinatura isotópica de indivíduos que vivem em areas diferentes do rio. Métodos Foram utilizadas análises de isótopos estáveis (δ13C e δ15N) em três pontos do rio e foram realizadas análises de Stable Isotope Mixing Models e Bayesian Ellipses. Resultados Nossos resultados mostraram que há um enriquecimento isotópico diferencial ao longo do curso do rio em 13C, fornecendo resultados importantes sobre as condições ambientais e os impactos antropogênicos na região. Além disso, a biologia alimentar de P. brasiliana foi caracterizada como um consumidor primário, corroborando com o hábito alimentar de detritívoros observado em estudos anteriores de análise de conteúdo estomacal. Conclusões Nossa pesquisa, limitada a uma única área ao longo da costa norte do estado de São Paulo, revela descobertas intrigantes que merecem ser replicadas em outras áreas dentro da região. Isso é especialmente crucial dada a crescente quantidade de influências antropogênicas resultantes do desenvolvimento urbano, ressaltando a necessidade de um monitoramento aprimorado dessas áreas. P δ13C δC δ C δ15N δN N Ellipses 13C região disso primário estomacal pesquisa Paulo urbano

ABSTRACT Introduction: Salivary gland tumors are rare malignant neoplasms, with a higher incidence in the parotid gland. Despite their low incidence, the possible complications derived from them can lead to high comorbidity in patients. Methods: We conducted a retrospective, observational and descriptive study of 105 patients diagnosed with malignant neoplasms of the salivary glands at the Hospital Universitario La Paz. 102 correspond to primary tumors and 3 of them are metastases of pulmonary origin. Results: In our series the parotid gland is the most frequent site. Histologically, adenoid cystic carcinoma is the most common tumor. The 75.23 % of the patients were diagnosed with cytology by fine needle aspiration and puncture (FNA), and the remaining cases with biopsy. The most indicated treatment was surgery, especially for tumors of epithelial lineage. Some 33.5 % received adjuvant treatment. Some 18 % of the patients who suffered post-surgical complications presented facial paralysis. During the course of the disease, 23.80 % of the total developed distant metastases, the lung being the most affected organ. Of the patients, 26.66 % suffered at least one recurrence. Survival at 2 years was 87.6 % and at 5 years 75.3 %. Discussion: Unlike other studies, in our case the most frequent lineage of salivary glands tumors is adenoid cystic carcinoma. This could be explained because our hospital is a reference in facial paralysis. One of the most important points in the management of these patients is not only the local and distant control of the tumor, but also the treatment of possible sequelae.

RESUMEN Introducción: Los tumores malignos de glándulas salivares son neoplasias malignas poco frecuentes, con una mayor incidencia en la glándula parótida. A pesar de su baja incidencia, las posibles complicaciones derivadas de los mismos pueden conllevar gran comorbilidad en los pacientes. Material y métodos: Hemos realizado un estudio retrospectivo, observacional y descriptivo de 105 pacientes con diagnóstico de neoplasias malignas de glándulas salivales en el Hospital Universitario La Paz. 102 corresponden a tumores primarios y 3 de ellos son metástasis de origen pulmonar. Resultados: En nuestra serie la glándula parótida es el lugar de asiento más frecuente. Histológicamente, el carcinoma adenoide quístico es el tumor más común. El 75,23 % de los pacientes fueron diagnosticados con una citología mediante punción y aspiración con aguja fina (PAAF), y los restantes casos con una biopsia. El tratamiento más indicado fue la cirugía, sobre todo para aquellos tumores de estirpe epitelial. Un 33,5 % recibió tratamiento adyuvante. Un 18 % de los pacientes que sufrieron complicaciones postquirúrgicas presentó parálisis facial. Durante el desarrollo de la enfermedad, el 23,80 % del total desarrolló metástasis a distancia, siendo el pulmón el órgano más afectado. El 26,66 % de los pacientes sufrió al menos una recidiva. La supervivencia a los 2 años fue del 87,7 % y a los 5 años del 75,5 %. Discusión: A diferencia de otros estudios, en nuestro caso la estirpe más frecuente es el carcinoma adenoide quístico, lo cual podría explicarse porque se trata de un hospital de referencia para el tratamiento de la parálisis facial. Uno de los puntos más importantes en el manejo de estos pacientes es, no solo el control locorregional y a distancia, sino también el tratamiento de las posibles secuelas.

ABSTRACT Ejaculate allocation patterns vary widely among species and often depend on characteristics of the individual. However, it is poorly known whether ejaculate allocation patterns change in response to distinct ontogenetic stages (i.e., adolescent vs. adult). The present study aims to describe the mating process and test variations in ejaculate allocation in response to the ontogenetic stage of the Chilean kelp crab Taliepus dentatus (H. Milne Edwards, 1834). Mating consists of the following sequence: (1) pre-copulatory guarding (i.e., male grasping female and/or caging female between legs), (2) copulation in sternum-to-sternum position, and (3) post-copulatory guarding (i.e., male grasping female or carrying her around by the chelae). The mating behavior and ejaculate allocation pattern differed between the two contrasting male ontogenetic stages. Adolescent males generally delivered less ejaculate in repeated short copulations and adult males transferred more ejaculate in a single extended copulation. Ejaculate allocation in adolescents was dependent on female size, but not so in adults. Variation in the ejaculate allocation pattern may be common in species with contrasting male ontogenetic stages, where less competitive males (i.e., adolescents) economize their limited seminal reserves. Conversely, adults which have a greater capacity to produce seminal material (fluids + spermatozoa) may invest greater quantities of seminal material.

ABSTRACT Introduction: Restoration of normal orbital volume and globe position following traumatic injury is often difficult. Intraoperative navigation has emerged as a tool to allow the visualization of the implant position intraoperatively, by means of the planification in the preoperative computed-tomographic scan (CT scan). Objectives: The aim of this study was to compare the postoperative changes in orbital volume between two groups of study: one group that underwent surgical intervention before the implementation of intraoperative navigation (control group), and other group of patients which had undergone surgery with the aid of a navigation system (Software iPlan CMF version 3.0.5, Brainlab(r), Feldkirchen, Germany) (navigation group). Another endpoint of our study was to determine it the presurgical planification and intraoperative navigation aided to position the implant. For that purpose, we determined the implant position with respect to the orbital floor and medial orbital wall and compared it between both groups of study. As secondary endpoints, we compared the rate of postoperative outcomes and reintervention rate between both groups. Materials and methods: A retrospective cohort study was designed. We selected a total of 35 consecutive orbital operations for unilateral orbital fractures performed between 2015 and 2018 at the Department of Oral and Maxillofacial Surgery in La Paz Hospital (Madrid), Spain. We collected information regarding: demographic data, cause of the fracture, time elapsed between diagnosis and surgical treatment, symptoms at diagnosis (diplopia, globe projection, ocular motility impairment), radiological findings (affected wall, muscular entrapment, herniation of the periorbital structures), and outcomes after surgical treatment (diplopia, globe position, ocular motility impairment, reintervention). By means of the iPlan CMF software, the orbital volume was determined in the preoperativeand postoperative CT scan. The plate position was determined by measuring the distance between the plate and the orbital rim, the distance between the plate and the residual posterior intact bony ledge and the distance between the plate and the medial orbital wall. Measurements were performed automatically in the three planes of space, although we used the sagital plane to measure the distance between the plate and the orbital rim and between the plate and the residual posterior intact bony ledge. To measure the distance between the plate and the medial orbital wall we used the axial plane. Results: After surgery, we observed that abnormal globe position was significatively less frequent in the navigation group than in the control group (p = 0.029). The reoperation rate was 11 % in the navigation group and 35% in the control group (p = 0.071). Mean orbital volume of the unaffected orbit was 29.32 ± 2.64 cm3 in the navigation group and 28.64 ± 2.68 cm3 in the control group. Mean orbital volume of the affected orbit was 34.19 ± 3.67 cm3 in the navigation group and 32.78 ± 3.09 cm3 in the control group. Mean reconstructed orbital volume was 29.47 ± 2.75 cm3 in the navigation group and 28.88 ± 3.72 cm3 in the control group. Mean volume reduction and the mean difference in volume between unaffected and reconstructed side did not show significative differences between both groups. The mean distance from plate to orbital floor at the residual posterior intact bony ledge showed significative differences (p = 0.001), being inferior in the navigation group. Conclusions: The use of intraoperative navigation in orbital fractures is effective in improving plate positioning in the residual posterior intact bony ledge of the floor of the orbit, reducing complications such as enophthalmos compared to conventional surgery. Furthermore, the use of intraoperative navigation seems to decrease the rate of reintervention compared to conventional surgery. The restoration of orbital volume seems to be well addressed by both methods.

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ABSTRACT The outbreak caused by the SARS-CoV-2 virus is currently very active in Spain. Many infected people still require to be hospitalized. Around 10-15 % of hospitalized patients require intensive care, where they are intubated for a prolonged period, needing tracheotomies some weeks after the intubation. We will be conducting an observational study of the tracheotomies performed by our oral and maxillofacial Department to COVID-19 patients on intensive care units between March 17th and April 17th, 2020. This study will be analyzing the patients' epidemiological and clinical aspects, surgical technique employed, surgical time, type of cannula used, postoperative complications and the patients' clinical monitoring. A total of 22 patients underwent open elective tracheotomy. There were twenty-two males and three females aged between 40 and 77 (mean: 64,9 years-old). In all cases tracheotomy was carried out due to pulmonary process caused by COVID-19 bilateral pneumonia. Two patients presented pneumothorax in the immediate postoperatory care as a complication, one perished during the procedure and another did so after arriving to the Intensive Care Unit after the tracheotomy surgery. Even though tracheotomy is a ruled surgical technique, the special characteristics of COVID-19 patients make of this procedure a critical situation, mainly due to lung instability and quick desaturation of the patients. This requires the surgery to be carried out by experienced physicians in order to reduce operative time and to be able to react to any eventualities that may arise.

RESUMEN El brote epidémico causado por el virus SARS-CoV-2 se encuentra plenamente activo en España. Alrededor del 10-15 % de los pacientes ingresados precisan cuidados en unidades de críticos, siendo intubados de forma prolongada y precisando la realización de traqueotomías. Se realiza un estudio observacional de las traqueotomías realizadas por nuestro Servicio de Cirugía Oral y Maxilofacial a pacientes COVID-19 de unidades de cuidados intensivos realizadas entre el 17 de marzo y el 17 de abril de 2020. El estudio analiza aspectos epidemiológicos y clínicos de los pacientes, el tipo de técnica quirúrgica empleada, el tiempo quirúrgico, el tipo de cánula empleada, las complicaciones postquirúrgicas y el seguimiento clínico de los pacientes. Un total de 22 pacientes fueron sometidos a traquetomía reglada abierta. Fueron dieciocho hombres y cuatro mujeres de edades entre 40 y 77 años (64,9 años de media). En todos los casos la realización de traqueotomía fue como consecuencia del proceso pulmonar por la neumonia bilateral COVID-19. Dos pacientes presentaron un neumotórax en el postoperatorio inmediato como complicación, un paciente falleció durante la realización del procedimiento y otro tras su llegada a la Unidad de Cuidados Intensivos tras la realización de la traqueotomía. A pesar de que la traqueotomía es una técnica quirúrgica reglada, las características especiales de los pacientes COVID-19 hacen de este procedimiento una situación crítica por la inestabilidad pulmonar y la rápida desaturación del paciente. Todo ello obliga a la realización del procedimiento por facultativos con experiencia para disminuir el tiempo quirúrgico y poder enfrentarse a cualquier eventualidad.

Abstract Introduction: a survey on peri-operative nutritional support in pancreatic and biliary surgery among Spanish hospitals in 2007 showed that few surgical groups followed the 2006 ESPEN guidelines. Ten years later we sent a questionnaire to check the current situation. Methods: a questionnaire with 21 items sent to 38 centers, related to fasting time before and after surgery, nutritional screening use and type, time and type of peri-operative nutritional support, and number of procedures. Results: thirty-four institutions responded. The median number of pancreatic resections (head/total) was 29.5 (95 % CI: 23.0-35; range, 5-68) (total, 1002); of surgeries for biliary malignancies (non-pancreatic), 9.8 (95 % CI: 7.3-12.4; range, 2-30); and of main biliary resections for benign conditions, 10.4 (95 % CI: 7.6-13.3; range, 2-33). Before surgery, only 41.2 % of the sites used nutritional support (< 50 % used any nutritional screening procedure). The mean duration of preoperative fasting for solid foods was 9.3 h (range, 6-24 h); it was 6.6 h for liquids (range, 2-12). Following pancreatic surgery, 29.4 % tried to use early oral feeding, but 88.2 % of the surveyed teams used some nutritional support; 26.5 % of respondents used TPN in 100 % of cases. Different percentages of TPN and EN were used in the other centers. In malignant biliary surgery, 22.6 % used TPN always, and EN in 19.3 % of cases. Conclusions: TPN is the commonest nutrition approach after pancreatic head surgery. Only 29.4 % of the units used early oral feeding, and 32.3 % used EN; 22.6 % used TPN regularly after surgery for malignant biliary tumours. The 2006 ESPEN guideline recommendations are not regularly followed 12 years after their publication in our country.

Resumen Introducción: realizamos una encuesta sobre soporte nutricional perioperatorio en cirugía pancreática y biliar en hospitales españoles en 2007, que mostró que pocos grupos quirúrgicos seguían las guías de ESPEN 2006. Diez años después enviamos un cuestionario para comprobar la situación actual. Métodos: treinta y ocho centros recibieron un cuestionario con 21 preguntas sobre tiempo de ayunas antes y después de la cirugía, cribado nutricional, duración y tipo de soporte nutricional perioperatorio, y número de procedimientos. Resultados: respondieron 34 grupos. La mediana de pancreatectomías (cabeza/total) fue de 29,5 (IC 95 %: 23,0-35; rango, 5-68) (total, 1002), la de cirugías biliares malignas de 9,8 (IC 95 %: 7,3-12,4; rango, 2-30) y la de resecciones biliares por patología benigna de 10,4 (IC 95 %: 7,6-13,3; rango, 2-33). Solo el 41,2 % de los grupos utilizaban soporte nutricional antes de la cirugía (< 50 % habian efectuado un cribado nutricional). El tiempo medio de ayuno preoperatorio para sólidos fue de 9,3 h (rango, 6-24 h), y de 6,6 h para líquidos (rango, 2-12). Tras la pancreatectomía, el 29,4 % habían intentado administrar una dieta oral precoz, pero el 88,2 % de los grupos usaron algún tipo de soporte nutricional y el 26,5 % usaron NP en el 100 % de los casos. Los demás grupos usaron diferentes porcentajes de NP y NE en sus casos. En la cirugía biliar maligna, el 22,6 % utilizaron NP siempre y NE en el 19,3 % de los casos. Conclusiones: la NP es el soporte nutricional más utilizado tras la cirugía de cabeza pancreática. Solo el 29,4 % de las unidades usan nutrición oral precoz y el 32,3 % emplean la NE tras este tipo de cirugía. El 22,6 % de las instituciones usan NP habitualmente tras la cirugía de tumores biliares malignos. Las guías ESPEN 2006 no se siguen de forma habitual en nuestro país tras más de 10 años desde su publicación.

Objective: To determine the effect exerted by the administration of heme iron and ferrous sulfate with vitamin C in rat liver and brain. Materials and methods: The study used Holtzman albino rats housed in a bioterium with a temperature of 22 ± 2 °C, humidity between 50 and 70 %, and 12 hours of light and 12 hours of darkness. They received elemental iron 4.0 mg/kg b.w. as heme iron or ferrous sulfate + vitamin C 10 mg for seven days, at which time they were sacrificed, and blood, liver and brain were extracted. Histological sections were made and treated with hematoxylin-eosin for microscopic observation, and serum antioxidant capacity was measured. Results: The brains of the rats treated with heme iron and ferrous sulfate + vitamin C did not undergo significant changes, while the histological sections of the livers of the rats treated with heme iron showed a parenchyma without polar distribution, some nuclei lacking cytoplasm and numerous Küpffer cells at the sinusoidal level. In contrast, the rats treated with ferrous sulfate + vitamin C had a significantly deteriorated hepatic parenchyma, some areas with loose nuclei without cytoplasm and others with disappeared cytoplasmic membranes. In addition, in some areas, the liver parenchyma was homogenized. Conclusions: The brains of the rats treated with heme iron and those with ferrous sulfate + vitamin C did not practically undergo any change. In contrast, the liver of the rats treated with ferrous sulfate + vitamin C had greater liver damage than those treated with heme iron

Objetivo: Determinar el efecto que ejerce la administración de hierro hemo y la de sulfato ferroso con vitamina C en hígado y cerebro de rata. Materiales y métodos: Se utilizaron ratas albinas Holtzman mantenidas en un bioterio con temperatura de 22 ± 2° C, humedad entre 50 y 70 % y 12 horas de luz y 12 horas de oscuridad, que recibieron 4,0 mg de hierro elemental/ kg p.c. bajo la forma de hierro hemo o como sulfato ferroso + 10 mg de vitamina C durante siete días, a cuyo término se sacrificaron y se les extrajo sangre, hígado y cerebro. Se hicieron los cortes histológicos que se trataron con hematoxilina-eosina para la observación microscópica y en el suero se midió la capacidad antioxidante. Resultados: Los cerebros de las ratas que recibieron tratamiento con hierro hemo y sulfato ferroso + vitamina C no sufrieron alteraciones significativas, mientras que los cortes histológicos de hígado de ratas tratadas con hierro hemo mostraron un parénquima sin distribución polar, algunos núcleos carentes de citoplasma y numerosas células de Küpffer a nivel del sinusoide. En cambio, las ratas que fueron tratadas con sulfato ferroso + vitamina C presentaron un parénquima hepático deteriorado notablemente, algunas áreas con núcleos sueltos sin citoplasma y otras con citoplasma cuya membrana había desaparecido. Además, en algunas zonas, el parénquima hepático se encontraba homogenizado. Conclusiones: Los cerebros de las ratas tratadas con hierro hemo y las que recibieron sulfato ferroso + vitamina C prácticamente no sufrieron modificación alguna, en cambio, el hígado de las ratas tratadas con sulfato ferroso + vitamina C presentaron mayor daño hepático que las tratadas con hierro hemo.

Objective: To determine the effect of vitamin C on ferrous sulfate, the active ingredient of an antianemic syrup. Materials and methods: The reaction between the ferrous sulfate contained in an antianemic syrup and vitamin C was determined using the decomposition technique of deoxyribose, which evaluates the formation of malondialdehyde by the action of free radicals. Results: In an assay medium consisting of 50 mM phosphate buffer (pH 7.4), the ferrous sulfate antianemic syrup at a concentration of 1.080 mM reacted with vitamin C at concentrations between 5.0 x 10-6 mM and 0.5 mM, generating levels of free radicals that decrease when vitamin C is used at a concentration of 5.0 x 10-2 mM, and increase at a concentration of 0.5 mM. When ferrous sulfate is used under similar conditions, an increase in the generation of free radicals is observed, which reaches a maximum value with vitamin C at a concentration of 5.0 x 10-6 mM, remains unchanged at concentrations of two orders of magnitude higher, and subsequently decreases at higher concentrations. Vitamin C at a concentration of 1.0 mM reacts with ferrous sulfate used at concentrations between 0.270 and 2.160 mM, describing a hyperbolic curve. In contrast, ferrous sulfate syrup used at the same concentrations showed a high increase at low non-linear concentrations, but a linear response from the 0.540 mM concentration of the syrup, a response that was higher than that reached by the ferrous sulfate dissolved in distilled water. Conclusions: Vitamin C reacts with ferrous sulfate syrup generating free radicals. This response depends on the relative concentrations of ferrous sulfate, vitamin C and syrup excipients.

Objetivo: Determinar el efecto que ejerce la vitamina C sobre el sulfato ferroso, principio activo de un jarabe antianémico. Materiales y métodos: La reacción que se produce entre el sulfato ferroso de un jarabe antianémico y la vitamina C se determinó al aplicar la técnica de descomposición de la desoxirribosa, que evalúa la formación de malondialdehído por acción de radicales libres. Resultados: En un medio de ensayo constituido por tampón fosfato 50 mM (pH 7,4), el jarabe antianémico de sulfato ferroso a una concentración 1,080 mM reaccionó con la vitamina C en concentraciones comprendidas entre 5,0 x 10-6 mM y 0,5 mM, generando radicales libres que disminuyen cuando se utiliza una concentración de vitamina C de 5,0 x 10-2 mM mientras que a una concentración 0,5 mM, se eleva. Cuando se usa sulfato ferroso en condiciones similares se aprecia un incremento de la generación de radicales libres que alcanza un valor máximo a una concentración de vitamina C de 5,0 x 10-6 mM que se mantiene invariable a concentraciones de dos órdenes de magnitud mayor y, ulteriormente, decrece a concentraciones más elevadas. La vitamina C a una concentración 1,0 mM reacciona con el sulfato ferroso utilizado en concentraciones comprendidas entre 0,270 y 2,160 mM describiendo una curva de tipo hiperbólica. En cambio, el jarabe de sulfato ferroso, utilizado en las mismas concentraciones, mostró un elevado incremento a bajas concentraciones de tipo no lineal pero que tuvo una respuesta lineal a partir de la concentración 0,540 mM del jarabe, respuesta que fue mayor a la alcanzada por el sulfato ferroso disuelto en agua destilada. Conclusiones: La vitamina C reacciona con el jarabe de sulfato ferroso y genera radicales libres, esta respuesta depende de las concentraciones relativas de sulfato ferroso, vitamina C y de los excipientes del jarabe.

Resumen En el presente artículo, estudio la evolución del gasto militar en el Estado de Bolívar, entre los años de 1859 y 1886, durante los gobiernos del liberalismo radical en los Estados Unidos de Colombia. Para ello, compilé a través de la Gaceta de Bolívar y otros documentos oficiales, los presupuestos públicos anuales del Estado, centrando mi interés en analizar el gasto en el departamento administrativo de la milicia. Mi objetivo principal es mostrar, cómo las políticas del liberalismo radical se enfocaron en la descentralización fiscal y militar, con el fin de fortalecer a los poderes locales, cediéndole a las élites regionales el control y la administración de los recursos del Estado de Bolívar y de su milicia. Para lograr este objetivo, indagué por las formas de financiación de la milicia del Estado y los gastos internos para su funcionamiento, dando cuenta de la escasa partida presupuestal para pagar sueldos, material de guerra, educación y sanidad militar, lo que conllevó a que en la práctica la milicia estatal reclamara de la sociedad a través de recursos privados, las expropiaciones y los empréstitos, los rubros necesarios para su organización y funcionamiento.

Summary This article studies the evolution of military expense in the State of Bolívar between the years of 1859 and 1889, during the governments of radical liberalism in the United States of Colombia. The data for this research was compiled from the Gaceta de Bolívar and other official documents, such as the public annual budgets of the State. The interest of this research was the expense analysis of the administrative department of the milicia. The main objective was to demostrate how the politics of radical liberalism focused on fiscal and military descentralization, with the aim of strengthening local powers, handing over the control and administration of the financial resources of the State of Bolívar and its milicia to the regional elite. For this purpose, this research analyzes the forms of financing in the State militia and the internal costs of its functioning, accounting for the scarce budget allocation for paying wages, war material, military education and health service. This led to a practice by which the State militia demanded private funding from society in order to cover expropriations and loans, the necessary budget lines for its organization and operation.

Résumé Dans cet article nous étudions les dépenses militaires de l'État de Bolivar entre 1859 et 1886 au temps du libéralisme radical des Etats-Unis de Colombie. Pour analyser les dépenses du département administratif de la milice, nous avons collecté dans la Gaceta de Bolívar et dans d'autres documents oficiels les budgets publics annuels de l'État. Notre but est de montrer comment les politiques du libéralisme radical, qui se distinguaient par la décentralisation iscal et militaire, ont permis de renforcer les pouvoirs locaux et de concéder aux élites régionales le contrôle et à la gestion des ressources de l'État de Bolivar et de sa milice. Pour ce faire, nous avons cherché à connaitre les formes de financement de la milice de l'État et son fonctionnement en détail, ce qui nous a emmené à constater que les rubriques budgétaires allouées aux salaires, au matériel de guerre, à l'éducation et à la santé militaire étaient clairement insuffisantes et que la milice de l'État devait recourir à la société, par le biais des ressources privés, expropriations et emprunts, pour obtenir l'argent nécessaire à son organisation et fonctionnement.

Introduction: Different blood gas criteria have been used in the diagnosis of hepatopulmonary syndrome (HPS). Patients and methods: Arterial blood gases were prospectively evaluated in 194 cirrhotic candidates for liver transplantation (LT) in the supine and seated position. Three blood gas criteria were analyzed: classic (partial pressure of oxygen [PaO2] < 70 mmHg and/or alveolar-arterial gradient of oxygen [A-a PO2] ≥ 20 mmHg), modern (A-a PO2 ≥ 15 mmHg or ≥ 20 mmHg in patients over 64) and the A-a PO2 ≥ threshold value adjusted for age. Results: The prevalence of HPS in the supine and seated position was 27.8% and 23.2% (classic), 34% and 25.3% (modern) and 22.2% and 19% (adjusted for age), respectively. The proportion of severe and very severe cases increased in a seated position (11/49 [22.4%] vs 5/66 [7.6%], p = 0.02). No difference was observed in the pre-LT, post-LT and overall mortality in patients with HPS, regardless of the criteria used. Conclusion: Obtaining blood gas measurements in the supine position and the use of modern criteria are more sensitive for the diagnosis of HPS. Blood gas analysis with the patient seated detects a greater number of severe and very severe cases. The presence of HPS was not associated with an increase in mortality regardless of blood gas criterion used.

Cystic pancreatic neuroendocrine tumors represent 13% of all neuroendocrine tumors. The aim of this study is to analyze the phenotype and biologic behavior of resected cystic neuroendocrine tumors. A systematic review and meta-analysis were conducted until September 2016 using a search in Medline, Scopus, and EMBASE with the terms "cystic pancreatic endocrine neoplasm", "cystic islets tumors" and "cystic islets neoplasms". From the 795 citations recovered 80 studies reporting on 431 patients were selected. 87.1% (n = 387) were sporadic tumors and 10.3% (n = 40) corresponded to multiple endocrine neoplasia type 1. Were diagnosed incidentally 44.6% (n = 135). Cytology was found to have a sensitivity of 78.5%. Were non-functional tumors 85% (n = 338), and among the functional tumors, insulinoma was the most frequent. According to the European Neuroendocrine Tumor Society staging, 87.8% were limited to the pancreas (I-IIb), and 12.2% were advanced (III-IV). Disease-free survival at 5 years in stages (I-IIIa) and (IIIb-IV) was 91.5% and 54.2%, respectively; and was significantly lower (p = 0.0001) in functional tumors. In patients with multiple endocrine neoplasia there was a higher incidence of functional (62.5%) and multifocal (28.1%) tumors. Disease-free survival at 5 and 10 years was 60%. Cystic pancreatic neuroendocrine tumors exhibit phenotypical characteristics which are different to those of solid neuroendocrine tumors.

Los tumores quísticos neuroendocrinos representan entre el 13% de los tumores neuroendocrinos de páncreas. El objetivo del trabajo es realizar una revisión sistemática y un metaanálisis de las series de casos descritas. Se realizó una revisión sistemática hasta septiembre de 2016 mediante una búsqueda en Medline, Scopus y EMBASE con los términos: "cystic pancreatic endocrine neoplasm", "cystic islets tumors" y "cystic islets neoplasms". De 795 citas se seleccionaron 80 estudios que describían 431 pacientes, incluyendo 5 casos propios. El 87,1% (n = 387) eran tumores esporádicos y el 10,3% (n = 40) correspondían a neoplasia endocrina múltiple tipo 1. El 44,6% (n = 135) fueron diagnosticados de forma incidental. La citología mostró una sensibilidad del 78,5%. El 85% (n = 338) eran tumores no funcionantes; y el insulinoma fue el más frecuente entre los funcionantes. Según la estadificación European Neuroendocrine Tumor Society, el 87,8% estaban limitados al páncreas (I-IIb) y el 12,2% eran avanzados (III-IV). La supervivencia libre de enfermedad a los 5 años en estadios (I-IIIa) y en los estadios (IIIb-IV) fue del 91,5% y 54,2% respectivamente; y fue significativamente menor (p = 0,0001) en los tumores funcionantes. En los pacientes con MEN-1 hubo mayor incidencia de funcionantes (62,5%) y multicéntricos (28,1%). Los tumores quísticos neuroendocrinos de páncreas expresan un fenotipo diferente a los tumores endocrinos sólidos, pero tienen un pronóstico similar, tras la resección a excepción de los tumores hereditarios.

Background: The macro-aggregated albumin lung perfusion scan (99mTc-MAA) is a diagnostic method for hepatopulmonary syndrome (HPS). Aim: To determine the sensitivity of 99mTc-MAA in diagnosing HPS, to establish the utility of 99mTc-MAA in determining the influence of HPS on hypoxemia in patients with concomitant pulmonary disease and to determine the correlation between 99mTc-MAA values and other respiratory parameters. Methods: Data from 115 cirrhotic patients who were eligible for liver transplantation (LT) were prospectively analyzed. A transthoracic contrast echocardiography and 99mTc-MAA were performed in 85 patients, and 74 patients were diagnosed with HPS. Results: The overall sensitivity of 99mTc-MAA for the diagnosis of HPS was 18.9% (14/74) in all of the HPS cases and 66.7% (4/6) in the severe to very severe cases. In HPS patients who did not have lung disease, the degree of brain uptake of 99mTc-MAA was correlated with the alveolar-arterial oxygen gradient (A-a PO2) (r = 0.32, p < 0.05) and estimated oxygen shunt (r = 0.41, p < 0.05) and inversely correlated with partial pressure of arterial oxygen (PaO2) while breathing 100% O2 (r = -0.43, p < 0.05). The 99mTc-MAA was positive in 20.6% (7/36) of the patients with HPS and lung disease. The brain uptake of 99mTc-MAA was not associated with mortality and normalized in all cases six months after LT. Conclusions: The 99mTc-MAA is a low sensitivity test for the diagnosis of HPS that can be useful in patients who have concomitant lung disease and in severe to very severe cases of HPS. It was not related to mortality, and brain uptake normalized after LT.

In the present study we have proposed a theoretical model based on Kopelman, Brief & Guzzo's model (1990), in which transformational leadership is positioned as an antecedent of organizational climate, and the psychological capital, as a consequence of that climate. The theoretical model was tested using structural equations in a sample of 277 employees of a public Administration. The good fit of the data according to the revised goodness of fit indexes, both in the confirmatory analysis for each variable and in the structural model statistically validates our theoretical model, accepting the study hypotheses. This makes clear the need for the Administration to propose transformational leadership measures at the individual, team and organizational levels to strengthen the achievement of positive outcomes through positives organizational climate and psychological capital.

En el presente estudio se muestra una propuesta teórica basada en el modelo de Kopelman, Brief y Guzzo (1990) en la que se ha posicionado al liderazgo transformacional como antecedente del clima organizacional, y al capital psicológico como consecuente de dicho clima. Nuestra propuesta ha sido probada haciendo uso de ecuaciones estructurales en una muestra compuesta por 277 empleados de una Administración pública. El buen ajuste de los datos según los índices de bondad de ajuste revisados, tanto en los análisis confirmatorios para cada variable como del modelo estructural final valida estadísticamente nuestra propuesta teórica, aceptándose las hipótesis de estudio. Se hace de esta manera evidente la necesidad de que la Administración plantee medidas basadas en el liderazgo transformacional a nivel individual, de equipos de trabajo y de organización para fortalecer la consecución de resultados organizacionales positivos a través de un clima organizacional y un capital psicológico positivos.