Resumen El artículo es la presentación del primer procedimiento exútero intraparto (EXIT), realizado en el Hospital Universitario San Ignacio y realizado por un grupo interdisciplinario (anestesiología, otorrinolaringología pediátrica, neonatología y ginecología). La ejecución de la estrategia EXIT es poco frecuente. Su objetivo es asegurar la vía aérea del neonato durante el parto cuando existe riesgo de obstrucción, dada por compresión secundaria a masas cervicales o mediastinales, malformaciones congénitas craneofaciales o de la vía aérea. Esta estrategia busca disminuir el riesgo de mortalidad del neonato. El caso corresponde al de una mujer primigestante de 33 años, con edad gestacional de 38 semanas y diagnóstico a la semana 25 de lesión quística cervical en el feto. Durante la atención del parto se aseguró intraparto la vía aérea del neonato con intubación orotraqueal y, a su vez, se disminuyeron los riesgos de morbimortalidad de la madre. En este caso, se trataba de una malformación vascular linfática macroquística. El objetivo del artículo es destacar que, con una adecuada planeación y diagnóstico prenatal de las malformaciones cervicales, mejora significativamente el pronóstico del paciente, así como sus resultados a corto y largo plazo.

Abstract The present article is the report of the first Ex Utero Intrapartum (EXIT) procedure, carried out at the San Ignacio University Hospital, by an interdisciplinary group (anesthesiologist, pediatric otolaryngologist, neonatologist and obstetrician). The need for an EXIT strategy is rare. Its objective is to secure the newborn's airway during childbirth when there is a risk of airway obstruction that may be caused by secondary compression from cervical or mediastinal masses, congenital craniofacial or airway malformations. The aim of the surgery is to reduce the risk of mortality of the newborn. We present a 33 years old patient with a gestational age of 38 weeks and a diagnosis of cervical cystic lesion in the fetus by gestational week 25. The delivery was performed by securing the neonate’s airway with orotracheal intubation. In this case, a vascular macrocystic lymphatic malformation was confirmed. The objective of the article is to emphasize that proper planning and prenatal diagnosis of cervical malformations significantly improves the patient's prognosis, both in the short and the long term results.

Abstract Introduction Myiasis is a disease causedby fly larvae that growinthetissues of animals and humans. It can cause a variety of local symptoms, like erythema or pain, depending on its location, and generalized symptomatology, such as fever andmalaise.Myiasis can generate severe complications, for instance sepsis, or directly impact vital tissues. Its management varies depending on the location, and on the preferences of the doctor that faces this challenge. Myiasis usually occurs in tropical countries, and, in many places, it is not a rare condition. The cases are rarely reported, and there are no publishedmanagement protocols. Objective To review the literature regarding the most common agents, the predisposing factors and the treatment alternatives for otic myiasis, a rare form of human myiasis caused by the infestation of fly larvae in the ear cavities. Data synthesis We present a systematic review of the literature. The search in five databases (Medline, Embase, Cochrane Database of Systematic Reviews, LILACS and RedALyC) led to 63 published cases from 24 countries, in the 5 continents. The ages of the patients ranged fromnewborn to 65 years old. Themost common agents belong to the Sarcophagidae or Calliphoridae families. Chronic otitis media, previous otic surgical procedures, mental deficit, alcohol or drug abuse, sleeping outdoors, prostration, and malnutrition were predisposing factors. The treatment alternatives are herein discussed. Conclusion The results highlight the need for monitoring, follow-up and standardization of medical approaches.

Resumen Introducción: El hipotiroidismo resulta de una inadecuada producción de hormonas tiroideas. Es conocido que existe una relación entre los trastornos psiquiátricos mayores y el hipotiroidismo. Objetivo: Determinar la prevalencia de hipotiroidismo en los pacientes hospitalizados por trastorno psiquiátrico mayor en la Clínica Montserrat en el periodo de marzo a octubre de 2010. Material y métodos: Se realizó un estudio descriptivo transversal, para el que se seleccionó una muestra de 105 pacientes que ingresaron a la Clínica Montserrat con diagnóstico de trastorno psiquiátrico mayor (depresión mayor, trastorno afectivo bipolar, trastorno de ansiedad generalizada, trastornos de ansiedad, trastorno mixto ansioso-depresivo y esquizofrenia) en el periodo mencionado. Para evaluar el hipotiroidismo se realizó una prueba de Hormona Estimulante del Tiroides (TSH). Resultados: La prevalencia general del hipotiroidismo fue del 10,5% (intervalo de confianza del 95%, 5%-16%). Al determinar el hipotiroidismo por diagnóstico, se encontró que había mayor prevalencia en los trastorno de pánico (12,5%) y depresivo (11,1%) y menor en el trastorno bipolar (10,3%) y la esquizofrenia (9,9%). Conclusiones: La prevalencia general del hipotiroidismo fue menor que en la población general (18,5-4,6%) y se encontró hipotiroidismo en otros trastornos diferentes de la depresión.

Abstract Introduction: Hypothyroidism results from inadequate production of thyroid hormone. It is known that there is a relationship between the major psychiatric disorders and hypothyroidism. Objective: To determine the prevalence of hypothyroidism in patients admitted due to major psychiatric disorders in Montserrat Hospital during the period from March to October 2010. Material and methods: A descriptive cross-sectional study was conducted on 105 patients admitted to Montserrat Hospital with a primary diagnosis of major psychiatric disorder (major depression, bipolar affective disorder, generalised panic disorder, panic disorder, mixed anxiety-depressive disorder, and schizophrenia) in the aforementioned period. Thyroid stimulating hormone (TSH) was performed to assess the evidence of hypothyroidism. Results: The overall prevalence of hypothyroidism was found to be 10.5% (95%CI, 5-16%). It was 12.5% in anxiety disorder, 11.1% in depressive disorder, with a lower prevalence of 10.3% for bipolar disorder, and 9.9% for schizophrenia. Conclusions: The overall prevalence of hypothyroidism was found to be less than in the general population, which is between 4.64% and 18.5%, and hypothyroidism was found in disorders other than depression.

El estudio se realizó en la zona bananera de Urabá (Colombia); con los cvs. Gran Enano y Valery. A partir de la siembra, cada tres a cuatro hojas emitidas, se muestrearon tres plantas por cv., cada una correspondiente a una repetición. Estas se separaron en sus diferentes órganos y se estimó la materia seca total. Se analizó cada cv. a partir de curvas de crecimiento. La acumulación de materia seca en ambos cvs. se ajustó al modelo típico de la curva sigmoidea del crecimiento vegetal. En la fase exponencial, el cormo fue la principal fuente de asimilados para el desarrollo;mientras que en la fase lineal y de senescencia,el pseudotallo y hojas fueron órganos reservorio; al formarse el racimo, tales reservas fueron enviadas a ese sumidero. En general, a medida que avanzaba el desarrollo, los órganos vegetativos no presentaron pérdidas de materia seca, solo disminución en la tasa de acumulación de asimilados;a diferencia del racimo que desde su emisión mantuvo una tasa elevada, llevando a que al momento de la cosecha el fruto, representara cerca del 50% de la materia seca total de la planta.

This research was conducted in the banana zone on Urabá (Colombia), whith cvs. Gran Enano and Valery. Since planting, each three to four leaves sprouted, three plants per variety were sampled, each corresponding to a repetition. These were separated into its different organs and the total dry matter was estimated. Each cv. was analyzed on a growth curve. The dry matter accumulation on both cvs. is adjusted to the typical sigmoid curve of the plant growth. In the exponential phase, the corm was the main source of assimilates for the development; while in the lineal and senescence phase, the pseudo-stem and leaves were the reservoir organs; when the bunch is formed, such reserves were sent to this drain. In general, while the development progressed, the vegetative organs did not show any dry matter lost, only reduction in the assimilates accumulation rate; unlike the bunch that from its emission kept a high rate, leading the fruit to represent, in the harvest season, almost 50% of the total dry matter of the plant.