Resumen Antecedentes. La primera monografía del género Viguiera fue publicada en 1918 por Blake, incluyendo alrededor de 141 especies. Schilling & Panero en sus estudios sobre la Subtribu Helianthinae (Tribu Heliantheae) basados en secuencias moleculares de los Espaciadores nucleares Transcritos Interno y Externos, así como de cpDNA, proponen reclasificar al género reubicando sus especies en al menos otros nueve géneros. Pregunta: ¿Es posible identificar patrones distintivos entre las especies de la nueva clasificación de Viguiera s. l. y los resultados obtenidos de los estudios químicos reportados? Especies consideradas: Sesenta y siete especies en la circunscripción amplia de Viguiera con estudios químicos y actividades biológicas informados. Resultados: Las especies del género Viguiera s.l. sintetizan terpenoides, representados principalmente por lactonas sesquiterpénicas y diterpenos, aunque también se reportan triterpenos, poliacetilenos, terpenoides volátiles y flavonoides. En todas las especies estudiadas se obtuvieron los principales tipos de metabolitos, siendo algunos más frecuentes que otros en ciertos clados. Conclusión: Los principales constituyentes del género Viguiera s l. son germacrólidas, heliangólidas, furanoheliangólidas, diterpenos tetracíclicos y flavonoides. Se notan algunas relaciones quimiotaxonómicas interesantes. No obstante, no se observaron patrones distintivos claros entre los clados y grupos químicos de los géneros segregados. Estos resultados son probablemente consecuencia de la diversidad de objetivos y metodologías de los estudios químicos reportados.

Abstract Background: The first monograph of the genus Viguiera was published in 1918 by Blake, including about 141 species. Schilling & Panero based on studies of molecular sequences of nuclear Internal Transcribed Spacer and External Transcribed Spacer, as well as cpDNA, proposed to reclassify the genus, relocating its species in at least other nine genera. Question: Is it possible to identify distinctive patterns between the species of the new classification of Viguiera s. l. and the results of the chemical studies reported? Species considered: Sixty-seven species within the wide Viguiera circumscription with chemical studies and biological activities reported. Results: The species of the genus Viguiera synthesize terpenoids represented mainly by sesquiterpene lactones and diterpenes, with triterpenes, polyacetylenes, volatile terpenoids and flavonoids also present. The main types of secondary metabolites were present in the studied species, although some compounds were more frequent than others in some clades. Conclusion: Germacrolides, heliangolides, furanoheliangolides, tetracyclic diterpenes and flavonoids are the main constituents of Viguiera and segregated genera. Some interesting chemotaxonomic relationships are noted. Nevertheless, nondistinctive clear patterns were observed between clades and chemical groups. These results are likely a consequence of the diversity of objectives and methodologies of the reported chemical studies on Viguiera.

ABSTRACT Introduction: We have previously shown that some patients present thrombocytopenia (less than 100 × 109/L platelets) in non-alcoholic fatty liver disease (NAFLD). To further explore the nature of this association, we have now analyzed the association of thrombocytopenia with neutropenia (less than 0.5 × 109/L granulocytes) in NAFLD. Material and methods: Persons with NAFLD were prospectively accrued in the study after February 2018. The presence of NAFLD was defined by both serologic determinations (Fibromax ®) and liver transient elastography (TE/Fibroscan ®). Results: In 123 consecutive patients with NAFLD without cirrhosis, thrombocytopenia was identified in 20 (16%), whereas neutropenia was identified in 9 (7%). In the subset of 20 patients with NAFLD and thrombocytopenia, granulocytopenia was identified in 5 (25%), whereas in the subset of 9 patients with granulocytopenia, thrombocytopenia was identified in 5 (55%). We found a significant association between thrombocytopenia and both leukopenia and granulocytopenia (OR 8.25, 95% CI 1.9–34.2, p = 0.004). Conclusions: Both thrombocytopenia and neutropenia were identified in persons with NAFLD and, as there is a significant relationship between these two variables, we speculate that this finding may support the possibility of hypersplenism being involved in the cytopenias found in NAFLD without cirrhosis.

Abstract Hypertrophic cardiomyopathy (HCM) is a clinical condition, but its name has been subjected to frequent changes over the years, largely because of its morphological and functional heterogeneity, which leads the clinician who is focused on its study to have difficulty in understanding how to diagnose it and when and how to treat it. Regarding its name, it has been called in more than 75 different ways, and it has being classified with difficulty through echocardiography for more than 40 years. Today, it is necessary to understand that the diverse phenotypic behavior, as well as the evolutionary stages of the disease, must be approached in a practical and effective way, so that it easier to understand its clinical behavior and prognosis, as well as the therapeutic needs in each particular case. We review the aspects related to the name of the condition and propose a new classification that could provide the clinical and surgical cardiologist a better understanding of HCM in its various morphological and functional aspects.

Resumen La Miocardiopatía Hipertrófica es una entidad clínica que ha sido sometida durante años a cambios frecuentes en su denominación, en gran parte consecuencia de su heterogeneidad morfológica y funcional, lo que hace que el clínico enfocado a su estudio, tenga dificultad en el entendimiento de cómo hacer el diagnóstico y cuándo y cómo tratarle. Nominativamente ha sido llamada de más de 75 formas diferentes y clasificada con dificultad mediante ecocardiografía hace ya más de 40 años. Hoy en día es necesario entender que su comportamiento fenotípico diverso así como las etapas evolutivas de la enfermedad, deben ser abordadas de una forma práctica y eficaz, de tal forma que ello facilite el entendimiento de su comportamiento clínico y su pronóstico, así como de las necesidades terapéuticas en cada caso en particular. Se hace una revisión de los aspectos nominativos de la entidad y proponemos una nueva clasificación que podría facilitar al cardiólogo clínico y quirúrgico un mejor entendimiento de la Miocardiopatía Hipertrófica en sus diversas formas morfológicas y funcionales.

Abstract Objective: Bladder cancer represents the seventh most common cancer with highly variable morbidity and mortality due to detection, treatment and follow-up strategies, with radical cystectomy (RC) being the treatment that offers the best oncological control. A morbidity rate between 30-93% has been reported at 30 days, and mortality greater than 8%. This variability is due to the scarcity of standardized reports using scales such as Clavien-Dindo (CD). Due to the little evidence of publications on complications associated with RC, we decided to make a standardized report of these, using the CD scale of the RCs performed in our hospital, with the goal of finding out the incidence and real severity of these. Materials and methods: A retrospective analysis was made of a prospectively maintained database of RCs performed in our center between 1994 and 2019. All patients over 18 years of age who underwent RC during the study period were included, and all patients with incomplete documentation of the immediate 30 day-postoperative were excluded. Descriptive statistics were used for data presentation. The Kolmogorov-Smirnov test was used to determine the data distribution. An inferential mean comparison analysis was performed using the Student's t-test for variables with normal distribution, and non-parametric tests (Mann-Whitney U-test) for those with non-normal distribution. Results: The mean age of the study population was 61.16 years (SD 10.1). Patients without major complications had a BMI 2.45 kg/m2 lower compared to patients with major complications (95% CI -4.7 to -0.18). Bleeding and surgical time, as well as type of derivation, were not significantly associated with major complications. Study limitations: It was a retrospective study, so the SAS could not be calculated for the entire population. Also, it was a small cohort of patients in a tertiary care center with a restricted number of hospital beds, which considerably reduces the statistical power of the study to find low-frequency events (mortality). Extending the follow-up to more than 30 days could modify the incidence of complications. Originality: Our series is the first to use a standardized system (Clavien-Dindo scale) to report postoperative complications in patients undergoing RC in Mexico. Conclusions: RC continues to be one of the surgeries with the highest morbidity. The use of standardized scales for reporting complications associated with RC would allow us to establish prevention strategies and establish homogeneous surveillance criteria with other specialties.

Resumen Objetivo: El cáncer de vejiga representa el séptimo cáncer más frecuente con una morbimortalidad muy variable debido a estrategias de detección, tratamiento y seguimiento, siendo la cistectomía radical (CR) el tratamiento que ofrece el mejor control oncológico. Se ha reportado una tasa de morbilidad entre un 30-93% a 30 días y una mortalidad mayor al 8%. Esta variabilidad obedece a la escasez de reportes estandarizados utilizando escalas como Clavien-Dindo. Debido a la poca evidencia de publicaciones sobre complicaciones asociadas a CR, decidimos realizar un reporte estandarizado de estas, usando la escala de CD de las CR realizadas en nuestro hospital con la meta de averiguar la incidencia y gravedad real de estas. Materiales y métodos: Análisis retrospectivo de una base mantenida prospectivamente de CR realizadas en nuestro centro entre 1994 y 2019. Se incluyeron todos los pacientes mayores de 18 años, sometidos a una CR en el periodo de estudio y se excluyeron a todos los pacientes con documentación incompleta del postoperatorio inmediato a 30 días. Se utilizó estadística descriptiva para la presentación de los datos. Se aplicó la prueba de Kolmogorov-Smirnov para determinar la distribución de los datos. Se realizó un análisis inferencial de comparación de medias utilizando la prueba T de Student para las variables con distribución normal y con pruebas no paramétricas (prueba de U de Mann-Whitney) para aquellas con distribución no normal. Resultados: La media de edad de la población de estudio fue de 61.16 años (DE 10.1). Los pacientes sin complicación mayor presentaron un IMC de 2.45 kg/m2 menor en comparación con los pacientes con complicación mayor (IC95% -4.7 a -0.18). El sangrado y tiempo quirúrgico, así como el tipo de derivación no se asoció significativamente con la complicación mayor. Limitaciones del estudio: Estudio retrospectivo, por lo que no se le pudo calcular el SAS a la totalidad de nuestra población. Cohorte reducida de pacientes en un centro de tercer nivel de atención con un número restringido de camas en hospitalización, lo cual disminuye de manera considerable el poder estadístico del estudio para encontrar eventos de baja frecuencia (mortalidad). El ampliar el seguimiento a más de 30 días podría modificar la incidencia de complicaciones. Originalidad: Nuestra serie es la primera en utilizar un sistema estandarizado (escala Clavien-Dindo) para reportar complicaciones posquirúrgicas en pacientes sometidos a CR en México. Conclusiones: La CR continúa siendo una de las cirugías con mayor morbilidad. La aplicación de escalas estandarizadas para el reporte de complicaciones asociadas a la CR nos permitiría establecer estrategias de prevención y establecer criterios homogéneos de vigilancia con otras especialidades.

Background: The negative impact of tobacco smoking on renal function has been widely studied. However, there is limited knowledge about the effect of smoking on pre-operative and post-operative renal function in living kidney donors. Objective: The objective of the study was to evaluate the short- and mid-term impact of smoking on donor renal function. Methods: This is a retrospective study of 308 patients who underwent living donor nephrectomy (LDN) at a tertiary referral hospital. We compared baseline characteristics as well as functional outcomes following LDN according to history of tobacco smoking. Estimated glomerular filtration rate (eGFR) was calculated with the modification of diet in renal disease equation in 6 time periods: pre-operative, 1 week, 1 month, 6 months, 12 months, and 24 months after surgery. We performed a Kaplan-Meier analysis for chronic kidney disease (CKD) outcome and binary logistic regression analysis to identify risk factors associated with CKD at 24 months of follow-up. Results: Among donors, 106 (34.4%) reported a smoking history before nephrectomy. Smoking donors had worse pre-operative eGFR than non-smokers (90 ± 26.3 mL/min/1.73m2 vs. 96 ± 27 mL/min/1.73 m2, respectively; p = 0.02) and lower eGFR at 1 week (p = 0.01), 1 month (p ≤ 0.01), 6 months (p = 0.01), and 12 months (p = 0.01) after LDN. Tobacco smoking (OR 3.35, p ≤ 0.01) and age ≥ 40 years at donation (OR 6.59, p ≤ 0.01) were associated with post-operative development of CKD at 24 months after LDN. Conclusions: Living kidney donors with a tobacco smoking history had an increased risk of developing chronic kidney disease following nephrectomy. Smoking-cessation strategies should be implemented.

ABSTRACT Background: The biology of some hematological diseases varies among different populations. No previous studies have evaluated the clinical behavior of mantle cell lymphoma (MCL) in México. Objective and Methods: This is a retrospective review of MCL cases seen in Mexico from January 2003 to June 2020. A total of 12 cases were identified. Results: There were nine males and three females; median age was 56 years. Eight patients had a high MCL international prognostic index score, one was intermediate, and three were low. Five patients had circulating malignant monoclonal cells. Initial treatment included rituximab, cyclophosphamide, daunorubicin, vincristine, and prednisone (R-CHOP) and CHOP. Subsequent treatment included hematopoietic stem cell transplantation in five patients; two were given maintenance therapy. Splenectomy was done in four patients. Median overall survival (OS) for all the patients has not been reached and exceeds 162 mos: OS at 162 mos was 56%. Achieving a complete remission (CR) after the first treatment was a significant prognostic factor, with a median OS exceeding 141 mos in patients achieving CR, and 16 mos among those not achieving CR (p = 0.0006). Conclusion: Some of MCL patients in Mexico have an indolent clinical course, particularly patients who achieve a CR to initial treatment and who undergo splenectomy.

Abstract Objective: To analyze the microbiology and incidence of antibiotic resistance in patients that underwent transurethral resection of bladder tumor (TURBT) and identify risk factors for urinary tract infection (UTI) after the procedure. Methodological design: A retrospective, analytic, descriptive study on data from 199 patients that underwent TURBT at a tertiary care hospital in Mexico City between 2017-2019. The microbiologic characteristics of isolation frequency and drug-resistance pattern were analyzed before and after the procedure. Binary logistic regression was carried out to identify independent risk factors for UTI. Results: Of the 199 patients evaluated, 28 (14%) had a positive urine culture (PUC) before the procedure and the most frequently isolated uropathogens were Escherichia coli (48%), Enterococcus faecalis (24%), and Proteus mirabilis (7%). UTI after TURBT was reported in the 20 patients (10%) that made up group 1. The most frequent pathogen was E. coli (45%), which was resistant to trimethoprim/sulfamethoxazole (60%) and ciprofloxacin (40%). Other isolated pathogens were E. faecalis (27%) and P. mirabilis (9%). The control group included the 179 (90%) patients that did not have a UTI. PUC was statistically significant in relation to necrosis (p=0.001) and muscle-invasive bladder cancer (p=0.03). In the multivariate analysis, PUC was associated with UTI after TURBT (OR 7.04 [95% CI 2.11-23.29]). Limitations: A retrospective study with information limited to that in the case records. Originality and value: There are few articles on TURBT-associated UTI in the international literature and none in Mexico, the present study being the first. Conclusions: The prevalence of UTI after TURBT was 10%. Pre-procedure PUC was the most highly associated risk factor for UTI after TURBT. The most frequently isolated uropathogens were E. coli, E. faecalis, and P. mirabilis. E. coli was most resistant to trimethoprim/sulfamethoxazole (60%) and ciprofloxacin (40%).

Resumen Objetivo: Investigar la incidencia, microbiología y resistencia antibiótica en pacientes sometidos a resección transuretral de vejiga (RTUV) e identificar factores de riesgo para infección de vías urinarias (IVU) después de procedimiento. Diseño metodológico: Estudio retrospectivo, descriptivo y analítico de 199 pacientes sometidos a RTUV en un hospital de tercer nivel en Ciudad de México entre 2017-2019. Se analizaron las características microbiológicas de frecuencia de aislamiento y patrón de resistencia antes y después del procedimiento. Se realizó regresión logística binaria para identificar factores de riesgo independientes a IVU. Resultados: Se analizaron 199 pacientes, de estos 28 pacientes (14%) presentaron un urocultivo prequirúrgico positivo (UPP), los uropatógenos más frecuentemente aislados fueron Escherichia coli (48%), Enterococcus faecalis (24%) y Proteus mirabilis (7%). Se reportó IVU después de RTUV en 20 pacientes (10%) los cuales conformaron el grupo 1. El patógeno más frecuente fue E. coli (45%), el cual era resistente a trimetoprima/sulfametoxazol (60%) y ciprofloxacino (40%). Otros patógenos aislados fueron E. faecalis(27%) yP. mirabilis(9%). En el grupo control se incluyeron 179 (90%) pacientes ya que no presentaron IVU. Se encontró diferencia significativa en la presencia de UPP y necrosis (p=0.001), al igual que en presencia de cáncer músculo-invasor (p=0.03). En el análisis multivariado el UPP se asoció a IVU después de RTUV (OR 7.04 [95% IC 2.11-23.29]). Limitaciones: Estudio retrospectivo limitado a información reportada en expediente. Originalidad y valor: Existe poca literatura acerca de IVU asociadas a RTUV a nivel mundial, en México no hay información, siendo este estudio único en su campo. Conclusiones: La prevalencia de IVU después de RTUV fue de 10%. El factor de riesgo con mayor asociación fue el UPP para IVU después de RTUV. Los uropatógenos más frecuentemente aislados fueron E. coli,E. faecalisyP. mirabilis. Trimetoprima/sulfametoxazol (60%) y ciprofloxacino (40%) fueron los antibióticos con mayor resistencia para E. coli.

ABSTRACT Background: The ideal treatment of coronavirus disease (COVID)-19 has yet to be defined, but convalescent plasma (CoPla) has been successfully employed. Objective: The objective of the study was to study the safety and outcomes of the administration of CoPla to individuals with severe COVID-19 in an academic medical center. Methods: Ten patients were prospectively treated with plasma from COVID-19 convalescent donors. Results: Over 8 days, the sequential organ failure assessment score dropped significantly in all patients, from 3 to 1.5 (p = 0.014); the Kirby index (PaO2/FiO2) score increased from 124 to 255, (p < 0.0001), body temperature decreased significantly from 38.1 to 36.9°C (p = 0.0058), and ferritin levels also dropped significantly from 1736.6 to 1061.8 ng/ml (p = 0.0001). Chest X-rays improved in 7/10 cases and in 6/10, computerized tomography scans also revealed improvement of the lung injury. Decreases in C-reactive protein and D-dimer levels were also observed. Three of five patients on mechanical ventilation support could be extubated, nine were transferred to conventional hospital floors, and six were sent home; two patients died. The administration of CoPla had no side effects and the 24-day overall survival was 77%. Conclusions: Although other treatments were also administered to the patients and as a result data are difficult to interpret, it seems that the addition of CoPla improved pulmonary function.

Abstract Introduction: Clinical aptitude (ClAp) is essential in medical interns' (MI) during their undergraduate internship. Its evaluation is indispensable. Aim: To compare the final clinical aptitude of MI in various hospital settings. Method: Medical Interns (MI) in natural groups who completed their undergraduate internship (UI) in five different hospitals. Seventy (70) MI were studied in a sample obtained in a census. A valid and consistent (KR: 0.77) final instrument was applied at the end of the UI and included 30 clinical cases (CC) and five indicators: risk factors (RF), diagnosis (DX), paraclinicals (PCL), treatment (Tx) and prognosis (PRN), encompassing internal medicine (IM), pediatrics (PED), family medicine (FM), emergency medicine (EM), general surgery (GS) and obstetrics-gynecology (OG). There were 75 items per module, totaling 450. We requested data on the MI grade average and university of origin. Incomplete or inadequately completed surveys were excluded. Non-parametric statistics: to compare every module's medians and that of every rotation (Kruskal-Wallis). Hospitals were compared (Mann-Whitney U test). The average university grade was correlated with the overall median (Spearman). Answers were determined randomly. Results: There was no correlation between the university grade averages and the overall medians. A low ClAp was detected in the hospital settings (Median: 177/450). There were significant differences in favor of Gì and G5 in almost all modules and indicators vs. G4. The highest medians were obtained in EM (50/75) and FM (43/75) while the lowest were in O-G (5/75). Results were NS in RF and PCL. The highest values were observed in PRN (48%), followed by DX (41%) and TX (33%). Comparisons between universities were NS in IM, GS, RF, PCL and PRN. Results were low in acute appendicitis, labor, preeclampsia and pyelonephritis. Comments: ClAp was found to be lacking. A stricter following of the MI's development is warranted.

Resumen Introducción: La aptitud clínica (APCL) es esencial en el médico internado de pregrado (MIP). Su evaluación es primordial. Objetivo: Comparar la aptitud clínica final del MIP en sedes hospitalarias. Método: MIP en grupos naturales que finalizaron su internado de pregrado (IP) en 5 sedes hospitalarias. Se estudiaron 70 MIP en una muestra por censo. Se aplicó un instrumento al final del IP, válido y consistente (KR: 0.77) con 30 casos clínicos (CC), con 5 indicadores: factores de riesgo (FR), diagnóstico (DX), paraclínicos (PCL), tratamiento (TRAT) y pronóstico (PRN). En medicina interna (MI), pediatría (PED), medicina familiar (MF), urgencias (URG), cirugía general (CG) y ginecobstetricia (GO). Reactivos 75 por módulo y 450 en total. Se solicitó el promedio y universidad de procedencia. Se excluyeron encuestas incompletas o mal llenadas. Estadísticos no paramétricos: para comparar las medianas de cada módulo y de cada rotación (Kruskal-Wallis). Se compararon las sedes, una contra otra (U de Mann-Whitney). Se co rrelacionó el promedio universitario con la mediana global (Spearman). Se determinaron las respuestas por azar. Resultados: No hubo correlación entre las calificaciones universitaria s y las medianas globales. Se observó una APCL baja en las sedes (Mdn: 177/450). Se encontraron diferencias significativas a favor de G1 y G5 en casi todos los módulos e indicadores vs. G4. Las medianas más altas se obtuvieron en URG (50/75) y MF (43/75) y las más bajas en GO (5/75). Los resultados fueron NS en FR y PCL. Los valores más altos se observaron en PRN (48%), seguido de DX (41%) y TX (33%). Entre universidades fueron NS en MI, CG, FR, PCL y PRN. Se obtuvieron resultados bajos en apendicitis aguda, trabajo de parto, preeclampsia y pielonefritis. Comentarios: Se observó una APCL aún insuficiente. Se amerita un seguimiento más estrecho de su desarrollo.

Abstract The objective of this systematic review was doing a search of the validity of neck perimeter as a marker of adiposity in children and adolescents as well as in adults. A systematic search for articles published before June 30, 2017 was conducted using the PubMed and Web of Science databases. Original studies, in Spanish or English, were searched to analyze the association between neck circumference and any other marker of adiposity. MeSH (Medical Subject Heading) categories were used in PubMed. The search criteria used were: (("neck circumference" or "neck diameter") AND ("Body Composition" [Mesh] OR "Anthropometry" [Mesh])). This search was repeated in Web of Science. We identified 494 studies, of which 47 were finally selected for this review. From the total, 66% of studies (16 in children and adolescents and 15 in adults) only specify that there is a relationship between neck circumference and body mass index or waist circumference, waist/hip circumference ratio in children and adults. We also observed that neck circumference was directly associated with adiposity markers indirectly measured by reference methods such as computed tomography (CT) or dual-energy x-ray absorptiometry (DXA) in adults. Conversely, no studies were found in children and adolescents. In conclusion, neck circumference is associated with doubly-indirect markers of total and central fat mass in children and adolescents, while in adults it is associated with adiposity parameters measured with indirect and doubly-indirect methods. Further studies including methods that address the association between neck circumference and body composition analyzed using reference methods are required, especially in children and adolescents.

Resumen El objetivo de la presente revisión sistemática fue realizar una búsqueda acerca de la validez del perímetro de cuello como marcador de adiposidad en niños y adolescentes así como en población adulta. Se realizó una búsqueda sistemática de artículos publicados antes del 30 de junio de 2017, utilizando las bases de datos PubMed y Web of Science. Se buscaron estudios originales, en idioma español o inglés, que analizaran la asociación entre el perímetro del cuello y al menos un marcador de adiposidad. En PubMed se usaron las categorías MeSH (medical subject heading). El criterio de búsqueda utilizado fue: ("neck circumference" or "neck diameter") AND ("Body Composition"[Mesh] OR "Anthropometry"[Mesh]). Se repitió la búsqueda en Web of Science. Se identificó un total de 494 estudios, de los cuales 47 fueron finalmente seleccionados para esta revisión. El 66% de los estudios (16 en niños y adolescentes y 15 en adultos) solo especifican que existe relación entre perímetro del cuello e indicadores doblemente-indirectos tales como el índice de masa corporal, la circunferencia de cintura o ratio circunferencia cintura/cadera en niños y adultos. Además, se observó que el perímetro del cuello se asocia de forma directa con marcadores de adiposidad indirectos, medidos mediante métodos de referencia tales como la tomografía axial computarizada (TAC) o la absorciometría dual de rayos X (DXA) en adultos, mientras que no se encontraron estudios en niños. En conclusión, el perímetro del cuello se asocia a marcadores indirectos de masa grasa total y central en niños y adolescentes, mientras que en adultos el perímetro del cuello se asocia a parámetros de adiposidad medidos tanto con métodos indirectos como doblemente-indirectos. Se requieren nuevos estudios con métodos que analicen la asociación entre el perímetro del cuello y la composición corporal analizada mediante métodos de referencia, principalmente en niños y adolescentes.

Abstract Myocardial perforation related to cardiac electronic devices leads is a rare, but unfortunate complication, since its clinical implications are potentially lethal. The fluoroscopic outcome of case of subacute right ventricular perforation is presented, together with an analysis based on a literature review. © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Resumen La perforación miocárdica relacionada a electrodos de estimulación cardiaca es una complicación poco frecuente, pero desafortunada, ya que sus implicaciones clínicas son potencialmente letales. Nosotros describimos la evolución fluoroscópica de un caso de perforación subaguda del ventrículo derecho, así como el análisis en función de la revisión de la literatura. © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. Este es un artículo Open Access bajo la licencia CC BY-NC-ND (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Endometriosis is the presence of functional ectopic endometrial tissue outside the uterine cavity. The clinical presentation is variable and depends on the location. It is considered the third leading cause of hospitalization in the United States. In this case, we report a 44-year-old woman with hematochezia caused by deep infiltrating endometriosis within the sigmoid colon, after having undergone a hysterectomy 11 years ago. The patient received surgical resection due to suspicion of carcinoma.

La endometriosis es la existencia e implantación de estroma y glándulas endometriales funcionales fuera del útero, pero con funcionalidad similar al tejido endometrial dentro de la cavidad uterina. Tiene una presentación clínica variable, ya que depende del sitio de implantación. Se ha determinado que es la tercera causa de hospitalización en los Estados Unidos. Se presenta el caso de una paciente de 44 años de edad con hematoquecia causada por endometriosis profunda infiltrante en colon sigmoides, después de once años de haberse realizado la histerectomía. La paciente fue tratada mediante resección quirúrgica debido a que se sospechaba de un carcinoma.

Resumen Entre los insectos acuáticos, los plecópteros desempeñan un rol destacado en la descomposición y la recirculación de nutrientes y contribuyen, en la red trófica, como alimento de otros insectos y vertebrados. El propósito de este estudio fue conocer la variación de la biomasa y la dieta del género Anacroneuria durante cuatro meses en la parte media del río Gaira. Se recolectaron en total 1.284 individuos y se organizaron en cinco clases de tallas (0,1−0,5, 0,6−1,0, 1,1−1,5, 1,6−2,0 y 2,1−2,5 cm). Se encontraron diferencias en las clases de las tallas (H’=100,3; p<0,01; n=644) (las tallas mayores de 2 cm no se registraron en los muestreos 5 y 6). La abundancia entre microhábitats también registró diferencias significativas, donde la mayor abundancia se observó en la hojarasca (763 individuos) y la menor en la piedra (86 individuos). La biomasa acumulada total fue 441,6 PSLC mg/m2, donde las tallas intermedias (0,6−2,0 cm) fueron las que más contribuyeron a la biomasa del género (promedio PSLC: 215,53 ± 4,67 mg/m2), mientras que las tallas más grandes (2,1−2,5 cm) presentaron la menor contribución (promedio PSLC: 48,90 ± 4,62 mg/m2). No se encontró relación entre el contenido estomacal y las tallas; los restos animales y los detritos fueron los ítems alimentarios más frecuentes. La biomasa disponible por el género Anacroneuria evidenció una importante disponibilidad energética que es afectada negativamente por las precipitaciones y los caudales.

Abstract Among the aquatic insects, the Plecoptera play an important role in decomposition and nutrient recycling. Moreover, they are important in the energy flow throughout the system, as they are food to other insects and vertebrates. The aim of this research was to study the biomass and diet dynamics of Anacroneuria during four months in the middle basin of the Gaira River. A total of 1284 organisms were collected and organized into five size classes (0.1−0.5, 0.6−1.0, 1.1−1.5, 1.6−2.0 y 2.1−2.5 cm). We found differences size classes (H’=100.3; p<0.01; n=644). The > 2 cm size class was not found during samplings 5 and 6. Abundance was significantly different among microhabitats; with the highest abundance observed in leaves (763 organisms) and the lowest in gravel stones (86 organisms). The cumulative biomass was 441.6 PSLC mg/m2, where the intermediate sizes (0.6−2,0 cm) were the largest contributors to the biomass of the genus (average AFDW: 215.53 ± 4.67 mg/m2), while the largest size (2.1-2.5 cm) had the lowest contribution (average AFDW: 48.90 ± 4.62 mg/m2). The was no significant correlation between gut contents and body size. The most common fragments in gut contents were animals and detritus. Biomass available to the Anacroneuria genus had provides a high energy content that was negatively affected by rainfall and discharges.