Background: Central America experiences a high burden of dengue reporting about 8% of all cases in the continent. This work reports the epidemiology of dengue in the sub region in a 10 years period. Aim: To describe the epidemiology of dengue in Central America and the Dominican Republic. Methods: Study period from 2005 to 2014. The data on dengue cases and deaths of the countries of Central America and the Dominican Republic, reported by the Ministries of Health, were compiled and analyzed and corroborated with the data published in the online bulletins and the interactive database of the Pan American Health Organization (PAHO). Population statistics were obtained from the National Statistics and Census Institutes of each country. Results: During the study period, 1,118,464 cases of dengue were notified. There were 32,431 serious cases reported, 888 people died. The lethality per case of dengue was on average 0.08%. The four dengue serotypes circulated during the decade analyzed. Discussion: Clinical and epidemiological information indicates high incidence rates, which have fluctuated in recent years, with significant co-circulation of several serotypes at the same time. Conclusions: Notorious surveillance data collection differences were identified between countries, determining a heterologous epidemiological pattern.

Resumen Introducción: Centroamérica experimenta una alta carga de la enfermedad por dengue aportando cerca de 8% de todos los casos del continente. Este trabajo reporta la epidemiología del dengue en la subregión en un período de 10 años. Objetivos: Documentar la epidemiología del dengue en Centro América y República Dominicana. Material y Métodos: Período de estudio: años 2005-2014. Se recopilaron y analizaron los datos de casos y muertes por dengue de los países de Centro América y República Dominicana, reportados por los Ministerios de Salud y se corroboró con los datos publicados en los boletines en línea y la base de datos interactiva de la Organización Panamericana de la Salud (OPS). Se obtuvieron estadísticas poblacionales de los Institutos Nacionales de Estadística y Censo de cada país. Resultados: Durante el período de estudio fueron notificados 1.118.464 casos de dengue. Reportados 32.431 casos graves, 888 personas fallecidas. La letalidad por caso de dengue fue en promedio 0,08%. Los cuatro serotipos de dengue circularon durante el decenio estudiado. Discusión: La información clínica y epidemiológica, indica tasas de incidencia alta, que han fluctuado en los últimos años, con co-circulación significativa de varios serotipos a la vez. Conclusiones: Se identificaron diferencias notorias en la recolección de datos de la vigilancia entre países. Se determinó un patrón epidemiológico heterogéneo.

Neuromas of the bile duct develop from the sympathetic and parasympathetic nerve fibers that surround the wall of the bile duct. A 44-year-old woman with a history of conventional cholecystectomy six months prior to hospital admission attended emergency due to obstructive jaundice that lasted 15 days. In the imaging studies, the presence of a mass at the level of the bile ducts is considered, considering the diagnosis of a malignant neoplasm. Due to the antecedents, the absence of tumor markers, it was decided to perform a percutaneous biopsy without conclusive results, performing later a surgical intervention with anatomopathological study compatible with neuroma of biliary tract amputation. The amputation neuroma at the level of the bile duct is an infrequent tumor. It can manifest clinically as obstructive jaundice and usually simulates a malignant tumor of the bile ducts. Surgical management is the definitive treatment.

Los neuromas del conducto biliar se desarrollan a partir de las fibras nerviosas simpáticas y parasimpáticas que envuelven la pared de la vía biliar. Mujer de 44 años de edad con antecedente de colecistectomía convencional seis meses previos al ingreso acude a emergencia por ictericia obstructiva de 15 días de evolución. En los estudios de imagen impresiona la presencia de una masa a nivel de las vías biliares considerándose el diagnostico de una neoplasia maligna. Por los antecedentes, ausencia de marcadores tumorales se decide realizar una biopsia percutánea sin resultados concluyente, realizándose posteriormente una intervención quirúrgica con estudio anatomo-patológico compatible con neuroma de amputación de vía biliar. El neuroma de amputación a nivel de la vía biliar es un tumor infrecuente. Puede manifestarse clínicamente como una ictericia obstructiva y suele simular a un tumor maligno de las vías biliares. El manejo quirúrgico es el tratamiento definitivo.

The morphology of an as yet undetermined Neoalbionella species is described from specimens collected from the second dorsal fin of the southern lanternshark Etmopterus granulosus, caught at a submerged ridge off Juan Fernández Archipelago, Southeastern Pacific Ocean, Chile. Two features of the females suggest that this may be an undescribed species: the presence of one secondary denticle on the claw of the maxilliped, and three setae on the outer lobe of the maxillule. However, males are essential to describe new species of Lernaeopodidae but were not found. This is a new host and geographical record of Neoalbionella sp. off the Pacific coast of South America-

Durante o estudo dos metazoários parasitos de Paroaria dominicana Linnaeus, 1758 (Passeriformes), quatro infrapopulações de Platynosomum illiciens (Brown, 1901) (Trematoda) foram coletadas nos ductos hepáticos, com intensidades parasitárias de 10, 11, 18 e 36 espécimes respectivamente. Diferenças entre os valores morfométricos médios e o número total de ovos das infrapopulações foram estatisticamente testadas. O peso do fígado não se correlacionou ao peso das aves, ao comprimento do corpo das aves e à abundância parasitária. Foram detectadas correlações positivas entre o tamanho das infrapopulações e o número de ovos produzidos e entre o tamanho do corpo dos parasitos e o tamanho dos ovos. Correlações negativas foram observadas entre a intensidade parasitária e o peso do fígado; entre o tamanho das infrapopulações e o tamanho dos indivíduos dessas infrapopulações; entre o número e o tamanho dos ovos e entre o tamanho do corpo dos parasitos e o número de ovos. Os resultados indicaram que as infrapopulações maiores se estabeleceram em aves com fígados menores e que quanto maiores as infrapopulações foram observados menor tamanho corporal e menor tamanho dos ovos, os que se apresentaram em maior quantidade.

During the study of the metazoan parasites of Paroaria dominicana Linnaeus, 1758 (Passeriformes), four infrapopulations of Platynosomum illiciens (Brown, 1901) (Trematoda), parasitic in the liver ducts were collected, with intensity of infection 10, 11, 18 and 36 specimens respectively. Differences between the means of morphometrical values and the total number of eggs were statistically tested. The liver weigh were not significantly correlated with avian total weigh and length, and with the total parasitic abundance. Positive correlations were observed between the size of infrapopulations and the total number of eggs, and between parasite body size and the eggs. size. Negative correlations were observed between parasitic intensity and liver weigh; between the size of infrapopulations and the parasite body size; between total number and the size of eggs and between parasite body size and total number of eggs. These results suggests that host with smaller liver had greater infrapopulations. These greater infrapopulations showed smaller parasite body size and higher size and number of eggs.

A new species of Acantholochus Cressey, 1984 (Copepoda: Bomolochidae) parasitic on the gills of common snook, Centropomus undecimalis, from the coastal zone of the State of Rio de Janeiro, Brazil, is described and illustrated. The new species differs from all other species of Acantholochus by the presence of only one inner seta on middle segment of the second and third endopods.

A new species of Anoplodiscus (Monogenea, Anoplodiscidae), parasitic on gills of the red porgy, Pagrus pagrus, from the coastal zone of the State of Rio de Janeiro, Brazil, is described and illustrated. The new species can be differentiated from the other species of this genus by the shape of the accessory piece of the copulatory complex, and the length of the vagina. This is the first record of a species of Anoplodiscus in the Neotropical region.

Fifty-five specimens of pink cusk-eel, Genypterus brasiliensis Regan, 1903 (Osteichthyes: Ophidiidae) collected from the coastal zone of the State of Rio de Janeiro, Brazil (approx. 21-23°S, 41-45°W), from September 2000 to January 2001, were necropsied to study their parasites. All fish were parasitized by one or more metazoan. Fourteen species of parasites were collected. G. brasiliensis is a new host record for nine parasite species. The larval stages of cestodes and the nematodes were the majority of the parasite specimens collected, with 38.4% and 36.5%, respectively. Cucullanus genypteri was the dominant species with highest prevalence and/or abundance. The parasites of G. brasiliensis showed the typical overdispersed pattern of distribution. Six parasite species showed correlation between the host's total body length and prevalence and abundance. Host sex did not influence prevalence and parasite abundance of any parasite species. The mean diversity in the infracommunities of G. brasiliensis was H= 0.364 ± 0.103, with correlation with the host's total length and without differences in relation to sex of the host. One pair of adult endoparasites (C. genypteri and A. brasiliensis) showed positive covariations between their abundances. Negative association or covariation was not found. Differences between the qualitative and quantitative aspects of the parasite community of G. brasiliensis from Rio de Janeiro and Argentina suggest the existence of two population stocks of pink cusk-eel in the South America Atlantic Ocean.

Male breast carcinoma is very uncommon (0.1% of all the male cancers), which makes us have later diagnosis that darken the prognosis. A series of 7 breast carcinomas in 6 males with a mean age of 60 years (47-72 years old) and with a mean time between the first symptom and the operation of 14.3 months (5 to 30 months) is presented. The stages were as follows: I(1), II(3). III(1) and IV(1). The histopathological study showed 6 infiltrating ductal carcinomas: l multicenter and l intraductal (multicenter). 54 patients were treated with modified radical mastectomy (3 with Patey's operation and 2 with Madden's operation). The patient with bilateral carcinoma underwent Halsted's radical mastectomy in the left breast and simple tumorectomy plus axilary lymphadenectomy in the right. 5 patients received coadjuvant treatment: 2, chemotherapy; l, radiotherapy; 1, chemotherapy plus radiotherapy; and 1, hormone therapy. The sixth patient died 9 days after the operation due to end-stage disseminated disease and the other died from metastatic disease 3,5 years later. The other 4 survive free of disease at 7, 5.5, and 5 years. The diagnostic and therapeutic aspects are analyzed through a wide bibliographic review and it is concluded that it is a neoplasia with similar characteristics and prognosis in both sexes. However, results are poorer in males due to the delay in making the diagnosis compared with females

El carcinoma de mama es muy poco frecuente en el varón (0,1 a 0,2 % de todos los cánceres masculinos), lo que condiciona diagnósticos más tardíos que ensombrecen el pronóstico. Se presenta una serie de 7 carcinomas de mama en 6 varones con edad media de 60 años (47 a 72 años) y tiempo medio primer síntoma-intervención de 14,3 meses (5 a 30 meses). Los estadios fueron: I(1), II(3), III(1) y IV(1). El estudio histopatológico evidenció 6 carcinomas ductales infiltrantes: 1 multicéntrico y 1 intraductal (multicéntrico). Se trataron 5 de ellos con mastectomía radical modificada (3 con la de tipo Patey y 2 con la de Madden). En el que presentaba el carcinoma bilateral, se practicó mastectomía radical de Halsted en la mama izquierda y tumorrectomía simple más linfadenectomía axilar en la derecha. Recibieron tratamiento coadyuvante 5 pacientes: 2, quimioterapia; 1, radioterapia; 1, quimioterapia más radioterapia y 1, hormonoterapia. Fallece el sexto paciente al 9no. día del posoperatorio por enfermedad diseminada en estadio terminal y otro a los 3,5 años de enfermedad metastásica; sobreviven los 4 restantes libres de enfermedad a los 7,5,5 y 5 años. Se analizan los aspectos diagnósticos y terapéuticos en una amplia revisión bibliográfica y se concluye en que es una neoplasia de unas características y pronósticos similar en uno y otro sexos, no obstante, se publican peores resultados en el varón debido a la mayor demora en el diagnóstico respecto al femenino

One hundred specimens of white croakers, Micropogonias furnieri (Desmarest 1823) (Osteichthyes: Sciaenidae) collected from Pedra de Guaratiba (23°01'S, 43°38'W), State of Rio de Janeiro, Brazil, from September 1997 to August 1999, were necropsied to study their parasites. The majority of the fish (95%) were parasitized by metazoan. Twenty-eight species of parasites were collected. The nematodes were the 40.5% of the total number of parasites specimens collected. Dichelyne elongatus was the most dominant species. Lobatostoma ringens, Pterinotrematoides mexicanum, Corynosoma australe, D. elongatus, and Caligus haemulonis showed a positive correlation between the host's total length and parasite prevalence and abundance. The monogenean P. mexicanum had differences in the prevalence and abundance in relation to sex of the host. The mean diversity in the infracommunities of M. furnieri was H=0.499±0.411, with correlation with the host's total length and without differences in relation to sex of the host. One pair of ectoparasites showed positive covariation, and two pairs of endoparasites showed positive association and covariation between their prevalences and abundances, respectively. Negative association or covariations were not found. The dominance of endoparasites in the croakers parasite infracommunities reinforced the differences found in sciaenids from the South American Pacific Ocean, in which the ectoparasites are dominant.

Parasitological analysis of 237 Menticirrhus ophicephalus, 124 Paralonchurus peruanus, 249 Sciaena deliciosa, 50 Sciaena fasciata and 308 Stellifer minor from Callao (Perú) yielded 37 species of metazoan parasites (14 Monogenea, 11 Copepoda, 4 Nematoda, 3 Acanthocephala, 1 Digenea, 1 Aspidobothrea, 1 Eucestoda, 1 Isopoda and 1 Hirudinea). Only one species, the copepoda Bomolochus peruensis, was common to all five hosts. The majority of the components of the infracommunities analyzed are ectoparasites. The Brillouin index (H) and evenness (J´) were applied to the fully sampled metazoan parasite infracommunities. High values of prevalence and mean abundance of infection are associated to the polyonchoinean monogeneans; the low values of J' reinforce the strong dominance of this group in the studied communities. The paucity of the endoparasite fauna may be a consequence of the unstable environment due to an upwelling system, aperiodically affected by the El Niño Southern Oscillation phenomena.