RESUMO: A vacinação tem sido usada para prevenir perdas associadas à infecção pelo alfaherpesvírus bovino 1 (BoHV-1), embora anticorpos adquiridos passivamente possam comprometer a eficácia das vacinas. A imunização intranasal (IN) de bezerros com vacinas de BoHV-1 vivas modificadas pode contornar o obstáculo relacionado à presença de anticorpos adquiridos passivamente, conferindo proteção aos animais vacinados. Nesse contexto, avaliou-se a segurança e imunogenicidade de uma cepa brasileira de BoHV-1 com deleção no gene da glicoproteína E (BoHV-1gEΔ) na imunização IN de bezerros. Dez bezerros, de um a dois meses de idade e com títulos neutralizantes (VN) variando de 2-64, foram inoculados IN com BoHV-1gEΔ (107,1TCID50), e quatro permaneceram como controles não vacinados (títulos de VN 8-32). Após a instilação IN, os bezerros apresentaram secreção nasal transitória leve (2-6 dias) e excretaram o vírus vacinal nas secreções nasais em baixos títulos (<102,6TCID50/mL) por 4-8 dias. Interessantemente, os bezerros vacinados não apresentaram aumento nos títulos de anticorpos neutralizantes após a vacinação. Em vez disso, eles apresentaram uma redução gradual nos anticorpos neutralizantes séricos nas semanas seguintes - semelhante aos controles não vacinados. Após o desafio IN com uma cepa BoHV-1 virulenta heteróloga no dia 55 pós-imunização (107,63TCID50), os bezerros vacinados excretaram o vírus em títulos menores a partir do sexto dia pós-desafio (p < 0,07) e por um período de tempo menor do que o observado nos controles (p < 0,0024). É importante notar que tanto a duração quanto a intensidade dos sinais clínicos foram reduzidas nos animais vacinados. Além disso, os bezerros vacinados apresentaram um aumento abrupto nos títulos neutralizantes após o desafio, indicando uma imunização adequada por BoHV-1gEΔ. Em resumo, a imunização IN de bezerros com anticorpos passivos com a cepa BoHV-1gEΔ foi capaz de estimular a imunidade, proporcionando proteção virológica e clínica parciais após o desafio.

ABSTRACT: Vaccination has been used to prevent the losses associated with Bovine alphaherpesvirus 1 (BoHV-1) infection but passively acquired antibodies may compromise vaccine efficacy. Intranasal immunization (IN) of calves with modified live viral BoHV-1 vaccines has proven to overcome the acquired passive antibodies and confer adequate protection. Herein, we evaluated the safety and immunogenicity of a glycoprotein E-deleted Brazilian BoHV-1 strain (BoHV-1gEΔ) for IN immunization of calves. Ten 1-to-2 months-old calves with virus-neutralizing titers (VN) ranging from 2-64 were immunized IN with viable BoHV-1gEΔ (107.1 TCID50) and four remained as unvaccinated controls (VN titers 8-32). After IN immunization, calves presented a transient (2-6 days) mild nasal secretion and shed the vaccine virus in nasal secretions in low titers (<102.6TCID50/mL) for 4-8 days. Interestingly, the vaccinated calves did not show an increase in VN titers after vaccination. Rather, they presented a gradual reduction in serum VN antibodies in the following weeks - similarly to unvaccinated controls. Upon IN challenge with a virulent heterologous BoHV-1 strain at day 55 post-immunization (107.63TCID50), vaccinated calves shed significantly less virus from day 6 post-challenge onwards (p < 0.07) and for a shorter period of time than the controls (p < 0.0024). Importantly, both the duration and intensity of clinical signs were reduced in vaccinated animals. In addition, vaccinated calves showed an abrupt raise in VN titers post-challenge, indicating adequate immunological priming by vaccination. In summary, immunization of calves harboring passive antibodies with BoHV-1gEΔ by the IN route was able to prime the immunity to afford partial virological and clinical protection upon challenge.

Abstract Introduction: Spinal injuries are common among young adult men. Recognizing kinematics can help reduce the number of late diagnoses, especially if there are consciousness disorders. Vertebral fractures can be single or multiple, and they are often associated with extravertebral injuries. Objectives: To examine the distribution of the lesion based on the mechanism of production, to characterize the neurological condition, to evaluate the lesion pattern and its relationship with extravertebral lesions, and to analyze the treatment. Materials and Methods: This was a multicenter, prospective study of patients admitted with post-trauma vertebral injuries between July 1, 2018 and June 30, 2020. Age, gender, kinematics, neurological condition, affected sector, pattern of injury, and associated extravertebral injuries were all examined. Results: There were 281 patients (60% men) evaluated, with 400 vertebral and 118 extravertebral lesions. The causes were as follows: polytrauma in 62 cases, falls from great heights in 147 patients, and traffic accidents in 98. ASIA E was the most frequently observed neurological picture (8 cases), which was not determined at admission. The T2-L5 sector was the most affected, mostly by compression injuries. Head and chest trauma were the most common extravertebral injuries; there was one case of SCIWORA and one early death. Conclusions: The most commonly affected spinal sectors were thoracolumbar, thoracic, and lumbar; the injuries are typically caused by falls from great heights and, in general, are isolated, with no neurological injuries. The treatment is determined by the stability and neurological condition.

Resumen Introducción: Las lesiones raquídeas son frecuentes en hombres adultos jóvenes. Reconocer la cinemática ayuda a disminuir la tasa de diagnósticos tardíos, principalmente si hay trastornos de la conciencia. Las fracturas vertebrales pueden ser únicas o múltiples, y asociarse con lesiones extravertebrales. Los objetivos de este estudio fueron analizar la distribución de la lesión según el mecanismo de producción, caracterizar el cuadro neurológico, evaluar el patrón de lesión y la asociación con lesiones extravertebrales, y analizar el tratamiento. Materiales y Métodos: Estudio multicéntrico, prospectivo de pacientes con lesiones vertebrales postrauma, que ingresaron entre el 1 de julio de 2018 y el 30 de junio de 2020. Se analizaron los siguientes parámetros: edad, sexo, cinemática, cuadro neurológico, sector afectado, patrón de lesión, lesiones extravertebrales asociadas. Resultados: Se evaluó a 281 pacientes (60% hombres) con 400 lesiones vertebrales y 118 extravertebrales que, en 62 casos, conformaban un cuadro de politraumatismo; 147 con trauma por caída de altura y 98, por accidente de tránsito. El cuadro neurológico más observado fue ASIA E (8 casos), no determinado al ingreso. El sector T2-L5 fue el más afectado, en su mayoría, por lesiones por compresión. Las lesiones extravertebrales más frecuentes fueron el trauma de cráneo y de tórax; hubo un caso de SCIWORA y un óbito temprano. Conclusiones: Los sectores raquídeos más afectados fueron: el toracolumbar, el torácico y el lumbar; las lesiones suelen deberse a caídas de altura y suelen ser únicas, sin cuadro neurológico. El tratamiento se decide según la estabilidad y el cuadro neurológico.

Abstract The condition called "river disease" (MDR by its acronym in Spanish) is an intoxication in immature stages of honey bees caused by a compound from the genus Sebastiania Spreng and concentrated in the exudates of Epormenis cestri Berg. Our objective was to determine the temporal dynamics of the life cycle of E. cestri, its association with the predominant vegetation components and the influence of the Uruguay river on the size of its populations. With this aim, we selected 5 sites in the vicinity of the Uruguay river where populations of E. cestri were sampled using the Stem-tap technique modified for this purpose. The effect of landscape components on the abundance of E. cestri was evaluated using GLMM. It was determined that the hatching of the E. cestri eggs was in mid-October, finding a staggered distribution of its phenophases. In addition, we found significantly negative effects of the Espinal forest cover and the increase in the distance from the banks of the Uruguay river on the total abundance of E. cestri. This work shows some first clues for the understanding of how the components of the landscape structure the populations of E. cestri, allowing to predict the critical moment of incidence of MDR.

The second part of the Inter-Society Argentine Consensus on Urinary Tract Infection (UTI) includes the analysis of special situations. In patients with urinary catheter, urine culture should be requested only in the presence of UTI symptomatology, before instrumentation of the urinary tract, or as a post-transplant control. The antibiotics recommended for empirical treatment in patients without risk factors are third-generation cephalosporins or aminoglycosides. UTIs associated with stones are always considered complicated. In case of obstruction with urosepsis, an emergency drainage should be performed via a percutaneous nefrostomy or ureteral stenting. In patients with stents or ureteral prostheses, such as double J catheters, empirical treatment should be based on epidemiology, prior antibiotics, and clinical status. Before the extracorporeal lithotripsy procedure, bacteriuria should be investigated and antibiotic prophylaxis should be administered in case of positive result, according to the antibiogram. First generation cephalosporins or aminoglycosides are valid alternatives. The use of antibiotic prophylaxis with first-generation cephalosporins or aminoglycosides before percutaneous nephrolithotomy is recommended. Transrectal prostatic biopsy can be associated with infectious complications, such as UTI or acute prostatitis, mainly due to Escherichia coli or other enterobacteria. In patients without risk factors for multiresistant bacteria and negative urine culture, prophylaxis with intravenous amikacin or ceftriaxone is recommended. In patients with positive urine culture, prophylaxis will be performed according to the antibiogram, from 24 hours before to 24 hours post-procedure. For the targeted treatment of post-transrectal biopsy prostatitis, carbapenems for 3-4 weeks are the treatment of choice.

La segunda parte del Consenso Argentino Intersociedades de Infección Urinaria incluye el análisis de situaciones especiales. En pacientes con sonda vesical se debe solicitar urocultivo solo cuando hay signo-sintomatología de infección del tracto urinario, antes de instrumentaciones de la vía urinaria o como control en pacientes post-trasplante renal. El tratamiento empírico recomendado en pacientes sin factores de riesgo es cefalosporinas de tercera generación o aminoglucósidos. Las infecciones del tracto urinario asociadas a cálculos son siempre consideradas complicadas. En caso de obstrucción con urosepsis, deberá realizarse drenaje de urgencia por vía percutánea o ureteral. En pacientes con stents o prótesis ureterales, como catéteres doble J, el tratamiento empírico deberá basarse en la epidemiología, los antibióticos previos y el estado clínico. Antes del procedimiento de litotricia extracorpórea se recomienda pesquisar la bacteriuria y, si es positiva, administrar profilaxis antibiótica según el antibiograma. Cefalosporinas de primera generación o aminoglúcosidos son opciones válidas. Se recomienda aplicar profilaxis antibiótica con cefalosporinas de primera generación o aminoglúcosidos antes de la nefrolitotomía percutánea. La biopsia prostática trans-rectal puede asociarse a complicaciones infecciosas, como infecciones del tracto urinario o prostatitis aguda, principalmente por Escherichia coli u otras enterobacterias. En pacientes sin factores de riesgo para gérmenes multirresistentes y urocultivo negativo se recomienda realizar profilaxis con amikacina o ceftriaxona endovenosas. En pacientes con urocultivo positivo, se realizará profilaxis según antibiograma, 24 horas previas a 24 horas post-procedimiento. Para el tratamiento dirigido de la prostatitis post-biopsia trans-rectal, los carbapenémicos durante 3-4 semanas son el tratamiento de elección.

ABSTRACT Plants are considered among the main sources of biologically active chemicals. The species Solidago chilensis Meyen, Asteraceae, is native to the southern parts of South America, where the aerial parts of the plant are commonly used for the treatment of inflammatory conditions. However, the effects of S. chilensis on human cancer cells remain to be elucidated. In this study, we evaluated the antiproliferative effects of the hydroalcoholic and dichloromethane extracts of S. chilensis, as well as their chemical constituents quercitrin and solidagenone against the five human tumor cell lines in vitro. The dichloromethane extract showed a promisor antiproliferative effects in vitro, especially against glioma cell line. Besides, the hydroalcoholic extract and quercitrin were inactive. The diterpene solidagenone showed highly potent antiproliferative effects against breast (MCF-7), kidney (786-0), and prostate cancer (PC-3) cells (total growth inhibition: TGI < 6.25 µg/ml). Solidagenone meets the theoretical physico-chemical criteria for bioavailability of drugs, according to the "Rule of Five" and, by theorical studies, the observed biological effects were probably related to the interaction of the molecule with nuclear receptors and as an enzymatic inhibitor. This study contributes to chemical study and to the identification of antiproliferative molecules in S. chilensis.

Resumo: O seguinte artigo analisa uma das mais importantes produções audiovisuais argentinas do ano de 2017, o filme O Outro Irmão, de Adrián Caetano, transposição cinematográfica do romance Sob este Tremendo Sol de Carlos Busqued. Tentamos mostrar como esse novo filme de Caetano distingue-se de suas produções anteriores pertencentes ao gênero noir (Um Urso Bermelho, Bolivia, Tumberos), a partir da construção de um mundo que pode ser relacionado sem dificuldade à concepção de Deleuze da imagem-pulsão, um mundo que não deixa lugar para os códigos dos filmes anteriores do diretor. Da mesma forma, tentamos ampliar a tese sobre o filme e mostrar que a razão utilitária e a animalidade aparecem como determinantes fundamentais do gênero noir no presente.

Abstract: The following article analyzes one of the most important Argentine audiovisual productions of 2017: the film The Lost Brother, by Adrián Caetano, a transposition of the novel Under this Terrible Sun, by Carlos Busqued. I will try to show how this film distinguishes itself from Caetano’s previous film noir productions (Red Bear, Bolivia, Tombers), presenting a world that can be easily linked to Deleuze's conception of the impulse-image, a world in which there is no place for the loyalty codes that characterize his previous films. I will also try to expand the thesis about the film and show that utilitarian reason and animality appear as constructing pillars of the film noir in the present.

Resumen: El siguiente artículo analiza una de las producciones audiovisuales argentinas más importantes del año 2017, la película El otro hermano, de Adrián Caetano, transposición cinematográfica de la novela Bajo este sol tremendo, de Carlos Busqued. Intentamos mostrar de qué modo esta nueva producción de Caetano se distancia de sus producciones anteriores pertenecientes al género negro (Un oso rojo, Bolivia, Tumberos), a partir de la construcción de un mundo que se puede emparentar sin dificultad con la concepción deleuzeana de la imagen-pulsión, un mundo que ya no deja lugar para los códigos de las películas previas del director. Asimismo, tratamos de extender la tesis sobre la película y mostrar que la razón utilitaria y la animalidad aparecen como determinantes contemporáneas fundamentales del film noir en la actualidad.

ABSTRACT OBJECTIVE The objective of this study is to analyze the trend of the Key Indicators of the National Health System of Spain and its autonomous communities, related to Specialized Care, from the publication of the Law of Cohesion and Quality. METHODS This is an ecological study of temporary series of Spain and its autonomous communities from 2003 to 2014. We have analyzed 10 indicators related to Specialized Care (percentage of expenditure, professionals, waiting lists, surgical activity, average duration, infections, and mortality) using the Prais-Winsten regression method. We have obtained data from the health information system of the Spanish Ministry of Health, Social Services, and Equality. RESULTS Specialized care expenditure (APC = 0.059, 95%CI 0.041–0.074), number of medical professionals (APC = 0.0006, 95%CI 0.0003–0.0009) and nursing professionals (APC = 0.001, 95%CI 0.0005–0.0016), hospital infections (APC = 0.0003, 95%CI 0.0002–0.0004), and in-hospital mortality (APC = 0.0008, 95%CI 0.0006–0.001) had an increasing trend in Spain. Average duration presented a decreasing trend (APC = -0.0017, 95%CI -0.002– -0.0014). The trend of waiting lists (specialized appointment and non-urgent surgical interventions) was static. The trend of these indicators varied in the Autonomous Communities. CONCLUSIONS We have observed a non-compliance with the principles of equity and quality of the services offered. Increased aging, technological development, and inadequate strategies taken to reduce health costs may be the main causes.

RESUMEN OBJETIVO Analizar la tendencia de los Indicadores Clave del Sistema Nacional de Salud de España y sus comunidades autónomas, relacionados con la Atención Especializada, desde la publicación de la Ley de Cohesión y Calidad. MÉTODOS Estudio ecológico de series temporales de España y sus comunidades autónomas desde 2003 hasta 2014. Se analizaron 10 indicadores relacionados con Atención Especializada (porcentaje de gasto, profesionales, listas de espera, actividad quirúrgica, estancia media, infecciones y mortalidad) utilizando el método de auto-regresión de Prais-Winsten. Los datos se obtuvieron del sistema de información sanitaria del Ministerio de Sanidad, Servicios Sociales e Igualdad español. RESULTADOS Existió una tendencia creciente del gasto en atención especializada (APC = 0,059; IC95% 0,041–0,074), número de profesionales de medicina (APC = 0,0006; IC95% 0,0003–0,0009) y enfermería (APC = 0,001; IC95% 0,0005–0,0016), infecciones hospitalarias (APC = 0,0003; IC95% 0,0002–0,0004) y mortalidad intrahospitalaria (APC = 0,0008; IC95% 0,0006–0,001) en España. La estancia media presentó una tendencia decreciente (APC = -0,0017; IC95% -0,002– -0,0014). La tendencia de las listas de espera (consulta especializada e intervenciones quirúrgicas no urgentes) fue estática. La tendencia de estos indicadores varió en las Comunidades Autónomas. CONCLUSIONES Se observa un incumplimiento de los principios de equidad y calidad de las prestaciones ofrecidas. El aumento del envejecimiento, el desarrollo tecnológico y estrategias poco adecuadas tomadas para reducir los costes sanitarios pueden ser las principales causas.

ABSTRACT OBJECTIVE The objective of this study is to analyze the trend of the Key Indicators of the National Health System of Spain and its autonomous communities, related to Specialized Care, from the publication of the Law of Cohesion and Quality. METHODS This is an ecological study of temporary series of Spain and its autonomous communities from 2003 to 2014. We have analyzed 10 indicators related to Specialized Care (percentage of expenditure, professionals, waiting lists, surgical activity, average duration, infections, and mortality) using the Prais-Winsten regression method. We have obtained data from the health information system of the Spanish Ministry of Health, Social Services, and Equality. RESULTS Specialized care expenditure (APC = 0.059, 95%CI 0.041–0.074), number of medical professionals (APC = 0.0006, 95%CI 0.0003–0.0009) and nursing professionals (APC = 0.001, 95%CI 0.0005–0.0016), hospital infections (APC = 0.0003, 95%CI 0.0002–0.0004), and in-hospital mortality (APC = 0.0008, 95%CI 0.0006–0.001) had an increasing trend in Spain. Average duration presented a decreasing trend (APC = -0.0017, 95%CI -0.002– -0.0014). The trend of waiting lists (specialized appointment and non-urgent surgical interventions) was static. The trend of these indicators varied in the Autonomous Communities. CONCLUSIONS We have observed a non-compliance with the principles of equity and quality of the services offered. Increased aging, technological development, and inadequate strategies taken to reduce health costs may be the main causes.

RESUMEN OBJETIVO Analizar la tendencia de los Indicadores Clave del Sistema Nacional de Salud de España y sus comunidades autónomas, relacionados con la Atención Especializada, desde la publicación de la Ley de Cohesión y Calidad. MÉTODOS Estudio ecológico de series temporales de España y sus comunidades autónomas desde 2003 hasta 2014. Se analizaron 10 indicadores relacionados con Atención Especializada (porcentaje de gasto, profesionales, listas de espera, actividad quirúrgica, estancia media, infecciones y mortalidad) utilizando el método de auto-regresión de Prais-Winsten. Los datos se obtuvieron del sistema de información sanitaria del Ministerio de Sanidad, Servicios Sociales e Igualdad español. RESULTADOS Existió una tendencia creciente del gasto en atención especializada (APC = 0,059; IC95% 0,041–0,074), número de profesionales de medicina (APC = 0,0006; IC95% 0,0003–0,0009) y enfermería (APC = 0,001; IC95% 0,0005–0,0016), infecciones hospitalarias (APC = 0,0003; IC95% 0,0002–0,0004) y mortalidad intrahospitalaria (APC = 0,0008; IC95% 0,0006–0,001) en España. La estancia media presentó una tendencia decreciente (APC = -0,0017; IC95% -0,002– -0,0014). La tendencia de las listas de espera (consulta especializada e intervenciones quirúrgicas no urgentes) fue estática. La tendencia de estos indicadores varió en las Comunidades Autónomas. CONCLUSIONES Se observa un incumplimiento de los principios de equidad y calidad de las prestaciones ofrecidas. El aumento del envejecimiento, el desarrollo tecnológico y estrategias poco adecuadas tomadas para reducir los costes sanitarios pueden ser las principales causas.

Background: Fibromyalgia syndrome (FMS) is a chronic, generalized and diffuse pain disorder accompanied by other symptoms such as emotional and cognitive deficits. The FMS patients show a high prevalence of gastrointestinal symptoms. Recently it has been found that microbes in the gut may regulate brain processes through the gut-microbiota-brain axis, modulating thus affection, motivation and higher cognitive functions. Therefore, the use of probiotics might be a new treatment that could improve the physical, psychological and cognitive state in FMS; however, no evidence about this issue is available. Methods: This paper describes the design and protocol of a double-blind, placebo-controlled and randomized pilot study. We use validated questionnaires, cognitive task through E-Prime and biological measures like urine cortisol and stool fecal samples. The trial aim is to explore the effects of eight weeks of probiotics therapy in physical (pain, impact of the FMS and quality of life), emotional (depression, and anxiety) and cognitive symptoms (attention, memory, and impulsivity) in FMS patients as compared to placebo. Conclusion: This pilot study is the first, to our knowledge, to evaluate the effects of probiotics in FMS. The primary hypothesis was that FMS patients will show a better performance on cognitive tasks, and an improvement in emotional and physical symptoms. These results will contribute to a better understanding in the gut-brain axis. Here we present the design and protocol of the study.

Antecedentes: el síndrome de fibromialgia (FMS) es un trastorno crónico, generalizado y difuso que produce dolor acompañado de otros síntomas emocionales y cognitivos. Así mismo, los pacientes con FMS muestran una alta comorbilidad de síntomas gastrointestinales. En este sentido, recientemente se ha encontrado que la microbiota intestinal es capaz de regular procesos cerebrales a través del eje intestino-microbiota-cerebro, modulando así a nivel afectivo, emocional, motivacional y de funciones cognitivas complejas. Por lo tanto, el uso de probióticos podría ser una nueva estrategia terapéutica para mejorar el estado físico, psicológico y cognitivo en pacientes con FMS. Sin embargo, aún no hay evidencia disponible sobre este tema. Métodos: este artículo describe el diseño y el protocolo de un estudio piloto doble ciego, controlado con placebo y aleatorizado. Se utilizan cuestionarios validados, tareas cognitivas a través de E-Prime y medidas biológicas como cortisol de orina y muestras de heces. El objetivo del estudio es explorar el efecto de un tratamiento multiespecies probióticas durante ocho semanas en la sintomatología física (dolor, impacto del FMS y calidad de vida), emocional (depresión y ansiedad) y cognitiva (atención, memoria e impulsividad) en pacientes con FMS. Conclusión: el protocolo de este estudio piloto, a nuestro conocer, es el primero que pretende evaluar los efectos de los probióticos en FMS. La hipótesis de partida es que los pacientes con FMS mostrarán un mejor desempeño en las tareas cognitivas y una mejoría en los síntomas emocionales y físicos. Estos resultados contribuirán a una mejor comprensión del eje intestino-cerebral.

Resumen La hipertensión pulmonar (HP) es una complicación frecuente de las enfermedades respiratorias crónicas y en particular de la enfermedad pulmonar obstructiva crónica (EPOC). En la mayoría de los casos la misma es de grado leve a moderada, de lenta progresión y se asocia a enfermedades concomitantes que deben de ser diagnosticadas y tratadas. Su aparición y progresión determina un fuerte impacto en la capacidad funcional y en la supervivencia de estos pacientes. Si bien su desarrollo está asociado con la severidad de la obstrucción al flujo aéreo, no siempre es así y se puede observar en estadios más tempranos de la misma. Una pequeña proporción de pacientes se presenta con una HP severa asociada a obstrucción bronquial leve a moderada, hipoxemia severa, hipocapnia y una capacidad de difusión pulmonar al monóxido de carbono muy baja. Se le ha denominado “HP desproporcionada”, la cual presenta alta mortalidad y un rápido deterioro funcional similar a la hipertensión arterial pulmonar idiopática. El diagnóstico se confirma mediante un cateterismo cardiaco derecho, el cual se reserva para casos seleccionados. El manejo de la HP en la EPOC consiste en descartar comorbilidades, optimizar el tratamiento de la EPOC y la oxigenoterapia continua domiciliaria. No existe evidencia en la actualidad de que la HP asociada a EPOC se beneficie de algún tratamiento vasodilatador específico

Summary Pulmonary hypertension (PH) is a common complication of chronic respiratory diseases and, in particular, chronic obstructive pulmonary disease (COPD). In most cases it is mild, with low progression and is associated with concomitant diseases that should be diagnosed and treated. Its appearance and progression have a strong impact on the functional capacity and survival of these patients. Although it is closely related to the severity of airflow obstruction, not always is the case and it can be seen in earlier stages of the same. A small proportion of patients may develop severe PH associated with mild to moderate bronchial obstruction, severe hypoxaemia, hypocapnia and very low lung diffusion capacity. It has been called “PH out of proportion” and it is associated with high mortality and rapid functional worsening, similar to idiopathic pulmonary arterial hypertension. The diagnosis is confirmed by right heart catheterization which is reserved for selected cases. Management of PH in COPD relies on ruling out comorbidities, optimising therapy for COPD and long-term domiciliary oxygen therapy. At present, there is no evidence that PH in COPD would benefit from any specific vasodilator therapy

Angiomyolipoma (AML) is a hamartomatous growth that usually affects the kidney. One third of patients with AML present with manifestations of tuberous sclerosis. Oral AML is rare with only 6 cases reported in the English-language literature. In the present case, AML was located in the upper lip of a 43 year-old woman. Clinically, it presented as a firm nodule, well circumscribed and measuring 1x2 cm. It was surgically excised. Histopathological analysis showed a lesion composed of an admixture of smooth muscle cells, blood vessels, and adipose tissue. The immunohistochemical study revealed positivity for vimentin, smooth muscle actin, pan specific muscle actin and desmin. CD68, CD34 and mast cell antibodies showed focal immunoreactivity. S100 protein, Ki-67, and HMB-45 were negative. Based on these histological and immunohistochemical features the diagnosis was of oral AML. No recurrence was observed after 2 years of follow-up.

El angiomiolipoma (AML) es un crecimiento tumoral hamartomatoso que usualmente afecta el riñón. Un tercio de los pacientes con AML cursan con manifestaciones de esclerosis tuberosa. El AML de la cavidad oral es raro y hasta la fecha se han reportado 6 casos en la literatura de habla inglesa. El presente caso constituye un AML localizado en el labio superior en una paciente de 43 años de edad. Clínicamente era un nódulo de 1x2cm., firme y bien circunscrito. Fue removido quirúrgicamente. El estudio histológico reveló una lesión compuesta por una mezcla de músculo liso, vasos sanguíneos y tejido adiposo. El análisis inmunohistoquímico reveló positividad para vimentina, actina alfa de músculo liso, pan-actina músculo específico y desmina. CD68, CD34 y anticuerpos anti-mastocitos mostraron inmunoreactividad focal. Proteína S-100, Ki-67 y HMB-45 fueron negativos. Basados en estas características histológicas e inmunohistoquímicas se estableció el diagnóstico de AML oral. No se ha observado recurrencia 2 años después de su remoción.

This article analyzes the influence which they have the wooded masses in the water production of the river basin of the Purapel river, located in the central zone of Chile. This river basin has a surface of 264., km² and it has been affected by processes of vegetational substitution, happening of native forests a massive forestation, mainly of Pinus radiata (D.Don). The made multitemporary analysis, showed that the vegetal cover I vary of 0 per cent of forest plantations in 1957, 51,7 per cent for year 1997. The methodology studied the use of the ground in 1957, 1978 and 1997; the precipitations were analyzed and the flow and hidrogramas of hour in hour studied; the variation of the water reserves was analyzed on monthly scale and annual, the runoff coefficients of monthly and annual were analyzed, the maximum flow, and finally, their relation with the vegetal cover and the water production studied between years 1960 and 2000. The results allow to conclude that for the river basin of the Purapel river, differences in the observed hydrology behavior in the 40 studied years do not exist. The oscillations observed in the hydrologyc variables would have to the amounts and happened intensities of precipitation and to the high intermonthly variability. Only the monthly reserves show a different behavior, since they tend to be increased in 1979/2000 period. It would have to important precipitations fallen in the decade of the 80, and not directly to a change of the type of vegetal cover.

Este artículo analiza la influencia que tienen las masas boscosas en la producción de agua de la cuenca del río Purapel, ubicada en la zona central de Chile. Esta cuenca tiene una superficie de 264,6 km² y se ha visto afectada por procesos de sustitución vegetacional, pasando de bosques nativos a una forestación masiva, principalmente de la especie Pinus radiata (D. Don). El análisis multitemporal realizado, mostró que la cobertura vegetal varió del 0% de plantaciones forestales en el año 1957, al 51,7% para el año 1997. La metodología estudió el uso del suelo en los años 1957, 1978 y 1997; se analizaron las precipitaciones y se estudiaron los caudales y los hidrogramas de hora en hora; se analizó la variación de las reservas de agua a escala mensual y anual, se analizaron los coeficientes de escorrentía mensual y anual, se estudiaron los caudales máximos, y finalmente, su relación con la cobertura vegetal y la producción de agua entre los años 1960 y 2000. Los resultados permiten concluir que para la cuenca del río Purapel, no se observan diferencias estadísticas en las cantidades de agua generadas por los escurrimientos en los 40 años estudiados. Las oscilaciones observadas en las variables hidrológicas se deberían a los montos e intensidades de precipitación ocurridos y a la alta variabilidad intermensual. Sólo las reservas mensuales muestran un comportamiento distinto, ya que tienden a incrementarse en el periodo 1979/2000. Ello se debería a las importantes precipitaciones caídas en la década del 80, y no directamente a un cambio del tipo de cobertura vegetal.