Guía clínica de manejo de la diabetes insípida y del síndrome de secreción inapropiada de hormona antidiurética en el postoperatorio de la cirugía hipofisaria

Changes in water metabolism and regulation of vasopressin (AVP) or antidiuretic hormone (ADH) are common complications of pituitary surgery. The scarcity of studies comparing different treatment and monitoring strategies for these disorders and the lack of prior clinical guidelines makes it difficult to provide recommendations following a methodology based on grades of evidence. This study reviews the pathophysiology of diabetes insipidus and inappropriate ADH secretion after pituitary surgery, and is intended to serve as a guide for their diagnosis, differential diagnosis, treatment, and monitoring.     

Efectos de la actividad física de intensidad suave sobre las condiciones físicas de los adultos mayores: revisión sistemática

Physical activity can improve function in people over 65. The aim of the study was to evaluate the efficacy of mild intensity exercise interventions on the functional health and quality of life of this population. A systematic review was conducted using WOS (n = 20), Scopus (n = 235), PubMed (n = 15), and PEDro (n = 20) databases. Eight studies met the inclusion criteria. Six hundred and nineteen subjects with an age range of 60-103 years were evaluated. Interventions included endurance, aerobic, and vibration exercises. Those who used pedometers, telephone calls and follow-up controls showed positive effects in increasing physical activity. Five studies evaluated strength and showed that increasing strength also improved balance and walking speed. The results indicate that applying mild intensity physical activity interventions is a way of ensuring improved functional health and quality of life in older people.     

Revisión Crítica de Investigaciones y Literatura Micológicas Durante Los Años 1950–1960 en Ecuador

Sumario En este trabajo se hace una revisión de los artículos publicados sobre Micología Médica, durante la década de 1950 a 1960, en la República del Ecuador.Por el estudio de este material se advierte que por el esfuerzo de pocos investigadores se ha logrado poner de manifiesto, en el período considerado, la mayor parte de las afecciones micósicas que tienen importancia en Patología humana y que, como era de esperarse, existían en el País.Conviene señalar que por el accidente geográfico de los Andes, el Ecuador posee por un lado, regiones típicamente tropicales en la parte del litoral y en la región oriental o amazónica y por otro lado una serie de matices climáticos cuando se asciende desde las planicies hasta la meseta interandina de clima templado o frío. Por ello en este trabajo se menciona siempre la procedencia de los pacientes, la cual se ubica fácilmente en el mapa que se adjunta.Las micosis superficiales por dermatofitos se encuentran tanto en la costa como en la sierra, pero en la primera región se reparten por igual los casos de microsporias y de tricoficias, en tanto que en la sierra predominan las microsporias.En la costa se han identificado las siguientes especies de dermatofitos:T. tonsurans, T. rubrum, T. mentagrophytes, T. violaceum yT. album;M. canis, M. Audouinii yM. gypseum. Hasta ahora no hay datos ciertos de la existencia deT. Schoenleinii en el País.De micosis profundas se describieron casos de Blastomicosis Sudamericana, Histoplasmosis, Coccidioidomicosis, Cromoblastomicosis, Rhinosporidiosis, Criptococcosis, Geotricosis, Micetomas y Moniliasis.La mayor parte de estas afecciones se encontraron en sitios de la costa, que es zona en general baja, cálida y húmeda.Sin embargo, los casos de Coccidioidomicosis procedieron de valles de la sierra, que no obstante encontrarse en esa región tienen clima semi-tropical. Aún más, alguno de los casos de Blastomicosis Sudamericana ocurrió en uno de esos valles.En el examen de tierras para investigar hongos patógenos, se encontró entre los dermatofitos,M. gypseum yT. mentagrophytes. En 109 muestras de tierra de provincias de la costa y sierra, se encontró dos vecesH. capsulatum, 1 vezCriptococcus sp., dos vecesNocardias y varias veces especies del géneroAspergillus.

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Summary In this paper a survey is made of published articles about Medical Mycology during the decade 1950 to 1960 in the Republic of Ecuador.Through the study of this material it is noticed that due to the efforts of only a few investigatiors it has been possible to discover, during this period, most of the mycotic affections which are important in human pathology, and as it was expected they really existed in the country.It is convenient to mention that due to the geographical site of the Andes, Ecuador has for one side, typical tropical regions at the part of the litoral and to the oriental region; and for another side several climatic conditions when going up from the low lands to the interandean plateau with a temperate or cold climate. That is why the origin of the patients is always mentioned which is easily located on the included map.The superficial mycoses due to dermatophytes are found in the coastal as in the interandean region, but in the first one the cases of microspories and tricophyties are equaly distributed, meanwhile in the interandean zone the microspories predominate over the other.The following species have been identified on the coast:T. tonsurans, T. rubrum, T. mentagrophytes, T. violaceum andT. album; M. canis, M. Audouinii andM. gypseum. Until now there are no sure facts about the existence ofT. Schoenleinii in the country.The following deep mycoses have been observed: South American Blastomycosis, Histoplasmosis, Coccidioidomycosis, Chromoblastomycosis, Rhinosporidiosis, Cryptococcosis, Geotricosis, Mycetomas and Moniliasis.The greatest part of these affections were found in places of the coast, which is a zone generally low, warm, and humid.However, the cases of Coccidioidomycosis originated from valleys of the interandean zone.Even more, some of the cases of South American Blastomycosis occurred in one of those valleys.In soil surveys, in order to investigate pathogens, there were found among dermatophytes,M. gypseum andT. mentagrophytes. From 109 samples of soils from litoral and interandean provinces, there occurred: twiceH. capsulatum, onceCriptoccocus spp., twiceNocardias and many times species ofAspergillus genus.

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Director del Instituto Nacional de Higiene Leopoldo Izquieta Perez Guayaquil-Ecuador.     

Flora y vegetation briofítica higro-hidrófila de la comunidad Valenciana (Este de España)

The bryophyte flora and vegetation have been studied in aquatic and wet environments of Valencia County (eastern Spain). A catalogue of 74 taxa is given, 3 species are new for eastern Spain and 6 for provinces of Valencia County (Valencia = 4, Castellón = 2). Aquatic communities have been studied according to the Braun-Blanquet (1952) method. Nine associations belonging to the classes Adiantetea, Montio-Cardaminetea and Platyhypnidio-Fontinalietea have been recognized. One association has been described as new, Fontinaletum hypnoidis ass. nova, which always grows submerged in calcareous, unpolluted and flowing water. Ecological and syntaxonomical data on problematical communities in the Mediterranean region (EucladioAdiantetum, Eucladietum and Eucladio-Didymodonetum) are given, as well as information on the dynamics of the communities.