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Hector Alejandro Rodriguez-Garcia,1 Andrew S Wright,2–4 Robert B Yates1–3 1Department of Surgery, Center for Esophageal and Gastric Surgery, 2Center for Videoendoscopic Surgery, 3Hernia Center, 4Institute for Simulation and Interprofessional Studies, UWMC, University of Washington, Seattle, USA Abstract: Gastric volvulus is the abnormal torsion of the stomach along its short or long axis. Most patients who experience gastric volvulus present with mild or intermittent gastric obstructive symptoms. However, severe acute gastric volvulus can result in complete gastric outlet obstruction and ischemia. Consequently, acute gastric volvulus warrants immediate evaluation and management. The goals of management are to relieve the obstruction and prevent recurrent volvulus. Techniques to manage gastric volvulus depend on patient characteristics and the presence of gastric ischemia. In the absence of gastric ischemia, gastric volvulus can be managed with anterior abdominal wall gastropexy or paraesophageal hernia repair. If gastric ischemia is present, operative resection of the affected portion of the stomach is indicated. When operative management is indicated, many patients with gastric volvulus can be managed with minimally invasive (laparoscopic, endoscopic, or laparoendoscopic) techniques. Keywords: gastric volvulus, paraesophageal hernia, hiatal hernia

Gustavo Echeverría,1,2 Armando Reyna-Bello,3 Elizabeth Minda-Aluisa,1 Maritza Celi-Erazo,1 Lisbeth Olmedo,1 Herakles A García,4 Miguel Angel Garcia-Bereguiain,5–7 Jacobus H de Waard,5,8 On behalf of the UNU/BIOLAC network for infectious cattle diseases1Instituto de Investigación en Salud Publica y Zoonosis (CIZ), Universidad Central del Ecuador, Quito, Ecuador; 2Facultad de Ciencias Veterinarias, Programa de Doctorado, Universidad de Buenos Aires, Buenos Aires, Argentina; 3Departamento de Ciencias de la Vida y la Agricultura, Carrera de Ingeniería en Biotecnología, Universidad de las Fuerzas Armadas ESPE, Santo Domingo, Ecuador; 4Departamento de Parasitologia, Instituto de Ciências Biomédicas, University of São Paulo, São Paulo, Brazil; 5One Health Research Group. Facultad de Ciencias de la Salud, Universidad de Las Américas (UDLA), Quito, Ecuador; 6School of Biological Sciences and Engineering, Yachay Tech, Urcuquí, Ecuador; 7Laboratorio para Investigaciones Biomedicas. Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador; 8Instituto de Biomedicina Dr. Jacinto Convit, Universidad Central de Venezuela, Caracas, VenezuelaBackground: Q fever is an underreported zoonotic disease of cattle and men in most countries of the world. Very little information about the prevalence of Coxiella burnetii infection in animals and humans comes from South and Central America and systematic studies are lacking. Methods: A seroprevalence survey for Q fever amongst cattle, farm workers and students was conducted in Ecuador using a commercial ELISA kit.Results: Survey results showed an unexpectedly high prevalence of Coxiella burnetii antibodies in dairy cattle (43%) and in farm workers (34%). In addition, a clinical case in a human of acute Q fever in the convalescent stage was detected. Conclusion: We conclude that the disease is endemic in Ecuador but is overlooked by medical and laboratory personnel. Q fever should be considered a public health issue in Ecuador and further research into the clinical relevance of this infection is recommended.Keywords: Q fever, Coxiella burnetii, Ecuador, phase I antibodies, phase II antibodies