Colorimetric Analysis of Hibiscus Beverages and their Potential Antioxidant Properties.

In food industry, roselle beverages and their subproducts could be functional ingredients since they are an excellent source of bioactive compounds with improved performance due to their important anthocyanins content. The aim of this study was to analyze anthocyanin content and antioxidant properties of aqueous infusions elaborated with color contrasting Hibiscus materials and design a mathematical model in order to predict color-composition relationship. Color measurements of beverages from roselle (Negra, Sudan and Rosa) were made by transmission spectrophotometry, anthocyanins quantification was determined by HPLC, and antioxidant potential was evaluated by in vitro methods (ABTS and FRAP assays). Beverages prepared with particle size minor of 250 µm presented until 4- and 2- times more anthocyanins content and antioxidant capacity respectively, in comparison to beverages prepared with powders with particle size major of 750 µm. Positive correlations among pigments composition and color parameters were found (p < 0.05), showing that anthocyanins content, antioxidant capacity, C*ab and hab values increased in relation with the smallest particle size of flours. Also, mathematical models were stablished to predict anthocyanin content (r ≥ 0.97) and antioxidant capacity (r ≥ 0.89) from color data; we propose equations for quick estimation of the antioxidant capacity in the Hibiscus beverages with high anthocyanin content. The obtained models could be an important tool to be used in food industry for pigment characterization or functional compounds with potential health benefits.

[Motivation and self-directed learning among medical students]. / Aspectos motivacionales involucrados en el aprendizaje autodirigido en estudiantes de medicina. Un enfoque cualitativo.

BACKGROUND: Motivation is an essential aspect in the training process of medical students. The association that motivation can have with learning self-regulation is of utmost importance for the design of curriculum, teaching methods and evaluation. AIM: To describe the motivational aspects of self-directed learning among medical students from a traditional Chilean University. MATERIAL AND METHODS: A qualitative, descriptive study based on grounded theory of Strauss and Corbin. Twenty 4th and 5th year medical students were selected using a maximum variation sampling technique. After obtaining an informed consent, semi-structured interviews and field notes were carried out. Data were analyzed to the level of open coding through Atlas-ti 7.5.2. RESULTS: From the student point of view, personal motivational aspects are linked to the search for information, constant updating, the perception of the physician-patient relationship and interest in subject matters. From the scope of teachers, a main issue is related to their ability to motivate students to develop independent study skills. CONCLUSIONS: Personal motivational aspects facilitate the development of independent study skills, specifically in the search of information. The role of teachers is crucial in promoting these skills and the perception of medical students from their learning process.

[Learning strategies of autonomous medical students]. / ¿Cómo abordan su aprendizaje los estudiantes de medicina autónomos? Una aproximación cualitativa.

BACKGROUND: Understanding how autonomous students are capable of regulating their own learning process is essential to develop self-directed teaching methods. AIM: To understand how self-directed medical students approach learning in medical schools at University of Concepción, Chile. MATERIAL AND METHODS: A qualitative and descriptive study, performed according to Grounded Theory guidelines, following Strauss & Corbin was performed. Twenty medical students were selected by the maximum variation sampling method. The data collection technique was carried out by a semi-structured thematic interview. Students were interviewed by researchers after an informed consent procedure. Data were analyzed by the open coding method using Atlas-ti 7.5.2 software. RESULTS: Self-directed learners were characterized by being good planners and managing their time correctly. Students performed a diligent selection of contents to study based on reliable literature sources, theoretical relevance and type of evaluation. They also emphasized the discussion of clinical cases, where theoretical contents can be applied. This modality allows them to gain a global view of theoretical contents, to verbalize knowledge and to obtain a learning feedback. CONCLUSIONS: The learning process of autonomous students is intentional and planned.

Ontogenetic and spatiotemporal variability in anchoveta Engraulis ringens diet off Peru.

In this study, historical data available since 1954 were used to get new insight to ontogenetic and spatiotemporal variability in Peruvian anchovy or anchoveta Engraulis ringens diet. Whatever the period, E. ringens foraged mainly on macrozooplankton and the importance of euphausiids in E. ringens diet appears directly related to euphausiids abundance. This bottom-up effect is also observed at smaller scale because the euphausiids fraction increased with E. ringens total length and euphausiids accessibility. Selecting the largest prey, the euphausiids, provides an energetic advantage for E. ringens in its ecosystem where oxygen depletion imposes strong metabolic constraints on pelagic fishes. This study illustrates the plasticity of E. ringens that allows it to cope with its highly variable environment.

Comparative study of anthocyanin and volatile compounds content of four varieties of Mexican roselle (Hibiscus sabdariffa L.) by multivariable analysis.

Anthocyanins are a group of water-soluble pigments that provide red, purple or blue color to the leaves, flowers, and fruits. In addition, benefits have been attributed to hypertension and cardiovascular diseases. This study compared the content of total anthocyanins and volatile compounds in aqueous and ethanolic extracts of four varieties of Mexican roselle, with different levels of pigmentation. The multivariable analysis of categorical data demonstrated that ethanol was the best solvent for the extraction of both anthocyanins and volatile compounds. The concentration of anthocyanin in pigmented varieties ranged from 17.3 to 32.2 mg of cyanidin 3-glucoside/g dry weight, while volatile compounds analysis showed that geraniol was the main compound in extracts from the four varieties. The principal component analysis (PCA) allowed description of results with 77.38% of variance establishing a clear grouping for each variety in addition to similarities among some of these varieties. These results were validated by the confusion matrix obtained in the classification by the factorial discriminate analysis (FDA); it can be useful for roselle varieties classification. Small differences in anthocyanin and volatile compounds content could be detected, and it may be of interest for the food industry in order to classify a new individual into one of several groups using different variables at once.

[Multicenter study on the monitoring of in vitro susceptibility to tigeeyeline in Santiago, Chile]. / Estudio multicéntrico de la vigilancia de la susceptibilidad in vitro a tigeciclina en Santiago de Chile.

The objective of this multicenter study was to determine tigecycline susceptibility rates, measured by agar diffusion, in nine hospitals in Santiago and to compare these rates with other antimicrobials. Each center studied 20 strains per month. All intermediate and fully resistant strains as well as 10% of susceptibile strains were also studied by the broth microdilution method. Overall, 2301 strains were studied displaying the following susceptibility rates for tigecycline: 100% for Streptococcus sp, Enterococcus sp, and E. coli respectively, 99.8% for Staphylococcus sp, 93% for Klebsiella and 80% for Acinetobacter baumarmii. For Proteus, Providencia and Morganella the susceptibility rates were 4%. For cefotaxime-resistant Klebsiella and imipenem-resistant A. baumarmii susceptibility rates were 95% and 80% respectively. The agar diffusion and broth dilution method were 100% concordant for tigecycline susceptible strains but only 27% for resistant or intermediate strains represented mostly by Acinetobacter baumannii. The majority of these strains (57/59) proved to be susceptible after retesting. The great majority (96,6%) of strains tested from nine Chilean hospitals proved to be susceptible to tigecycline with exception for Proteus, Providencia and Morganella (66% resistance). Using the agar diffusion method for measuring tigecycline susceptibility to A. baumannii may be misleading.

[Initial pattern of elderly patients and effect on their orientation after their visit in the emergency departments. Results from a national study]. / Trajectoire initiale des patients âgés et impact sur leur orientation après leur passage dans les services d'urgences. Résultats d'une enquête nationale.

PURPOSE: We have little information on the geriatric characteristics of elderly patients visiting the emergency departments (ED) in France. In order to develop an adapted prevention of the arrival of some elderly patients, the determinants of their arrival to the ED deserves to be better known. METHODS: A one-day cross-sectional study was conducted in French ED. A standardized questionnaire was used for each patient over 80 years (Pts), specifying the sociodemographic characteristics, the circumstances of visit to and care received in the ED, and the orientation of the patients after consulting the ED. RESULTS: On a sample of 1298 Pts, health event leading to ED started at home in 63.8% of cases. When the patients initiated themselves the recourse to health care (RHC), they called less often a general practitioner (61.9% of cases) than when the RHC was triggered by their family (69.6%, p=0.01). When a health care professional initiated the RHC, it was a GP in more than 80% of cases. Return to residence was more frequent when the patient triggered the RHC (34.5% versus 22.9% for the family and 16.0% for the professional health care, p<0,001). CONCLUSION: The actor of the decision of arrival to the ED has an impact in the RHC, in resources utilisation, and on the patient's orientation after coming in ED. The results of this study may help to design strategies aiming at avoiding unnecessary ED consultations of elderly persons.

Urinary kallikrein and plasma renin activity in normal human pregnancy.

Urinary kallikrein excretion (UK), plasma renin activity (PRA), and 24-hour urine volume, sodium, and potassium excretion rates were determined sequentially in 16 normal pregnant women. Throughout gestation, UK was significantly elevated as compared to values obtained in 13 control women (1466 +/- 152 vs 375 +/- 90 U/g creatinine). The highest level was observed in Period 2 of gestation, corresponding to Weeks 17 to 24. PRA was also significantly elevated during pregnancy (11.97 +/- 1,35 vs 1.06 +/- 0.90 ng/ml/hr), with the highest level in Period 2. Mean 24-hour urine volume, sodium, and potassium excretion rates were significantly higher during pregnancy. Nor correlation was found between UK and: PRA, urine volume, and sodium and potassium excretions. These findings indicate a consistent activation of the renal-kallikrein-kinin system during pregnancy. We postulate that this vasodilator system might play a role in the maintenance of normotension in pregnancy, counteracting tha effect of the renin-angiotensin-aldosterone system.

Health hazards in international tourists visiting Paris in August: a five-year retrospective epidemiologic survey.

BACKGROUND: Travel-related illnesses have been studied in visitors to developing countries, but no studies have examined the incidence of health problems in visitors to developed countries. METHODS: 4, 093 foreign tourists visiting Paris in August and attending to emergency medical care for acute health problems were included in an epidemiological survey conducted over 5 consecutive years. The objective was to determine what types of acute health problems occur in a foreign tourist population and to estimate the incidence of the main health hazards. RESULTS: Gastroenteritis represented the main cause of medical care in that population (from 14.5-21.9%) followed by traumatology, ENT problem, viral syndrome and dermatology which represented altogether 60-64% of all medical problems. Two factors were related to the distribution of diseases observed: age and nationality. The monthly incidence of gastroenteritis was estimated to be between 1.33 to 2.92 per 10,000 visitors, and the overall incidence of health problems between 8 to 10 per 10,000. CONCLUSIONS: Even if the incidence rate of gastroenteritis is low compared with developing countries, further studies are needed to support the hypothesis that gastroenteritis could be attributed to sanitary conditions in some restaurants of the French capital.

Ermakov-Lewis angles for one-parameter supersymmetric families of Newtonian free damping modes.

We apply the Ermakov-Lewis procedure to the one-parameter damped modes y recently introduced by Rosu and Reyes, which are related to the common Newtonian free damping modes y by the general Riccati solution [H. C. Rosu and M. Reyes, Phys. Rev. E 57, 4850 (1998)]. In particular, we calculate and plot the angle quantities of this approach that can help to distinguish these modes from the common y modes.

Idiopathic thrombocytopenic purpura in patients at risk for acquired immunodeficiency syndrome. Histopathologic study, immunohistochemistry, and ultrastructural study on six spleens.

Some cases of idiopathic thrombocytopenic purpura (ITP) may be related to the prodromal phase of the acquired immunodeficiency syndrome (AIDS). The morphologic features of six spleens removed in this context were studied. In the white pulp, lymphoid follicular hyperplasia was constant but hardly distinguishable from that of control ITP on routine light microscopic grounds. Moreover, its bland appearance contrasted with the major histopathologic changes usually described in lymph node biopsy specimens from patients with AIDS-related complex. Immunohistochemistry and electron microscopy demonstrated, respectively, an excess of cytotoxic-suppressor lymphocytes with a decreased CD4/CD8 ratio in the germinal centers and viral particles of the human immunodeficiency virus. The immunohistochemical and ultrastructural studies were more helpful than light microscopy in presenting histopathologic arguments in favor of the human immunodeficiency virus infection.

[High prevalence of infection by hepatitis B virus and HIV in incarcerated French drug addicts]. / Forte prévalence de l'infection par le virus de l'hépatite B et le virus HIV chez les toxicomanes français incarcérés.

This clinical and biological study was undertaken to assess the prevalence of infection by HIV, HBV and HDV in male drug abusers entering a prison. One hundred and thirteen drug users accepted to be tested: 14 (12 p. 100) were homosexual; 12 (11 p. 100) consumed more than 80 g per day of alcohol. The mean duration of drug addiction was 5 +/- 2.9 years; 50 (44 p. 100) declared having used a personal syringe while 63 (56 p. 100) usually shared their syringe. Serum activity of transaminases higher than twice the normal value was noted in 36 cases (32 p. 100). One hundred and two (90 p. 100) drug abusers had a HBV marker, 17 (15 p. 100) were HBs Ag carriers, 9 had anti-HBc antibody alone. The prevalence of antibodies to the HDV was 23 p. 100 and was higher among the HBs Ag carriers (65 p. 100). There were no cases of AIDS. Clinical examination showed lymphadenopathy in 49 cases (43 p. 100), a weight loss of more than 10 p. 100 in 47 cases (42 p. 100), and in 69 cases (61 p. 100), HIV positive serology, confirmed by Western blot. The duration of drug addiction was longer in the 102 drug users with HBV markers. Long duration of drug abuse and the use of a shared syringe increased the risk of HIV infection. No relation was noted between the presence of HBV markers and HIV positive serology. In this population the prevalence of HIV, HDV markers and HIV infection was high, but no relation with the duration of previous incarceration or homosexuality was found.(ABSTRACT TRUNCATED AT 250 WORDS)

[Value of echotomography for the diagnosis of lithiasis of the common bile duct]. / Valeur de l'échotomographie pour le diagnostic de lithiase de la voie biliaire principale.

The accuracy of ultrasonography (US) for the diagnosis of cholelithiasis and for dilatation of the intra- and extra-hepatic biliary tree is well known. However, the value of US for the diagnosis of common bile duct stones remains poorly defined. We performed a prospective study in 100 patients who were referred for endoscopic retrograde cholangiopancreatography (ERCP); all the examinations were carried out by the same sonographist in the 24 h preceding the ERCP. Fifty patients had choledocholithiasis, 20 patients had obstruction of the bile ducts without lithiasis and the common bile duct (CBD) was free in 30 patients. The sensitivity of US for the diagnosis of choledocholithiasis was 40 p. 100, the specificity 90 p. 100. The positive and negative predictive values of the "CBD stone" sign was 80 p. 100 and 60 p. 100 respectively. In a total of 30 false negatives, the CBD could not be explored in 4 cases, dilatation of the CBD was missed in one case, and obstruction of the CBD by an other disease was diagnosed in 2; in all the other cases, US was able to appreciate the CBD size as well as the ERCP. In the 20 patients with an obstructed CBD but without choledocholithiasis, US diagnosed a stone in 5 cases. Age, serum bilirubin, existence of a previous cholecystectomy, technical difficulties, stone size were comparable in patients with true positive tests and in patients with false negative tests. However the diagnosis of choledocholithiasis was more frequently achieved in patients with dilated CBD over 10 mm (p less than 0.05) and in patients with multiple stones.(ABSTRACT TRUNCATED AT 250 WORDS)

Sentinel monitoring of general community health during the 1998 World Football Cup.

BACKGROUND: Present knowledge of the consequences of mass gatherings for the health of the community is scant. Our objective was to determine the impact of the 1998 World Football Cup on general community health. METHODS: We set up an electronic sentinel disease surveillance, before, during and after the World Football Cup tournament held in France from June 10 to July 12, 1998. Medical activity, and the daily number of cases of communicable, environmental, and societal diseases relating to mass gatherings were surveyed. The incidence of the pathologies surveyed in real time during and after the World Cup versus the pre-Cup reference period was the main outcome measure. Five sentinel networks participated, comprising 553 general practitioners, 60 hospital adult emergency departments, 19 private emergency community services, 4 community health centres, and the medical centre of the Paris airports. RESULTS: Throughout the 66-day study period, physicians reported 558,829 medical encounters via 21,532 connections to the computer. Compared to the reference period, the level of medical activity reflected by the pathological items surveyed remained stable during the study period. CONCLUSION: The 1998 World Football Cup had no epidemiological impact on general community health, as observed by sentinel networks located downstream of the specific health services provided by the French authorities to ensure high standards of safety.

[B virus, delta agent and human immunodeficiency virus infections in drug addicts]. / Les infections à virus B et delta et à virus de l'immunodéficience humaine chez les toxicomanes.

Infections with the B, D, A, NANB viruses and with the human immunodeficiency virus (HIV) are very common among drug addicts, some of whom may harbour several of these pathogens. The serum of 90 per cent of drug addicts contains one of the HBV markers, and 20 per cent of them carry an anti-D antibody which is more often present in HBs Ag-positive subjects but may also be found in those who are positive for anti-HBs and anti HBc antibodies. The presence of an anti-delta antibody increases the risk of severe histological lesions (chronic active hepatitis, cirrhosis), as does chronic alcoholism associated with drug addiction. Fifty to sixty per cent of drug addicts are seropositive for HIV. At the AIDS stage, hepatic lesions are extremely frequent (90 per cent), but they have low activity and are seldom responsible for death.

[Total eclipse of the sun in August 11, 1999: a program of prevention and surveillance of ocular complications]. / Eclipse totale de soleil du 11 août 1999: programme de prévention et surveillance des complications oculaires.

Watching directly at the sun without appropriate protection, particularly during a solar eclipse, can cause severe retinal injuries. On 11 August 1999, a total solar eclipse crossed France. The Direction Générale de la Santé implemented a prevention strategy. A formal agreement was developed with manufacturers and importers of protective glasses and more than 30 million glasses, conformed with safety standards, were distributed in France. Information campaign reach the whole population in France. In order to evaluate the impact of this campaign, The National Institute of Public Health in France implemented a nation-wide surveillance of ocular complications related to the eclipse. Information on patients was collected using a standardised questionnaire. The questionnaire was sent to the 5,600 private and public sector ophthalmologists practising in France and to five hundred hospital emergency units. A total of 147 patients were reported to have had a retinal injury associated with viewing the eclipse. Seventeen cases were severe (visual acuity < 2/10th) of whom 7 had bilateral injury. Forty-four per cent of patients were aged 15 to 29 years and 46% viewed the eclipse in three regions in the south of France which were sunny on 11th August. One hundred and six patients (67% aged 30 years and more) presented with keratitis. Thirty-six per cent occurred in 2 northern regions of France, which were overcast on the day. A hundred patients watched the whole eclipse without any protection, 74 reported to have removed their EC glasses, and 32 used non-appropriate devices. Only 4 patients presenting with retinal injury reported having used the EC glasses the whole time whilst viewing the eclipse. France is the only country in Europe to have implemented an exhaustive prospective surveillance of ocular injuries related to the solar eclipse. According to current data, the quality and availability of EC glasses did not contribute significantly to ocular injuries. Clinical and epidemiological studies are being conducted in order to further document the evolution of patients presenting with retinal injuries, the circumstances of observation, and their comprehension of preventive messages.

[Behavior of brain perfusion with SPECT tomography 99mTc ethylene dicysteine (ECD) in alcohol and cocaine dependents during abstinence]. / Comportamiento de la perfusión cerebral con tomografía SPECT- 99mTc etilencisteína dímero (ECD) en dependientes a alcohol y cocaína durante abstinencia.

Brain perfusion abnormalities after an abstinence period of 28 days in a group of patients with alcohol and / or cocaine dependence was investigated. They were related with gender, consumption period and number of drugs. Fifty men and 10 women were included and SPECT perfusion was performed using 99mTc ethylene cysteine dimer (ECD) with qualitative and semiquantitative section analysis. Perfusion abnormalities were observed in 60% of the patients, principally in frontal, temporal and parietal lobes. The abnormalities were focal in 58.3%, diffuse in 41.7% and bilateral in 95% of all patients. Abnormalities were observed in 68% of the men and in only 20% of the women (p = 0.01). Patients with brain perfusion abnormalities had a longer period of consumption corresponding to a median of 17.5 years in patients with abnormalities versus nine years in those with no abnormalities (p = 0.036), however, their ages as well as the number of drugs consumed were not significantly different. In conclusion, after 28 days of alcohol and / or cocaine abstinence there is significant presence of brain perfusion abnormalities with 99mTc ECD. This could be explained by vasospasm and / or secondary endothelial lesions.

[Assessment of coronary revascularization with 99mTC-sestamibi SPECT. Quantitative analysis of segmentary perfusion]. / Evaluación de la revascularización coronaria con 99m Tc-sestamibi SPECT. Análisis cuantitativo de perfusión segmentaria.

UNLABELLED: We analyzed the change in myocardial perfusion recovery after revascularization using Dipyridamole-99mTc-Sestamibi SPECT in 37 patients (mean age 59 years old; 33 males), all of whom had wall motion abnormalities and 84% who had myocardial infarction. The perfusion defects were evaluated before the revascularization and at 64 days of the angioplasty in 18 cases and of the coronary artery bypass graft (CABG) in 19 and were compared with a normal Dipyridamole database. The bullseye parameters were: decrease in severity, size and ischemia area of the defect and worsening of the defect. It was found that the defects decreased in an average of 31. 4% for extension and 35,8% for severity (with no significant differences between the 2 techniques); the ischemia was reduced in 75.7%. No new defects appeared although some presented a slight worsening. The net change in reduction was 26% for extension and 29% for severity. CONCLUSION: In patients with a high prevalence of myocardial infarction, revascularization obtained a moderate decrease in the perfusion defects and a significant ischemia decrease.

Hemorragia uterina anormal / Uterine abnormal hemorrhage

La hemorragia uterina anormal (HUA) es un signo y síntoma clínico frecuente en el consultorio de ginecología, manifestándose en cualquier etapa de la vida de la mujer. Se presenta en el 25% de adolescentes y en el 50% en mayores de 40 años; además represen-ta un 25% de las cirugías ginecológicas. Tiene como factores predisponente la raza, gemelar, agregación familiar, asociación a enfermedades geneticas. La cantidad y duración de las menstruaciones es muy subjetiva, por lo que hay problemas para valorar las pérdidas sanguíneas de las pacientes. El diagnóstico de hemorragia uterina disfuncional es por exclusión, primero se debe descartar las causas orgánicas. Por ello la HUA es un problema frecuente que se puede presentar a cualquier edad repercutiendo en varios aspectos como el sanitario y social, su tratamiento debe ser multidisciplinario, ya que no debemos olvidar que es una de las principales causas de anemia en la mujer y también de histerectomías. (AU)

The HUA is a common clinical signs and symptoms in gynecology clinic, being a disorder in the female genital tract, can occur at any age of life of women. It comes in a 25% in adolescents and 50% older than 40 years and 25% of gynecological surgeries. It has an ethnic predisposition, twins, familial aggregation, association with genetic diseases. The amount and duration of menses is very subjective, so there are problems in assessing blood loss of patients. The diagnosis of dysfunctional uterine bleeding is by exclusion, you must first rule out organic causes. Thus the HUA is a common problem that can occur at any age impacting several aspects such as health and social, treatment should be multidis-ciplinary, and we must not forget that it is a major cause of anemia in women and hysterectomy. (AU)

Aspectos motivacionales involucrados en el aprendizaje autodirigido en estudiantes de medicina. un enfoque cualitativo / Motivation and self-directed learning among medical students

Background: Motivation is an essential aspect in the training process of medical students. The association that motivation can have with learning self-regulation is of utmost importance for the design of curriculum, teaching methods and evaluation. Aim: To describe the motivational aspects of self-directed learning among medical students from a traditional Chilean University. Material and Methods: A qualitative, descriptive study based on grounded theory of Strauss and Corbin. Twenty 4th and 5th year medical students were selected using a maximum variation sampling technique. After obtaining an informed consent, semi-structured interviews and field notes were carried out. Data were analyzed to the level of open coding through Atlas-ti 7.5.2. Results: From the student point of view, personal motivational aspects are linked to the search for information, constant updating, the perception of the physician-patient relationship and interest in subject matters. From the scope of teachers, a main issue is related to their ability to motivate students to develop independent study skills. Conclusions: Personal motivational aspects facilitate the development of independent study skills, specifically in the search of information. The role of teachers is crucial in promoting these skills and the perception of medical students from their learning process.