Effect of solvent viscosity on the activation barrier of hydrogen tunneling in the lipoxygenase reaction.

Hydrogen tunneling in enzyme reactions has played an important role in linking protein thermal motions to the chemical steps of catalysis. Lipoxygenases (LOXs) have served as model systems for such reactions, showcasing deep hydrogen tunneling mechanisms associated with enzymatic C-H bond cleavage from polyunsaturated fatty acids. Here, we examined the effect of solvent viscosity on the protein thermal motions associated with LOX catalysis using trehalose and glucose as viscogens. Kinetic analysis of the reaction of the paradigm plant orthologue, soybean lipoxygenase (SLO), with linoleic acid revealed no effect on the first-order rate constants, kcat, or activation energy, Ea. Further studies of SLO active site mutants displaying varying Eas, which have been used to probe catalytically relevant motions, likewise provided no evidence for viscogen-dependent motions. Kinetic analyses were extended to a representative fungal LOX from M. oryzae, MoLOX, and a human LOX, 15-LOX-2. While MoLOX behaved similarly to SLO, we show that viscogens inhibit 15-LOX-2 activity. The latter implicates viscogen sensitive, conformational motions in animal LOX reactions. The data provide insight into the role of water hydration layers in facilitating hydrogen (quantum) tunneling in LOX.

El desarrollo de la coordinación en levantadores de pesas, en la categoría 13-14 años

En la categoría 13-14 años del deporte levantamiento de pesas, la formación de habilidades técnicas y el desarrollo de capacidades constituyen objetivos principales. En las observaciones realizadas a los entrenamientos, se apreciaron deficiencias en la ejecución de los ejercicios clásicos, debido a insuficiencias en la coordinación de las fases de movimiento. Para dar solución a este problema científico, se define como objetivo valorar los resultados de la aplicación de acciones pedagógicas para el desarrollo de la coordinación en levantadores de pesas de la categoría escolar. Se aplicaron acciones que favorecieron el desarrollo de contenidos dirigidos a la planificación y entrenamiento de las capacidades coordinativas en las preparaciones metodológicas y de ejercicios de preparación física general y especial; además, se aplicó un test para evaluar la coordinación de las fases del ejercicio clásico arranque en el proceso de entrenamiento. Se utilizaron métodos del nivel teórico como el análisis-síntesis, el sistémico-estructural y el inductivo-deductivo y empíricos como la observación, el análisis de documentos, la encuesta y la experimentación, además de métodos matemáticos y estadísticos. Se consideraron novedosos los resultados de la aplicación de las acciones y el sistema de ejercicios para el desarrollo de la coordinación en los pesistas de la categoría 13-14 que reflejaron incremento de la velocidad en la ejecución y la coordinación del movimiento, así como un aumento de las puntuaciones de la evaluación técnica con relación a cursos anteriores, lo que propició una mejor ubicación de los pesistas de la provincia en la competencia nacional.

Na categoria de levantamento de peso de 13-14 anos, o treinamento de habilidades técnicas e o desenvolvimento de capacidades são os principais objetivos. Nas observações feitas durante as sessões de treinamento, foram constatadas deficiências na execução dos exercícios clássicos, devido a insuficiências na coordenação das fases do movimento. Para solucionar esse problema científico, o objetivo foi avaliar os resultados da aplicação de ações pedagógicas para o desenvolvimento da coordenação em levantadores de peso da categoria escolar. Foram aplicadas ações que favoreceram o desenvolvimento de conteúdos voltados para o planejamento e treinamento das capacidades coordenativas nas preparações metodológicas e exercícios de preparação física geral e especial; além disso, foi aplicado um teste para avaliar a coordenação das fases do exercício clássico de partida no processo de treinamento. Foram utilizados métodos teóricos como análise-síntese, sistêmico-estrutural e indutivo-dedutivo, bem como métodos empíricos como observação, análise de documentos, pesquisa e experimentação, além de métodos matemáticos e estatísticos. Os resultados da aplicação das ações e do sistema de exercícios para o desenvolvimento da coordenação nos levantadores de peso da categoria 13-14 foram considerados novos, pois refletiram um aumento na velocidade de execução e coordenação de movimentos, bem como um aumento nas pontuações da avaliação técnica em relação aos cursos anteriores, o que levou a uma melhor colocação dos levantadores de peso da província na competição nacional.

In the 13-14-year-old category of the weightlifting sport, the training of technical skills and the development of capacities are the main objectives. In the observations made to the training, deficiencies were observed in the execution of the classic exercises, due to insufficiencies in the coordination of the movement phases. In order to solve this scientific problem, the objective is to assess the results of the application of pedagogical actions for the development of coordination in weightlifters of the 13-14 years category. Actions were applied that favored the development of contents directed to the planning and training of the coordinative capacities in the methodological preparations and exercises of general and special physical preparation; in addition, a test was applied to evaluate the coordination of the phases of the classic snatch exercise in the training process. Methods of the theoretical level such as analysis-synthesis, systemic -structural and inductive-deductive and empirical methods such as observation, document analysis, survey and experimentation, as well as mathematical and statistical methods were used. The results of the application of the actions and the system of exercises for the development of coordination in weightlifters of the 13-14 category were considered novel, reflecting an increase in speed in the execution and movement coordination, as well as an increase of the scores of the technical evaluation in relation to previous school courses, which led to a better placement of the province's weightlifters in the national competition.

Shortcomings of applying data science to improve professional football performance: Takeaways from a pilot intervention study.

Positional tracking data allows football practitioners to derive features that describe patterns of player behavior and quantify performance. Existing research using tracking data has mostly focused on what occurred on the pitch, such as the determinants of effective passing. There have yet to be studies attempting to use findings from data science to improve performance. Therefore, 24 professional players (mean age = 21.6 years, SD = 5.7) were divided into a control team and an intervention team which competed against each other in a pre-test match. Metrics were gathered via notational analysis (number of passes, penalty box entries, shots on goal), and positional tracking data including pass length, pass velocity, defensive disruption (D-Def), and the number of outplayed opponents (NOO). D-Def and NOO were used to extract video clips from the pre-test that were shown to the intervention team as a teaching tool for 2 weeks prior to the post-test match. The results in the post-test showed no significant improvements from the pre-test between the Intervention Team and the Control Team for D-Def (F = 1.100, p = 0.308, η2 = 0.058) or NOO (F = 0.347, p = 0.563, η2 = 0.019). However, the Intervention Team made greater numerical increases for number of passes, penalty box entries, and shots on goal in the post-test match. Despite a positive tendency from the intervention, results indicate the transfer of knowledge from data science to performance was lacking. Future studies should aim to include coaches' input and use the metrics to design training exercises that encourage the desired behavior.

Estrategias terapéuticas para Helicobacter pylori en Colombia / Therapeutic strategies for Helicobacter pylori in Colombia

Resumen El amplio espectro de enfermedades causadas por la infección Helicobacter pylori obliga a un diagnóstico oportuno y dar un tratamiento altamente eficaz, reduciendo el riesgo de morbilidad y aumentando la probabilidad de erradicación. Son varias las terapias que tienen respaldo en la literatura, por lo que se deben conocer sus ventajas y limitaciones, incluyendo las resistencias bacterianas locales y seleccionar la mejor opción. Este artículo revisa los esquemas de tratamiento más utilizados y ofrece pautas para el manejo y seguimiento del paciente con infección por Helicobacter pylori en Colombia.

Abstract The wide spectrum of diseases caused by Helicobacter pylori infection requires a timely diagnosis and a highly effective treatment, reducing the risk of morbidity and increasing the probability of eradication. There are several therapies that are supported in the literature, therefore, its advantages and limitations, including our local resistances, must be known to select the best option. This article reviews the most widely used treatment regimens and offers guidelines for the management and follow-up of patients with Helicobacter pylori infection in Colombia.

Enfermedad del hígado graso asociada con la disfunción metabólica. Una nueva propuesta para una dolencia en auge

La enfermedad por hígado graso no alcohólica se caracteriza por la acumulación de grasa hepática que excede el 5 % de su peso. El espectro de esta condición incluye la esteatosis hepática, esteatohepatitis y fibrosis progresiva con cirrosis. Además, existe la posibilidad de desarrollar hepatocarcinoma sin el antecedente de cirrosis. Su fisiopatología se basa actualmente en el componente metabólico y se considera como la manifestación hepática de una disfunción metabólica sistémica. La acumulación de grasa causa citotoxicidad, inflamación y fibrosis. Debido al auge en su investigación, se ha propuesto el término de enfermedad del hígado graso asociado con una disfunción metabólica, confiriéndole unos criterios diagnósticos claros y retirando el concepto como entidad de descarte. El diagnóstico incluye la documentación de esteatosis hepática y fibrosis como marcador pronóstico mediante estudios imagenológicos y puntajes bioquímicos. El tratamiento consiste en la reducción del peso y mejorar la condición metabólica basal. Actualmente, se encuentran en estudio nuevos fármacos que buscan interferir con la inflamación hepática. El manejo incluye, además, el control del riesgo cardiovascular y de otras enfermedades concomitantes.

SUMMARY Nonalcoholic fatty liver disease is characterized by fat accumulation in the liver exceeding 5% of its weight. The spectrum of the disease includes fatty liver, steatohepatitis and progressive fibrosis leading to cirrhosis. It is also possible to develop hepatocellular carcinoma even without cirrhosis. Its physiopathology highlights the metabolic component of the disease, being acknowledged as a hepatic expression of a multisystemic metabolic disorder. Fat accumulation causes apoptosis, inflammation and fibrosis. In the view of the rising research on the subject, a new terminology is being proposed, consisting in metabolic associated fatty liver disease, now perceived as a standalone condition not needing the exclusion of other entities to make a diagnosis. The diagnosis includes the identification of liver steatosis and fibrosis, as a prognosis marker, using imaging studies and scoring models with biochemical markers. Treatment consists primarily in weight reduction and improving the metabolic baseline condition. New studies seeking pharmacologic interventions targeting hepatic inflammation are being conducted. Therapy also includes appropriate management of other medical comorbidities and cardiovascular risk control.

First Record of Mansonia dyari in the State of Morelos, Mexico, Based on Morphology and COI DNA Barcoding.

Collections of mosquitoes were conducted for the surveillance of species of medical importance in the state of Morelos, Mexico, in June 2017. Species collected included Mansonia (Mansonia) dyari, which was identified using morphological characters and cytochrome c oxidase I DNA barcoding. Although 3 species of genus Mansonia have been previously reported in Mexico, this is the 1st confirmed record of Ma. dyari in Morelos State, where no Mansonia species had been recorded. Historical records of Ma. dyari and Ma. indubitans in Mexico were reviewed. Therefore, this record increases the number of mosquito species occurring in Morelos to 46. The specimens collected in this study were deposited in the Culicidae collection of the Universidad Autónoma Agraria Antonio Narro, Unidad Laguna.

El Capital Psicológico Positivo y su Relación con Comportamientos Discrecionales en Trabajadores de Lima, Perú / Positive Psychological Capital and its Relation to Discretional Behaviors of Workers in Lima, Peru / O Capital Psicológico Positivo e a sua Relação com Comportamentos Discricionários em Trabalhadores de Lima, Peru

Resumen Se evaluó la relación existente entre el capital psicológico positivo, las conductas de ciudadanía organizacional y las conductas contraproducentes de trabajo a través de un estudio transversal correlacional. Para esto se contó con una muestra de 137 trabajadores de diversas organizaciones de Lima, con una edad entre los 21 y los 63 años (M=36.51; DE=9.71). Los resultados mostraron relaciones directas entre el capital psicológico y las conductas de ciudadanía organizacional, así como relaciones inversas entre el capital psicológico y las conductas contraproducentes de trabajo. Además, se encontraron diferencias dentro de las variables a nivel de edad y experiencia laboral total. Los resultados aportan evidencia acerca de la importancia del desarrollo del capital psicológico dentro de las organizaciones para la generación de conductas deseables en el entorno de trabajo. Las limitaciones y recomendaciones son incluidas al final del estudio.

Abstract The study evaluated the relation among positive psychological capital, organizational citizenship behaviors, and counterproductive work behaviors, through a cross-section correlational study of a sample of 137 workers aged 21 to 63 (M =36.51; DE =9.71), from different companies in Lima. Results showed direct relations between psychological capital and organizational citizenship behaviors, as well as inverse relations between psychological capital and counterproductive work behaviors. Also, differences were found within the variables of age and total work experience. These findings contribute evidence regarding the importance of the development of psychological capital within organizations, in order to foster desirable behaviors in the workplace. The final section of the study includes limitations and recommendations.

Resumo A relação existente entre o capital psicológico positivo, os comportamentos de cidadania organizacional e os comportamentos de trabalho contraproducentes foi avaliada através de um estudo transversal correlacional. Nesse sentido, contamos com uma amostra de 137 trabalhadores de diversas organizações de Lima, com idade entre 21 e 63 anos (M = 36,51; DE =9,71). Os resultados mostraram relações diretas entre capital psicológico e comportamentos de cidadania organizacional, bem como relações inversas entre capital psicológico e comportamentos de trabalho contraproducentes. Além disso, foram encontradas diferenças dentro das variáveis em nível de idade e experiência total de trabalho. Os resultados fornecem evidências sobre a importância do desenvolvimento do capital psicológico dentro das organizações para a geração de comportamentos desejáveis no ambiente de trabalho. As limitações e recomendações estão incluídas no final do estudo.

Effectiveness of a Pediatric Abusive Head Trauma Prevention Program Among Spanish-Speaking Mothers.

INTRODUCTION: This study aimed to evaluate participants' knowledge of and intent to share key messages of the Period of PURPLE Crying abusive head trauma prevention program among a majority Spanish-speaking population. METHODS: This study was a retrospective review of a postintervention survey administered in the perinatal unit of a community birthing hospital. Surveys were administered to mothers of newborns by perinatal nurses as part of routine process evaluation prior to hospital discharge between May 30, 2014, and May 15, 2015. RESULTS: A majority of participants (86.4%) answered all six knowledge questions correctly. Among participants who reported that the father or significant other was not present during the PURPLE education (44.1%), all (100%) reported intending to share the PURPLE information with their partners. The majority of participants (88.1%) intended to share the information with others who take care of their infants. CONCLUSION: The PURPLE abusive head trauma prevention program demonstrated positive preliminary results in knowledge and intended behavior among a population of majority Spanish-speaking participants. These findings offer an important first step toward provision of effective universal abusive head trauma prevention among growing Spanish-speaking populations. Further evaluation is needed of acceptability, retention of messages, and postintervention behavior change among Spanish-speaking participants and nurses.

Gonadal development of Peprilus medius (Peters, 1869) (Perciformes: Stromateidae) from Southeast of the Gulf of California, Mexico / Desarrollo gonádico de Peprilus medius (Peters, 1869) (Perciformes: Stromateidae) del Sureste del Golfo de California, México

The gonadal development assessment is a fundamental work in researching the reproduction of Peprilus medius, on the way to understand its population dynamics and to achieve a sustainable management of its fisheries. The diagnosis based on morphochromatic features is the quicker, more practical and cheaper method, and properly validated, it may be an accurate procedure. This is particularly useful in researches when it is required to provide prompt and accurate information to support decision-making for fisheries management, and during long-term fisheries monitoring to detect changes in reproductive patterns due to environmental anomalies. These are issues of concern in P. medius and other fishery resources. In this context, a scale that describes the gonadal development through morphochromatic and histological features is presented, and plus anatomical observations of the reproductive organs. Ovarian development was characterized through six phases: immature, development (sub-phases: early and late), mature, spawning (sub-phases: partial and partial post-spawning), post-spawning and resting. Testicular development was described through five phases: immature, development, ejaculation, ejaculated and resting. The position and shape of the reproductive organs are apparently defined by the shape of the fish and the visceral cavity. P. medius's gonads show a gonadal lobe at lower position and an upper lobe in the visceral cavity, and both lobes presented a horizontal placement from gonopore toward the back of the fish. In addition, gonadal deformities occurrence due to deformities in the visceral cavity was evidenced. We recommend to use presented descriptions as a guide in gonadal assessment.

La evaluación del desarrollo gonádico es una labor fundamental para investigar la reproducción de Peprilus medius, en vías a comprender la dinámica de sus poblaciones y lograr un manejo sustentable de sus pesquerías. El diagnóstico a partir de características morfocromáticas es el método más rápido, práctico y barato, y adecuadamente validado puede ser un procedimiento preciso. Este es particularmente útil en investigaciones cuando se requiere aportar información rápida y precisa que apoye la toma de decisiones de manejo pesquero, y durante los monitoreos pesqueros de largo plazo, que permiten detectar cambios en los patrones reproductivos debido a anomalías ambientales. Estos son temas preocupantes en P. medius y otros recursos pesqueros. En ese contexto se presenta una escala que describe el desarrollo gonádico a través de características morfocromáticas e histológicas, y además se presentan observaciones anatómicas de los órganos reproductores. El desarrollo ovárico fue caracterizado a través de seis fases: inmadura, desarrollo (subfases: inicial y avanzado), maduro, desove (subfases: parcial y postdesove parcial), postdesove y reposo. El desarrollo testicular fue descrito a través de cinco fases: inmadura, desarrollo, eyaculación y reposo. La posición y forma de los órganos reproductores están aparentemente definidos por la forma del pez y su cavidad visceral. Las gónadas de P. medius muestran un lóbulo gonádico en posición inferior y uno superior en la cavidad visceral, y ambos lóbulos presentan una colocación horizontal desde el gonoporo hacia la parte posterior del pez. Además se evidencia la ocurrencia de deformidades en las gónadas debido a deformidades en la cavidad visceral. Recomendamos utilizar las descripciones presentadas como una guía en la evaluación de las gónadas.

A phosphatidylcholine hyaluronic acid chitin-nanofibrils complex for a fast skin remodeling and a rejuvenating look.

BACKGROUND: The reduction of mortality worldwide has led older individuals to seek intervention modalities to improve their appearance and reverse signs of aging. OBJECTIVE: We formulated a medical device as innovative block-polymer nanoparticles based on phosphatidylcholine, hyaluronan, and chitin nanofibrils entrapping amino acids, vitamins, and melatonin. METHODS: Viability and collagen synthesis were controlled on fibroblasts ex vivo culture while adenosine triphosphate production was evaluated on keratinocytes culture. Subjective and objective evaluations were performed in vivo on selected volunteer patients. RESULTS: In accordance with our previous studies, both the in vitro and in vivo obtained results demonstrate the efficacy of the injected block-polymer nanoparticles in reducing skin wrinkling and ameliorating the signs of aging.

Growth-hormone-releasing peptide 6 (GHRP6) prevents oxidant cytotoxicity and reduces myocardial necrosis in a model of acute myocardial infarction.

Therapies aimed at enhancing cardiomyocyte survival following myocardial injury are urgently required. As GHRP6 [GH (growth hormone)-releasing peptide 6] has been shown to stimulate GH secretion and has beneficial cardiovascular effects, the aim of the present study was to determine whether GHRP6 administration reduces myocardial infarct size following acute coronary occlusion in vivo. Female Cuban Creole pigs were anaesthetized, monitored and instrumented to ensure a complete sudden left circumflex artery occlusion for 1 h, followed by a 72 h reperfusion/survival period. Animals were screened clinically before surgery and assigned randomly to receive either GHRP6 (400 microg/kg of body weight) or normal saline. Hearts were processed, and the area at risk and the infarct size were determined. CK-MB (creatine kinase MB) and CRP (C-reactive protein) levels and pathological Q-wave-affected leads were analysed and compared. Evaluation of the myocardial effect of GHRP6 also included quantitative histopathology, local IGF-I (insulin-growth factor-I) expression and oxidative stress markers. GHRP6 treatment did not have any influence on mortality during surgery associated with rhythm and conductance disturbances during ischaemia. Infarct mass and thickness were reduced by 78% and 50% respectively, by GHRP6 compared with saline (P<0.01). More than 50% of the GHRP6-treated pigs did not exhibit pathogological Q waves in any of the ECG leads. Quantitative histopathology and CK-MB and CRP serum levels confirmed the reduction in GHRP6-mediated necrosis (all P<0.05). Levels of oxidative stress markers suggested that GHRP6 prevented myocardial injury via a decrease in reactive oxygen species and by the preservation of antioxidant defence systems (all P<0.05). Myocardial IGF-I transcription was not amplified by GHRP6 treatment compared with the increase induced by the ischaemic episode in relation to expression in intact hearts (P<0.01). In conclusion, GHRP6 exhibits antioxidant effects which may partially contribute to reduce myocardial ischaemic damage.

Homeostatic model assessment and risk for hypertension during pregnancy: a longitudinal prospective study.

The purpose of this study was to determine the association between insulin resistance and hypertension during pregnancy with the homeostatic model assessment (HOMA-IR). A longitudinal prospective study was carried out. One hundred sixty normotensive pregnant women were followed from the first trimester until delivery. HOMA-IR levels were determined each trimester. Statistical analysis included one-way analysis of variance and multivariate logistic regression. At follow-up, 134 women (83.8%) remained normotensive, 18 (11.2%) developed gestational hypertension, and 8 (5%) developed preeclampsia. At first trimester, HOMA-IR levels were higher in women who developed gestational hypertension (2.1 +/- 0.2) than in women who developed preeclampsia (1.2 +/- 0.0), or remained normotensive (1.2 +/- 0.3); p < 0.01. In the logistic regression analysis, HOMA-IR levels at first trimester were statistically significant ( p = 0.03) to predict development of gestational hypertension. Our results support the use of the HOMA-IR as an alternative index for the assessment of the risk for hypertension during pregnancy.

Intramyocardial gene transfer of vascular endothelial growth factor 121 improves myocardial perfusion and function in the ischemic porcine heart

Vascular endothelial growth factor (VEGF) is an endothelial cell-specific mitogen that is angiogenic in vitro and in vivo. Several studies report on gene transfer of VEGF121 to promote angiogenesis in the ischemic myocardium of animals and patients. We hypothesized that intramyocardial administration of naked plasmid DNA encoding VEGF121 could improve myocardial perfusion and function in a porcine model of myocardial ischemia. Yorkshire swine underwent thoracotomy and placement of an ameroid constrictor on the circumflex coronary artery. Four weeks later, pVEGF121 plasmid was administered into the ischemic myocardium. Four weeks after gene transfer, SPECT imaging demonstrated significant reduction in the ischemic area in pVEGF121-treated animals compared with controls. In the pVEGF121 group, most of the animals evolved from light ischemia to a normal perfusion. In contrast, control animals exhibited similar or impaired ischemic conditions. Our results indicate that intramyocardial gene transfer of VEGF121 as naked plasmid DNA results in significant improvement in myocardial perfusion and function.

Ascitis cirrótica y sus complicaciones en un hospital de referencia departamental / Cirrhotic ascites and their complications in a departmental referral hospital

La ascitis es la complicación más común de la cirrosis hepática. Hasta 50% de los pacientes con cirrosis compensada desarrollarán ascitis en los siguientes 10 años de su evolución, y su presencia se asocia con una pobre supervivencia. Algunos estudios indican que los parámetros que estiman la hemodinámica sistémica y la función renal son mejores predictores de la supervivencia que aquellos que estiman la función hepática. Objetivos. Establecer las características de los pacientes con ascitis cirrótica en nuestro hospital, su etiología, manifestaciones clínicas, estadio funcional hepático, presencia de complicaciones, grado de activación de los sistemas retenedores de volumen y su correlación con el estadio funcional. Materiales y métodos. El presente es un estudio descriptivo de serie de casos, realizado entre junio de 2000 y junio de 2002. Se reclutaron a todos los pacientes con ascitis cirrótica que ingresaron al hospital. Se estudió la etiología de la enfermedad hepática, se hizo el perfil hepático con función hepática, la punción de la ascitis al ingreso con estudio citoquímico y bacteriológico para establecer el gradiente de albúmina, la presencia o no de infección (peritonitis bacteriana espontánea -PBE- o sus variedades, neutroascitis y bacteriascitis), nitrogenados, creatinina, sodio (Na) sérico y urinario, orina de 24 horas para depuración renal, niveles de renina y angiotensina. Se utilizó la clasificación de Child Pugh para establecer el estadio funcional hepático y se correlacionó el mismo con los niveles de renina y angiotensina. Se determinó la presencia de otras complicaciones de la ascitis como el síndrome hepatorrenal, la frecuencia de sangrado digestivo y la presencia de encefalopatía hepática. Resultados. Se reclutaron 58 pacientes, 37 (63,8%) de sexo masculino. El promedio de edad fue de 59,5 años. La mayoría (73,5%) procedía del área rural de Cundinamarca y estaba conformada por agricultores (70,4%). La ascitis fue el motivo de consulta principal (29,4%), seguida por hemorragia digestiva (23,5%), ictericia (11,1%), y dolor abdominal (11,1%). En 87,5% de los pacientes la etiología fue alcohólica y en 12,5% otras causas (autoinmune, virales B y C, y hemocromatosis). Cuarenta y uno por ciento cursó con hemorragia de vías digestivas altas, con sangrado secundario a várices esofágicas en 78,9%. Se presentó encefalopatía hepática al ingreso en 51,7% de los pacientes. El 41,37% se presentó con CHILD B, 29,3% con CHILD C, y sólo 29,3% con CHILD A. La totalidad de los pacientes tenía gradiente de albúmina mayor de 1,1. El promedio del gradiente de albúmina fue de 1,76. Se observó infección del líquido ascítico con neutroascitis en 17,6%. El 72,7% de los pacientes con neutroascitis cursó con proteínas en líquido ascítico menores de 1,0 g/dl. En 66,6% el sodio en orina se encontró por debajo de 50 mg/dl. En 34,5% se presentó elevación de azoados, en 5,1% hubo síndrome hepatorrenal tipo1, en 13,8% síndrome hepatorrenal tipo 2, en 13,79% insuficiencia renal de origen prerrenal y un paciente (1,72%) tuvo nefropatía diabética. Se realizó medición de renina y aldosterona a 33 pacientes. Los niveles de renina se encontraron elevados en 22,2% de los pacientes con Child-Pugh A, en 66,6% de los Child B y en 77,8% de los Child C. La aldosterona estuvo elevada en 46,6% de los pacientes con Child B y 77,8% con Child C. En los pacientes con neutroascitis la renina sérica estaba elevada en 60% de los pacientes. El sodio urinario se mostró disminuido en todos los pacientes con hiperreninismo e hiperaldosteronismo sérico con promedio de 25,5 mg/dl. Los pacientes con síndrome hepatorrenal tipo 1 cursaron con marcada disminución en el sodio urinario, elevación de renina y aldosterona sérica, todos tenían neutroascitis, se encontraban en Child C y todos fallecieron. Conclusiones. El presente estudio confirma el predominio de etiología alcohólica en nuestros pacientes, la mayoría consulta por ascitis, ingresan en estadios avanzados de la enfermedad hepática, frecuentemente con complicaciones asociadas (PBE - encefalopatía). Se demostró la correlación entre la activación de los sistemas retenedores de volumen con el estadio avanzado de la enfermedad, el sodio urinario disminuido, la infección del líquido ascítico y el mal pronóstico.

The ascitis is the more common complication of the Liver cirrhosis. Until 50% of the patients with compensated cirrhosis developed ascitis in the following 10 years of their evolution and their presence associates with a poor survive. There are some studies indicating that the parameters that estimate the systemic hemodynamic and the renal function is better predictors of the survive that those that estimate the hepatic function. Objectives. To Establish the characteristics of the patients with cirrhotic ascitis in our hospital, their etiology, clinical manifestations, hepatic functional stadium, witnesses of its complications, the grade of activation of the volume systems retainers and its correlation with the functional stadium. Materials and methods. The present is a descriptive study of series of cases, realized among June of 2.000 to June 2.002. All the patients were gathered with cirrhotic ascitis that entered to the hospital. To all the patients they are studied the etiology of the hepatic illness, hepatic profile with hepatic function, punction of the ascitic fluid to the entrance with chemical and bacteriologic study to establish the albumin gradient, the presence or not of infection (PBE or its varieties - neutroascitis, bacteriascitis), nitrogen blood urea, creatinine, blood and urinal Sodium (Na) levels, urinate of 24 Hr. for renal depuration, blood renin and angiotensin levels. We uses the classification of Child Pough to establish the hepatic functional stadium and correlates the same with the renin and angiotensin levels. We determinate the presence of other complications of the ascitis, like the hepatorenal syndrome, the frequency of upper gastrointestinal hemorrhage and the presence of hepatic encefalopathy. Results. 58 patients were gathered, 37 (63,79%) of masculine sex. The age average was of 59,5 years. Most (73,52%) they were coming from rural area of Cundinamarca and farmers (70,37%). The ascitis was the reason of main consultation (29,4%) continued by digestive hemorrhage (23,5%), jaundice (11,1%), and abdominal pain (11,1%). In 87,5% of the patients the etiology was alcoholic and in 12,5% other causes (autoinmune, viral B and C and hemocromatosis). 41,17% studied with upper gastrointestinal hemorrhage, with secondary bleeding to esophageal varices in 78,9%. Hepatic encefalopathy was presented to the entrance in 51,7% of the patients. 41.37% was presented with CHILD B, 29.3% with CHILD C, and alone 29.3% with CHILD A. 100% of the patients had albumin gradient bigger than 1,1. The average of the albumin gradient was of 1.76. Infection of the ascitic fluid was observed with neutroascitis in 17,6%. 72,7% of the patients with neutroascitis studied had ascitic fluid proteins smaller than 1,0 gr/dl. In 66,6% the urine Sodium was below 50 mg/dl. 34,48% of the patients presented nitrogens elevation, 5,1% with hepatorrenal type 1 syndrome, 13,79% with hepatorrenal type 2 syndrome, 13,79% with renal insufficence of prerenal origin and a patient (1,72%) with diabetic nefropathy. We mensurate Renin and Aldosterone levels to 33 patients. The renin levels were elevated in 22,2% of the patients with Child-Pugh A, 66,6% Child B and 77,77% Child-Pugh C and the Aldosterone risen in 46,6% of the patients with Child B and 77,77% with Child C. In the patients with neutroascitis the blood renin was elevated in 60% of the patients. The urinal sodium was shown diminished in 100% of the patients with blood Hiperreninism and hiperaldosteronism with average of 25,46 mg/dl. The patients with hepatorrenal type 1 syndrome studied had marked decrease in the urinal sodium levels, elevation of blood Renin and Aldosterone levels, all with neutroascitis, in Child C and all died. Conclusions. The present study confirms the prevalence of alcoholic etiology in our patients, most consults for the ascitis, they enter in advanced stadiums of the hepatic illness, frequently with associate complications (PBE-encefalopathy) and the correlation was demonstrated among the activation of the volume retainers systems with the advanced stadium of the illness, the diminished urinal sodium, the infection of the ascític fluid and its poor prognosis.

Detection of biological tissue in gels using pulsed digital holography.

An out of plane optical sensitive configuration for pulsed digital holography was used to detect biological tissue inside solid organic materials like gels. A loud speaker and a shaker were employed to produce a mechanical wave that propagates through the gel in such a way that it generates vibrational resonant modes and transient events on the gel surface. Gel surface micro displacements were observed between the firing of two laser pulses, both for a steady resonant mode and for different times during the transient event. The biological tissue sample inserted approximately 2 cm inside the gel diffracts the original mechanical wave and changes the resonant mode pattern or the transient wave on the gel surface. This fact is used to quantitatively measure the gel surface micro displacement. Comparison of phase unwrapped patterns, with and without tissue inside the gel, allows the rapid identification of the existence of tissue inside the gel. The results for the resonant and transient conditions show that the method may be reliably used to study, compare and distinguish data from inside homogeneous and in-homogeneous solid organic materials.

Varices esofagicas: experiencia clinica en un Hospital de referencia regional / Oesophageal varices

Estudios endoscópicos muestran que la prevalencia de várices esofágicas en los pacientes con cirrosis es de 60 por ciento, mientras que la probabilidad a 5 años de desarrollar várices esofágicas seria de 83 por ciento. En los pacientes con várices 20 por ciento experimentan un primer episodio de sangrado por año, el cual tiene una mortalidad de 30 por ciento. Se estima que 40 por ciento de los pacientes cirróticos fallecen a consecuencia de hemorragia por várices esofágicas. Objetivos: 1. Describir las causas más frecuentes de várices esofágicas y el estado funcional de los pacientes a quienes se les encontraron éstas mediante un examen endoscópico. 2. Evaluar complicaciones, efectividad del tratamiento endoscópico y mortalidad en los pacientes con sangrado secundario a várices esofágicas. Materiales y métodos: estudio descriptivo. Se tomaron los pacientes a quienes se les realizó endoscopia digestiva alta y se les encontraron várices esofágicas entre el 1 de octubre de 2000 y el 31 de diciembre de 2001, un total de 50 pacientes. Se determinaron los diagnósticos más frecuentes, las complicaciones y mortalidad de los pacientes a quienes se les realizó endoscopia digestiva alta y se les encontraron várices esofágicas, aplicándoseles distribución de frecuencia en porcentajes. Resultados: total de pacientes 50. A 26 se les realizaron endoscopias diagnósticas y a 24 a quienes se les realizaron endoscopios terapéuticas, con un total de 83 endoscopias. Con promedio de edad 52 años; 55 por ciento hombres. El grado de várices es mayor en los pacientes a quienes se les realizó procedimientos terapéuticos (grado III vs. grado I, clasificación NIEC). Con infección del líquido ascitico (PBE) presentó 5 por ciento del grupo diagnóstico vs. 25 por ciento del grupo terapéutico. El control endoscópico del sangrado se logro en 97,5 por ciento de los casos, con ligadura 63 por ciento, escleroterapia 29 por ciento y mixto 8 por ciento. Se presentó resangrado en 46 por ciento con ligadura, 57 por ciento con escleroterapia y 50 por ciento con mixta. La mortalidad en el grupo terapéutico fue de 30 por ciento, vs. 0 por ciento en el diagnóstico; 70 por ciento de esta fueron en pacientes con várices grado III, con infección del líquido ascitico (86 por ciento), y Child C (100 por ciento). Conclusión: la mortalidad se encuentra directamente relacionada con el grado de las várices, a un Child avanzado y a la presencia de infección en el líquido ascitico

Hepatic encephalopathy: a review.

Hepatic encephalopathy (HE) is a complication that presents in as many as 28% of patients with cirrhosis, and reported up to ten years after the diagnosis of cirrhosis. Commonly, it is observed in patients with severe hepatic failure and is characterized by neuropsychiatric manifestations that can range in severity from a mild alteration in mental state to a coma; additionally, some neuromuscular symptoms can be observed. This complication of either acute or chronic hepatic disease is the result of a diminished hepatic reservoir and inability to detoxify some toxins that originate in the bowel. Today, the role of astrocytes, specifically the Alzheimer type II cells, is known to be very important in the pathogenesis of the hepatic encephalopathy, and will be reviewed later. In conclusion, the objectives of this review are: To understand the pathogenesis of hepatic encephalopathy, To recognize the precipitating factors, as well as preventive measures for the development of the hepatic encephalopathy, To describe the new classification of hepatic encephalopathy and its clinical implications, To recognize the clinical manifestations and stages of the disease, To understand the main diagnostic tests used to detect the hepatic encephalopathy, To describe the main therapeutic treatments of hepatic encephalopathy.

Valoración anatómica zonal y estadificación de la extensión local del cáncer de próstata mediante el ultrasonido tridimensional y su correlación histopatológica / Three-dimensional ultrasound and prostate cancer

Propósito: evaluar la utilidad del ultrasonido tridimensional (3DUS) en la extensión local del carcinoma prostético frente al ultrasonido bidimensional (2DUS), y confirmarlo histopatológicamente con biopsias dirigidas sobre zonas de interés. Material y métodos: Treinta pacientes a los que se les practicó una biopsia por sospecha de lesión maligna durante el examen dígitorrectal o (PSA) elevado se valoraron transrectalmente con 2DUS, pero esto se complementó con 3DUS para reconstrucciones volumétricas por dos observadores. Se hicieron cortes multiplanares desde la base hasta la punta para reconocer la anatomía zonal y lesiones sospechosas. Para la estadificación local mediante 3DUS se utilizaron los criterios T de la clasificación TNM del carcinoma. Ambos hallazgos preliminares fueron registrados y analizados por separado previo a la biopsia. Se planeó la biopsia transrectal con la guía ecográfica bidimensional, que sigue la extensión señalada por el 3DUS, complementada con protocolo de biopsias por sextantes. Resultados: de los 30 pacientes, el reporte histopatológico mostró adenocarcinoma en 10 (33,3 por ciento). Los hallazgos preliminares 2DUS revelaron zonas hipoecoicas sospechosas en 6 (60 por ciento); mientras que con 3DUS encontramos 8 (80 por ciento). Ambos estudios mostraron diferencias frente a los 18 restantes con ecografía y estudio histopatológico negativo (p<0,01), con una sensibilidad del 60 por ciento y 80 por ciento, para 2DUS y 3DUS, respectivamente, y una especificidad del 90 por ciento (OR: 36 y 95 por ciento IC). De los 8 pacientes positivos en el 3DUS, 2 eran T2; 4, T3, y 2, T4. El 3DUS mostró mayor precisión en la definición y extensión del área afectada frente al 2DUS, lo que determinó la biopsia dirigida. Un único barrido a 90 grados en 3DUS fue almacenado para su análisis posterior. Conclusión: las reconstrucciones multiplanares y 3D permiten una mejor evaluación de la anatomía zonal, de la extensión local y de los planos vecinos, lo que podría aumentar la sensibilidad y lograr una mejor estadificación en el estudio del adenocarcinoma prostático. Además, el 3DUS es un examen operador independiente que permite un análisis posproceso

Anemia perniciosa: Presentacion de casos y revision de temas / Pernicious anemia

La anemia perniciosa es considerada una enfermedad autoinmune, en la cual coexisten la anemia megaloblástica por deficiencia de vitamina B12 y la gastritis crónica atrófica corporal difusa (gastritis tipo A), asociándose frecuentemente con otros trastornos autoinmunes. Es una entidad poco frecuente y subdiagnosticada. Se presentan 10 casos de pacientes con anemia megaloblástica (siete mujeres, tres hombres), que consultaron al Hospital Universitario de la Samaritana y al Hospital San Blas, con diagnóstico definitivo de anemia perniciosa