A new species of Contracaecum (Nematoda: Anisakidae) found parasitizing Nannopterum brasilianus (Suliformes: Phalacrocoracidae) and Hoplias argentinensis (Characiformes: Erythrinidae) in South America: morphological and molecular characterization of larval and adult stages.

Nematode species of the genus Contracaecum Railliet & Henry, 1912 have been reported around the world in many species of fish-eating birds and seals. Here, Contracaecum jorgei n. sp. is morphologically described using light and scanning electron microscopy for adults and fourth-stage larvae (L4) found in the bird Nannopterum brasilianus and third-stage larvae (L3) found in the freshwater fish Hoplias argentinensis, both from the province of Córdoba, Argentina. Additionally, sequences of cytochrome c oxidase subunit II were obtained from these specimens and molecular phylogenetic analysis was used to determine its relationships within the genus. The present species is distinguished from other species by the number and disposition of cephalic papillae; shape and size of the interlabia; length of the spicules; and number and arrangement of papillae in the posterior end of the male. Furthermore, in the molecular analyses, sequences obtained from adult L4 and L3 specimens of C. jorgei n. sp. were similar and grouped, forming an independent lineage, thus confirming it as a distinct species. Thus, morphological characteristics associated with molecular data support the proposal of a new species.

Overwhelming genetic heterogeneity and exhausting molecular diagnostic process in chronic and progressive ataxias: facing it up with an algorithm, a gene, a panel at a time.

Ataxias are one of the most frequent complaints in Neurogenetics units worldwide. Currently, more than 50 subtypes of spinocerebellar ataxias and more than 60 recessive ataxias are recognized. We conducted an 11-year prospective, observational, analytical study in order to estimate the frequency of pediatric and adult genetic ataxias in Argentina, to describe the phenotypes of this cohort and evaluate the diagnostic yield of the algorithm used in our unit. We included 334 ataxic patients. Our diagnostic approach was successful in one-third of the cohort. A final molecular diagnosis was reached in 113 subjects. This rate is significantly higher in the subgroup of patients with a positive family history, where the diagnostic yield increased to 55%. The most prevalent dominant and recessive ataxias in Argentina were SCA-2 (36% of dominant ataxias) and FA (62% of recessive ataxias), respectively. Next generation sequencing-based assays were diagnostic in the 65% of the patients requiring these tests. These results provide relevant epidemiological information, bringing a comprehensive knowledge of the most prevalent subtypes of genetic ataxias and their phenotypes in our territory and laying the groundwork for rationally implementing genetic diagnostic programs for these disorders in our country.

Hiperparatiroidismo primario en adolescente. Reporte de caso / Primary hyperparathyroidism in adolescent. Case report

INTRODUCTION: The hypercalcemia is infrequent in pediatrics, its clinical is diverse, and its etiology is determined by age. Among the dependent causes of parathormone (PHT) is the hyperthyroidism, state of hypersecretion of PHT by parathyroid glands (PG). The primary hyperparathyroidism (PHPT) is rare in children, there are 200 reported cases. In older children, the causes for PHPT correspond to parathyroid adenoma, multiglandular disease and parathyroid carcinoma. OBJECTIVE: Report a case of an 11 years old male adolescent. He presents three months symptoms of constipation, anorexia, vomiting and weight loss. Urgent consultation due to an increase of his symptoms, in exams stand out: calcemia 16.67 mg/dl (NV 8.8-10.8 mg/dl), phosphatemia 2.21 mg/dl (NV 4.5-5.5 mg/dl), parathormone (PHT) 308.7 pg/ml (NV 15-68.3 pg/ml), calciuria/creatininuria 0.56 (NV < 0.2). He was hospitalized to manage his severe hypercalcemia, it was indicated hyperhydration, monopotassium phosphate, intravenous hydrocortisone and furosemide. In his study was performed a cervical ultrasound which showed a solid node in the right parathyroid gland, hypoechogenic and scintigram parathyroid compatible with right superior parathyroid adenoma. In the waiting for surgery was necessary the administration of intravenous pamidronate. In the post-operatory, he evolved with hipocalcemia that was corrected with intravenous calcium carbonate, overlapping to oral calcium and calcitriol. CONCLUSION: The PHPT is a pathology of low prevalence in pediatrics, one hundred times less than adults. In the adolescent, the most frequent cause is the parathyroid adenoma. It should be considered as a differential diagnosis in cases of symptomatic hypercalcemia in this age group

Efecto de edulcorantes no calóricos en la calidad sensorial de jugo de naranja / Effect of non caloric sweeteners in sensory quality of orange juice

The consumption of non-caloric sweeteners is increasing in Chile being present in a wide variety of foods. The objective of this study was to evaluate the effect of distinct non-caloric sweeteners in the sensory qualities of orange juice as compared to sugar. The sweeteners selected were stevia, sucralose, saccharin and aspartame. These were added to natural juices in amounts equivalent to sugar in sweetness. Sensory analysis was performed with a group of youths of both sexes. An acceptability test was applied with an hedonic scale of 5 points evaluating aroma and flavor. The results indicate that the juice aroma is not affected by the use of sugar or sweeteners rated 3.5 to 3.7 (corresponding to "I like"). However, in the evaluation of flavor, significant differences were found, the best results corresponding to juice sweetened with sugar and sucralose (3,5 y 3,6 respectively).

El consumo de edulcorantes no calóricos es cada vez más masivo en nuestro país y están presentes en una gran variedad de alimentos. El objetivo de este estudio fue evaluar el efecto de edulcorantes no calóricos en la calidad sensorial de jugo de naranja, en comparación con el azúcar. Los edulcorantes seleccionados fueron estevia, sucralosa, sacarina y aspartamo. Se adicionaron a jugos naturales en cantidades equivalentes de dulzor respecto al azúcar. El análisis sensorial se realizó con un grupo de jóvenes de ambos sexos. Se aplicó una prueba de aceptabilidad con escala hedónica de 5 puntos, evaluando los parámetros de aroma y sabor. Los resultados indican que el aroma de los jugos no se ve afectado por la utilización de azúcar o edulcorantes, con calificación entre 3,5 a 3,7 (que corresponde a "me gusta"). Sin embargo, en la evaluación de sabor las muestras significativamente mejor evaluadas corresponden a jugos endulzados con azúcar y sucralosa (3,5 y 3,6 respectivamente).

Influence of the liquid viscosity on the formation of bubble structures in a 20kHz field.

The cavitation field in a cylindrical vessel bottom-insonified by a 19.7kHz large area transducer is studied experimentally. By adding controlled amounts of Poly-Ethylene Glycol (PEG) to water, the viscosity of the liquid is varied between one- and nine-fold the viscosity of pure water. For each liquid, and for various displacement amplitudes of the transducer, the liquid is imaged by a high-speed camera and the acoustic field is measured along the symmetry axis. For low driving amplitudes, only a spherical cap bubble structure appears on the transducer, growing with amplitude, and the axial acoustic pressure field displays a standing-wave shape. Above some threshold amplitude of the transducer, a flare-like structure starts to build up, involving bubbles strongly expelled from the transducer surface, and the axial pressure profile becomes almost monotonic. Increasing more the driving amplitude, the structure extends in height, and the pressure profile remains monotonic but decreases its global amplitude. This behavior is similar for all the water-PEG mixtures used, but the threshold for structure formation increases with the viscosity of the liquid. The images of the bubble structures are interpreted and correlated to the measured acoustic pressure profiles. The appearance of traveling waves near the transducer, produced by the strong energy dissipated by inertial bubbles, is conjectured to be a key mechanism accompanying the sudden appearance of the flare-like structure.

Is some better than none: are TEG and TGA profiles different in severe FVIII-deficient patients with inhibitors?

Severe factor VIII (FVIII)-deficient patients with and without FVIII inhibitors cannot be distinguished using FVIII levels. The FVIII assay is sensitive to detect factor levels below 1%. While severe FVIII-deficient, non-inhibitor patients have FVIII < 1%, they may retain unmeasurable residual factor activity. In contrast, inhibitor patients have a FVIII antibody that presumably fully eliminates FVIII activity. It is unknown whether thromboelastography (TEG) and thrombin generation assay (TGA) can differentiate between patients with FVIII < 1% with and without the presence of FVIII inhibitors. The primary objective was to discern whether TEG and TGA could differentiate between severe FVIII-deficient patients with and without the presence of FVIII inhibitors. A secondary objective was to correlate TEG and TGA to annualized bleeding rates. This observational study performed TEG and TGA in healthy volunteers (N = 15), severe FVIII-deficient (N = 15) and severe FVIII-deficient patients with inhibitors (N = 15). Kaolin-activated TEG was better at differentiating reaction time (31.3 vs. 120 min respectively, P = 0.004) and kinetics time (6.1 vs. 23.1 min respectively, P = 0.028) between the non-inhibitor and inhibitor patients. TEG activated by tissue factor in plasma-containing corn trypsin inhibitor failed to differentiate groups. The TGA failed to differentiate peak thrombin, endogenous thrombin potential and lag time between groups. There was no correlation between TEG and TGA with annualized bleeding rates. Kaolin-activated TEG, but not TGA, differentiated between severe FVIII-deficient patients with and without inhibitors. These assays did not find a correlation to annualized bleeding rate.

Failure of corn trypsin inhibitor to affect the thrombin generation assay in plasma from severe hemophiliacs.

BACKGROUND: The thrombin generation assay (TGA) is an important global coagulation assay; however, it suffers from the lack of preanalytical standardization. The addition of corn trypsin inhibitor (CTI) to blood collection tubes before TGA has been previously advocated to block the contact activation pathway. Emerging data, however, suggest that CTI may only be necessary when minimal tissue factor (TF) concentrations < 1 pmol are used. OBJECTIVES: To determine whether blood collection tubes containing CTI influenced TGA parameters. METHODS: This cross-sectional, observational study performed the TGA using TF 1 pmol L(-1) in 15 healthy volunteers, 14 severely factor VIII (FVIII)-deficient patients, and 15 severely FVIII-deficient patients with documented FVIII inhibitors. TGA was conducted using blood tubes that contained CTI 33 µg mL(-1) and no CTI. RESULTS: CTI markedly reduced peak thrombin (P = 0.002) and endogenous thrombin potential (P < 0.001) in the healthy volunteers but had no significant effect on TGA parameters in severely FVIII-deficient patients or those with inhibitors. CONCLUSIONS: This lack of effect raises additional questions regarding the need for CTI as a preanalytical addition to blood collection tubes during TGA in severe hemophiliacs, particularly when activating samples with TF 1 pmol L(-1) .

La prevención como eje en la extensión / Prevention as the extension shaft

El presente artículo pretende dar a conocer eltrabajo realizado en el marco del programa de extensión “Trastornos en el desarolo del enguaje y su incidencia en el Aprendizaje” dependiente de la Facultadde Ciencias de la Salud de la UNSL. Dicho programatiene como objetivo general, prevenir, detectar, evaluar yrealizar tratamiento fonoaudiológico en niños de unacomunidad vulnerable. Para alcanzar este objetivo, seplantearon las actividades en cuatro fases. Fase 1, refiere al contacto y acuerdos instiucionales. Fase 2, con laorganización del trabajo y la formación de recursos. Fase3, con la divulgación y presentación a eventos científicos, y por último la fase 4, que se refiere al seguimientode la casuística detectada. La población destinatariadel programa son niños de nivel inicial y primer ciclo dela Escuela Nº 141 “Los Andes” de la localidad de Baldede la provincia de San Luis. De la totalidad de niñosevaluados, se han detectado 35 niños con difcultadesen diversos aspectos del enguaje y repercusiones en elaprendizaje de grado variable que se coresponde conun 47% de la población total. Indicador que da cuentade la importancia de la deteción temprana para favorecer los procesos de aprendizaje posteriores. Identifcaraquelos casos que son susceptibles de un abordajefonoaudiológico, permite potenciar aquelas áreas enlas que los niños muestran difcultades, favoreciendoasí una adecuada integración escolar, familar y social.

This article seks to highlight he work done underthe extension program "Developmental disorders oflanguage and its efects on learning proces" under theFaculty of Health Sciences of the UNSL. This program isintended to adres “Prevent, detect, ases andfonoaudiological treat to children in a vulnerablecommunity”. To achieve this goal, the activites wereraised in four phases. Phase 1 refers to the contact andinstiutional arangements. Phase 2, work organizationand resource training. Phase 3, with the disclosure andpresentation of scientifc events, and finaly phase 4, whichrefers to the monitoring of casuistry detected. The targetpopulations of the program are children of preschol eveland first level of the Schol No. 141 “Los Andes” Baldetown in San Luis province. Of al children tested, weredetected 35 children with dificulties in various aspects oflanguage and learning implications of varying degreswhich coresponds to 47% of the total sample population.Indicator that realizes the importance of early detection to faciltate subsequent learning proceses. Identify cases that are susceptible to fonoaudiological andpsychological aproach, alows strengthening thoseareas where children show dificulties, which contribute to adequate schol, family and social integration.

Composition and diversity of ichthyofauna in La Viña reservoir (Córdoba, Argentina).

Several dams have been built in central and north Argentina. There are more than 20 reservoirs in Córdoba province, with a total estimated surface area of around 15,000 ha. Although construction of dams continues, some aspects about the richness, abundance and diversity of ichthyofauna in many of these environments are unknown, which prevents adequate management of fish resources. The goal of this work was to evaluate specific richness and diversity of ichthyofauna in La Viña reservoir (31 degrees 47' S and 65 degrees 01' W, 1,050 ha, 846 m asl), one of the major reservoirs in Córdoba. Fifteen seasonal samplings were made in 1999-2002 using trawl nets and gillnets. A total of 3,242 specimens belonging to 7 species distributed in 5 orders and 5 families were caught. The tetra Astyanax eigenmanniorum (52.9%) and the silverside Odontesthes bonariensis (29.3%) were the most abundant species; the latter is the main target species for lake fishing and had greatest biomass (63.8%). Average diversity for all samples was H'T = 1.63 (95% confidence interval 1.49 to 1.77). Shannon-Wiener and Simpson diversity indexes values were generally intermediate. Specific richness of La Viña reservoir was moderate compared with other impoundments in central and north Argentina.

Composition and diversity of ichthyofauna in La Viña reservoir (Córdoba, Argentina)

Several dams have been built in central and north Argentina. There are more than 20 reservoirs in Córdoba province, with a total estimated surface area of around 15,000 ha. Although construction of dams continues, some aspects about the richness, abundance and diversity of ichthyofauna in many of these environments are unknown, which prevents adequate management of fish resources. The goal of this work was to evaluate specific richness and diversity of ichthyofauna in La Viña reservoir (31° 47' S and 65° 01' W, 1,050 ha, 846 m asl), one of the major reservoirs in Córdoba. Fifteen seasonal samplings were made in 1999-2002 using trawl nets and gillnets. A total of 3,242 specimens belonging to 7 species distributed in 5 orders and 5 families were caught. The tetra Astyanax eigenmanniorum (52.9%) and the silverside Odontesthes bonariensis (29.3%) were the most abundant species; the latter is the main target species for lake fishing and had greatest biomass (63.8%). Average diversity for all samples was H'T = 1.63 (95% confidence interval 1.49 to 1.77). Shannon-Wiener and Simpson diversity indexes values were generally intermediate. Specific richness of La Viña reservoir was moderate compared with other impoundments in central and north Argentina.

Na área central e norte da Argentina há uma importante quantidade de represas. Na província de Córdoba, existem, na atualidade, mais de 20 reservatórios que ocupam uma superfície aproximada de 15.000 ha. Embora a construção de represas continue em uma grande quantidade de ambientes, não se conhecem alguns aspectos da riqueza, abundância e diversidade da ictiofauna, dificultando a gestão e manejo dos recursos pesqueiros. O objetivo do trabalho foi avaliar a riqueza específica e a diversidade da ictiofauna do reservatório La Viña (31° 47' S e 65° 01' W, 1.050 ha, 846 msnm), um dos mais importantes de Córdoba. No período entre 1999-2002, realizaram-se 15 amostragens estacionais, utilizando-se redes de arrasto e de espera. Coletaram-se 3.242 indivíduos de 7 espécies distribuídas em 5 ordens e 5 famílias. Em função do número total de espécies, as de maior abundância foram lambari Astyanax eigenmanniorum (52,9%) e peixe-rei Odontesthes bonariensis (29,3%), sendo esta última espécie o objetivo da pescaria do lago e a que alcançou a maior biomassa (63,8%). Considerando o total da amostragem, a diversidade média foi de H'T = 1,63, com um intervalo de confiança (95%) de 1,49 a 1,77. No geral, os índices de diversidade de Shannon-Wiener e Simpson foram médios. Comparando com outros reservatórios da área central e norte da Argentina, a riqueza específica do reservatório La Viña é moderada.

Composition and diversity of ichthyofauna in La Viña reservoir (Córdoba, Argentina) / Composição e diversidade da ictiofauna do reservatório La Viña (Córdoba, Argentina)

Several dams have been built in central and north Argentina. There are more than 20 reservoirs in Córdoba province, with a total estimated surface area of around 15,000 ha. Although construction of dams continues, some aspects about the richness, abundance and diversity of ichthyofauna in many of these environments are unknown, which prevents adequate management of fish resources. The goal of this work was to evaluate specific richness and diversity of ichthyofauna in La Viña reservoir (31° 47' S and 65° 01' W, 1,050 ha, 846 m asl), one of the major reservoirs in Córdoba. Fifteen seasonal samplings were made in 1999-2002 using trawl nets and gillnets. A total of 3,242 specimens belonging to 7 species distributed in 5 orders and 5 families were caught. The tetra Astyanax eigenmanniorum (52.9 percent) and the silverside Odontesthes bonariensis (29.3 percent) were the most abundant species; the latter is the main target species for lake fishing and had greatest biomass (63.8 percent). Average diversity for all samples was H'T = 1.63 (95 percent confidence interval 1.49 to 1.77). Shannon-Wiener and Simpson diversity indexes values were generally intermediate. Specific richness of La Viña reservoir was moderate compared with other impoundments in central and north Argentina.

Na área central e norte da Argentina há uma importante quantidade de represas. Na província de Córdoba, existem, na atualidade, mais de 20 reservatórios que ocupam uma superfície aproximada de 15.000 ha. Embora a construção de represas continue em uma grande quantidade de ambientes, não se conhecem alguns aspectos da riqueza, abundância e diversidade da ictiofauna, dificultando a gestão e manejo dos recursos pesqueiros. O objetivo do trabalho foi avaliar a riqueza específica e a diversidade da ictiofauna do reservatório La Viña (31° 47' S e 65° 01' W, 1.050 ha, 846 msnm), um dos mais importantes de Córdoba. No período entre 1999-2002, realizaram-se 15 amostragens estacionais, utilizando-se redes de arrasto e de espera. Coletaram-se 3.242 indivíduos de 7 espécies distribuídas em 5 ordens e 5 famílias. Em função do número total de espécies, as de maior abundância foram lambari Astyanax eigenmanniorum (52,9 por cento) e peixe-rei Odontesthes bonariensis (29,3 por cento), sendo esta última espécie o objetivo da pescaria do lago e a que alcançou a maior biomassa (63,8 por cento). Considerando o total da amostragem, a diversidade média foi de H'T = 1,63, com um intervalo de confiança (95 por cento) de 1,49 a 1,77. No geral, os índices de diversidade de Shannon-Wiener e Simpson foram médios. Comparando com outros reservatórios da área central e norte da Argentina, a riqueza específica do reservatório La Viña é moderada.

Laparoscopic re-operation for failed Heller myotomy.

Laparoscopic Heller myotomy for achalasia has a 10-20% failure rate and may require re-operation to control persistent or recurrent symptoms. We report follow-up of 15 patients who underwent laparoscopic re-operation for failed Heller myotomy. Between 1993 and 2004, 15 patients underwent laparoscopic re-operation for failed Heller myotomy at our center. The mean duration between procedures was 23 months. Follow-up was completed at a mean duration of 30 months in 14 patients (93%) via a telephone questionnaire. Our overall failure rate for primary surgery (n = 106) was 5.6%. The mechanisms of failure were incomplete myotomy (33%), myotomy fibrosis (27%), fundoplication disruption (13%), too tight fundoplication (7%) and a combination of myotomy fibrosis and incomplete myotomy (20%). Significant symptom improvement was observed with postoperative symptom resolution seen in 71% of patients with dysphagia, 89% for regurgitation, 58% for heartburn and 40% for chest pain. Fifty percent reported excellent results and 79% would recommend the procedure to a friend. Subsequent dilations were performed in four patients (29%). Two patients required conversion to open surgery (13%). Three patients (20%) failed the re-operation and required further revisional surgery. Complications included intraoperative perforation in three (none of which resulted in postoperative morbidity) and a pneumothorax in one patient. Prior endoscopic therapies (pneumatic dilation or Botulinum toxin) were not associated with poor results. Laparoscopic re-operation for failed Heller myotomy is feasible and results are encouraging.

[Instrument for the functional evaluation of disability rehabilitation. Study on the reliability and clinical experience with the use of functional independence measure]. / Instrumento de evaluación funcional de la discapacidad en rehabilitación. Estudio de confiabilidad y experiencia clínica con el uso del functional independence measure.

BACKGROUND: The Functional Independence Measure (FIM) is an instrument widely used to assess the results and progress of a medical rehabilitation program. AIM: To assess the inter rater agreement in the application of FIM and show the clinical experience with its use in disabled patients enrolled in a rehabilitation program. PATIENTS AND METHODS: FIM was applied in 40 patients and the inter rater agreement was assessed, comparing raters with and without training in its use. Agreement was evaluated using Kappa test. Afterwards, the FIM was used to assess changes in 100 patients hospitalized and being rehabilitated at the Rehabilitation ward of a general hospital. RESULTS: Inter rater agreement is high in physical areas of the FIM and low in cognitive areas. Training significantly improves agreement in communication and cognitive areas. During a mean period of hospitalization of 38 days, FIM score changed from a mean of 47.2 to 92 points, with an improvement of 1.18 points per hospitalization day. The higher improvement was achieved in the physical area of the instrument. CONCLUSIONS: Training is required for a proper application of FIM. When used adequately, this instrument allows an assessment of the degree of disability and the changes obtained with rehabilitation programs.

Umbilical cord beta-endorphin and early childhood motor development.

Stress during delivery has been associated with elevated umbilical cord plasma beta-endorphin levels. Published research suggests that much cord beta-endorphin originates from fetal pituitary. Intact pituitary function is required for normal growth and development. Relationships between cord beta-endorphin and child development have not been previously reported. We measured paired maternal and cord plasma beta-endorphin concentration in a set of 106 low risk deliveries by solid phase two-site immunoradiometric assay. Geometric mean maternal and cord beta-endorphin concentrations were 128 pg/ml and 196 pg/ml, respectively, with corresponding ranges of 33-533 pg/ml and 70-579 pg/ml. Cord beta-endorphin concentration was significantly higher than maternal, regardless of delivery mode, and the two were significantly correlated (r = 0.231; P = 0.017). Multiple regression modeling showed that forceps delivery, maternal beta-endorphin concentration, bradycardia, vaginal delivery, and birth weight each made independent contributions to elevated cord beta-endorphin. Depressed cord beta-endorphin predicted more day 2 neurological soft signs, lower 6-month mental development, and lower 36-month motor score on psychometric tests of the children. Poorer fine motor control and coordination were predominantly associated with lower beta-endorphin. Level of cord beta-endorphin independent of delivery stress exerted the primary influence upon child motor development. Higher levels of stress-independent beta-endorphin may play a direct role in motor development.

Maternal influences on cord blood lead levels.

We constructed models of umbilical cord blood lead (PbB), with and without the addition of maternal PbB at delivery and earlier in pregnancy, to determine which factors explaining cord PbB depended upon maternal PbB and which did not. We prospectively studied women of low-to-middle socioeconomic status who lived in the Valley of Mexico from 12 weeks of pregnancy to delivery. We measured maternal venous PbB during pregnancy and at delivery, and umbilical cord PbB (1-38 micrograms/dl, 0.05-1.83 mumol/l). We used multiple regression analyses to model cord PbB and a logit analysis to model the maternal-cord PbB relationship. Older mothers using lead-glazed pottery and canned foods delivered babies with increased cord PbB, while those with occasional alcohol use during pregnancy, high milk intake, and more spontaneous abortions delivered babies with lower cord PbB. Maternal PbB at 36 weeks of pregnancy and at delivery independently explained additional variance in cord PbB, but maternal PbB earlier in pregnancy did not. Some of the effects of lead-glazed pottery, maternal abortions, alcohol use, and canned food use on cord PbB were mediated through maternal PbB. The effects of maternal age and milk intake on cord PbB were independent of their influence on maternal PbB near delivery. Cord PbBs were higher than maternal PbBs at delivery in 33% of the cases, and were predominant in mothers over 30 and those drinking milk less than once per day. Measurable influence of maternal PbB on delivery cord PbB is limited to the four to eight weeks prior to delivery. Many factors suspected of influencing bone lead also control cord PbB, some of them independently of their effect on maternal delivery PbB. Minimizing fetal exposure near the end of pregnancy may require long-term control of maternal lead exposure and good management of pregnancy and diet.

An unusual case of lightning injury: a melted silver necklace causing a full thickness linear burn.

An unusual case of lightning injury is shown. Flash-over current caused the fusion of a silver necklace producing a linear full thickness burn in the neck and chest with the silver welded throughout the wound.

Mechanisms of the toxic effect of lead. I. Free lead in erythrocyte.

In this work, a selection of children was examined based on their free erythrocyte protoporphyrin (FEP) and total blood lead (PbB) contents. Two groups with clear differences in lead sensibility were selected. One group with high FEP levels (deep lead alteration), named "normal," and one group with low FEP levels (discrete lead alteration), named "lead tolerant," and both with similar PbB concentration, were formed. The selection, based on FEP level, showed a correlation with other indicators (neuromotor alterations). A lower activity of the enzymes Glyceraldehyde 3-phosphate dehydrogenase (GA3PD), Glucose 6-phosphate dehydrogenase (G6PD), 6-phosphogluconate dehydrogenase (6PGD), and Lactate dehydrogenase (LDH) was found in the normal group when compared to the tolerant group. Therefore, the influence of the lead acetate upon the same erythrocyte enzyme activities was investigated. Lead inhibition of the enzymes GA3PD and G6PD was found, and this inhibition could be related to the free lead content found in the erythrocytes. Inhibition of the enzymes 6PGD and LDH was also found, but these enzymes were not inhibited by exposure to lead acetate. Erythrocyte free lead content was high in the normal group when compared to the lead tolerant group and could be a determinant factor in the biochemical alterations found. Low erythrocyte free lead contents could be an indicator of lead tolerance. TCA-precipitation was found to be a useful method to evaluate free lead content; it gave similar results to gel filtration molecular chromathography.