[Image-guided brachyablation for hepatocarcinoma. Report of one case]. / Image-Guided BrachyAblation (IGBA) en hepatocarcinoma. Descripción de la técnica y reporte del primer caso en Chile.

Eighty percent of hepatocarcinomas are inoperable at the moment of diagnosis. Liver transplantation is the treatment of choice in these cases, but local therapies are another alternative. Among these, Image-Guided BrachyAblation is a safe choice. We report a 76-year-old male with a hepatocarcinoma, who was considered inoperable due to the high surgical risk of the patient. A local treatment with Image-Guided BrachyAblation was decided. A brachytherapy needle was placed in the tumor under computed tomography guidance and a 15 Gy single dose was delivered from an Iridium-192 source. The patient had no immediate complications and at one month of follow up he continued without incidents.

A mathematical model and quantitative comparison of the small RNA circuit in the Vibrio harveyi and Vibrio cholerae quorum sensing systems.

Quorum sensing is the process by which bacteria regulate their gene expression based on the local cell-population density. The quorum sensing systems of Vibrio harveyi and Vibrio cholerae are comprised of a phosphorelay cascade coupled to a small RNA (sRNA) circuit. The sRNA circuit contains multiple quorum regulated small RNA (Qrr) that regulate expression of the homologous master transcriptional regulators LuxR (in V. harveyi) and HapR (in V. cholerae). Their quorum sensing systems are topologically similar and homologous thereby making it difficult to understand why repression of HapR is more robust than LuxR to changes in Qrr. In this work we formulate and parameterize a novel mathematical model of the V. harveyi and V. cholerae sRNA circuit. We parameterize the model by fitting it to a variety of empirical data from both species. We show that we can distinguish all of the parameters and that the parameterizations (one for each species) are robust to errors in the data. We then use our model to propose some experiments to identify and explain kinetic differences between the species. We find that V. cholerae Qrr are more abundant and more sensitive to changes in LuxO than V. harveyi Qrr and argue that this is why expression of HapR is more robust than LuxR to changes in Qrr.

Point-of-care testing for sexually transmitted infections in low-resource settings.

BACKGROUND: Both the global incidence and the prevalence of sexually transmitted infections (STIs) continue to increase, affecting hundreds of millions of individuals, particularly in low-to middle-income countries. Although a definitive diagnosis is desirable to inform STI treatment, syndromic management is the most widely used strategy in resource-limited settings. With the development of point-of-care (POC) tests, it is important to discuss how laboratories will need to adapt to new training and supervisory roles in support of testing, which will largely be performed by peripheral clinical staff. OBJECTIVES: To discuss potential applications of STI POC tests, how they could improve existing STI control strategies and the role of clinical and reference laboratories in support of initiatives to improve STI management and control activities. SOURCES: Narrative literature review and expert opinion. CONTENT: The paper outlines the current status of the STI epidemic worldwide and discusses the problems associated with current approaches to control these infections, particularly in low-resource settings. The roles of clinical and reference laboratories will need to change to provide support for POC and near-patient STI testing as these technologies are introduced into clinical as well as laboratory settings. IMPLICATIONS: Laboratories will be expected to play a leading role in the introduction and implementation of POC and near-patient STI testing. They will be required to facilitate training and provide technical and supervisory support to clinical staff on the use of these technologies to augment existing STI management and surveillance programmes. In order to provide quality service, they will need to develop, introduce and maintain sustainable local quality control and external quality assurance systems. Evidence from implementation research for introduction and scale up of STI POC tests in different STI epidemic and laboratory infrastructure settings is required.

Kinetic Control of the Li0.9Mn1.6Ni0.4O4 Spinel Structure with Enhanced Electrochemical Performance.

The development of more sustainable societies has become an urgent goal worldwide. Electrical batteries are currently seen as one of the most important energy storage technologies for the development of decarbonized societies. However, many lithium-ion battery manufacturers currently utilize cobalt, a toxic and hazardous mineral, in their batteries. Lithium-deficient manganese nickel oxide spinels are considered promising candidates owing to their high potential and environmental friendliness. Their electrochemical performance highly depends on their average and local structures, such as phase purities, lattice parameters, and cation sites. Thus, a synthesis protocol should be designed to control these structural parameters to improve their electrochemical performance. In this study, we controlled the average and local structures of Li0.9Mn1.6Ni0.4O4 spinels obtained by co-precipitation by optimizing their cooling rates. High-resolution techniques, including transmission electron microscopy, synchrotron X-ray diffraction, and Auger-composition analysis combined with density functional theory calculations, X-ray absorption spectroscopy, and electrochemical analysis, were used to understand the average and local structural variations and their effects on the electrochemical properties. As a result, the control of oxygen diffusion at different cooling rates can promote the rearrangement of the structure, resulting in a cation-disordered spinel with minimal variations in lattice parameters and composition. Excellent electrochemical properties were noted in the cation-disordered spinel with high crystallinity and a slightly oxygen-rich surface produced via optimized cooling rates.

Polycystin-1 mitigates damage and regulates CTGF expression through AKT activation during cardiac ischemia/reperfusion.

During ischemia/reperfusion (I/R), cardiomyocytes activate pathways that regulate cell survival and death and release factors that modulate fibroblast-to-myofibroblast differentiation. The mechanisms underlying these effects are not fully understood. Polycystin-1 (PC1) is a mechanosensor crucial for cardiac function. This work aims to assess the role of PC1 in cardiomyocyte survival, its role in profibrotic factor expression in cardiomyocytes, and its paracrine effects on I/R-induced cardiac fibroblast function. In vivo and ex vivo I/R and simulated in vitro I/R (sI/R) were induced in wild-type and PC1-knockout (PC1 KO) mice and PC1-knockdown (siPC1) neonatal rat ventricular myocytes (NRVM), respectively. Neonatal rat cardiac fibroblasts (NRCF) were stimulated with conditioned medium (CM) derived from NRVM or siPC1-NRVM supernatant after reperfusion and fibroblast-to-myofibroblast differentiation evaluated. Infarcts were larger in PC1-KO mice subjected to in vivo and ex vivo I/R, and necrosis rates were higher in siPC1-NRVM than control after sI/R. PC1 activated the pro-survival AKT protein during sI/R and induced PC1-AKT-pathway-dependent CTGF expression. Furthermore, conditioned media from sI/R-NRVM induced PC1-dependent fibroblast-to-myofibroblast differentiation in NRCF. This novel evidence shows that PC1 mitigates cardiac damage during I/R, likely through AKT activation, and regulates CTGF expression in cardiomyocytes via AKT. Moreover, PC1-NRVM regulates fibroblast-to-myofibroblast differentiation during sI/R. PC1, therefore, may emerge as a new key regulator of I/R injury-induced cardiac remodeling.

Binge drinking and insomnia in students from health sciences at one university in Rio de Janeiro, Brazil.

In spite of the many studies examining alcohol consumption, recent reviews have indicated that binge drinking has not been extensively studied. Furthermore, it is becoming increasingly clear that sleep is associated with many physiological functions and to drug addictions. The present study aimed to evaluate the relationship between alcohol binge drinking and insomnia in college students of health sciences. All first-year health sciences students (n=286) were evaluated in a cross-sectional study. Envelopes containing the Insomnia Severity Index (ISI), the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), and questions capturing sociodemographic data were distributed and collected in classes. It was found that most non-drinkers were female (70.6%), although there were no sex-related differences in the number of binge drinkers (more than 5 drinks on each occasion at least once a week), allowing statistical comparison. The Mann-Whitney U test indicated that the ISI scores were significantly greater in female than male binge drinkers (P=0.014). Moderate or severe insomnia was reported by 23% of the sample, with alcohol being the most frequently associated substance. A specialized intervention was suggested by ASSIST: brief for marijuana (19.2%) and tobacco (23.3%) use, and moderate (31.5%) or intensive (1.4%) for alcohol consumers. The data highlighted the need to pay attention to the habits of college students beyond obtaining scientific information. New data suggesting the influence of genetics on insomnia may be of importance when performing additional studies on the sex differences in alcohol binge drinking.

Field evaluation of the performance and testing costs of a rapid point-of-care test for syphilis in a red-light district of Manaus, Brazil.

OBJECTIVES: To assess the performance, usefulness and cost of a rapid treponemal antibody assay (VisiTect Syphilis) to detect syphilis in high risk populations. METHODS: People who attended STI clinics in Manaus, Brazil, were screened for syphilis using the fluorescent treponemal antibody absorption (FTA-Abs) test and a non-treponemal test (Venereal Diseases Research Laboratory (VDRL)), and for HIV. Finger prick blood samples were tested with VisiTect Syphilis. The rapid test was evaluated against the reference FTA-Abs and for its usefulness in detecting active syphilis (FTA-Abs and VDRL positive). Operational performance was assessed through providers' and patients' interviews. An economic evaluation was conducted from the provider's perspective. RESULTS: 510 patients (60% men) were enrolled, of whom 13 (2.5%) were HIV-1 seropositive. Syphilis prevalence (FTA-Abs) was 18% and active syphilis prevalence was 7.5%. 11% (57/506) of samples were positive by VisiTect. The sensitivity, specificity, positive and negative predictive values of VisiTect Syphilis were 57% (95% CI 45.8 to 66.7), 99% (95% CI 97.0 to 99.6), 91% (95% CI 80.0 to 96.7) and 91% (95% CI 88.0 to 93.5), respectively. VisiTect Syphilis identified 79% (30/38) of active syphilis cases. The cost per case of syphilis was $16.8 for VDRL, $33.2 for low cost and $56.3 for high cost VisiTect Syphilis; the cost per case of active syphilis was $21.3, $57.5 and $97.6, respectively. Patients identified finger prick pain and preference for venous blood collection as minor barriers to test use. CONCLUSION: VisiTect Syphilis had low sensitivity in field use and was less cost effective than conventional VDRL. However, rapid and correct identification of a high proportion of active syphilis cases combined with operational characteristics suggest a role in high risk populations.

Antitumor effects of non-replicative herpes simplex vectors expressing antiangiogenic proteins and thymidine kinase on Lewis lung carcinoma establishment and growth.

There is growing evidence that combinations of antiangiogenic proteins with other antineoplastic treatments such as chemo- or radiotherapy and suicide genes-mediated tumor cytotoxicity lead to synergistic effects. In the present work, we tested the activity of two non-replicative herpes simplex virus (HSV)-1-based vectors, encoding human endostatin::angiostatin or endostatin::kringle5 fusion proteins in combination with HSV-1 thymidine kinase (TK) molecule, on endothelial cells (ECs) and Lewis lung carcinoma (LLC) cells. We observed a significant reduction of the in vitro growth, migration and tube formation by primary ECs upon direct infection with the two recombinant vectors or cultivation with conditioned media obtained from the vector-infected LLC cells. Moreover, direct cytotoxic effect of HSV-1 TK on both LLC and ECs was demonstrated. We then tested the vectors in vivo in two experimental settings, that is, LLC tumor growth or establishment, in C57BL/6 mice. The treatment of pre-established subcutaneous tumors with the recombinant vectors with ganciclovir (GCV) induced a significant reduction of tumor growth rate, while the in vitro infection of LLC cells with the antiangiogenic vectors before their implantation in mice flanks, either in presence or absence of GCV, completely abolished the tumor establishment.

The influence of body composition on the six-minute walk test in Chilean preschool and school children / Influencia de la composición corporal en el test de la caminata de seis minutos en preescolares y escolares chilenos

Background: the six minutes' walk test (6MWT) measures submaximal physical activity. Objective: this study determines the association of children´s nutritional status and body composition with the results of the 6MWT. Methods: a sample of 1419 Chilean children, 4 to 10 years of age, were assessed including anthropometry, body composition by validated equations, the 6MWT test, and in 50 % of the sample heart rate prior the test, at one minute into the test, and at one minute posttest with a Polar watch. Results: the distance walked ranged from 473.1 ± 47.8 meters in preschool children to 584.2 ± 65.7 meters in school children. In heart rate there was a significant difference between obese and eutrophic children. The distance walked in the 6MWT was positively associated with fat-free mass (p < 0.05) and BMI (R2 = 0.49). Body composition influences 6MWT quartile distribution, as well as nutritional status. Age and height explained 49 % of the variance (R2 = 0.42 and 0.47, respectively) in the 6MWT, and there are significant differences in this variable by sex, body composition, and nutritional status. Conclusions: body composition was associated with walking performance in children. Thus, it is important to evaluate height and body composition when assessing the six-minute walk test because of this important relationship (AU)

Introducción: el test de la marcha de seis minutos (TM6M) mide una actividad física submáxima. Este estudio evaluó el efecto del test de la marcha sobre la composición corporal y el estado nutricional en niños. Métodos: en una muestra de 1419 niños chilenos de 4 a 10 años de edad se evaluaron la antropometría, la composición corporal por ecuaciones validadas, el TM6M y, en el 50 % de la muesta, la frecuencia cardíaca mediante un reloj Polar. Resultados: la distancia caminada varió desde 473,1 ± 47,8 metros en los niños preescolares hasta 584,2 ± 65,7 metros en los escolares. En la frecuencia cardíaca hubo una diferencia significativa entre niños obesos y eutróficos. La distancia caminada se asoció positivamente con la masa libre de grasa (R2 = 0,37) y el IMC (R2 = 0,49). Por otra parte, la composición corporal varía en función de los cuartiles de composición corporal y el estado nutricional. La edad y la altura explicaron el 49 % de la varianza de la prueba (R2 = 0,42 and 0,47, respectivamente). Existen diferencias significativas en la distancia recorrida en el TM6M en función del sexo, la composición corporal y el estado nutricional. Conclusiones: composición corporal, talla e IMC se asociaron a la distancia recorrida en el TM6M. Por tanto, se sugiere medir estas variables cuando se evalúe el test de marcha de seis minutos (AU)

Anthropometric indicators as predictors of total body fat and cardiometabolic risk factors in Chilean children at 4, 7 and 10 years of age.

BACKGROUND/OBJECTIVE: To compare the association between anthropometric indicators of global and central obesity as predictors of total body fat (TBF) and cardiometabolic risk factors in children. SUBJECTS/METHODS: A total of 1044 children were evaluated at 4 years (n=320), 7 years (n=1044) and 10 years (n=483). The following anthropometric indices were determined: body mass index (BMI) for age (BAZ, WHO), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR). To estimate TBF we used validated predictive equations. We measured blood sample concentrations of glucose, insulin, triglycerides, total cholesterol, Low-density lipoprotein (LDL) and High-density lipoprotein (HDL), adiponectin, C-reactive protein (CRP) and Insulin-like growth factor-1 (IGF-1). RESULTS: Adiposity and cardiometabolic markers, particularly those related to glucose metabolism increased from 4 years to 10 years. BAZ and WC were highly correlated to body fat at all ages (all r>0.8) but at 10 years WC was more strongly correlated than BAZ (r=0.94 WC vs r=0.88 BAZ, P<0.05); conversely, WHtR was significantly associated with body fat from 7 years (r=0.85) and 10 years (r=0.88). WHR was unrelated all over the period studied at all ages. Anthropometrical adiposity indicators became associated to cardiometabolic markers only from 7 years on with associations being slightly higher at 10 years, particularly for adiponectin and lipid markers. At all ages, BAZ, WC and WHtR performed similarly as cardiometabolic markers (P<0.05) while WHR was a slightly weaker marker. CONCLUSIONS: Relationship between anthropometrical indicators of adiposity and cardiometabolic markers becomes stronger from 7 years onwards; BAZ, WC and WHtR perform similarly as markers of cardiometabolic risk at least until 10 years of age.

Energy balance and physical activity in obese children attending day-care centres.

OBJECTIVE: To evaluate energy balance and physical activity in obese preschool children attending day-care centres. DESIGN: Cross-sectional study. SUBJECTS: Twenty-four 3-5 years old obese children selected at random from four different day-care centres in Santiago City, Chile. Total energy expenditure (TEE) was measured by doubly labelled water and physical activity as recorded by TRITRAC R3D motion sensor. Energy intake was assessed by measuring food intake while at the centre, along with the recording of additional food intake in the home. RESULTS: Obese children had a 5.4% higher weighed energy intake than their energy requirements 2001. Energy intake during the week was 7716+/-1092 kJ/day and 7401+/-1023 kJ/day in boys and girls, respectively. Minimal activity was higher in the day-care centres (62%) compared to 52% during the weekend at home. Light activity was higher during the weekend at home than during the week (25 versus 20%), but moderate-intense activity was similar (3-5%). CONCLUSIONS: Reduction in dietary energy provided at the day-care centres helps to balance energy requirements during the week. Obese children had marked sedentary characteristics with regards to physical activity, although children are more active at home in weekends. This situation suggests that educators and parents need to improve children's physical activity levels and nutrition habits.

[Gastric volvulus]. / Vólvulo gástrico. Presentación de un caso.

Gastric volvulus is a rare condition in pediatric population in which there is an abnormal rotation of one part of the stomach around itself. It's a surgical emergency. We report a six year old female admitted in the emergency due to upper abdominal distention, nausea without vomiting, physical exam revealed upper abdominal distention and abdominal tenderness, no bowel sounds. Laparotomy was performed and a gastric volvulus with occlusive vascular involvement was found. In the post operative period she required a second laparotomy due to adhesions in small bowel.

Binge drinking and insomnia in students from health sciences at one university in Rio de Janeiro, Brazil

In spite of the many studies examining alcohol consumption, recent reviews have indicated that binge drinking has not been extensively studied. Furthermore, it is becoming increasingly clear that sleep is associated with many physiological functions and to drug addictions. The present study aimed to evaluate the relationship between alcohol binge drinking and insomnia in college students of health sciences. All first-year health sciences students (n=286) were evaluated in a cross-sectional study. Envelopes containing the Insomnia Severity Index (ISI), the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), and questions capturing sociodemographic data were distributed and collected in classes. It was found that most non-drinkers were female (70.6%), although there were no sex-related differences in the number of binge drinkers (more than 5 drinks on each occasion at least once a week), allowing statistical comparison. The Mann-Whitney U test indicated that the ISI scores were significantly greater in female than male binge drinkers (P=0.014). Moderate or severe insomnia was reported by 23% of the sample, with alcohol being the most frequently associated substance. A specialized intervention was suggested by ASSIST: brief for marijuana (19.2%) and tobacco (23.3%) use, and moderate (31.5%) or intensive (1.4%) for alcohol consumers. The data highlighted the need to pay attention to the habits of college students beyond obtaining scientific information. New data suggesting the influence of genetics on insomnia may be of importance when performing additional studies on the sex differences in alcohol binge drinking.

Blockage of resting potassium conductance in frog muscle fibers by a toxin isolated from the sponge Haliclona viridis.

A fraction able to irreversibly depolarize sartorius muscle fibers was isolated from the marine sponge. The resting potential is decreased from -84 (-85, -83) mV (median and its 95% confidence interval) to -40 (-46, -30) mV. The fibers depolarized by the sponge toxin are restored to -54 (-57, -49) mV when external sodium is replaced by Tris or to -52 (-57, -47) mV when calcium is removed from the saline solution in the presence of 1 mM EDTA and 1 microM tetrodotoxin. Tetrodotoxin alone (1 micron) has no effect on the depolarization [-43 (-50, -37) mV] produced by the sponge and 5 mM manganese only repolarizes the fibers to -48 (-55, -40) mV. The depolarization is potentiated [-28 (-33, -23) mV] when chloride is replaced by glutamate in the external solution. The access resistance of the muscle fibers is not significantly changed from its control value of 2.74 (2.28, 3.30) M omega when toxin is added. By contrast 20 mM K+ superfused to the fibers changes membrane potential to -44 (-46, -42) mV and decreases access resistance to 1.99 (1.38, 2.87) M omega. The toxin is devoid of any effect on the endplate, since the depolarization of the postsynaptic membrane is identical to the extrajunctional area, and miniature endplate potentials of normal shape and high frequency are easy to record from toxin treated fibers. The action potential is not modified by the toxin. The toxin is a small polar compound insoluble in acetone and is likely to act on a receptor located on the outer phase of the membrane. The biological activity appears as a peak on elution with 1 M acetic acid on Bio Gel P2.

[Dissociation of a modular acetabular component in an uncemented total hip prosthesis. Effect of the modular design and anti-luxation rim. A case report]. / Dissociation du composant acétabulaire modulaire d'une prothèse totale de hanche non scellée. Effet de la modularité et du rebord anti-luxation. A propos d'un cas.

We report a case of dissociation between polyethylene and metal-backing of the acetabular component of a total hip prosthesis after reduction of a late dislocation. We refer to advantages and disadvantages of an elevated-rim acetabular liner in total hip arthroplasty. The position of the metallic markers of the polyethylene and/or excentric situation of the neck-head complex from the metal-back allowed us to diagnose it. An appropriate surgical technique avoiding the joint laxity, firm assembly of the modular components when they are implanted, gentle reduction of an eventual dislocation and fluoroscopic control, are factors which can avoid this rare complication.

A 38-year-old man with nephrotic syndrome, episodic fever and abdominal pain.

The differential diagnosis for a 38-year-old white man with a chronic fever associated with nephrotic syndrome is discussed in the setting of a clinicopathological conference at Louisiana State University Medical Center in Shreveport, Louisiana. The etiology and pathophysiology of fever-associated nephrotic syndrome are discussed.

[Hematologic changes in rats treated with high doses of vitamin K3 (menadione)]. / Alteraciones hematológicas en ratas tratadas con dosis elevadas de vitamina K3 (menadiona).

The present study describes the effect of high doses of vitamin K3 (8-30 mg/kg) administered daily by intramuscular injection during seven days; on blood smear, red blood cells (RBC) and concentration of hemoglobin (Hb) counts, value of hematocrit (Ht), mean corpuscular hemoglobin concentration (MCHC), reticulocyte and erythroblast counts, total and differential counting of leukocytes (WBC) and total and fractionated serum bilirubin concentration of albino male rats. Results were then compared with findings in normal rats treated with the same doses of sodium bisulfite. In animals treated with vitamin K3 a statistically significant decrease in the number of erythrocytes and in the concentration of Hb, Ht and MCHC was found together with a concomitant increase of erythroblast and reticulocyte counting. In regard to the blood smear, it was observed that erythrocytes vary in their hemoglobin content, size, shape and in their staining properties (polychromatophilia) where as the leukocytes were found to be morphologically normal, but in an increased number. Lymphocytes occasionally showed azurophil granules. Platelets assumed irregular shape and in normal amounts. The leukocytes count showed leukocytosis with marked neutrophilia, eosinophilia, lymphocytosis and monocytosis. Also, the presence of clinical jaundice with an increase of the serum "indirectly-reacting" bilirubin was also observed. These findings indicate that hypervitaminosis K3 induces a marked hemolytic microcytic hypochromic anemia and changes in the white blood cells count. Further studies will be pursued in order to obtain a better understanding of the causes and/or the mechanisms that induce these alterations in the blood cells.

Image-Guided BrachyAblation (IGBA) en hepatocarcinoma: descripción de la técnica y reporte del primer caso en Chile / Image-guided brachyablation for hepatocarcinoma: report of one case

Eighty percent of hepatocarcinomas are inoperable at the moment of diagnosis. Liver transplantation is the treatment of choice in these cases, but local therapies are another alternative. Among these, Image-Guided BrachyAblation is a safe choice. We report a 76-year-old male with a hepatocarcinoma, who was considered inoperable due to the high surgical risk of the patient. A local treatment with Image-Guided BrachyAblation was decided. A brachytherapy needle was placed in the tumor under computed tomography guidance and a 15 Gy single dose was delivered from an Iridium-192 source. The patient had no immediate complications and at one month of follow up he continued without incidents.

[Methods of body composition and four compartiments model in obese school children]. / Métodos de composición corporal y modelo de cuatro compartimentos en escolares obesos chilenos.

INTRODUCTION: In Chile, the prevalence of obesity in schoolchildren is 21.3%. The study and individual intervention of this malnutrition, it is necessary to have not only global indicators of nutritional status, but also indicators that give information on body composition. OBJECTIVE: To compare estimates of body fat isotopic dilution, plethysmography and radiographic absorptiometry 4C model in overweight schoolchildren. METHODS: We worked with 61 obese (BMI ≥ p 95) of both sexes, between 8 and 13 years, enrolled in a school in a district of the city of Santiago. The multicompartmental body composition determination, considered isotopic dilution, plethysmography and radiographic absorptiometry. Using as a reference standard four compartment model of Fuller. RESULTS: In both sexes, the method showed better agreement with the reference of 4 compartments was isotope dilution (r = 0.98, p < 0.01). In children, the isotopic dilution underestimates body fat in -0.40 kg. By contrast, DEXA and plethysmography overestimate body fat by 0.81 kg and 1.89 kg respectively. In women, all methods overestimate body fat, with less emphasis isotopic dilution value 0.46 kg, 0.52 kg after DEXA and plethysmography 1.31 kg. CONCLUSIONS: The deuterium isotopic dilution would be the most sensitive method for estimating body fat in research studies because it shows the best agreement with the gold standard multicompartmental model.

Nivel de indicadores de responsabilidad social empresarial (RSE) en la ese hospital local de Montelíbano, 2015 / Level of indicators of corporate social responsibility (CSR) in the ESE hospital local de Montelibano, 2015

Objetivo. Determinar el nivel de los indicadores de (RSE) con el fin de recomendar acciones de mejoramiento en la ESE Hospital Local de Montelibano. Materiales y métodos. Estudio descriptivo transversal cuantitativo, se tomó la población total de los funcionarios directivos, administrativos y operativos. Se utilizó la técnica de la encuesta con aplicación del cuestionario como instrumento para establecer el nivel de responsabilidad social de la empresa desde la percepción de los diferentes grupos de interés como son: Directivos, empleados, proveedores y usuarios determinados en la muestra. Una vez recolectada la información se procedió al registro, procesamiento, análisis y discusión de acuerdo con los objetivos planteados y los resultados de otros estudios usando para ello la elaboración de cuadros estadísticos y técnicas gráficas que ilustraron en forma resumida y organizada la información. La tabulación y graficación se realizó con ayuda de la hoja electrónica de cálculo Excel, la cual permitió hacer operaciones matemáticas sencillas, uso de funciones estadísticas, hasta tablas dinámicas y gráficos. Resultados. el 56% de la población de los grupos de interés, funcionarios y usuarios, era de sexo femenino, 100% de las edades de los usuarios osciló entre 18 a 33 años, y la de los funcionarios en el intervalo de los 24 a 59 años. En el nivel socioeconómico encontramos que el 89.5% de los usuarios perteneció al estrato I, mientras que el 8.9% vivían en estrato II y solo el 1.6% del total encuestados pertenecieron al estrato III, en los funcionarios se evidenció que la mayoría se clasificaron en un 65% en los estratos I y II. A nivel general y teniendo en cuenta la valoración de la percepción en cada grupo de indicadores, el nivel de Responsabilidad Social de la institución es de 3,0, la cual la clasificó en un nivel poco satisfactorio. Conclusiones. Aunque la Empresa muestra fortalezas en aspectos relacionados con la buena percepción que tienen los grupos de interés frente a factores como el fomento del trabajo en equipo, la no discriminación, la empleabilidad femenina, respeto al derecho de liquidación y despidos, capacitaciones continuas, mecanismos de conocimiento de las expectativas de las comunidades, minimización de desperdicios a través de la realización de programas de auditoría verde; presenta un alto nivel de insatisfacción en aspectos relacionados con el desarrollo de sus empleados y la calidad de vida de las familias y prestaciones superiores a la ley, poco ascenso en empleos femeninos a posiciones ejecutivas, falta de esquemas de trabajos flexibles y de programas para estimular la generación de ideas. Igualmente con la falta de aplicación de normas de certificación ambiental e información detallada del destino de sus productos y o servicios, no perciben metas formales ni declaración de principios medio ambientales para prevenir la contaminación, como tampoco la generación de incentivos previos y reconocimientos para los empleados que sugieran alternativas a los procesos de contaminación. A nivel general y teniendo en cuenta la valoración de la percepción en cada grupo de indicadores, el nivel de Responsabilidad Social de la institución es de 3.0, la cual la clasificó en un nivel poco satisfactorio.

Objective. To determine the level of corporate social responsibility indicators in order to design a strategic plan for improvement in the Local Hospital ESE Montelibano. Materials and Methods. Quantitative Cross-sectional study, the total population of managers, administrative and operational staff took the survey technique was used with application of the questionnaire as a tool to establish the level of social responsibility of the company from the perception of different interest groups such as: Managers, employees, suppliers and users identified in the sample. Once we collected the information we proceeded to the recording, processing, analysis and discussion in accordance with the objectives and results of other studies using for this purpose the preparation of statistical tables and graphs that illustrated techniques summarized and organized information. Tabulation and graphing was performed using electronic Excel spreadsheet, which allowed to make from simple math, using statistical functions, dynamic tables and graphs. Results. 56% of the population of interest groups officials and users were female, 100%, ages users ranged from 18 to 33 years, and that of officials in the range of 24 to 59 years . In the socioeconomic level found that 89.5% of users belonged to the stratum I, while 8.9% lived in stratum II and only 1.6% of the total respondents belonged to the stratum III, officials it became clear that most were classified in 65% in strata I and II. At a general level and taking into account the assessment of perception indicators in each group, the level of social responsibility of the institution is 3.0, which classified it in an unsatisfactory level. Conclusion. Although the Company shows strengths in areas related to good perception of stakeholders against factors such as promoting teamwork, non- discrimination, women's employability, respect for the right of settlement and layoffs, ongoing training, mechanisms of knowledge of the expectations of communities, waste minimization through the realization of green audit programs; It has a high level of dissatisfaction with aspects related to the development of its employees and the quality of life of families and above the law benefits, little rise in women to executive positions jobs, lack of schemes of flexible work and programs to stimulate the generation of ideas. Also with the lack of enforcement of environmental certification standards, and detailed information about the destination of its products or services, they do not receive formal statement or goals of environmental principles to prevent pollution, any generation previous incentives and recognition for employees They are suggesting alternatives to contamination processes. At a general level and taking into account the assessment of perception indicators in each group, the level of social responsibility of the institution is 3.0, which classified it in an unsatisfactory level.