[Perinatal outcome and five-year survival in children with prenatal diagnosis of hypoplastic left heart syndrome]. / Evolución perinatal y sobrevida a cinco años en niños con diagnóstico prenatal de síndrome de hipoplasia de ventrículo izquierdo.

Hypoplastic left heart syndrome (HLHS) is a congenital heart disease of low prevalence and high lethality. OBJECTIVE: to determine the perinatal outcome and survival at one and five years of fetuses with a prenatal diagnosis of HLHS. PATIENTS AND METHOD: Prospective cohort study of all the fetuses with HLHS from the Perinatal Reference Center (CERPO) born between January 2008 and December 2017. Demographic and clinical perinatal data were obtained from the CERPO database. At one and five years of age, a telephone survey was conducted to determine the surgical treatment and survival. RESULTS: 1,573 patients were admitted to the CERPO, 899 with congenital heart diseases (CHD), confirming the prenatal diagnosis of HLHS in 7% (110/1,573). The mean gestational age at diagnosis and the median at admission were 26+3 and 32+3 weeks, respectively. 89% were born alive, 90% at term, and 57% delivered by cesarean section. The median birth weight was 3,128 grams. 89% survive the prenatal period, 50% the early neonatal period, 33% the late neonatal period, 19% the first year, and 17% at 5 years. CONCLUSIONS: In this center, the one-year and five-year survival of fetuses with prenatal diagnosis of HLHS was 19% and 17%, respectively. It is important for prenatal counseling to consider publications based on local casuistry, that include patients with prenatal and postnatal diagnoses and those who underwent surgery, in order to provide more precise information to parents.

Experience in colorectal surgery at a quaternary care hospital in Bogotá, Colombia.

INTRODUCTION AND AIMS: Colorectal cancer is among the three most common cancers worldwide. Knowledge and identification of suboptimal outcome-associated factors enable comprehensive patient management. The aim of the present study was to present the results of the surgical management of colorectal cancer at a quaternary care university hospital. MATERIALS AND METHODS: An observational, analytic, cross-sectional study was conducted. Information was collected on a retrospective cohort of patients diagnosed with colorectal cancer from 2013 to 2017 at the Hospital Universitario Mayor Méderi, Bogotá, Colombia. RESULTS: Data on 452 patients, within the study period, were collected. A total of 48.5% of the patients were men, the overall complication rate was 24%, the surgical site infection (SSI) rate was 15.38%, anastomotic dehiscence occurred in 4.18% of the patients, bleeding required reoperation in 1.32%, and the intrahospital mortality rate was 7.47%. CONCLUSION: Colorectal cancer management at a university hospital was as beneficial as that provided by other types of hospitals, showing a direct association with complete R0 dissections; low complication rates, according to international reports; and reduced overall morbidity.

Transfusión intrauterina: tratamiento de anemia fetal severa en el Centro de Referencia Perinatal Oriente / Intrauterine transfusion: treatment of severe fetal anemia at the Oriente Perinatal Reference Center

RESUMEN INTRODUCCIÓN: La anemia fetal es una importante causa de morbilidad y mortalidad perinatal. En la actualidad la principal herramienta terapéutica es la transfusión fetal intrauterina, permitiendo una mejoría en el pronóstico y sobrevida en fetos con anemia severa. El objetivo de este estudio fue reportar los resultados obtenidos en el Centro de Referencia Perinatal Oriente (CERPO). MÉTODO: Se realizó un análisis descriptivo retrospectivo de los casos de anemia fetal que requirieron transfusión intrauterina en CERPO entre los años 2003-2019. RESULTADOS: Se incluyeron 17 embarazos, con un total de 27 procedimientos. La sobrevida perinatal fue de 82%, con un 18% de mortalidad perinatal. Se reporta una tasa de mortalidad de 3,7% asociado al procedimiento. CONCLUSIÓN: Los resultados observados son similares a lo publicado, con una tasa de complicaciones similar a lo reportado en la literatura internacional y nacional.

SUMMARY INTRODUCTION: Fetal anemia is an important cause of perinatal morbidity and mortality. At present, the main therapeutic tool is intrauterine fetal transfusion, allowing an improvement in the prognosis and survival in fetuses with severe anemia. The objective of this study was to report the results obtained in Centro de Referencia Perinatal Oriente (CERPO). METHOD: A retrospective descriptive analysis of the cases of fetal anemia that required intrauterine transfusion in CERPO between 2003-2019. RESULTS: There were 17 pregnancies included, with a total of 27 procedures. Perinatal survival was 82%, with 18% perinatal mortality; a mortality rate of 3.7% is reported per procedure. CONCLUSION: The observed results agree with previous reports.

Energy distribution of the neutron flux measurements at the Chilean Reactor RECH-1 using multi-foil neutron activation and the Expectation Maximization unfolding algorithm.

We present a methodology to obtain the energy distribution of the neutron flux of an experimental nuclear reactor, using multi-foil activation measurements and the Expectation Maximization unfolding algorithm, which is presented as an alternative to well known unfolding methods such as GRAVEL. Self-shielding flux corrections for energy bin groups were obtained using MCNP6 Monte Carlo simulations. We have made studies at the at the Dry Tube of RECH-1 obtaining fluxes of 1.5(4)×1013cm-2s-1 for the thermal neutron energy region, 1.9(5)×1012cm-2s-1 for the epithermal neutron energy region, and 4.3(11)×1011cm-2s-1 for the fast neutron energy region.

Intervenciones en hernias inguinocrurales: bilateralidad y recidiva hemiaria. Servicio de Cirugía del Hospital Naval de Viña del Mar / Reoperations in femoral and inguinal hernias: bilaterality and relapse. Surgery Service in the Navy Hospital Viña del Mar

Introducción: En nuestro país la hernioplastia inguinocrural es una de las intervenciones quirúrgicas más frecuentes, pero hay escasos estudios acerca de los resultados a largo plazo. Materiales y método: Estudio observacional de cohorte retrospectiva utilizando base de datos, fichas clínicas y electrónicas, con el objeto de analizar las causas de reintervenciones en hernioplastias inguinocrurales desde el año 2000 hasta el 2010, con seguimiento hasta junio del 2015. Resultados y discusión: Se realizaron 1.765 intervenciones con los códigos de hernia inguinal y femoral, de los cuales 100 casos requirieron reintervención: 84 hombres y 16 mujeres, con edad promedio de 62 años para la primera cirugía. En un tercio se encontró HTA, y en el 38% de los hombres uropatía obstructiva, sin ser estadísticamente significativo (p = 0,6). Se demostró intervención por hernia contralateral en el 38% de los casos, con aparición predominante dentro de los 3 primeros años desde la primera cirugía; en el 37% se demostró recidiva herniaria. Los pacientes que recidivaron equivalen al 2,7% del total de cirugías realizadas, pero al considerar las recidivas solo con técnica de Lichtenstein, esta fue del 1,7% con respecto al total de hernioplastias realizadas, presentándose dentro de los 3 primeros años. En 5 casos se demostró doble recidiva y en 2 casos triple recidiva. Cinco pacientes presentaron complicaciones: 2 hematomas, un seroma, una inguinodinia crónica y un paciente falleció por obstrucción intestinal postoperatoria. Conclusión: Nuestros resultados son similares a casuísticas nacionales y metaanálisis reportados en cuanto a tipo de pacientes, comorbilidades asociadas y porcentaje de recidiva a largo plazo, con menor tasa de complicaciones.

Introduction: In our country, hernioplasty for inguinocrural hernia is one of the most frequent surgical procedures, but there are scanty studies bring over of the long-term results. Materials and method: Observational retrospective cohort study, using clinical data base of patient's clinical history, in order to analyze the cause of reoperations on our inguinocrural hernioplasty data base, from the year 2000 to the year 2010, and with a follow up until June 2015. Results and discussion: In total they were performed 1,765 interventions coded crural and inguinal hernia, 100 cases required reoperation, 84 men and 16 women with an average age of 62 years for the first surgery. In a third hypertension was found, and in 38% of men, obstructive uropathy, not statistically significant (P=.6). Reoperation for contralateral hernia was performed in 38% of the cases, with predominant appearance within the first three years after the first surgery; in 37% of the cases, hernia recurrence was demonstrated. Patients, who recurred, were equivalent to 2.7% of all surgeries performed, but considering Lichtenstein technique, it was only 1.7% of all hernioplasties, occurring within the first three years. In 5 cases, we found double recurrence, and triple recurrence in two. Five patients had complications: two bruising, seroma, chronic inguinal pain and one death by postoperative intestinal obstruction. Conclusion: Our results were similar to those reported in our country in relation to the type of patients, comorbidities and recurrence at long-term, but with a lower rate of complications.

Membrane Cholesterol in Skeletal Muscle: A Novel Player in Excitation-Contraction Coupling and Insulin Resistance.

Membrane cholesterol is critical for signaling processes in a variety of tissues. We will address here current evidence supporting an emerging role of cholesterol on excitation-contraction coupling and glucose transport in skeletal muscle. We have centered our review on the transverse tubule system, a complex network of narrow plasma membrane invaginations that propagate membrane depolarization into the fiber interior and allow nutrient delivery into the fibers. We will discuss current evidence showing that transverse tubule membranes have remarkably high cholesterol levels and we will address how modifications of cholesterol content influence excitation-contraction coupling. In addition, we will discuss how membrane cholesterol levels affect glucose transport by modulating the insertion into the membrane of the main insulin-sensitive glucose transporter GLUT4. Finally, we will address how the increased membrane cholesterol levels displayed by obese animals, which also present insulin resistance, affect these two particular skeletal muscle functions.

Sobrecarga y Burnout en cuidadores informales del adulto mayor / Overload and Burnout among aged informal caregivers / Sobrecarga e Burnout com cuidadores informais do idoso

Objetivo: Conocer las condiciones personales, de sobrecarga y su relación con el Síndrome de Burnout en el cuidador informal del adulto mayor. Método: Estudio correlacional y transversal. Muestreo no probabilístico, por conveniencia. Muestra: 52 cuidadores informales de ancianos de ambos sexos. Se utilizó cédula de datos personales, la escala de Zarit y el cuestionario Maslach Burnout Inventory. El procesamiento de datos se realizó con el Statistical Package for the Social Sciences versión 20. Resultados: La media de edad de los cuidadores fue de 44 años, 58% están casados, 50% tienen escolaridad media superior, 45% son hijos de los seniles (35% son las hijas), el 27% trabajan como profesionistas, 73% tienen de 1 a 6 años cuidando al anciano; 42% dedica de 6-15 horas a su cuidado; 58% padece sobrecarga, con significancia (r = 0.442, p = 001) con las horas diarias dedicadas al cuidado. El Síndrome de Burnout mostró bajo riesgo en todas las dimensiones: Agotamiento Emocional 67%, Deshumanización 80% y Realización Personal 73%, aunque más del 20% lo padece en alguna dimensión. Conclusiones: La sobrecarga y el síndrome de Burnout en los cuidadores familiares se encontraron bajos. El factor relacionado con la sobrecarga y él Burnout fue el tiempo diario dedicado al cuidado. Con base en los resultados, se propone establecer programas preventivos de entrenamiento acerca del cuidado dirigidos a familiares de ancianos; con el fin de contribuir al bienestar de los cuidadores.

Objective: To explore the personal conditions associated with work overload and the Syndrome of Burnout among aged informal caregivers. Method: Correlational and transversal study using by-convenience not-probabilistic sampling. Sample: 52 aged informal caregivers of both sexes. A personal data form, the Zarit scale, and the Maslach Burnout Inventory questionnaire were all used. Data were processed with the Statistical Package for the Social Sciences version 20. Results: The care providers average age was 44 years old, 58% reported being married, 50% said they had a mid-high level education, 45% were sons of the elderly (35% were daughters), 27% said they worked as professionals, 73% stated they had a 1- 6 year-experience taking care of elders, 42% said that they usually devote between 6 and 15 hours daily to their care activities, and 58% turned out to be suffering from a work overload (r = .442, p=.001). A low Burnout Syndrome risk was found in all the corresponding dimensions: Emotional Fatigue 67%, Dehumanization 80%, and Personal Accomplishment 73%, though more than 20% of the respondents were shown to be suffering from the syndrome in at least one dimension. Conclusions: Work overloads and the Burnout Syndrome among the aged family caregivers were found to be low. An important factor associated with the work overload and the Burnout Syndrome was the time per day devoted to the care. Based on the results, it is suggested to establish preventive training programs related to caring and aimed at the aged family caregivers with the objective of contributing to the wellbeing of these specific caregivers.

Objetivo: Conhecer as condições pessoais, de sobrecarga e sua relação com a síndrome de Burnout no cuidador informal do idoso. Método: Estudo correlacional e transversal. Amostragem não probabilística por conveniência. Amostra: 52 cuidadores informais de idosos de ambos os sexos. Utilizou-se a cédula de dados pessoais, a escala de Zarit e o questionário Maslach Burnout Inventory. O processamento de dados realizou-se com o Statistical Package for the Social Sciences versão 20. Resultados: A média de idade dos cuidadores foi de 44 anos, 58% são casados, 50% são de escolaridade de ensino médio, 45% são filhos dos idosos (35% são as filhas), 27% trabalham como profissionais, 73% cuidam o idoso de 1 a 6 anos, 42% dedica ao cuidado de 6 a 15 horas, 58% padece de sobrecarga com significância (r=.442, p=001) pelo cuidado dedicado diariamente. A síndrome de Burnout mostrou um risco baixo em todas as dimensões: esgotamento emocional 67%, desumanização 80% e realização pessoal 73%, ainda que mais do 20% padeça em alguma dimensão. Conclusões: A sobrecarga e a síndrome de Burnout nos cuidadores familiares encontram-se baixos. O fator relacionado com a sobrecarga e o Burnout foi pelo cuidado dedicado diariamente. Com base nos resultados, propõem-se estabelecer programas preventivos de treino em volta do cuidado dirigido a familiares de idosos, com o fim de contribuir para o bem-estar dos cuidadores.

Contenido de sodio en pan elaborado en panaderia de distribución nacional y comparado con una panadería local en la ciudad de Chillán de Chile / Comparison of sodium content in bread from a bakery with national distribution and a local bakery of Chillán city, Chile

Introduction: The Chilean Ministry of Health (MINSAL) and the Chilean Federation of Bakers (FECHIPAN) agreed to progressively decrease sodium content in bread from 800 to 500 mg/100 g bread in 100 bakeries in 2011 and in 100% of bakeries in 2014. Objective: To analyze and compare the sodium content in bread from a bakery with national distribution (A) and a local bakery (B). Materials and methods: A total of 100 samples were analyzed in each bakery 50 each of the two types of bread known as marraqueta and hallulla (types of bread rolls). Analysis was performed at different times of the day and at different days of the week. Sodium content was determined by the AOAC (2005) method using atomic absorption spectrophotometry and compared with the sodium content declared in the nutrition label in bakery A. Differences between content for type of bread, bakery and time of sampling were established by ANOVA and Student's t-test with the STATA 12.0 software at a p<0.05 level of significance. Results: Total sodium in bread (mg/100 g unit) was estimated as 619.6±127.7 mg for hallulla and 641.0±93.3 for marraqueta. There were no significant differences in sodium content in both bakeries (p=0.971) and type of bread (p=0.177). Sodium content was higher on Wednesdays (p<0.0001, p=0.016) and at 17 hours (p<0.000001, p=0.028) in hallulla and marraqueta, respectively. Total sodium content in both bakeries varied between 412.5 and 954.5 mg/100 g. Conclusions: Bread from both bakeries showed similar sodium contents although they exceeded the MINSAL-FECHIPAN agreement by 26% to 80%.

Introducción: El Ministerio de Salud de Chile (MINSAL) y la Federación de Panaderos de Chile (FECHIPAN) acordaron reducir progresivamente el contenido de sodio en el pan de 800 mg a 500 mg/100 g pan, en 100 panaderías el 2011 y en 100% de ellos el año 2014. Objetivo: Analizar el contenido de sodio en pan de una panadería de distribución nacional (A) comparada con una de tipo local (B). Materiales y métodos: Se analizaron 100 muestras de pan por panadería, 50 de marraqueta y 50 de hallulla, en diferentes horas y días de la semana. El contenido de sodio se determinó con el método AOAC (2005) mediante espectrofotometría de absorción atómica y se comparó con el contenido de sodio declarado en el etiquetado nutricional de la panadería A. Se utilizó ANOVA y T-student para establecer diferencias del contenido de sodio por tipo de pan, panadería y hora de extracción, utilizando el software STATA 12.0 con un nivel de significancia p<0,05. Resultados: El sodio total en el pan (mg/100 g pan) se estimó en 619,6±127,7 mg para hallulla y 641±93,3 para marraqueta, sin diferencias significativas para su contenido en ambas panaderías (p=0,971) y tipo de pan (p=0,177). El sodio fue mayor el día miércoles (p<0,0001 - p=0.016) y a las 17 horas (p<0,000001 - p=0.028) en pan hallulla y marraqueta respectivamente. Con variabilidad en el contenido de sodio total en ambas panaderías entre 412,5 a 954,5 mg/100 g. Conclusiones: El pan de ambas panaderías presenta similar contenido de sodio pero excediéndose 26% a 80% del acuerdo MINSAL-FECHIPAN.

Dermoscopic criteria associated with BRAF and NRAS mutation status in primary cutaneous melanoma.

BACKGROUND: The identification of BRAF mutations in melanoma led to the development and implementation of new and effective therapies. Few clinical and histological features have been associated with this mutational status. OBJECTIVES: The main objective of this study was to investigate clinical, histopathological and dermoscopic characteristics of primary melanomas according to BRAF or NRAS mutational status. METHODS: An observational retrospective study including melanoma dermoscopy images assessed for somatic mutations in BRAF and NRAS. RESULTS: Seventy-two patients were included, 30 women (42%) and 42 men (58%), mean age was 59 ± 15.51 years. BRAF-mutated melanomas were more frequently located on the trunk (n = 18, 64% for BRAF-mutated vs. n = 11, 29% for wild-type melanomas, P = 0.013). Histological ulceration was associated with the presence of BRAF mutations [odds ratio (OR) 3.141; 95% confidence interval (CI) 1.289-7.655; P = 0.002]. The Breslow index tended to be thicker in BRAF-mutated compared with wild-type (P = 0.086). BRAF mutations were present in 28 (39%) patients and only four cases were positive for NRAS mutations (6%), BRAF and NRAS mutations being mutually exclusive. The presence of dermoscopic peppering was associated with MAPK mutations (BRAF and NRAS) (OR 1.68; 95% CI 1.089-2.581; P = 0.015). Dermoscopic ulceration was also associated with BRAF mutations excluding acral and facial melanomas (OR 2.64; 95% CI 1.032-6.754). CONCLUSIONS: This study showed a correlation between BRAF and NRAS status and dermoscopic findings of 'peppering' as an expression of regression and melanophages in the dermis, suggesting a morphological consequence of immune behaviour in BRAF-mutated melanomas.

The L-kynurenine-probenecid combination reduces neuropathic pain in rats.

BACKGROUND: l-Kynurenine has antinociceptive effects in acute and inflammatory pain. This study determined the effect of l-kynurenine and its metabolite (kynurenic acid) on rats subjected to neuropathic pain. METHODS: L5/L6 spinal nerve ligation induced tactile allodynia as measured with von Frey filaments using the up-down method. High-performance liquid chromatography and Western blot analysis determined kynurenic acid levels and expression of kynurenine amino transferase II (KAT II), respectively. RESULTS: l-Kynurenine (50-200 mg/kg, i.p.) or probenecid (100 mg/kg, i.p.) did not affect allodynia in neuropathic rats. In contrast, l-kynurenine (50-200 mg/kg, i.p.) in combination with probenecid (100 mg/kg, i.p.), an inhibitor of organic anion transport, reversed allodynia. Furthermore, intrathecal kynurenic acid (1-30 µg) reversed allodynia. Probenecid (100 mg/kg, i.p.) supplementation enhanced the maximal antiallodynic effect of intrathecal kynurenic acid (10 µg). Only the combined administration of l-kynurenine (200 mg/kg)/probenecid (100 mg/kg) increased the kynurenic acid concentration in cerebrospinal fluid. KAT II is expressed in dorsal root ganglia and dorsal spinal cord. KAT II expression was unchanged by the spinal nerve ligation or l-kynurenine/probenecid combination. The kynurenine/probenecid combination did not affect motor activity. CONCLUSIONS: l-Kynurenine produces its antiallodynic effect in the central nervous system through kynurenic acid. This effect may result from blockade of N-methyl-d-aspartate receptors. KAT II is expressed in dorsal root ganglion and dorsal spinal cord. Combined l-kynurenine and probenecid therapy has the potential to reduce neuropathic pain in humans.

Electric organ discharge diversity in the genus Gymnotus: anatomo-functional groups and electrogenic mechanisms.

Previous studies describe six factors accounting for interspecific diversity of electric organ discharge (EOD) waveforms in Gymnotus. At the cellular level, three factors determine the locally generated waveforms: (1) electrocyte geometry and channel repertoire; (2) the localization of synaptic contacts on electrocyte surfaces; and (3) electric activity of electromotor axons preceding the discharge of electrocytes. At the organismic level, three factors determine the integration of the EOD as a behavioral unit: (4) the distribution of different types of electrocytes and specialized passive tissue forming the electric organ (EO); (5) the neural mechanisms of electrocyte discharge coordination; and (6) post-effector mechanisms. Here, we reconfirm the importance of the first five of these factors based on comparative studies of a wider diversity of Gymnotus than previously investigated. Additionally, we report a hitherto unseen aspect of EOD diversity in Gymnotus. The central region of the EO (which has the largest weight on the conspecific-received field) usually exhibits a negative-positive-negative pattern where the delay between the early negative and positive peaks (determined by neural coordination mechanisms) matches the delay between the positive and late negative peaks (determined by electrocyte responsiveness). Because delays between peaks typically determine the peak power frequency, this matching implies a co-evolution of neural and myogenic coordination mechanisms in determining the spectral specificity of the intraspecific communication channel. Finally, we define four functional species groups based on EO/EOD structure. The first three exhibit a heterogeneous EO in which doubly innervated electrocytes are responsible for a main triphasic complex. Group I species exhibit a characteristic cephalic extension of the EO. Group II species exhibit an early positive component of putative neural origin, and strong EO auto-excitability. Group III species exhibit an early, slow, negative wave of abdominal origin, and variation in EO auto-excitability. Representatives of Group IV generate a unique waveform comprising a main positive peak followed by a small, load-dependent negative component.

Perfil sociodemográfico y de intereses profesionales de los estudiantes de licenciatura en enfermería / Socio-demographic profile and professional interests of students of Bachelor's degree in nursing

Introducción: Aunque en los servicios de salud a nivel mundial existe deficiencia de personal de enfermería, en América Latina el índice de deserción en las escuelas de enfermería es elevado; esta problemática recae en trabajadores en ejercicio quienes deben brindar cuidado enfermero en situaciones de cansancio y estrés. La problemática lleva a pensar que no existen características adecuadas en los estudiantes que ingresan para cursar favorablemente la carrera. Objetivo: Determinar las características sociodemográficas, económicas, familiares, de antecedentes escolares e intereses profesionales de estudiantes que ingresan a estudiar la carrera de Enfermería. Suponemos una relación entre deserción e intereses u objetivos que guiaron a alumnos en la selección de carrera, sus características socio-económicas-familiares y del plantel que provienen. Metodología: Estudio transversal y descriptivo, se consideró el 100% de las cédulas de tutoría aplicadas a estudiantes de Enfermería que ingresaron entre 2001 y 2006. Los datos sociodemográficos, económicos y familiares se obtuvieron por medio de preguntas abiertas o cerradas, para clasificar nivel socioeconómico se utilizó la propuesta de Sigmarket, los intereses profesionales se evaluaron a partir de una escala tipo likert. Resultados: El perfil obtenido mostró una población joven, predominantemente solteros, que no realizan trabajo remunerado, dependen económicamente de sus padres, de condiciones socioeconómicas precarias, sus intereses están orientados hacia la obtención de conocimientos y aspectos de carácter social Conclusiones: Fue importante identificar una tendencia, aunque no significativa estadísticamente, de permanencia en mayor medida de los alumnos con condiciones sociales más precarias, y aquellos cuyos intereses de orden social se ubican en el nivel más alto.

Introduction: Although it exists a deficiency in nursing staff at a global level in health services, in Latin America the rate of dropout in nursing schools is high; this problem lies over workers who must provide nurse care in situations of fatigue and stress. The problem leads us to think there are no appropriate characteristics for students to successful fulfill their career. Objective: to determine the socio demographic, economic and family characteristics, school background and professional interests of students entering nursing. We assume an existing relationship between dropout, the interests or goals that guided students in the selection of the career in nursing, the socio-economic-family characteristics and the institution of origin. Methodology: cross-sectional and descriptive study that considered the 10000% of admission interviews made to incoming nursing students from 200001 to 200006. The socio-demographic, economical and familiar data were obtained from closed and openended questions; the Sigmarket proposal was used for the classification of the socioeconomic level, the professional interests were evaluate from a likert scale. Results; the obtained profile showed a young population, mainly single, that doesn't have a paid job and depends from their parents economically, from a low socio-economic conditions, their interests are focus towards the acquisition of knowledge and aspects of social nature. Conclusions: it was important to identify a mayor tendency, although not statistically significant, of continuing the career from part of the students with lower social conditions and those whose social interests are located in the highest level.

Influence of copper on root exudate patterns in some metallophytes and agricultural plants.

A hydroponic experiment was carried out to determine the root exudation patterns in two Cu-metallophytes (Oenothera picensis and Imperata condensata) and two agricultural plants (Lupinus albus and Helianthus annuus). Plants were grown in nutrient solution at increasing Cu doses (0, 0.125, 0.25, 0.5, 1 and 2mgCuL(-1)), and plant growth, root elongation, Cu accumulation and root exudates were measured. All plants showed a decrease of over 60% in root elongation at the highest Cu supply level, being O. picensis the most sensitive specie and showing the highest shoot and root Cu concentrations (116 and 2657µgCug(-1), respectively), which were six fold higher than the other species. Differences in root exudation patterns of low molecular weight organic acids were found, with extremely high amounts of succinic acid exuded by O. picensis (1049µmolg(-1)h(-1)), and citric acid by I. condensata (164µmolg(-1)h(-1)). In metallophytes, the organic acid exudation was increased even with no root elongation, meanwhile agricultural plants exuded citric acid at constant levels. Exudation of phenolic compounds was highly species-dependent, with catechin mainly exuded by I. condensata, (2.62µmolg(-1)h(-1)) cinnamic acid by O. picensis (5.08µmolg(-1)h(-1)) and coumaric acid exclusively exuded by H. annuus (13.6µmolg(-1)h(-1)) at high Cu levels. These results indicated that differences in root exudation patterns among metallophytes and agricultural plants could affect their Cu tolerance. Particularly, the higher exudation rate showed by I. condensata can be an effective exclusion mechanism to tolerate high Cu concentrations, supporting its use in Cu phytostabilization programs.

mtDNA mutations, hearing loss and aminoglycoside treatment in Mexicans.

UNLABELLED: Streptomycin and aminoglycoside derivatives are commonly used to treat tuberculosis and other stubborn infections; these drugs may alter auditory and/or vestibular function. Mutations in mitochondrial DNA have been associated with hypersensitivity to aminoglycosides; no studies have been conducted in Mexicans, which are very prone to such alterations because aminoglycosides have been prescribed carelessly for many years, irrespective of the ailment to be treated. AIM: We investigated "hot spot" mutations described previously as causing inner ear alterations. METHODS: Hot spot mutations at the 12S rRNA gene and the tRNA Serine (UCN) gene were screened by PCR-RFLP and sequencing in 65 subjects undergoing audiological and vestibular testing. STUDY DESIGN: Experimental. RESULTS: 32 individuals had healthy auditory and vestibular function, whereas 33 subjects had auditory affections. We found none of the previously reported mutations related to aminoglycoside hypersensitivity, or non-syndromic hearing loss. Two hearing-impaired patients that had been treated with streptomycin had the T1189C variant of the mitochondrial 12S rRNA region. CONCLUSION: Mutations related to hearing loss in other ethnic backgrounds were not found in Mexicans. However, the T1189C variant is possibly a putative mutation related to aminoglycoside hypersensitivity and was present in 2 patients.

mtDNA mutations, hearing loss and aminoglycoside treatment in Mexicans / Mutações em DNA mitocondrial, hipoacusia e tratamento de mexicanos com aminoglicosídeos

Streptomycin and aminoglycoside derivatives are commonly used to treat tuberculosis and other stubborn infections; these drugs may alter auditory and/or vestibular function. Mutations in mitochondrial DNA have been associated with hypersensitivity to aminoglycosides; no studies have been conducted in Mexicans, which are very prone to such alterations because aminoglycosides have been prescribed carelessly for many years, irrespective of the ailment to be treated. AIM: We investigated "hot spot" mutations described previously as causing inner ear alterations. METHODS: Hot spot mutations at the 12S rRNA gene and the tRNA Serine (UCN) gene were screened by PCR-RFLP and sequencing in 65 subjects undergoing audiological and vestibular testing. STUDY DESIGN: Experimental. RESULTS: 32 individuals had healthy auditory and vestibular function, whereas 33 subjects had auditory affections. We found none of the previously reported mutations related to aminoglycoside hypersensitivity, or non-syndromic hearing loss. Two hearing-impaired patients that had been treated with streptomycin had the T1189C variant of the mitochondrial 12S rRNA region. CONCLUSION: Mutations related to hearing loss in other ethnic backgrounds were not found in Mexicans. However, the T1189C variant is possibly a putative mutation related to aminoglycoside hypersensitivity and was present in 2 patients.

Derivados de aminoglicosídeos e estreptomicina são comumente utilizados para tratar tuberculose e outras infecções mais resistentes; esses medicamentos podem alterar a função vestibular e/ou auditiva. Mutações no DNA mitocondrial têm sido associadas à hipersensibilidade a aminoglicosídeos; não há estudos conduzidos com mexicanos, que são muito predispostos a tais alterações, uma vez que aminoglicosídeos têm sido exageradamente prescritos há anos, sem associações à doença sendo tratada. OBJETIVO: investigamos mutações "hot spot" previamente descritas como causas de alterações no ouvido interno. MÉTODOS: Mutações hot spot no gene 12S rRNA e gene SerinatRNA (UCN) foram triados pela PCR-RFLP e sequenciados em 65 indivíduos sujeitos a exames audiométricos e vestibulares. Desenho do estudo: Experimental. RESULTADOS: 32 indivíduos com funções auditiva e vestibular normais, e 33 indivíduos com doenças auditivas. Não encontramos nenhuma das mutações previamente relatadas como associadas à hipersensibilidade aos aminoglicosídeos, ou perda auditiva não-sindrômica. Dois pacientes com hipoacusia que haviam sido tratados com estreptomicina tinham a variante T1189C na região 12S rRNA. CONCLUSÃO: Mutações associadas à hipoacusia em outras etnias não foram encontradas em mexicanos. Entretanto, a variante T1189C é possivelmente uma mutação associada à hipersensibilidade a aminoglicosídeos, e esteve presente em dois pacientes.

Valoración del timo fetal a través de la relación timo-tórax / Fetal thymus evaluation by thymus-torax ratio

Introduction: Recent advances in ultrasound technology have made possible an easy and accurate visualization of the fetal thymus in vast majority of cases. On ultrasound, thymus is visualized in the upper mediastinum, between sternum and great vessels. Despite several previous papers published, there is no consensus regarding a clear correlation between these measurements and thymus hypoplasia. Nowadays thymus evaluation is not mandatory in routine ultrasound examinations, however at referral centers its evaluation could help to identify patients with high risk for microdeletion 22 q11. Recently it has been proposed a new method to assess the thymus; the “thymus-torax ratio”, this has been proven to be altered in 95 percent of fetuses with congenital heart disease and microdeletion 22q11. This study describes the experience at our unit using this new tool as part of routine fetal examinations. Materials and methods: A descriptive study, 44 ultrasound examinations between 19 and 38 weeks of gestation, in which thymus-thoracic ratio was measured as part of the routine fetal examination at this perinatal referral center. Objective: Determinate the factibility of measurement of the thymus- thoracic ratio in routine fetal ultrasound examinations. Results: The thymus- thoracic ratio was measured successfully at our routine fetal ultrasound examinations, results were similar to those previously reported. The ratio was not affected by fetal or maternal pathology and gestational age. Discussion: The thymus thorax ratio appears to be constant through gestation despite of maternal and fetal pathologies; it seems to have advantages over other types of measurements described in previous publications. However, due to small number of cases we suggest a new analysis with a larger number of patients.

Avances recientes en ultrasonido han permitido una visualización fácil y certera del timo fetal en la gran mayoría de los fetos examinados. En el examen de ultrasonido, el timo se encuentra en el mediastino superior, entre el esternón y los grandes vasos. A pesar de numerosas publicaciones, actualmente no existe consenso respecto de las técnicas utilizadas para realizar estas mediciones y el diagnostico de hipoplasia de timo. La evaluación del timo fetal no forma parte del examen de ultrasonido de rutina. Sin embargo, en centros de referencia pudiera ser de utilidad para identificar los pacientes con alto riesgo de presentar microdelecion 22q11. Recientemente se ha propuesto una nueva forma de evaluar el timo a través de la relación timo- tórax, la cual ha probado estar alterada en el 95 por ciento de los fetos con cardiopatía congénita y microdelecion 22q11. Este estudio describe nuestra experiencia en la incorporación de esta nueva herramienta en el examen de rutina fetal. Materiales y métodos: Estudio descriptivo, 44 reportes de exámenes ultrasonográficos realizados entre las 19 y 38 semanas de gestación, en los cuales se realizó la medición de la relación timo- tórax como parte del examen fetal de rutina, en este centro de referencia perinatal. Objetivo: Describir la experiencia de la unidad en la medición de la relación timo- tórax en el examen ultrasonografico fetal de rutina. Resultados: La medición de la relación timo- tórax fue incorporada de manera exitosa como parte del protocolo estándar de mediciones realizado en la unidad, con resultados similares a los reportados previamente. La relación no fue afectada por patología fetal o materna ni edad gestacional. Discusión: la relación timo- tórax parece ser constante a través de la gestación a pesar de la presencia de patología materna o fetal, siendo una medida que aparentemente provee ventajas sobre las otras descritas previamente en la literatura. Sin embargo debido al tamaño de la muestra...

Rol de las trombofilias en infertilidad: ¿juegan un rol? / The role of thrombophilias in infertility: do they have a role?

Las trombofilias son un grupo de enfermedades que favorecen la formación de trombosis, tanto arteriales como venosas, y han sido asociadas con diferentes complicaciones durante el embarazo, entre las cuales podemos mencionar: aborto recurrente, preclampsia, restricción de crecimiento intrauterino y muerte fetal in útero, entre otras. Recientemente, se ha sugerido una asociación entre trombofilias e infertilidad. Las mutaciones de la enzima Metilentetrahidrofolato Reductasa (MTHFR) y de Leiden se encuentran con mayor frecuencia en pacientes con infertilidad de causa desconocida, al compararlas con grupos controles. Durante la etapa de estimulación ovárica diversas trombofilias han sido vinculadas con la aparición de sindrome de hiperestimulación ovárica severo. Por último, las pacientes con historia de falla recurrente de implantación, luego de múltiples ciclos de fertilización in Vitro, demuestran una mayor prevalencia de trombofilias que las pacientes con éxito en dichas terapias. Este artículo presenta una revisión de las publicaciones relevantes que abordaran los distintos aspectos de la relación entre trombofilias e infertilidad hasta agosto de 2009. El objetivo es describir los estudios utilizados y sus implicancias en el manejo de la pareja infértil.

Thrombophilias are a group of conditions that favor the genesis of arterial/venous thrombosis. Several complications throughout pregnancy have been associated with trhombophilias, including recurrent spontaneous abortion, preeclampsia, intrauterine growth restriction and fetal demise. Recently, an asociation has been sugested between infertility and thrombophilias, involving diferent aspects of the infertile couple therapy. MTHFR and Leiden mutations can be found more frecuently in patients with diagnosis of unknown infertility when compared with control groups. During ovarian estimulation, thrombophilias have been linked with severe ovarian hiperstimulation syndrome. Furthermore, patients with recurrent implantation failure after in vitro fertilization therapy show a higher rate of thrombophilias than patients with succesful IVF therapy. A review of the relevant publications concerning the topic thrombophilia and infertility until august 2009 is presented in this article. The aim of this article is to describe the results of the studies and its relevance in the infertile couple treatment.

Copper reduces striatal protein nitration and tyrosine hydroxylase inactivation induced by MPP+ in rats.

Striatal administration of 1-methyl-4-phenylpyridinium (MPP(+)), the active metabolite of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), causes nigrostriatal dopaminergic pathway damage similar to that observed in Parkinson's disease. Copper acts as a prosthetic group of several antioxidant enzymes and recent data show that copper attenuated MPP(+)-evoked neurotoxicity. We evaluated the effect of copper (as a supplement) upon proteins nitration (60 kDa) and tyrosine hydroxylase (TH) inactivation induced by MPP(+) (10 microg/8 microL) injection into the rat striatum. Copper pretreatment (10 micromol/kg i.p.) prevented both MPP(+)-induced proteins nitration and TH inactivation. Copper treatment also prevented the dopamine-depleting effect of MPP(+) injection. Those results were accompanied by a significant reduction of enzymatic activity of the constitutive nitric oxide synthase (cNOS), whereas, the protein levels of the three isoforms of NOS remained unchanged. Results indicate that the effect of copper against MPP(+)-induced proteins nitration and TH inactivation in the striatum of rat may be mediated by a reduction of cNOS activity.

La calidad de la atención de Enfermería a los pacientes de un Hospital Regional del ISSSTE, en México D. F: Un estudio basado en el grado de satisfacción de los usuarios / The quality of nursing care patients of a Regional Hospital ISSSTE in Mexico D. F: A study based on the degree of user satisfaction

El objeto de esta investigación es conocer cual es la calidad de la atención que proporciona Enfermería en el Hospital Regional 1º de Octubre del ISSSTE, en México, D.F con base en el grado de satisfacción de los usuarios. La variable medida fue la calidad de la atención. El tipo de investigación fue descriptivo, diagnóstico, analítico, transversal y observacional. La población estuvo constituida por 445 pacientes del Hospital Regional 1º de Octubre del ISSSTE, internados en los cuatro servicios básicos como son: Cirugía, Pediatría, Gineco - Obstetricia y Medicina Interna. La muestra total es de 198 pacientes. La investigación fue realizada en el año 1999. Se midió la variable Calidad de Atención de Enfermería con base en la teoría de Avedis Donabedian de clasificar las modalidades de: estructuras, proceso y resultados. De cada modalidad se establecieron indicadores. Se comprobó la hipótesis de trabajo que califica de alta calidad, la atención que Enfermería proporciona a los pacientes. Se disprueba la hipótesis nula al considerar que los usuarios se sienten satisfechos con la atención que Enfermería les proporciona y la calidad de atención que reciben.

This research aims to know what the attention quality delivered by Nursing in the Regional ISSSTE Hospital 1o. de Octubre in Mexico City is, based on the users satisfaction level. The measured variable was attention quality. The research type was descriptive, diagnostic, analytical, transversal, and observational. Population consisted of 445 patients from the Regional ISSSTE Hospital 1o. de Octubre, who were interned in the four basic services: Surgery, Pediatrics, Gyneco-Obstetrics, and Internal Medicine. The total sample had 198 patients. The research was carried out during 1999. Nursing attention quality variable was measured based on the Avedis Donabedian's theory, which classifies the structures, process, and result modalities. Indicators were set for each modality. The work hypothesis that qualifies the high quality of attention delivered by nursing to the patients was checked. The null hypothesis was proven off when considering that users feel satisfied with the attention nursing is providing then and with the attention quality they are receiving.

Embriopatías asociadas al uso de misoprostol / Moebius syndrome and arthrogriposis associated to the use of misoprostol

Se presenta un caso clínico de síndrome de Moebius y artrogriposis asociado al uso de misoprostol durante el primer trimestre de gestación.

We present a case of Moebius syndrome and arthrogriposis associated to the use of misoprostol during the first trimester of gestation.