A mouse model of the protease-activated receptor 4 Pro310Leu variant has reduced platelet reactivity.

BACKGROUND: Protease-activated receptor 4 (PAR4) mediates thrombin signaling on platelets and other cells. Our recent structural studies demonstrated that a single nucleotide polymorphism in extracellular loop 3 and PAR4-P310L (rs2227376) leads to a hyporeactive receptor. OBJECTIVES: The goal of this study was to determine how the hyporeactive PAR4 variant in extracellular loop 3 impacts platelet function in vivo using a novel knock-in mouse model (PAR4-322L). METHODS: A point mutation was introduced into the PAR4 gene F2rl3 via CRISPR/Cas9 to create PAR4-P322L, the mouse homolog to human PAR4-P310L. Platelet response to PAR4 activation peptide (AYPGKF), thrombin, ADP, and convulxin was monitored by αIIbß3 integrin activation and P-selectin translocation using flow cytometry or platelet aggregation. In vivo responses were determined by the tail bleeding assay and the ferric chloride-induced carotid artery injury model. RESULTS: PAR4-P/L and PAR4-L/L platelets had a reduced response to AYPGKF and thrombin measured by P-selectin translocation or αIIbß3 activation. The response to ADP and convulxin was unchanged among genotypes. In addition, both PAR4-P/L and PAR4-L/L platelets showed a reduced response to thrombin in aggregation studies. There was an increase in the tail bleeding time for PAR4-L/L mice. The PAR4-P/L and PAR4-L/L mice both showed an extended time to arterial thrombosis. CONCLUSION: PAR4-322L significantly reduced platelet responsiveness to AYPGKF and thrombin, which is in agreement with our previous structural and cell signaling studies. In addition, PAR4-322L had prolonged arterial thrombosis time. Our mouse model provides a foundation to further evaluate the role of PAR4 in other pathophysiological contexts.

Safety of Plasma Rich in Growth Factors (PRGF) as additive to healthy human sperm samples: a pilot study.

OBJECTIVE: The aim of our study was to assess if the addition of PRGF to healthy human sperm affects its motility and vitality. METHODS: This was a prospective study, with 44 sperm donors on whom sperm analysis was performed. Nine mL of blood was collected and PRGF was obtained using PRGF-Endoret® technology. The influence of different dilutions of PRGF (5%, 10%, 20%, 40%) applied to 15 sperm donors was compared, and sperm motility was assessed after 30 minutes. In the second part of the study, 29 sperm donors were studied to analyze the influence of 20% dilution of PRGF at 15, 30 and 45 minutes in fresh and thawed sperm samples. Motility was assessed after the addition of PRGF and after analysis each aliquot was frozen. After thawing, concentration and motility were assessed at the same time periods. RESULTS: There were no differences in sperm motility in fresh samples between dilutions of PRGF when assessed 30 minutes after administration, nor between them, nor when compared to the control group immediately prior to treatment. No trend was observed between motility and PRGF dilution in linear regression analysis. There were no significant differences in thawed samples. CONCLUSIONS: The administration of 20% PRGF dilution had no effect on sperm motility compared to samples without PRGF. In addition, there was no change in sperm vitality when comparing samples with and without PRGF. More studies focusing on subnormal sperm samples, analyzing different PRGF concentrations and increasing the number of study variables are needed.

Optimization of a Plasma Rich in Growth Factors Membrane for the Treatment of Inflammatory Ocular Diseases.

The main purpose of the present study is to develop an immunosafe fibrin membrane obtained by plasma rich in growth factors technology (is-mPRGF) with improved mechanical properties that could be applied in patients with inflammatory ocular diseases. Blood was drawn from three healthy donors and centrifuged, and the collected PRGF was activated and distributed into two groups: (i) mPRGF: a PRGF membrane maintained at 37 °C for 30 min; (ii) IS5+30: mPRGF incubated at 37 °C for 5 min and then incubated at 56 °C for 30 min. The content of both membranes was analyzed for several growth factors such as IgE and the complement activation, as well as biological activity on different ocular surface cells. Furthermore, the physical and mechanical characterizations were also evaluated. IS5+30 completely reduced the complement activity and decreased the IgE while preserving the concentration of the main growth factors. IS5+30 induced similar biological activity regarding mPRGF on the different ocular surface cells analyzed. Furthermore, no significant differences in release kinetics or fibrin degradation were observed between both membranes. Summarizing, IS5+30 totally reduces complement activity while preserving the concentration of most growth factors and their biological activity. Furthermore, the physical and mechanical properties of the fibrin membrane are preserved after heat inactivation.

Autologous Platelet Rich Plasma (PRGF) Preserves Genomic Stability of Gingival Fibroblasts and Alveolar Osteoblasts after Long-Term Cell Culture.

Plasma rich in growth factors (PRGF) has several applications in dentistry that may require repeated applications of PRGF. Furthermore, it has been used for ex vivo expansion of human origin cells for their clinical application. One of the most relevant issues in these applications is to guarantee the genetic stability of cells. In this study, the chromosomal stability of gingival fibroblasts and alveolar osteoblasts after long-term culture was evaluated. Cells were expanded with PRGF or foetal bovine serum (FBS) as a culture medium supplement until passage 7 or 8 for gingival fibroblast or alveolar osteoblasts, respectively. A comparative genomic hybridization (CGH) array was used for the genetic stability study. This analysis was performed at passage 3 and after long-term culture with the corresponding culture medium supplements. The cell proliferative rate was superior after PRGF culture. Array CGH analysis of cells maintained with all the three supplements did not reveal the existence of alterations in copy number or genetic instability. The autologous PRGF technology preserves the genomic stability of cells and emerges as a safe substitute for FBS as a culture medium supplement for the clinical translation of cell therapy.

Manganese Ferrite Nanoparticles Encapsulated into Vitamin E/Sphingomyelin Nanoemulsions as Contrast Agents for High-Sensitive Magnetic Resonance Imaging.

Magnetic resonance imaging (MRI) is one of the most powerful non-invasive imaging modalities used in clinics due to its great spatial resolution and excellent soft-tissue contrast, though still less sensitive than other techniques such as the nuclear imaging modalities. This lack of sensitivity can be improved with the use of contrast agents based on nanomaterials. In recent years, researchers have focused on the development of magnetic nanoparticles, given their role as enhancers of the contrast signal based on the magnetic resonance. Manganese ferrite nanoparticles stand out, given their high magnetic susceptibility and magnetic soft nature. Herein, 10 nm MnFe2 O4 nanoparticles, functionalized with the natural antioxidant vitamin E (VitE-MFO) are encapsulated into simple, biodegradable and non-toxic nanoemulsions (NEs), by a reproducible one-step method obtaining stable 150 nm-sized magnetic nanoemulsions (VitE-MFO-NEs). After encapsulation, the superparamagnetic properties of VitE-MFO are maintained and MR imaging studies reveal an extremely high transverse relaxivity for VitE-MFO-NEs (652.9 × 10-3  m-1  s-1 ), twofold higher than VitE-MFO value. Moreover, VitE-MFO-NEs show great in vivo biocompatibility and good signal in in vivo and ex vivo MRI, which indicates their great potential for biomedical imaging enhancing the negative MR contrast and significantly improving the sensitivity of MRI.

Development and optimization of a personalized fibrin membrane derived from the plasma rich in growth factors technology.

PURPOSE: To develop and characterize a new type of plasma rich in growth factors (PRGF) membrane for patients in which immune system is involved in the disease etiology. METHODS: Blood from three healthy donors was collected to obtain the different fibrin membranes by PRGF technology. PRGF obtained volumes were activated and divided into two groups: PRGF membrane (mPRGF) obtained after incubation at 37 °C for 30 min (control); and is-mPRGF: mPRGF obtained after incubation for 30 min at 56 °C. The concentration of several growth factors, proteins, immunoglobulin E and the complement activity was determined in the different mPRGF. The proliferative potential of heat-inactivated mPRGF were assayed on keratocytes (HK) and conjunctival fibroblasts (HConF). In addition, morphological and physical features of the inactivated mPRGF were evaluated in contrast to the control mPRGF. RESULTS: Heat-inactivation of the mPRGF preserves the content of most of the growth factors involved in the ocular wound healing while reducing drastically the content of IgE and the complement activity. The heat-inactivated mPRGF conserve the morphological and physical characteristics of the fibrin meshwork in comparison with the control mPRGF. Furthermore, no significant differences were found in the biological activity of the control mPRGF regarding the heat-inactivated mPRGF (is-mPRGF) in any of both ocular cell types evaluated. CONCLUSIONS: The heat-inactivation of the PRGF membranes (is-mPRGF) reduces drastically the content of IgE and complement activity while preserving the content of most of the proteins and morphogens involved in ocular wound healing. Furthermore, the morphological and physical features of the immunosafe mPRGF were also preserved after heat-inactivation.

Sphingomyelin-Based Nanosystems (SNs) for the Development of Anticancer miRNA Therapeutics.

Gene replacement therapy with oncosuppressor microRNAs (miRNAs) is a promising alternative to interfere with cancer progression. However, miRNAs are highly inefficient in a biological environment, hampering a successful translation to clinics. Nanotechnology can tackle this drawback by providing delivery systems able to efficiently deliver them to cancer cells. Thus, the objective of this work was to develop biocompatible nanosystems based on sphingomyelin (SM) for the intracellular delivery of miRNAs to colorectal cancer cells. We pursued two different approaches to select the most appropriate composition for miRNA delivery. On the one hand, we prepared sphingomyelin-based nanosystems (SNs) that incorporate the cationic lipid stearylamine (ST) to support the association of miRNA by the establishment of electrostatic interactions (SNs-ST). On the other hand, the cationic surfactant (DOTAP) was used to preform lipidic complexes with miRNA (Lpx), which were further encapsulated into SNs (SNs-Lpx). Restitution of miRNA145 levels after transfection with SNs-Lpx was related to the strongest anticancer effect in terms of tumor proliferation, colony forming, and migration capacity assays. Altogether, our results suggest that SNs have the potential for miRNA delivery to develop innovative anticancer therapies.

Validación galénica del colirio de plasma rico en factores de crecimiento / Galenic validation of plasma rich in growth factors eye drops

Objetivo: Evaluación galénica del proceso de obtención y almacenamiento del colirio de plasma rico en factores de crecimiento PRGF-Endoret(R). Método: Para evaluar la asepsia en la obtención del colirio de PRGFEndoret(R) se realizó un ensayo de esterilidad siguiendo las normas descritas en la Farmacopea Europea y se analizó la estanqueidad de los dispensadores de colirio de PRGF-Endoret(R). Asimismo, se estudiaron las propiedades químicas y biológicas del colirio tras su proceso de obtención y almacenamiento. Se incluyeron ensayos de filtración del colirio, de un ciclo de congelación a -20 ºC y descongelación, así como de estabilidad durante tres y seis meses almacenados a -20 ºC. Resultados: Los ensayos de esterilidad mostraron que no hubo crecimiento microbiano en ninguno de los dispensadores analizados y se observó que el 100% de los monodosis analizados y el 98,4% de los tapones mantenían el hermetismo. Todos los factores de crecimiento analizados permanecieron constantes tras el filtrado del colirio de PRGF-Endoret(R). Además, todos los estudios de estabilidad llevados a cabo con el colirio de PRGF-Endoret(R) en el presente estudio mostraron que no se produjeron cambios significativos en los niveles de factores de crecimiento, en la actividad proliferativa celular ni en las características químicas analizadas. Conclusiones: El presente trabajo muestra que el proceso de elaboración del colirio de PRGF-Endoret(R) se lleva a cabo de forma controlada, aséptica y segura, siguiendo las normas descritas en la Farmacopea Europea. Además, el colirio de PRGF-Endoret(R) obtenido mantiene sus propiedades físico-químicas y biológicas tras someterlo a diferentes tiempos y temperaturas de almacenamiento

Objective: Galenic evaluation of the process for obtaining and storing the platelet rich in growth factors PRGF-Endoret(R) eye drops. Method: To assess whether the PRGF-Endoret(R) eye drops process is aseptically obtained, a sterility test was carried out on the eye drops; the tightness of the PRGF-Endoret(R) eye drops containers was also analyzed. Likewise, the chemical and biological properties of the PRGF-Endoret(R) eye drops were evaluated after the obtaining process and storage. Eye drop filtration tests, one cycle of freezing at -20 °C and thawing, and eye drop stability for three and six months stored at -20 °C were included. Results: The results obtained in the sterility test showed no microbial contamination in any of the analyzed eyedropper; tightness test showed that 100% of the eyedrop containers and the 98.4% of the plugs analyzed remained hermetic. On the other hand, all the growth factors measured remained constant after filtering the PRGF-Endoret(R) eye drops. Furthermore, the different eye drop stability tests carried out in this study showed no significant changes in the growth factors levels, cell proliferative activity or in the chemical characteristics analyzed. Conclusions: The PRGF-Endoret(R) eye drops are obtained in a safety and aseptic manner following the guidelines issued by the Spanish Agency for Drugs and Health Products and the Ministry of Health to obtain medicines for human use. The PRGF-Endoret(R) eye drops maintain their physical-chemical and biological properties after being subjected to different storage times and temperatures

Assessing the influence of biogeographical region and phylogenetic history on chemical defences and herbivory in Quercus species.

Biogeographical factors and phylogenetic history are key determinants of inter-specific variation in plant defences. However, few studies have conducted broad-scale geographical comparisons of plant defences while controlling for phylogenetic relationships, and, in doing so, none have separated constitutive from induced defences. This gap has limited our understanding of how historical or large-scale processes mediate biogeographical patterns in plant defences since these may be contingent upon shared evolutionary history and phylogenetic constraints. We conducted a phylogenetically-controlled experiment testing for differences in constitutive leaf chemical defences and their inducibility between Palearctic and Nearctic oak species (Quercus, total 18 species). We induced defences in one-year old plants by inflicting damage by gypsy moth larvae (Lymantria dispar), estimated the amount of leaf area consumed, and quantified various groups of phenolic compounds. There was no detectable phylogenetic signal for constitutive or induced levels of most defensive traits except for constitutive condensed tannins, as well as no phylogenetic signal in leaf herbivory. We did, however, find marked differences in defence levels between oak species from each region: Palearctic species had higher levels of constitutive condensed tannins, but less constitutive lignins and less constitutive and induced hydrolysable tannins compared with Nearctic species. Additionally, Palearctic species had lower levels of leaf damage compared with Nearctic species. These differences in leaf damage, lignins and hydrolysable (but not condensed) tannins were lost after accounting for phylogeny, suggesting that geographical structuring of phylogenetic relationships mediated biogeographical differences in defences and herbivore resistance. Together, these findings suggest that historical processes and large-scale drivers have shaped differences in allocation to constitutive defences (and in turn resistance) between Palearctic and Nearctic oaks. Moreover, although evidence of phylogenetic conservatism in the studied traits is rather weak, shared evolutionary history appears to mediate some of these biogeographical patterns in allocation to chemical defences.

Carga de cuidadores informales de personas con ezquizofrenia: Un desafio pendiente para la reforma de la atención en salud mental / Burden on informal caregivers of people with schizophrenia: still a challenge for mental health care reform

El propósito de este trabajo fue revisar el concepto decarga de los familiares y cuidadores informales, en especialde personas que sufren esquizofrenia. Se trata de un conceptopolisémico, que se refiere a la relación entre individuosadultos, donde el cuidador asume una responsabilidad porel otro, que no pudo anticipar, que no es remunerada, elque es objeto del cuidado, está discapacitado y no puedemantener obligaciones recíprocas que son las socialmenteesperadas para una relación entre adultos. Se diferencianlos aspectos objetivos (disminución del tiempo libre,atención y cuidados, efectos negativos en la salud, costoseconómicos, etc.) y subjetivos (distrés emocional) de estacarga del cuidado. Los pocos estudios realizados tienden amostrar que es un problema frecuente y relevante, que seha hecho más visible durante los procesos de reforma a laatención psiquiátrica, producto de un rol más importante yun mayor empoderamiento de estos cuidadores informales.Se revisan los diferentes factores que se asocian a la magnitudde esta carga, destacando aquellos que se refieren a losservicios sanitarios y a la importancia de entregar acciones depsicoeducación, terapéuticas y de apoyo a quienes asumenel cuidado de estos pacientes.

Consultas por dolor torácico en el servicio de urgencia hospitalario de una comunidad rural, Llay-Llay 2005-2007 / Consultations with pain as presenting complaint at the emergency unit of a rural community hospital in Llay-Llay, between 2005 and 2007

El dolor torácico es una de las causas más frecuentes de consulta servicios de urgencia. Engloba causas banales y otras potencialmente mortales como las cardiovasculares. Material y Método: Estudio descriptivo transversal. Se utilizaron fichas de atención y protocolos Auge de dolor torácico en consultantes por esta causa entre enero de 2005 y diciembre de 2007, en el servicio de urgencia del Hospital San Francisco de Llay-Llay. Resultados: Sobre un total de 957 pacientes, el 48,6 por ciento correspondió al sexo masculino y un 51,3 por ciento al sexo femenino, con una media de edad de 50,16 años. Los diagnósticos más prevalentes fueron la costocondritis (37,5 por ciento), trastorno ansioso (10,8 por ciento), precordalgia inespecífica (8,5 por ciento), crisis hipertensiva (6,6 por ciento) y angina inestable (3,6 por ciento). Cabe destacar un 2,4 por ciento de casos de infarto agudo del miocardio, de los cuales el 73,9 por ciento pertenecía al sexo masculino. Los principales factores de riesgo fueron la hipertensión arterial (39,7 por ciento), obesidad (32,7 por ciento) y tabaquismo (28,42 por ciento). El consumo de sustancias se objetivó en un 33,99 por ciento, principalmente alcohol y en el sexo masculino. La hospitalización alcanzó un 11,8 por ciento, principalmente hombres de entre 61-80 años de edad, cuyo diagnóstico principal correspondió a la esfera cardiovascular. Conclusión: En la gran mayoría de los casos el dolor torácico no representa gravedad, pero es fundamental descartar enfermedades serias, especialmente en pacientes con factores de riesgo. El diagnóstico y tratamiento oportuno deben basarse en un alto grado de sospecha del médico de urgencias, que cuenta con escasas herramientas, para lograr un diagnóstico específico y oportuno para mejorar el pronóstico de los pacientes que consultan por dolor torácico.

Chest pain is one of the most common presenting complaint at the emergency units. It includes banal and potentially lethal causes such as cardiovascular ones. Materials and Methods: Cross-sectional descriptive study. Medical care records and AUGE protocols for chest pain in patients with chest pain as chief complaint attending the emergency unit at the Hospital San Francisco de LLay-Llay between January 2005 and December 2007 were used. Results: Of a total of 957 patients, 48,69 percent were males and 51,3 percent were females, with a mean age of 50,16 years. The most prevalent diagnoses were costochondritis (37,5 percent); anxiety disorder (10,8 percent); non-specific precordialgia (8,5 percent), hypertensive crisis (6,6 percent) and unstable angina(3,6 percent). It is noteworthy that 2,4 percent were acute myocardial infarction cases, of which 73,9 percent occurred in males. The main risk factors were high blood pressure (39,7 percent), obesity (32,7 percent) and smoking (28,42 percent). Substance consumption was evidenced in 33,99 percent, mainly involving alcohol and occurring in males. Hospital admission reached 11,8 percent, involving mainly males aged between 61and 80, with diagnoses of cardiovascular conditions. Conclusion: In the great majority of the cases chest pain did not represent a severe condition, however it is critical to rule out serious diseases, particularly in patients with risk factors. Timely diagnosis and treatment should be based on a high degree of suspicion from the emergency unit physician, who has seldom tools to attain a specific and timely diagnosis that will enable the improvement of the prognosis of patients attending with chest pain as chief complaint.

Perfil población consultante en Policlínico de ETS, Consultorio Nº 1, Los Andes, 2001-2003 / Profile of consulting population at the sexually transmitted diseases (STD) polyclinic, dispensary Nº 1, Los Andes, 2001-2003

El objetivo fue caracterizar al grupo de pacientes inscritos en el policlínico de enfermedades de transmisión sexual (ETS) de esta provincia, determinando factores de riesgo, patologías de mayor prevalencia y cobertura de tratamiento en la atención primaria. Estudio descriptivo realizado en el Centro de Salud Cordillera Andina durante julio de 2004. Se recolectaron datos de 254 fichas, correspondientes al total de pacientes inscritos alguna vez en el programa desde el año 2001 al 2003. Las variables estudiadas fueron: edad al ingreso al programa; sexo; ocupación; domicilio; escolaridad; orientación sexual; número de parejas y uso de preservativo; consumo de alcohol y drogas; exámenes clínicos; diagnóstico principal y tratamiento. La edad promedio de ingreso fue de 30 años, el 78% de los pacientes correspondían al sexo masculino. De ellos un 38,1% era obrero, con una menor frecuencia de otras ocupaciones; sólo 47% completó la enseñanza media. Respecto a los hábitos: 8,6% refería orientación homo/bisexual; 48,9% tuvo 2- 4 parejas el último año; 57% nunca usó preservativo, 75,3% consumía alcohol y 39% otras drogas. De los diagnósticos realizados la gonorrea ocupó el 36,9%, la uretritis no gonocócica el 30,6%, y la sífilis el 18,9%. Se logra caracterizar esta población observándose una franca mayoría del sexo masculino, mientras entre las mujeres hay una frecuencia relativa de dueñas de casa. Destacan los elevados porcentajes de promiscuidad, consumo de alcohol y drogas, el bajo uso del preservativo y la baja escolaridad.

The objective was that of characterizing the group of patients registered at the Sexually Transmitted Disaeases (STD) Polyclinic of this province, determining risk factors, higher prevalence pathologies and treatment coverage in primary care. This is a descriptive studycarried out in the Cordillera Andina Health Center during July 2004. Data were collected from 254 medical record cards corresponding to the total number of patients registered in the program at any time from 2001 to 2003. The variables studied were: age at insertion into the program; sex; occupation; place of residence; schooling; sexual orientation; number of couples and use of preservatives; alcohol and drug consumption; clinical examinations; principal diagnosis and treatment. The average age of insertion was 30 years; 78% of the patients being males. Of these, 38.1% were manual workers with a lower frequency of other occupations; only 47% had completed middle school. As far as habits are concerned: 8.6% admitted homosexual/bisexual orientation; 48.9% had 2-4 couples during the last year; 57% never used a preservative, 75.3% consumed alcohol and 395 other drugs. Of diagnoses performed, gonorrhea was 36.9%, nongonococcal urethritis, 30.65 and syphilis, 18.9%. Characterization of this population is accomplished, finding in it a clear majority of males, while among women there is a relative frequency of housewives. High percentages of promiscuity, alcohol and drug consumption, low use of preservatives and low schooling stand out.

Epidemiology of tetanus in Chile during the past 25 years

Se realiza un análisis de las tendencias de morbi-mortalidad del tétanos en Chile en los últimos 25 años (1960-1984) y se examina el comportamiento de las variables epidemiológicas en el tiempo, el espacio y las personas. La morbi-mortalidad en estos 25 años ha tenido una tendencia descendente, atribuible al aumento de cobertura de la atención primaria, a la atención profesional del parto y a la introduccion de la vacuna antitetánica. La letalidad en algunos años fue de 110%, lo que evidencia la poca confiabilidad que tiene la notificación de los casos. La enfermedad se ha ido desplazando hacia edades mayores, razón por lo que se propone reconsiderar la medida de suprimir el refuerzo de la vacuna a los 12 años, que se tomó en 1983. La mortalidad por tétanos de los neonatos desde 1981 se mantiene en 0,0 por 1.000 nacidos vivos. La enfermedad es más frecuente en las regiones lluviosas del país, y un aumento relativo de los casos ocurre en los meses de diciembre y enero, como era de esperarse de la patogenia de la enfermedad

Desnutrición como causa originaria de muerte según Anuario de Defunciones, Chile 1970 - 1983 / Malnutrition as cause of death according to the Annual Report on Deaths, Chile 1970 - 1983

Se realiza un estudio descriptivo que analiza la desnutrición como causa originaria de muerte en Chile a toda edad y fundamentalmente en el menor de un año durante un período de 14 años desde 1970 a 1983. Se revisan los Anuarios de Defunciones y Causas de Muerte y se analiza el Grupo III de la CIE "Enfermedades de las Glándulas Endocrinas, de la Nutrición, del Metabolismo y Trastonos de la Inmunidad" en las categorías 260 a 269. De las 9.581 defunciones encontradas, el 50% correspondía a menores de un año. La Tasa de Mortalidad Específica por Desnutrición ha disminuido de 11,6 a 2,22 por 100.000 hb y en el menor de un año de 2,25 a 0,18 por 1.000 NV en los 14 años del estudio, este último descenso es más acentuado que el de la Mortalidad Infantil en el mismo período. El mayor número de casos corresponde a "otros estados de desnutrición" y se advierte un aumento de los casos de desnutrición calórica. Se hace énfasis en la importancia de un adecuado llene del certificado de defunción. Se reconoce la importancia de las medidas de fomento, protección y control del problema en los logros obtenidos

Estudio de campo de una vacuna B.C.G liofilizada / Field study of a lyophilized BCG vaccine

Se realiza un estudio de campo con 116 nños de 4 meses, vacunados al nacer con la vacuna BCG Liofilizada del Instituto Rhodia Merieux, importada de Francia y sometida a control de calidad por el Instituto de Salud Pública de Chile. En el presente trabajo se empleó el mismo método y observadores que en un trabajo anterior sobre la vacuna BCG Liofilizada de Laboratorios Connaught (Canadá). La vacuna en estudio deja una cicatriz semejante a las utilizadas anteriormente en Chile; la respuesta Tuberculínica es débil: media 4,8 mm. D.S. 3,5mm., y se encontró una diferencia significativa al compararla con la vacuna BCG Líquida fabricada por el Instituto de Salud Pública de Chile la que aparece dando una mucho mejor respuesta tuberculínica (p = <0.001). Al comparar las dos vacunas BCG Liofilizadas, no se advierten diferencias importantes, demostrándose ambas considerablemente más débiles en su respuesta tuberculínica que la vacuna BCG Líquida. Los controles de calidad "in vitro" de la vacuna BCG Liofilizada del Instituto Rhodia Merieux demostraron que se estable y promisoria desde el punto de vista operacional

Colpoperineograma o colpocistograma video y utilizacion del colpoperineograma. / Colpoperineogram or video colpocystogram and use of colpoperitoneogram

Se practicaron 82 colpoperineogramas: 72 pacientes se operaron, 10 estan pendientes. En los prolapsos de 3o. y 4o. grado encontramos vejigas arrinonadas con residuo miccional de 200 a 250 cc y una uretra que conserva el angulo recto, lo que explica la rareza de incontinencia de orina de los grandes prolapsos. El residuo miccional explica el aumento de las infecciones urinarias. Quince pacientes no tienen respuesta de Kegel, en el pre ni en postoperatorio, lo que hara posiblemente fracasar cualquier tecnica, si la paciente no hace ejercicios de rehabilitacion perineal. La curva de postoperado tardio es una curva media entre el preoperatorio y el postoperatorio inmediato

Nivel de vida y salud: análisis por regiones y concepto de pobreza extrema (PEX) / Health and life level: analysis by regions and concept of extreme poverty (PEX)

Comenta y relacionan la mortalidad infantil; 1)nivel de vida y salud, definido este criterio por un comité de expertos de la NU; 2) pobreza extrema, señalado por ODEPLAN y UC. De análisis comparativo se deduce; a) que la mortalidad infantil se relaciona con mayor número de indicadores (12 items) de nivel de vida y salud, lo que sugiere que este sigue siendo un mejor indicador en nuestro medio; b) que PEX es de utilidad relativa por basarse fundamentalmente en la calidad y equipamiento de la vivienda