Effects of Trace Mineral Injections on Measures of Growth and Trace Mineral Status of Primiparous Cows and their Calves.

The objective of this study was to evaluate the effects of injectable trace minerals (ITM) administrations at strategic moments in the beef cattle production cycle. At calving, 50 primiparous cows (Angus × Hereford) and their calves were randomly assigned to 1 of 2 treatments: 1) ITM: cattle assigned to the ITM treatment received an ITM injection at calving and a subsequent administration at breeding (cattle over 2 yr: 1.0 mL/90 kg body weight [BW]; calves: 1.0 mL/45 kg BW); or 2) Control: cattle assigned to the control treatment were administered with saline following the same procedure as the cattle assigned to the ITM treatment. Body weight, blood, and liver samples were collected from dams and calves at multiple time points to evaluate the growth and mineral status of cow-calf pairs. All variables were analyzed using the MIXED procedure of SAS. A treatment effect (P = 0.02) was observed for Cu liver concentration of primiparous cows at breeding. Cows assigned to ITM treatment had greater Cu status than cohorts assigned to Control treatment. No treatment effects were observed for the mineral status or growth of calves. The administration of ITM to primiparous cows enhanced Cu status when grazing Cu forages scarce of Cu.

Effects of electrolyte supplementation on performance and physiological responses of preconditioning beef calves.

The objective of this study was to evaluate the effects of electrolyte solution supplementation on the performance and physiological responses of beef calves during a 45-d preconditioning phase. Forty Angus × Hereford steers (230.4 ±â€…4.8 kg body weight [BW]) were sorted into 20 pens (2 steers/pen) following weaning (day 0). Treatments were randomly assigned to pens: (1) control: access to water only and (2) electrolyte: access to water and electrolyte solution supplementation (10% of total daily water intake) from days 1 to 14. Calf BW and blood samples were collected on days 0, 1, 3, 7, 14, 21, and 44 of the study. Blood samples were analyzed for sodium, potassium, albumin, haptoglobin, ceruloplasmin, and cortisol. All variables were analyzed using the MIXED procedure of SAS. Electrolyte solution consumption was estimated at 0.70 kg/calf daily (SEM ±â€…0.21). Calves assigned to the Electrolyte treatment had greater water and total liquid intake than control (P < 0.05). No effects of treatment were observed on ADG or BW (P > 0.05). Effects of day (P < 0.004), but not treatment or treatment × day were observed for sodium, potassium, albumin, cortisol, ceruloplasmin, and haptoglobin. Electrolyte solution supplementation during the preconditioning period did not improve performance nor influenced stress-related markers, however improved liquid intake.

[Anti-smoking intervention in the acute phase of acute coronary syndrome: Is there additional benefit in patients included in a cardiac rehabilitation program?] / Intervención antitabaco en fase aguda del síndrome coronario agudo: ¿existe beneficio adicional en pacientes incluidos en un programa de rehabilitación cardiaca?

BACKGROUND: Smoking is a challenge in secondary prevention after acute coronary syndrome (ACS). The objective was to assess whether the early anti-smoking intervention (ASI), in the acute hospitalization phase, improves the abstinence rate obtained during a cardiac rehabilitation program (CRP). METHODS: Multicenter clinical trial in which smoker patients admitted for ACS were randomized 1:1 to receive or not ASI from the first day of admission. Upon discharge, both groups were referred to the CRP, performing abstinence controls using co-oximetry. Patients lost were considered smokers. RESULTS: 72 patients were included, 58 men (80.5%), mean age 53 ± 8.1 years. They were admitted for ST elevation myocardial infarction 42 (58%), non-ST elevation myocardial infarction 29 (40%) and unstable angina 1 (1.3%). They smoked an average of 22 ± 11.3 cigarettes/day (pack-year index 37 ± 20). They completed the Richmond test (8.8 ± 1.3) and Fagestrom (5.69 ± 2.1). 36 patients (50%) were randomized to ASI, with no differences in the baseline characteristics of both groups. The dropout rate at the time of inclusion in CRP was higher in the ASI group (69 vs. 44%; p 0.034; OR 2.84), without statistical significance at discharge from the CRP (58 vs. 50%; p 0.478; OR 1.4) or at 12 months (58 vs. 44%; p 0.24; OR 1.75). CONCLUSIONS: The ASI during admission significantly improves the smoking cessation rate at the time of inclusion in the CRP. Part of these beneficial effects are reduced in the follow-up losing statistical significance with respect to the control group.

DNA barcoding of the National Museum of Natural History reptile tissue holdings raises concerns about the use of natural history collections and the responsibilities of scientists in the molecular age.

Natural history collections are essential to a wide variety of studies in biology because they maintain large collections of specimens and associated data, including genetic material (e.g., tissues) for DNA sequence data, yet they are currently under-funded and collection staff have high workloads. With the advent of aggregate databases and advances in sequencing technologies, there is an increased demand on collection staff for access to tissue samples and associated data. Scientists are rapidly developing large DNA barcode libraries, DNA sequences of specific genes for species across the tree of life, in order to document and conserve biodiversity. In doing so, mistakes are made. For instance, inconsistent taxonomic information is commonly taken from different lending institutions and deposited in data repositories, such as the Barcode of Life Database (BOLD) and GenBank, despite explicit disclaimers regarding the need for taxonomic verification by the lending institutions. Such errors can have profound effects on subsequent research based on these mis-labelled sequences in data repositories. Here, we present the production of a large DNA barcode library of reptiles from the National Museum of Natural History tissue holdings. The library contains 2,758 sequences (2,205 COI and 553 16S) from 2260 specimens (four crocodilians, 37 turtles, and 2,219 lizards, including snakes), representing 583 named species, from 52 countries. In generating this library, we noticed several common mistakes made by scientists depositing DNA barcode data in public repositories (e.g., BOLD and GenBank). Our goal is to raise awareness of these concerns and offer advice to avoid such mistakes in the future to maintain accurate DNA barcode libraries to properly document Earth's biodiversity.

Cáncer y riesgo cardiovascular / Cancer and cardiovascular risk

Los pacientes que sobreviven a un cáncer tienen una menor supervivencia a largo plazo, en parte debido al incremento de las enfermedades cardiovasculares (ECV). Hasta el 30% de los fallecimientos de pacientes con cáncer pueden ser de causa cardiovascular. El cáncer puede causar ateroesclerosis por diferentes mecanismos, los más frecuentes son las secuelas de los fármacos antitumorales, la radioterapia y el trasplante de células hematopoyéticas. Los factores de riesgo cardiovascular son prevalentes en los supervivientes de cáncer. Estos pacientes deberían ser considerados en alto riesgo cardiovascular. Se aconseja recomendar hábitos de vida saludables y un control estricto de los factores de riesgo. Hay una necesidad inmediata para ampliar la disponibilidad de servicios preventivos cardiovasculares de cara a reducir los efectos adversos tardíos de la quimioterapia y la radiación. La intervención precoz podría ayudar a mejorar el perfil de riesgo cardiovascular. (AU)

Cancer survivors have lower long-term survival, in part due to increased cardiovascular disease (CVD). Up to 30% of the deaths of patients with cancer may be due to cardiovascular causes. Cancer can cause atherosclerosis by different mechanisms, the most frequent being the sequelae of antitumour drugs, radiotherapy, and haematopoietic cell transplantation. Cardiovascular risk factors are prevalent in cancer survivors. These patients should be considered at high cardiovascular risk. It is advisable to recommend healthy lifestyle habits and strict control of risk factors. There is an immediate need to expand the availability of cardiovascular preventive services to reduce the late adverse effects of chemotherapy and radiation. Early intervention could help improve cardiovascular risk profile (AU)

[Cancer and cardiovascular risk]. / Cáncer y riesgo cardiovascular.

Cancer survivors have lower long-term survival, in part due to increased cardiovascular disease (CVD). Up to 30% of the deaths of patients with cancer may be due to cardiovascular causes. Cancer can cause atherosclerosis by different mechanisms, the most frequent being the sequelae of antitumour drugs, radiotherapy, and haematopoietic cell transplantation. Cardiovascular risk factors are prevalent in cancer survivors. These patients should be considered at high cardiovascular risk. It is advisable to recommend healthy lifestyle habits and strict control of risk factors. There is an immediate need to expand the availability of cardiovascular preventive services to reduce the late adverse effects of chemotherapy and radiation. Early intervention could help improve cardiovascular risk profile.

Diabetes gestacional: conceptos actuales / Gestational diabetes: Current concepts

Resumen OBJETIVO: exponer los conceptos más actualizados de diabetes y embarazo. MÉTODO: búsqueda en PubMed y Lilacs de artículos de revisión publicados en inglés o español entre los años 2001 y 2016 con los términos "diabetes mellitus", "diabetes gestacional", "diabetes y embarazo". RESULTADOS: se encontraron 525 artículos. El consenso total de los principales temas de diabetes y embarazo se concentra en las últimas 27 revisiones y 7 guías clínicas, que son la base de esta revisión. La diabetes gestacional se asocia con mayor riesgo de preeclampsia, de posibilidad de cesárea, macrosomía, distocia de hombros y mortalidad perinatal. Está demostrado que el primer paso en el tratamiento de la diabetes es la dieta adecuada y luego la insulina o metformina. La gliburida no debe indicarse para el control de la diabetes gestacional. CONCLUSIONES: la diabetes gestacional sigue siendo una de las principales complicaciones obstétricas con alta tasa de morbilidad materna, neonatal y pediátrica. El tratamiento debe enfocarse a la dieta como primera medida y, de ser necesario, una estrategia farmacológica de metformina e insulina como únicas opciones.

Abstract OBJECTIVE: To present the most up-to-date concepts of diabetes and pregnancy. METHOD: PubMed and lilacs search articles published in english or spanish between 2001 and 2016 with the terms "diabetes mellitus", "gestational diabetes", "diabetes and pregnancy". RESULTS: 525 articles were found. The overall consensus on the major issues of diabetes and pregnancy is concentrated in the last 27 reviews and 7 clinical guidelines, which are the basis of this review. Gestational diabetes is associated with an increased risk of preeclampsia, caesarean section, macrosomia, shoulder dystocia and perinatal mortality. It is proven that the first step in the treatment of diabetes is the proper diet and then insulin or metfomine. Glyburide should not be indicated for the management of gestational diabetes. CONCLUSIONS: Gestational diabetes continues to be one of the main obstetric complications with a high rate of maternal, neonatal and pediatric morbidity. Treatment should focus on diet as a first step and, if necessary, a pharmacological strategy of metformin and insulin as the only options.

Cryptic population structuring and the role of the Isthmus of Tehuantepec as a gene flow barrier in the critically endangered Central American River Turtle.

The critically endangered Central American River Turtle (Dermatemys mawii) is the only remaining member of the Dermatemydidae family, yet little is known about its population structuring. In a previous study of mitochondrial (mt) DNA in the species, three main lineages were described. One lineage (Central) was dominant across most of the range, while two other lineages were restricted to Papaloapan (PAP; isolated by the Isthmus of Tehuantepec and the Sierra de Santa Marta) or the south-eastern part of the range (1D). Here we provide data from seven polymorphic microsatellite loci and the R35 intron to re-evaluate these findings using DNA from the nuclear genome. Based on a slightly expanded data set of a total of 253 samples from the same localities, we find that mtDNA and nuclear DNA markers yield a highly congruent picture of the evolutionary history and population structuring of D. mawii. While resolution provided by the R35 intron (sequenced for a subset of the samples) was very limited, the microsatellite data revealed pronounced population structuring. Within the Grijalva-Usumacinta drainage basin, however, many populations separated by more than 300 kilometers showed signals of high gene flow. Across the entire range, neither mitochondrial nor nuclear DNA show a significant isolation-by-distance pattern, but both genomes highlight that the D. mawii population in the Papaloapan basin is genetically distinctive. Further, both marker systems detect unique genomic signals in four individuals with mtDNA clade 1D sampled on the southeast edge of the Grijalva-Usumacinta basin. These individuals may represent a separate cryptic taxon that is likely impacted by recent admixture.

Predictores electrocardiográficos y ecocardiográficos de fibrilación auricular en pacientes hipertensos / Electrocardiographic and echocardiographic predictors of atrial fibrillation in hypertensive patients

Introducción y objetivo La aparición de fibrilación auricular en pacientes hipertensos se asocia a una alta incidencia de complicaciones cardiovasculares. Se evalúan los parámetros clínicos, electrocardiográficos y ecocardiográficos predictores de fibrilación auricular en pacientes hipertensos. Pacientes y métodos Se analizó retrospectivamente a 183 pacientes hipertensos sin historia de fibrilación auricular atendidos en la Consulta de Hipertensión. Resultados Después de un seguimiento medio de 4±2,2 años, 23 pacientes (12,5%) presentaron fibrilación auricular. Los pacientes con fibrilación auricular durante el seguimiento presentaron mayor edad (74,6 vs 62,7 años; p<0,0005), mayor tasa de obesidad (60,8 vs 38,5%; p=0,049), mayor tasa de enfermedad cardiovascular establecida (52 vs 28%; p=0,025), menor tasa de pacientes dipper (41 vs 59%; p=0,014), mayor tamaño de aurícula izquierda (48,7 vs 38,2mm; p<0,0005), mayor masa de ventrículo izquierdo (324 vs 266g; p=0,014), menor fracción de eyección (62,6 vs 69,7%; p=0,002), mayor tasa de insuficiencia mitral (82 vs 51,7%; p=0,008), una mayor tasa de pacientes con criterios de hipertrofia ventricular izquierda (21,7 vs 7,4%; p=0,026) y mayor presencia de extrasistolia supraventricular (23,5 vs 6,1%; p=0,044). No hubo diferencias en ningún otro parámetro electrocardiográfico analizado: duración, amplitud, dispersión y eje de la onda P; intervalo PR; duración QRS y frecuencia cardiaca basal. Únicamente la edad (OR 1,06) y la dilatación de AI (OR 1,22) fueron factores significativos predictores independientes en al análisis multivariado. Conclusión En nuestra población de pacientes hipertensos, la edad y el diámetro de la AI son factores predictores para la aparición de fibrilación auricular (AU)

Introduction and objective Appearance of atrial fibrillation in hypertensive patients is associated with a high incidence of cardiovascular complications. Clinical, electrocardiographic and echocardiographic parameters, predictors of atrial fibrillation in hypertensive patients, have been evaluated. Patients and methods A total of 183 hypertensive patients with no history of atrial fibrillation who were seen in the Hypertension Medical Office were analyzed retrospectively. Results After a mean follow-up of 4±2.2 years, 23 patients (12.5%) developed atrial fibrillation. Patients with atrial fibrillation during follow-up were older (74.6 years vs. 62.7 years, p<.0005), had a higher rate of obesity (60.8% vs 38.5%, p=.049), higher rate of established cardiovascular disease (52% vs 28%, p=.025), lower rate of dipper patients (41% vs 59%, p=.014), larger left atrium (48.7mm vs 38.2mm, p<.0005), larger left ventricular mass (324g vs 266g, p=.014), lower ejection fraction (62.6% vs 69.7%, p=.002), higher rate of mitral insufficiency (82% vs 51.7%, p=.008), higher rate of patients with left ventricular hypertrophy criteria (21.7% vs 7.4%, p=.026), and greater presence of supraventricular extrasystoles (23.5% vs 6.1%, p=.044). There were no differences in any of the other electrocardiographic parameter analyzed, that is in duration, amplitude, dispersion and P wave axis, PR interval, QRS duration and baseline heart rate. Only age (OR 1.06) and dilated LA (OR 1.22) were independent significant predictors in the multivariate analysis. ConclusionIn our population of hypertensive patients, age and left atrium diameter are predictors of the onset of atrial fibrillation (AU)

Permanent Genetic Resources added to Molecular Ecology Resources Database 1 April 2010 - 31 May 2010.

This article documents the addition of 396 microsatellite marker loci to the Molecular Ecology Resources Database. Loci were developed for the following species: Anthocidaris crassispina, Aphis glycines, Argyrosomus regius, Astrocaryum sciophilum, Dasypus novemcinctus, Delomys sublineatus, Dermatemys mawii, Fundulus heteroclitus, Homalaspis plana, Jumellea rossii, Khaya senegalensis, Mugil cephalus, Neoceratitis cyanescens, Phalacrocorax aristotelis, Phytophthora infestans, Piper cordulatum, Pterocarpus indicus, Rana dalmatina, Rosa pulverulenta, Saxifraga oppositifolia, Scomber colias, Semecarpus kathalekanensis, Stichopus monotuberculatus, Striga hermonthica, Tarentola boettgeri and Thermophis baileyi. These loci were cross-tested on the following species: Aphis gossypii, Sooretamys angouya, Euryoryzomys russatus, Fundulus notatus, Fundulus olivaceus, Fundulus catenatus, Fundulus majalis, Jumellea fragrans, Jumellea triquetra Jumellea recta, Jumellea stenophylla, Liza richardsonii, Piper marginatum, Piper aequale, Piper darienensis, Piper dilatatum, Rana temporaria, Rana iberica, Rana pyrenaica, Semecarpus anacardium, Semecarpus auriculata, Semecarpus travancorica, Spondias acuminata, Holigarna grahamii, Holigarna beddomii, Mangifera indica, Anacardium occidentale, Tarentola delalandii, Tarentola caboverdianus and Thermophis zhaoermii.

Cobertura de defectos amplios de la mano con colgajo inguinal. A propósito de un caso / Coverage of large hand defects with inguinal flap. A case report

Se presenta el caso de un defecto amplio de cobertura de la mano en un varón de 53 años, con lesión asociada por cizallamiento, que desaconsejaba el uso de colgajos de proximidad. Se consiguió la cobertura con un colgajo inguinal adelgazado obteniendo una buena adaptación y aspecto estético (AU)

We present the case of a 53 years-old man with a large defect of the hand associated with degloving injury that did not advise us to use local flaps. We obtained coverage with a thin inguinal flap achieving a good adaptation and aesthetic appearance (AU)

Influencia de la procedencia del paciente en la evolución clínica del esguince cervical / Influence of the origin of the patient in the clinical course of whiplash

Introducción. El propósito es conocer la influencia que el tipo de contingencia de los pacientes con esguince cervical tiene en su curso evolutivo y en su pronóstico médico-laboral, para establecer la pauta más correcta de actuación que mejore su manejo terapéutico. Material y método. Se ha realizado un análisis dirigido a registrar la evolución clínica de los pacientes con esguince cervical, según el tipo de contingencia que ha generado su situación de incapacidad temporal, valorando determinados parámetros relacionados con el curso clínico de este proceso que pueden influir negativamente en una duración mayor de la incapacidad. Resultados. Los pacientes en situación de incapacidad temporal por un accidente laboral comenzaron antes la rehabilitación, necesitaron menos sesiones de tratamiento y se reincorporaron antes a su actividad laboral que aquellos en baja laboral por enfermedad común, en los que la demora en ser remitidos al gimnasio y el mayor tiempo transcurrido desde el alta de rehabilitación hasta el alta laboral determina una mayor duración de su incapacidad temporal y una mayor repercusión socioeconómica y laboral. Conclusiones. La posibilidad de acortar los tiempos medios transcurridos desde el momento del accidente hasta el alta laboral en la valoración médica final puede mejorar la respuesta clínica al tratamiento aplicado, además de reducir los elevados gastos asociados que implica una duración más prolongada de la incapacidad laboral de los pacientes diagnosticados de esguince cervical

Introduction. This study has aimed to know the influence that the specific contingency of patients with whiplash has on its evolution course and its medical-working prognosis to establish the most appropriate guideline to improve its therapeutic treatment. Material and methods. Part of this study was used to record the clinical evolution of patients with whiplash according to type of contingency that led to temporal incapacity. Some parameters related with the clinical course of this condition that could have a negative influence on the duration of the disability were evaluated. Results. Patients with temporal incapacity due to a working accident started rehabilitation earlier, needed fewer sessions and were able to get back to their working activity sooner than patients on sick leave due to common illness. In the latter group, the delay to be referred to the gym and the longer elapsed time from the time they were discharged from rehab to when they got medical authorization to restart their working activity determines a longer period of working disability and significantly higher socioeconomical and working impact. Conclusions. The possibility of shortening the mean times between the time of accident to return to work in the final medical evaluation may improve the clinical response to the treatment administered, and reduce the high cost associated to a longer period of working incapacity for patients diagnosed with whiplash

A randomized comparison of different methods of analgesia in abortion using manual vacuum aspiration.

OBJECTIVE: To estimate the effectiveness of different methods of analgesia among women treated with manual vacuum aspiration for spontaneous abortion. MATERIALS AND METHODS: The 113 patients diagnosed with incomplete abortion and considered candidates for manual vacuum aspiration were randomly assigned to 3 groups of analgesic administration: diclofenac plus paracervical block; meperidine plus diclofenac; and meperidine alone. Pain levels were evaluated using the Wong Scale of Pain. RESULTS: The mean pain scores for the three groups were: diclofenac and paracervical block 5.4; meperidine plus diclofenac 5.0; meperidine 5.7 (P=0.57). Analysis of pain using the levels mild (0-3), moderate (4-6), and severe (7-10) showed no statistical significance among the 3 groups of analgesics. Adverse effects were more common in the groups using analgesia containing meperidine. CONCLUSIONS: There was no significant difference between the analgesics used among the 3 groups. Most of the patients, regardless of the analgesic used, reported moderate pain.

Enantiomeric purity of (+/-) -methyl jasmonate in fresh leaf samples and commercial fragrances.

The enantiomeric purity of (+/-) -methyl jasmonate in fresh leaf material of Jasminum from different species and Rosmarinus officinalis was examined by solid-phase microextraction-GC-MS (SPME-GC-MS). For comparison with these natural products, commercial jasmine and rosemary fragrances were also studied. The extraction conditions were selected as a result of testing different values of temperature (40, 50, and 60 degrees C) and time (2, 15, 30, and 40 min). The results obtained in this work revealed a range of enantiomeric excesses for (+/-) -methyl jasmonate varying from 13 to 95% depending on the Jasminum specie considered. In contrast, (-) -methyl jasmonate always occurred as a pure enantiomer in all R. officinalis samples studied. This implies those Jasminum species in which the enantiomeric purity of (-) -methyl jasmonate is high enough and any R. officinalis sample might be used as natural sources of pure (-) -methyl jasmonate. Concerning the commercial fragrances, those of jasmine showed enantiomeric composition of (-) -methyl jasmonate ranging from 1 to 15% whereas those of rosemary exhibited practically the pure (-) -methyl jasmonate. This fact suggests the addition and nonaddition of the racemic mixture of methyl jasmonate to the commercial jasmine and rosemary samples, respectively.

Parálisis periódica tirotóxica: complicación inusual de una enfermedad frecuente / Thyrotoxic periodic paralysis: un uncommon complication of a common disease

La parálisis periódica tirotóxica es una entidad infrecuente incluida en el grupo de las parálisis periódicas hipopotasémicas. La mayoría de los casos descritos en la bibliografía corresponden a pacientes de raza oriental, y es excepcional la aparición en nuestro medio. Presentamos un caso de un varón de raza blanca de 27 años de edad, con diagnóstico reciente de hipertiroidismo por enfermedad de Graves-Basedow. Revisamos los hallazgos clínicos y de laboratorio, los factores desencadenantes, la fisiopatología y el tratamiento de esta rara complicación del hipertiroidismo (AU)

Thyrotoxic periodic paralysis is an uncommon disorder included in the group of hypokalemic periodic paralyses. Most of the cases described in the literature have occurred in Asian patients and it is extremely rare in our environment. We report a case of thyrotoxic periodic paralysis in a 27-year-old white man with a recent diagnosis of hyperthyroidism due to Graves' disease. We review the clinical and biochemical features, the precipitating factors, the pathophysiology and the treatment of this rare complication of hyperthyroidism (AU)

El intervalo intergenésico: un factor de riesgo para complicaciones obstétricas y neonatales / The intergenesic interval: a risk factor for obstetric and neonatal complications

Objetivo: Determinar el impacto del intervalo intergenésico sobre la morbilidad maternofetal. Materiales y métodos: Estudio de cohorte, realizado del 1 de mayo al 31 de diciembre de 2002 en el Departamento de Ginecología y Obstetricia del Complejo Hospitalario Metropolitano de la Caja del Seguro Social de Panamá. Se incluyeron pacientes con antecedentes de embarazo previo que ingresaron a la institución con diagnóstico de aborto o embarazo de cualquier edad gestacional y que egresaron con terminación del embarazo actual. Se excluyeron primigestas, pacientes con enfermedad preexistente al embarazo y de las que no se recolectó datos completos. Se correlacionaron patologías obstétricas, resultado neo natal y período intergenésico. El análisis de datos se realizó con EPI-INFO 2002, X2, OR con IC del 95% y p = 49 meses es un factor de riesgo para desarrollar preeclampsia (OR: 29; IC del 95%, 19-45), DPPNI (OR: 3,6; IC del 95% 1,2-11) Y para culminar su embarazo por cesárea (OR: 10,1; IC del 95% 6-17). Conclusión: Un período intergenésico = 49 meses está asociado con un incremento del riesgo para complicaciones obstétricas y neonatales. El período intergenésico óptimo para prevenir complicaciones matemofetales es de 25 a 48 meses (AU)

Objective: To determine the impact of the interval between pregnancies on maternal-foetal morbidity. Materials Method: A cohort study carried out from 1 st May until 31st December 2002 in the Gynaecology and Obstetric Department of the Metropolitan Hospital Complex (Social Security) in Panama. We inc1uded patients with previous pregnancies, and who were admitted with spontaneous abortion, and patients of any gestational age who were admitted because of pregnancy termination. We exc1uded primigravidas, patients with a disease existing before pregnancy, and those with incomplete records. We correlated obstetric pathologies, neonatal outcome, and the interval between pregnancies. Statistical analysis was made with EPI-INFO 2002, Chi-square. The odds ratio (OR) had a confidence interval (CI) of 95% and p = 49 months is a risk factor for the development of pre-ec1ampsia OR 29 (95% CI, 19-45), placental abruption OR 3.6 (95% CI, 1.2-11) and caesarean section OR 10.1 (95% CI, 6-17). Conclusions: An interval between pregnancies = 49 months are associated with an increase in obstetric and neonatal complications, thus the period between 25 and 48 months is optimal to prevent maternal-foetal complications (AU)

Perinatal outcome in women with severe chronic hypertension during the second half of pregnancy.

OBJECTIVES: To determine the perinatal outcome associated with severe chronic hypertension (SCH) in pregnancies of > or =20 weeks' gestation. METHODS: A retrospective analysis of data obtained prospectively of patients with SCH (> or =160/110 mmHg) who were hospitalized and delivered during a 5-year period. Each patient received intensive monitoring of the clinical status throughout the hospitalization (mother, fetus and neonates). Antihypertensive drugs were used for blood pressure > or =160/110 mmHg, glucocorticoids for pregnancies of 24-34 weeks and magnesium sulfate for women with superimposed pre-eclampsia (SPE). The main outcome measures were fetal and neonatal deaths, fetal growth restriction (FGR), major neonatal complications and length of stay in the neonatal intensive care unit (NICU). RESULTS: Of 154 women studied, 78% developed SPE and the mean week's gestation at delivery was 34.5+/-4.6. The average birth weight was 2329+/-1011 g. and the FGR was 18.5%. Four patients had a dead fetus at the time of admission, eight during the hospitalization and there were six neonatal deaths resulting in perinatal mortality of 11.4%. Thirty-eight babies were admitted to the NICU, average stay was 14.8 days. The most common contributors to neonatal mortality and morbidity were pulmonary complications and sepsis. CONCLUSIONS: This study found that the neonatal outcomes in pregnancy with SCH are better than the historical experience, but preterm deliveries, cesarean section, SPE, abruptions and total perinatal mortality remains very high.

Inmunonutrición / Immunonutrition

El objeto de esta revisión sistemática es valorar la calidad de la evidencia científica utilizada en las guías de práctica clínica, recomendaciones y consensos sobre la inmunonutrición. Estudiamos los efectos del uso de glutamina, ácidos grasos omega-3 y arginina tanto por vía gastrointestinal como parenteral. Finalizamos con una evaluación concienzuda de los trabajos clínicos más valorados en pacientes quirúrgicos, traumatológicos, quemados e ingresados en la UCI mixta. Presentamos tablas sobre la composición de los productos de nutrición enteral, así como resúmenes de los estudios clínicos llevados a cabo (AU)

Derivatization of chiral amino acids in supercritical carbon dioxide.

A new method is proposed to perform the derivatization of chiral amino acids occurring in complex samples using supercritical carbon dioxide as both the reaction medium and the agent used to extract the obtained derivatives prior to accomplishing the subsequent enantiomeric chromatographic analysis. The derivatization step under supercritical conditions involves the esterification of the carboxyl group and the acylation of the amino group of the amino acids without using a catalyst. A Chirasil-L-Val capillary column enabled the separation of the D- and L-forms of the amino acids as their N(O)-pentafluoropropionyl 1-propyl esters. Relative standard deviation values obtained from the gas chromatographic analysis for the derivatized amino acids ranged from 5 to 15%.