Calidad nutricional e impacto en medio ambiente por los insumos de un comedor universitario en Uruguay / Nutritional quality and environmental impact by the inputs of a university canteen in Uruguay

El espacio de comedores son una forma de garantizar el acceso a alimentos seguros, saludables y medio ambientalmente responsables para los estudiantes universitarios. Objetivo. Este estudio tuvo como objetivo caracterizar los estándares del menú, a partir de la evaluación de la calidad nutricional y del impacto en el medio ambiente por los insumos utilizados para su elaboración por un Comedor Universitario (CU) en Uruguay. Materiales y métodos. Se trató de un estudio de caso retrospectivo, relativo al año 2021. Las variables evaluadas fueron a) cantidad total de alimento comprado en kilogramos (kg); b) cantidad en kilocalorías (kcal) e impactos ambientales por: c) generación de residuos; d) huella hídrica (HH); y e) gases de efecto invernadero (GEI). También se realizaron cálculos para evaluar la ecoeficiencia (EE). Resultados. El CU sirvió 33.740 comidas en 2021, de las cuales el 87,1% fueron almuerzos. De los 78 tipos de alimentos comprados, 41 de ellos representaron el 93,17% del total en kilogramos. En la calidad nutricional, menos del 10% se clasificaron como alimentos procesados o ultraprocesados. En la evaluación de aspectos nutricionales e impactos ambientales, los alimentos de origen animal representaron el 26,52% del total en kg y el 69,78% de los HH. Un alimento de origen vegetal tuvo el mayor impacto de GEI debido a su origen. En cuanto a la EE, la valoración general mostró un resultado de 0,0626 para los alimentos de origen animal y 0,3838 para los de origen vegetal. Conclusiones. Corresponde a los servicios de alimentación para colectividades considerar, en la planificación del menú, además de la calidad nutricional y sanitaria de la oferta alimentaria, los impactos ambientales que estas genera(AU)

The canteens are a way to guarantee access to safe, healthy and environmentally responsible food for university students. Objective. The purpose of this research was to characterize the menu standards, based on the evaluation of the nutritional quality and the environmental impact of the inputs used for its preparation by a university canteen in Uruguay. Materials and methods. This was a retrospective case study, relating to the year 2021. The variables evaluated were a) total amount of food purchased in kilograms (kg); b) quantity in kilocalories (kcal) and environmental impacts due to: c) waste generation; d) water footprint (WF); and e) greenhouse gases (GHG). Calculations were also performed to assess eco-efficiency (EE). Results. The university canteen served 33,740 meals in 2021, of which 87.1% were lunches. Of the 78 types of food purchased, 41 of them represented 93.17% of the total in kilograms. In nutritional quality, less than 10% are classified as processed or ultra-processed foods. In the evaluation of nutritional aspects and environmental impacts, foods of animal origin represented 26.52% of the total in kg and 69.78% of WF. A vegetal based food had the highest GHG impact due to its origin. Regarding the EE calculations, the general assessment showed a result of 0.626 for foods of animal origin and 0.3838 for those of vegetable origin. Conclusions. It corresponds to the food services for communities to consider, in the planning of the menu, in addition to the nutritional and sanitary quality of the food offer, the environmental impacts that it generates(AU)

Referencias de Lacan a la lengua china: aspectos lingüísticos y matemáticos / Lacan´s references to the Chinese language: linguistic and mathematical aspects

El presente trabajo extrae referencias de Lacan sobre la lengua china - en los seminarios: "La identificación" (1961-1962), De un discurso que no fuera semblante (1971) y ... o peor (1971-1972) - para examinar aspectos lingüísticos y matemáticos, a través de aportes de sinólogos

The present paper extracts Lacan´s references on the Chinese language - in the seminars: "The Idenfication" (1961-1962), On a discourse that might not be a semblance (1971) and … or Worse (1971-1972) - to examine mathematical and linguistic aspects, through contributions of sinologists

Effect and safety of combination of interferon alpha-2b and gamma or interferon alpha-2b for negativization of SARS-CoV-2 viral RNA. Preliminary results of a randomized controlled clinical trial.

ObjectivesAn IFN-2b and IFN-{gamma} combination has demonstrated favorable pharmacodynamics for genes underlying antiviral activity which might be involved in the defense of a host from a SARS-CoV-2 infection. Considering this synergy, we conducted a randomized controlled clinical trial for efficacy and safety evaluation of subcutaneous IFN - 2b and IFN-{gamma} administration in patients positive for SARS-CoV-2. MethodsWe enrolled 19-82 years-old inpatients at the Military Central Hospital Luis Diaz Soto, Havana, Cuba. They were hospitalized after confirmed diagnosis for SARS-CoV-2 RNA by real-time reverse transcription polymerase chain reaction. Patients were randomly assigned in a 1:1 ratio to receive either, subcutaneous treatment with a co-lyophilized combination of 3.0 MIU IFN-2b and 0.5 MIU IFN-{gamma} (HeberFERON, CIGB, Havana, Cuba), twice a week for two weeks, or thrice a week intramuscular injection of 3.0 MIU IFN-2b (Heberon(R) Alpha R, CIGB, Havana, Cuba). Additionally, all patients received lopinavir-ritonavir (200/50 mg every 12 h) and chloroquine (250 mg every 12 h, i.e.standard of care). The primary endpoints were, from the start of treatment, the time to elimination of viral RNA and the time to progression to severe COVID-19. The protocol was approved by the Ethics Committee on Clinical Investigation from the Hospital and the Center for the State Control of Medicines, Equipment and Medical Devices in Cuba. Informed consent was obtained from each participant (INSTITUTION PROTOCOL IG/IAG/CV/2001). ResultsA total of 79 patients with laboratory-confirmed SARS-CoV-2 infection, including symptomatic or asymptomatic conditions, fulfilled the inclusion criteria and underwent randomization. Thirty-three subjects were assigned to the HeberFERON group, and 33 to the Heberon Alpha R group. Sixty-three patients were analyzed for viral elimination, of these 78.6% in the HeberFERON group eliminated the virus after 4 days of treatment versus 40.6% of patients in the Heberon Alpha R groups (p=0.004). Time to reach the elimination of SARS-CoV-2, as measured by RT-PCR was 3.0 and 5.0 days for the HeberFERON and Heberon Alpha R groups, respectively. A significant improvement in the reduction of time for virus elimination was attributable to HeberFERON (p=0.0027, Log-rank test) with a Hazard Ratio of 3.2 and 95% CI of 1.529 to 6.948, as compared to the Heberon Alpha R treated group. Worsening of respiratory symptoms was detected in two (6.6%) and one (3.3%) patients in HeberFERON and IFN-2b groups, respectively. However, none of the subjects transited to severe COVID-19 during the study or during the following clinical evaluation (21 more days). RT-PCR on day 14 after the start of the treatment was negative to SARS-CoV-2 in 100% and 91% of patients of the combination of IFNs and IFN-2b, respectively. Elimination in HeberFERON treated patients was related to a significant increase in lymphocytes counts and also a significant reduction in CRP as early as 7 days after commencing the therapeutic schedule. All the patients in both cohorts recovered and had their laboratory parameters return to normal values by day 14 after treatment initiation. Adverse events were identified in 31.5% of patients, 28.5% in the control group, and 34.4% in the HeberFERON group, with the most frequent adverse event being headaches (17.4%). ConclusionsIn a cohort of 63 hospitalized patients between 19 to 82 years-old with positive SARS-CoV-2, HeberFERON significantly eliminated the virus on day 4 of treatment when compared to treatment with IFN-2b alone. However, Heberon Alpha R alone also showed efficacy for the treatment of the viral infection. Both treatments were safe and positively impacted on the resolution of the symptoms. None of the patients developed severe COVID-19.

Malignant acanthosis nigricans as a paraneoplastic manifestation of metastatic breast cancer.

Malignant acanthosis nigricans is a rare paraneoplastic syndrome, usually associated with a gastric adenocarcinoma and less frequently with other neoplasms. In general, its appearance indicates a poor prognosis with a survival of < 2 years. We describe the case of a 40-year-old patient who presented with generalized cutaneous thickening that had a velvety appearance, was rapidly progressing, and involved right axillary adenopathy. Skin and nipple biopsy yielded results consistent with acanthosis nigricans, and palpable adenopathy biopsy results were compatible with mammary adenocarcinoma (human epidermal growth factor receptor 2 positive and estrogen and progesterone receptor negative) without a detectable primary tumor. This case of malignant acanthosis nigricans is presented because of the importance of its early recognition as a paraneoplastic syndrome and its relation with mammary adenocarcinoma, an association infrequently reported in the literature.

Sudden death circadian rhythm in Chagasic patients compared to non-Chagasic patients.

Chagas disease (Ch) affects 8-10 million people in Latin America, most of them are poor. Sudden death (SD) is the major cause of death in patients with Ch. To the best of our knowledge, the present report covers the largest reported series comparing the SD of Ch versus non-Ch patients Objective: To compare the circadian rhythm of SD in Ch versus non-Ch patients. METHODS: Retrospective analysis of all the cases of SD recorded in our department, including autopsied patients from 1963 until 2011. The pattern of SD of 262 patients (116 Ch and 146 non-Ch), 56.7% men, average age 54, 6 years old, divided into four groups: Group A: Ch with SD (n = 38), Group B: non-Ch with SD (n = 58), Group C. Ch with non SD (n = 89), and Group D: non-Ch with non SD (n = 81). For the statistical analysis, proportion comparison was used. RESULTS: 44.7% (17/38) of SDs in Group A (Ch) occurred between 6 a.m. and 5:59 p.m., while for Group B (not Ch) 70.7% (41 /58) died in that time (p < 0.005). 55.3% (21/38) of the SD in Group A (Ch) occurred between 6 p.m. and 5:59 a.m. compared with 29.3% (17/58) in Group B (p < 0, 005). CONCLUSIONS: Circadian rhythm of SD in patient with Ch differs from those with non-Ch. In Ch patients, SD occurs predominantly during the night compared with non-Ch SD that occurs predominantly during the day especially during the morning.

Estimación del tiempo de desarrollo de Lutzomyia evansi bajo condiciones experimentales / Estimation of development time for Lutzomyia evansi under experimental conditions

Objetivo: Estimar el tiempo promedio de desarrollo de Lutzomyia evansi. Materiales y métodos: Se inició una colonia de Lutzomyia evansi con individuos recolectados en la zona urbana de la ciudad de Sincelejo (Colombia). La colonia fue mantenida en el laboratorio durante tres generaciones filiales bajo condiciones experimentales promedio de 26°C de temperatura y 94% de humedad relativa. Resultados: La duración del desarrollo de Lutzomyia evansi fue de 36 a 45 días. El tiempo requerido para el desarrollo de los huevos fue en promedio de 6,75 días (rango de 6 a 8 días). La duración en promedio de los diferentes estadios larvales fue 5,75 días en larvas de primer estadio (rango de 5 a 8 días), 5,75 días en larvas de segundo estadio (rango de 4 a 7 días), 5 días en larvas de tercer estadio (rango de 4 a 7 días) y 7 días en larvas de cuarto estadio (rango e 6 a 8 días). En la fase de pupa, la duración en promedio fue de 9,75 días (rango de 7 a 17 días). Conclusiones: El tiempo promedio requerido para el desarrollo de Lutzomyia evansi, comprendido desde la alimentación sanguínea de la hembra madre hasta la emergencia del adulto, es de 40 días.

Objective: To estimate the mean development time for Lutzomyia evansi. Materials and methods: A laboratory colony of Lutzomyia evansi was started from sand flies collected in the urban area of the City of Sincelejo, Colombia. The colony was main-tained during three filial generations under experimental conditions of 26°C of mean tem-perature, and 94% of average relative humidity. Results: The duration of the development of Lutzomyia evansi was from 36 to 45 days. The development time for eggs was, on average, 6, 75 days (interval from 6 to 8 days). The mean duration of the different larval instars was 5,75 days in first instar (interval from 5 to 8 days), 5,75 days in second instar (interval from 4 to 7 days), 5 days in third instar (in-terval from 4 to 7 days) and 7 days in fourth instar (interval from 6 to 8 days). In the stage of pupa the development time was, on average, 9, 75 days (interval from 7 to 17 days). Conclusions: The mean development time for Lutzomyia evansi, from the female's blood meal to adult emergence, is 40 days.

Utilidad de la adenosina deaminasa (ADA): interferón gamma y biopsia pleural para el diagnóstico de tuberculosis pleural / Efficacy of the adenosine deaminase: interferon gamma and pleural biopsy for the diagnosis of pleural tuberculosis

El diagnóstico de la tuberculosis pleural es difícil usando solo los métodos convencionales. El objetivo de este trabajo es demostrar la eficacia de la adenosina deaminasa, interferón gamma y biopsia pleural para el diagnóstico de tuberculosis pleural y si estos biomarcadores podrían obviar la práctica de la biopsia. Se realizó el estudio prospectivo de 52 muestras de líquido pleural y 54 biopsias pleurales de 52 pacientes (M/F: 30/22). La edad promedio fue 38,8 ± 20,6 años. Los derrames fueron: tuberculosis pleural, 33 (63,46%), asociados a infección respiratoria baja. 10 (19,23%) y 9 neoplásicos (17,30%). La sensibilidad de interferon gamma, adenosina deaminasa y biopsia fue de: 88,0%, 76,0% y 65,0%, respectivamente y especificidad de: 78,0%, 63,0% y 100,0% respectivamente. Conclusiones: la adenosina deaminasa no es util aislada como método diagnóstico para la tuberculosis pleural. Se recomienda no obviar el cultivo ni la biopsia plaural y siendo Venezuela un país de alta prevalencia de tuberculosis, hacer de rutina, la medición de interferón gamma y la toracoscopia.

The diagnosis of pleural tuberculous is difficult using only conventional methods. The aim of this paper is to demostrate the efficacy of the adenosine deaminase Interferon gamma and pleural biopsy for the diagnosis of pleural tuberculosis and if these biomarkers could ignore the practice of the biopsy. The prospective study of 52 samples of pleural fluid and 54 pleural biopsies of 52 patients was conducted. The median age was 38.8 (20.6 years.). Tuberculosis etiology spills were 33 (63.46%): associated with low respiratory infection 10 (19.23%) and 9 neoplastic (17,30%). The sensitivity of Interferon gamma, adenosine deaminase and biopsy was 88.0%, 76.0% to 65.0% respectively and the specificity was 78.0% and 63.0% 100.0% respectively. Conclusions: the adenosine deaminase is not useful only as a diagnostic method for the pleural tuberculosis. It is recommended to not override the cultivation or do the pleural biopsy and being Venezuela as a country of high prevalence of tuberculosis. make routine, the measurement of gamma interferon and the thoracoscopy it is recommended.

Efecto del sulodexide sobre la capacidad de relajación y alteraciones estructurales de la arteria aorta en ratas diabéticas por estreptozotocina / Effect of sulodexide on aortic vasodilation capacity and associated morphological changes in rats with streptozotocin-induced diabetes

La disfunción endotelial (DE) se presenta en pacientes con hipercolesterolemia, hipertensión arterial, obesidad y diabetes mellitus. Evidencias sugieren un papel de los glicosaminoglicanos en la DE. Evaluamos el efecto del sulodexide (SLD), un glicosaminoglicano utilizado en el tratamiento de la albuminuria y la enfermedad isquémica en pacientes diabéticos, sobre la relajación arterial y los cambios morfológicos en un modelo experimental de diabetes tipo 1. La diabetes se indujo a ratas Sprague Dawley administrando estreptozotocina (STZ), 60 mg/kg, i.v. Los animales fueron distribuidos en los siguientes grupos: I= control, II= diabéticas, III: control + sulodexide, IV= diabéticas + sulodexide (15 mg/kg/día s.c). A los 3 meses fueron sacrificados, las aortas extraídas para evaluar la relajación vascular inducida por acetilcolina (Ach) y nitroprusiato de sodio en anillos precontraídos con fenilefrina. Fueron evaluadas histológicamente mediante microscopía de luz y coloraciones diversas. El SLD in vitro no modificó la tensión basal de los anillos arteriales en reposo o precontraídos con fenilefrina. La diabetes disminuyó la capacidad de relajación arterial en respuesta a la Ach en un 28,8-35,1% vs control, efecto que fue prevenido por SLD. No se observó diferencia significativa en la relajación inducida por nitroprusiato sódico entre los grupos. El estudio histológico en los animales diabéticos mostró alteraciones estructurales, particularmente en la íntima y la adventicia, cambios que fueron prevenidos por el tratamiento con SLD. Nuestros resultados apoyan la potencial utilidad terapéutica del SLD en el tratamiento de la disfunción endotelial.

Endothelial dysfunction (ED) is observed in patients with hypercholesterolemia, arterial hypertension, obesity and diabetes mellitus. Recent evidences suggest the involvement of glycosaminoglycans(GSG) in ED. We evaluated the effect of sulodexide (SLD), a natural GSG used in albuminuria and ischemic diabetes treatment, on arterial relaxation and vascular morphological changes in a diabetic type I model. Diabetes was induced, in Sprague-Dawley rats by streptozotocine (STZ) administration, 60 mg, iv. Rats were divided into four groups; I: control, II: diabetics, III: control + SLD, IV: diabetics treated with SLD (15 mg/day). After three months, phenylephrine precontracted aortic rings were used to evaluate acetylcholine (ACh) and sodium nitroprusside (NPS) relaxation capacities. Light microscopy of aorta was done with several staining procedures. In vitro, SLD did not change smooth muscle tone in resting or phenylephrine precontracted aortic rings. In diabetic rats, ACh relaxation was 28.8-35.1% lower than in control rats. Diabetic rats treated with SLD showed aortic ACh relaxation similar to control rats. No significative statistical difference was found in endothelium-independent NPS relaxation, between the different groups. Light microscopy histological studies revealed important morphological alterations, particularly in intima and adventitia layers of aortic artery; those changes were dramatically reversed in SLD treated rats. Our experiments support the conclusion that SLD is a potential drug for improving endothelial dysfunction in diabetes.

Wavelet transform and cross-correlation as tools for seizure prediction.

This paper describes the detection of preictal bursting using wavelet transform application and cross-correlation analysis. The wavelet transform is applied to data reduction and signal pre-processing. The extracted features provide simplified signals to process by means of the cross-correlation technique. The algorithm has been tested with a set of preictal data, interictal data and spontaneous crises, to determinate its sensitivity and its specificity (False Prediction Rate). The seizure occurrence period and the seizure prediction horizon are also calculated. The algorithm's merits are: 1) high sensitivity and 2) easy implementation.

Enfermedad de chagas sistémico en fase aguda por transmisión oral: diagnóstico integral de un caso autopsiado / Acute phase of systemic chagas disease due to oral transmission: integral diagnosis of an autopsied case

Se presenta el primer caso autopsiado en Venezuela con enfermedad de Chagas por transmisión oral. Se trata de una joven de 24 años de edad con 8 semanas de embarazo quien contrajo la enfermedad conjuntamente con 71 niños y 14 adultos, la mayoría integrantes de la comunidad escolar “Rómulo Monasterios” en la localidad de Chichiriviche de la costa Vargas, donde ocurrió el segundo brote agudo de enfermedad de Chagas por transmisión oral registrado en Venezuela. El diagnóstico epidemiológico, clínico, serológico y parasitológico en sangre y líquido pleural extraídos en vida, fueron confirmados con los hallazgos histopatológicos y moleculares (PCR) de los tejidos. Se plantearon las características peculiares del caso así como algunos aspectos de la transmisión oral, ampliamente estudiados en nuestro país en animales de experimentación.

This first autopsy case with Chagas disease by oral transmissions in Venezuela is presented. This is a 24 year old girl with 8 weeks of pregnancy who contracted the disease together with 71 and 14 adults, the majority members of the school community “Romulo Monasterios” in the town of Vargas State, where occurred the second acute Chagas disease outbreak by oral transmission in Venezuela.The epidemiological, clinical, serological and parasitological diagnosis in the blood and pleural fluid extracted in life, were confirmed with the histopathology and molecular (PCR) finding in the tissues, Special features of the case are shown, as well as, some aspects of oral transmission widely studied in our country in experimental animals.

[Effect of sulodexide on aortic vasodilation capacity and associated morphological changes in rats with streptozotocin-induced diabetes]. / Efecto del sulodexide sobre la capacidad de relajación y alteraciones estructurales de la arteria aorta en ratas diabéticas por estreptozotocina.

Endothelial dysfunction (ED) is observed in patients with hypercholesterolemia, arterial hypertension, obesity and diabetes mellitus. Recent evidences suggest the involvement of glycosaminoglycans (GSG) in ED. We evaluated the effect of sulodexide (SLD), a natural GSG used in albuminuria and ischemic diabetes treatment, on arterial relaxation and vascular morphological changes in a diabetic type I model. Diabetes was induced, in Sprague-Dawley rats by streptozotocine (STZ) administration, 60 mg, i.v. Rats were divided into four groups; I: control, II: diabetics, III: control + SLD, IV: diabetics treated with SLD (15 mg/day). After three months, phenylephrine precontracted aortic rings were used to evaluate acetylcholine (ACh) and sodium nitroprusside (NPS) relaxation capacities. Light microscopy of aorta was done with several staining procedures. In vitro, SLD did not change smooth muscle tone in resting or phenylephrine precontracted aortic rings. In diabetic rats, ACh relaxation was 28.8-35.1% lower than in control rats. Diabetic rats treated with SLD showed aortic ACh relaxation similar to control rats. No significative statistical difference was found in endothelium-independent NPS relaxation, between the different groups. Light microscopy histological studies revealed important morphological alterations, particularly in intima and adventitia layers of aortic artery; those changes were dramatically reversed in SLD treated rats. Our experiments support the conclusion that SLD is a potential drug for improving endothelial dysfunction in diabetes.

Tuberculosis pleural: Utilidad de la reacción en cadena de la polimerasa en muestras de tejido / Pleural tuberculosis: use of the polymerase chain reaction in tissue samples

El diagnóstico etiológico del derrame pleural tuberculoso, es difícil. La clínica y los ensayos paraclínicos suelen ser inespecíficos. El objetivo de este trabajo fue evaluar la sensibilidad y especificidad de la reacción en cadena de la polimerasa en tejido pleural para el diagnóstico de tuberculosis en comparación con el cultivo e histopatología, en pacientes con derrame pleural que ingresaron al servicio de Medicina Interna del Hospital “Dr. Domingo Luciani”, Caracas, Venezuela, entre abril de 2005 y agosto de 2006. Se estudiaron 52 pacientes, M/F (30 (57,7 por ciento)/22 (42,3 por ciento), con una edad promedio de 39 años. El valor de sospecha clínica fue del 69,2 por ciento. El cultivo resultó positivo en 6 casos (11,5 por ciento) y se identificaron lesiones granulomatosas tuberculoides en 40,4 por ciento. La reacción en cadena de la polimerasa mostró una sensibilidad del 50 por ciento y especificidad del 61 por ciento. Se concluyó que es una prueba eficaz para el diagnóstico de tuberculosis pleural

The diagnosis of tuberculous pleural effusion is difficult. The clinical trials and paraclinical essays are often nonspecific. The aim of this study was to evaluate the sensitivity and specificity of the polymerase chain reaction in pleural tissue for the diagnosis of tuberculosis in comparison with the culture and histopathological studies in patients with pleural effusion admited to the service of Internal Medicine Hospital Dr. Domingo Luciani, Caracas, Venezuela, between April 2005 and August 2006. We studied 52 patients, M/F (30 (57.7 percent)/22 (42.3 percent), with an average age of 39 years. The value of clinical suspicion was 69.2 percent. The culture was positive in 6 cases (11.5 percent) and tuberculoides granulomatous lesions were identified in 40.4 percent. Polymerase chain reaction showed a sensitivity of 50 percent and specificity of 61 percent. It was concluded that it is an effective test for the diagnosis of pleural tuberculosis

Determinación de la densidad y heterogeneidad de la angiogénesis en la valvulitis crónica reumática

En los países en desarrollo la fiebre reumática constituye aún, un problema de salud. La valvulopatía reumática es grave porque amerita en la mayoría de los casos, reemplazo valvular afectando inclusive a pacientes adolescentes y en la edad media de la vida. La evolución de la lesión valvular es progresiva con remodelado fibroso de sus estructuras. Histológicamente, la densidad de la neovascularización es variable y heterogénea dependiente de diferentes factores de crecimiento. El objetivo fue determinar la densidad y heterogeneidad de la angiogénesis o neovascularización en tres etapas de progresión de la valvulitis crónica reumática y su relación con la fibrosis e inflamación. Se realizó análisis histopatológico e inmunohistoquímico de 60 biopsias de pacientes con reemplazo valvular mitral, de ambos sexos divididos en tres grupos que caracterizan etapas de progresión de la valvulitis crónica. Se estimó la densidad de cada tipo de neovasos en las valvas y su relación con el grado de inflamación y fibrosis de la valva. Los promedios de edades de los grupos 1, 2 y 3 fueron: 15,3 ± 0,6; 31 ± 1,5 y 49,7 ± 1,4 años, respectivamente. La densidad total (vasos/mm2) de la angiogénesis fue decreciente desde el grupo 1 al 3; 14,78 ± 1,92, 5,98 ±1,08 y 3,55 ± 0,76, respectivamen te. (P< 0,001. ANOVA F=19,162). El neovaso predominante fue el “vaso madre”, estructura transitoria que evoluciona a las formas intermedias y a las más estables (vasos “hijos” y vasos con pared muscular). La presencia de la variabilidad de la densidad neovascular y la heterogeneidad de los neovasos en la etapa crónica de la valvulopatía reumática en relación con el proceso inflamatorio y de cicatrización, puede ser explicada por la acción de diferentes factores de crecimiento

In the developing countries the rheumatic fever still constitutes a health problem. The rheumatic valvulopathy is serious because in most of the cases replacement of the affected valve is needed, including adolescent patients and in the average age of the life. The evolution of the valvular lesions is progressive with fibrous remodeling of the structures. Histologically the angiogenesis density is variable and heterogeneous depending on different growth factors. The objective was to determine the angiogenesis density and heterogeneity in three stages of progression of the rheumatic chronic valvulitis and their relation with the fibrosis and inflammation. Histopathologic and immunohisthochemical analysis of 60 biopsies was done on patients with replacement of the mitral valve, of both sexes, divided in three groups that characterize stages of progression of the chronic valvulitis. Each type of neovasculature’s valvular density and its relation to the inflammation and fibrosis degree was estimated. The age averages of groups 1.2 and 3, were: 15.3 ± 0.6; 31 ± 1.5 and 49.7 ± 1.4 years, respectively. The total angiogenesis, density (vasos/mm2) decreassed from group 1 to the 3; 14.78 ± 1.92; 5.98 ± 1.08 and 3.55 ± 0.76 (P< 0.001), ANOVA, F=19.162. The predominant angiogenesis was the “mother-vase”, transitory structure that evolves to the intermediate and most stable forms: (“children vases” and “vases with muscular walls”). The presence of the neovascular density’s variability and the heterogeneity in the chronic stage of the rheumatic valvulopathy in relation to the inflammatory and of healing process could be explained as the effect of different growth factors