[Video-assisted thoracoscopic treatment for two ports for idiopathic palmar and axillary hyperhidrosis in children]. / Tratamiento videotoracoscópico por dos puertos para la hiperhidrosis palmar y axilar idiopática en el niño.

JUSTIFICATION: Primary hyperhidrosis is a benign disease that consists in the excessive production of sweat, mainly in the hands, axillas and feet. It may to interfere with the social and work life of the sufferer. It affects up to 3% of the population. In Cuba there are no epidemiological studies on its prevalence. One of the treatment modalities is videothoracoscopic sympathicotomy. OBJECTIVES: To describe the results of the videothoracoscopic sympathicotomy technique for two ports using apneic oxygenation to achieve lung collapse. METHOD: Descriptive, retrospective study of 27 cases operated by primary hyperhidrosis in the period from May 2015 to June 2018. Demographic and clinical characteristics of operated patients, results of the endoscopic surgical technique, postoperative complications and satisfaction were described. RESULTS: The 27 patients were adolescents with ages ranging from 11 to 19 years old, it was more frequent in the female sex. All patients had total solution of the symptoms in the intraoperative period, demonstrated by the cessation of sweat in the palms or axillas and by the verification of the increase of the palmar temperature in the monitor. No patient had intraoperative complications. Compensatory sweating occurred in four patients and one had intercostal neuritis. 100% of the patients were satisfied with the result at 30 days of treatment. CONCLUSIONS: It is a safe technique, with few complications, high satisfaction with the results and feasible to perform in pediatric hospitals with basic resources of minimal access surgery.

FUNDAMENTACION: La hiperhidrosis primaria es una enfermedad benigna que consiste en la excesiva producción de sudor, principalmente en manos, axilas y pies, y por ello puede llegar a condicionar la vida social y laboral de quien la padece. Afecta hasta el 3% de la población. En Cuba no hay estudios epidemiológicos sobre su prevalencia. Una de las modalidades de tratamiento es la simpaticotomía videotoracoscópica. OBJETIVOS: Describir los resultados de la técnica de simpaticotomía videotoracoscópica por dos puertos usando oxigenación apneica para lograr el colapso pulmonar. METODO: Estudio descriptivo, retrospectivo, de una serie de 27 casos operados por hiperhidrosis primaria en el periodo de mayo de 2015 a junio de 2018. Se describen características demográficas y clínicas de pacientes operados, resultados de la técnica quirúrgica endoscópica, complicaciones postoperatorias y satisfacción. RESULTADOS: Los 27 pacientes eran adolescentes con edades comprendidas entre 11 y 19 años, siendo más frecuente en el sexo femenino. Todos los pacientes tuvieron solución total de los síntomas en el periodo intraoperatorio, demostrados por el cese del sudor en palmas o axilas y por la comprobación del aumento de la temperatura palmar en el monitor. Ningún paciente tuvo complicaciones intraoperatorias. El sudor compensatorio se presentó en cuatro pacientes y un paciente tuvo neuritis intercostal. El 100% de los pacientes estuvieron satisfechos con el resultado a los 30 días del tratamiento. CONCLUSIONES: Es una técnica segura, con pocas complicaciones, elevada satisfacción con los resultados y factible de realizar en hospitales pediátricos con recursos básicos de cirugía de mínimo acceso.

Lynch syndrome diagnostics: decision-making process for germ-line testing.

Cancer risks and medical management of Lynch syndrome (LS) differ from other hereditary or familial clustering of colorectal cancer. Differential diagnosis has improved as a result of the growing clinical and molecular knowledge about LS. Appropriate application of these advances in several scenarios constitutes a decision-making process to further decide germ-line testing with accuracy and efficiency. However, an only molecular-screening algorithm, with a limited number of steps and choices, may be difficult to devise. How, when, where and at what expense to use the different diagnostic tools remain dynamic and changeable under different circumstances. From a clinical point of view, it is advisable to discuss conflicting aspects to guide LS diagnosis.

Effect of the addition of industrial by-products on Cu, Zn, Pb and As leachability in a mine sediment.

A series of incubation and leaching experiments were performed to assess the feasibility of three industrial by-products (red gypsum (RG), sugar foam (SF) and ashes from the combustion of biomass (ACB)) to reduce the leachability of Cu, Pb, Zn and As in a sediment of São Domingos mine (Portugal). The changes in the element solid phase speciation were also evaluated by applying a sequential extraction procedure. All amendments significantly reduced the leachability of Zn and Cu, whereas the treatment with RG+SF+ACB also decreased the mobility of As. The reduction in Cu leachability was especially remarkable. This could be due to the great affinity of carbonates (included in SF and SF+ACB amendments) to precipitate with Cu, and maghemite and rutile (RG amendment) for acting as relevant sorbents for Cu. Pb was the least mobile element in the sediment and none of the treatments reduced its mobility. The sequential extraction reveals that the amendments induced a significant decrease in the concentration of elements associated with the residual fraction. Cu, Pb and As are redistributed from the residual fraction to the Al, Fe, and Mn hydr(oxides) fraction and Zn from the residual fraction to the water/acid soluble, exchangeable and bound to carbonates pool.

Algorithm for phase extraction from a set of interferograms with arbitrary phase shifts.

The generalized analytical quadrature filter from a set of interferograms with arbitrary phase shifts is obtained. Both symmetrical and non symmetrical algorithms for any order are reported. The analytic expression is obtained through the convolution of a set of two-frame algorithms and expressed in terms of the combinatorial theory. Finally, the solution is applied to obtain several generalized tunable quadrature filters.

[A prospective, open, controlled and randomised study of clobazam versus carbamazepine in patients with frequent episodes of Rolandic epilepsy]. / Estudio prospectivo, abierto, controlado y aleatorizado de clobazam frente a carbamacepina en pacientes con crisis frecuentes de epilepsia rolándica.

INTRODUCTION: To date no controlled, randomised studies with flexible dose regimens have been conducted in children with rolandic epilepsy, and therapy is therefore still empirical. AIM: To evaluate the effectiveness and safety of clobazam (CLB) compared with that of carbamazepine (CBZ) in rolandic epilepsy. PATIENTS AND METHODS: A prospective, open, controlled and randomised study was carried out to compare CBZ and CLB in children with rolandic epilepsy with a follow-up over a two-year period. A random sample of 45 patients was taken and 38 of them finished the study. A flexible dose regimen was indicated. Control of seizures, academic performance, behaviour, adherence to treatment, parents' degree of satisfaction and side effect profiles were all evaluated. RESULTS: Both drugs were equally effective at controlling seizures (94.1% of patients with CLB and 100% of those with CBZ were free of seizures on ending the study; p = 0.26). CLB controlled seizures earlier (33.3 +/- 45 days versus 48.2 +/- 72.3; p < 0.05) and had fewer side effects than CBZ (side effects appeared in three patients with CLB and in eight of those on CBZ; p = 0). In two of the patients taking CBZ, the seizures got worse and a series of cognitive-behavioural complications also appeared. CONCLUSIONS: CBZ is an effective drug in rolandic epilepsy, but it may be associated with exacerbation of seizures as well as with cognitive-behavioural impairment. CLB in monotherapy seems to be an effective and better tolerated drug in this kind of epilepsy.

Central nervous system activity of the hydroalcoholic extract of Casimiroa edulis in rats and mice.

In order to evaluate the effects produced by the hydroalcoholic extract of leaves from Casimiroa edulis on the central nervous system, different behavioral tests and animal models of depression and anxiety were performed. The extract was administered intraperitoneally in male and female rats and tested on spontaneous motor activity, locomotor activity, exploration of an elevated plus-maze (EPM) and in the forced swimming test (FST). In addition, the extract was administered orally in male and female mice and evaluated in the following tests: general observation, pentobarbital-induced hypnosis, EPM, rota-rod, hole-board, and marble-burying. The results revealed that, in rats, the extract caused considerable reduction of locomotor and exploratory activities and increased the exploration of the EPM open arms in a similar way that diazepam. In the FST, the extract was as effective as fluoxetine in inducing shortening of immobility, along with a significant increase on climbing duration. On the other hand, in mice, the extract prolonged pentobarbital-induced hypnosis, increased exploration of the EPM open arms and partially protected from the pentylenetetrazol-induced convulsions. No significant effect was evident on motor coordination, hole-board and marble-burying tests. These results suggest that the hydroalcoholic extract of Casimiroa edulis may contain sedative principles with potential anxiolytic and antidepressant properties, which need further investigation.

[Pharmacologic activity of the aqueous wood extract from Quassia amara (Simarubaceae) on albino rats and mice]. / Actividad farmacológica del extracto acuoso de la madera de Quassia amara (Simarubaceae) en ratas y ratones albinos.

All the assays were done with an aqueous preparation of dry wood from Quassia amara (Simarubaceae). For the hippocratic assay, 12 female SDN rats were used, with an average weight of 144 g and separated in three groups of four individuals each. The dose used were 500 mg/kg and 1,000 mg/kg and the control group received 0.5 ml of distilled water. The extract administration and the observation of the animals were done daily during nine days. Acute toxicity of the preparation was studied with 25 male NGP mice with an average weight of 20.13 g, in groups of five individuals per dose. The oral administration was carry out with the following doses: 250, 500, 750 and 1,000 mg/kg, the control group received 0.5 ml of distilled water. No sign of acute toxicity was observed at any dose. For the toxicity analysis via intraperitoneal injection 15 male NGP mice were assigned to five groups (5 animals each) with doses of 500 and 1,000 mg/kg and a control group with 0.5 ml of distilled water. The group with the dose of 500 mg/kg, presented acute toxicity signs with a 24 hr recovery, and the 1,000 mg/kg dose was lethal to a 100% within 24 hr. The measuring of the peristaltic activity (movement of the intestinal content) were performed on 30 NGP male mice with an average weight of 22 g assigned to three groups of ten individuals each. One dose of 500 mg/kg and 1,000 mg/kg were orally administrated to each experimental group and 0.5 ml of distilled water to the control group. The marker used was activated carbon, orally supplied to every mice 30 min after the administration of the aqueous extract. The animals are decapitated and the measurement of the carbon motion in the small intestine was done after 30 min. Both dose increased the intestinal movement compared to the control group, but only the 1,000 mg/kg dose showed a statistically significant difference (p < or = 0.05).

[Cardiovascular effects of aqueous extracts of the leaves of Clusia coclensis (Guttiferae)]. / Efectos cardiovasculares del extracto acuoso de las hojas de Clusia coclensis (Guttiferae).

Aqueous extracts of the leaves of Clusia coclensis, (Guttiferae) injected intravenously to 42 normal Sprague-Dawley rats and to 42 Spontaneous Hypertensive rats, in 7 different doses, induced a rapid and transitory decrease in blood pressure and heart frequency. The magnitude of blood pressure decrease was dose-dependent. The effect was statistically significant (p < or = 0.01), probably due to sympathetic stimuli.

[Maximum oxygen consumption and serum lipids in diabetics, controls, and athletes]. / Consumo máximo de oxígeno y los lípidos séricos en diabéticos, controles y atletas.

Although it has been pointed out that the main cardiovascular risk factors in diabetic are dyslipidemias, hypertension, and cigarette smoking, very few studies have analyzed other risk factors, such as sedentarism and maximal aerobic capacity (VO2 max). The purpose of this study was to evaluate VO2 max and blood lipids (total cholesterol = TC, high density lipoproteins cholesterol = HDL; low density lipoproteins cholesterol = LDL; triglycerides = TG), in 19 diabetics subjects, 19 sedentary and 19 long distance runners. The diabetics of 5-10 years of evolution were non obese (body fat < 28%), and in regular metabolic control (Hb A1 < 12%). The athletes had more than five years of uninterrupted training. The diabetics had significantly lower VO2 max, than the other groups. The mean +/- SEM (mL/kg/min) in diabetics was 30.5 +/- 1.6 versus 41.3 +/- 2.3 in the controls and 54.2 +/- 2.5 in the athletes. There were significant group differences in TG (218 +/- 44 in diabetics vs 106 +/- 16 in controls and 94 +/- 10 mg/dL in athletes) and in HDL (27.3 +/- 4.3 in diabetes versus 34.1 +/- 4.3 and 43.9 +/- 6.3 mg/dL). These data suggest that sedentarism and low VO2 max may be important risk factors in diabetics. An aerobic program for them could perhaps change their blood lipids favorably as their VO2 max was significantly correlated with TG (r = -0.45), HDL (r = 0.52) and the TC/HDL ratio (r = -0.57).

[Effects of Casimiroa edulis (Rutacea) on blood pressure and heart rate in albino rats]. / Acciones de Casimiroa edulis (Rutacea) sobre la presión arterial media y frecuencia cardiaca en ratas albinas.

Aqueous extracts of Casimiroa edulis leaves injected intravenously to 20 normal Sprague-Dawley rats produced a rapid and transitory increase in blood pressure. The amplitude of the blood pressure rise was dose dependent. The increase was statistically significant (p < or = 0.01) at a concentration of 220 mOsm/l, and was associated with a significant heart rate decrease (p < or = 0.01) probably secondary to barorreceptor stimuli. The application of 130 mOsm/l of the extract did not produce a significant increase in blood pressure, which was followed by a rapid pressure normalization. The slight increase in cardiac rate during the pressure lift was probably due to sympathetic stimuli.

Enfermedad Diarréica Aguda en niños procedentes del municipio de Sancti Spíritus

Se realizó un estudio caso-control desde enero de 1987a enero 1988 en 245 niños ingresados en el Hossspital Pediátrico Provincial, residentes en el municipio de Sancti Spíritus, de ellos 178 presentaban Enfermedad Diarréica Aguda (EDA) y 67 estaban ingresados por otra enfermedad. Se aplicó una encuesta a casos y controles y se estudió las caracteristicas del agua, ablactación, condiciones sanitarias de las viviendas y su influencia en la aparición de las EDA; fueron realizados análisis virológicos y parasitológicos detectándose que los agentes biológicos representados fundamentalmente por los parásitos y la ablactación incorrecta desempeñaron un papel importante.Fue significativamente más frecuente las EDA en niños que residian en viviendas con malas condiciones higiénicas e ingerian agua de pozo las que fueron catalogadas en un alto porcentaje como de mala calidad bacteriológica.(AU)

[Effect of body posture on serum concentration of lipids]. / "Efecto de la postura corporal sobre la concentración de los lipidos séricos".

The purpose of this study was to evaluate the effects of body postural changes (supine-upright), upon the serum concentration of cholesterol (CT), triglycerides (TG), high density lipoproteins (HDL), low density (LDL) and very low density lipoproteins (VLDL) and hemoglobin, hematocrit, and plasma proteins (to calculate delta% change in plasma y volume). Nine healthy men participated as subjects. Their age ranged from 32 +/- 3 years old, and 16 +/- 4% body fat (X +/- SD). After 10-12 hours post absorptive and appropriate rest, they performed a standard orthostatic maneuver: subjects remained supine for 30 minutes, then assumed the standing position (unsupported and with minimal movement) for additional 30 minutes. Blood samples were obtained after 30 minutes supine and at 10, 20 and 30 minutes of standing. At 10 minutes of orthostatism, CT, TG, HDL and VLDL had a significant increase as compared to supine values; these changes were associated with a reduction of 8.9% on plasma volume (PV) (p less than 0.05). After 30 minutes of orthostatism CT, TG, HDL and VLDL showed increments of 8.5%, 33.3%, 20.1% and 32% respectively, in relation to the supine values (p less than 0.05). Changes on serum lipids were associated with PV reductions until 20 minutes of orthostatism. However, there was not a significant association between these variables at 30 minutes of standing. These data indicated that the body position and the time in which blood samples are obtained significantly influence lipid and lipoprotein serum level. Therefore, in any study related to lipids, such variables should be considered and properly controlled.

[Effects of an aerobic exercise program and diet on body composition and cardiovascular function in obese persons]. / Efectos de un programa de ejercicio aeróbico y dieta sobre la composición corporal y función cardiovascular en obesos.

The purpose of this study was to determine the effect of a combination of aerobic exercise and hypocaloric diet on body composition, cardiovascular function and some cardiovascular risk factors in obese patients. Ten subjects, (8 women 2 men X age 30 years and 138% of ideal body weight) volunteered as participants. The program lasted 12 weeks and consisted of a hypocaloric diet (1257 kcal/day) and 3-5 days/week supervised sessions of aerobic exercise (65-90% maximal heart rate and/or 50-80% of maximal oxygen uptake). The program resulted in a significant mean decrease in body weight of 7.7 kg. for the group (P less than or equal to 0.05). Mean (+/- EE) relative body fat significantly decreased from 35.9 +/- 2 to 31.6 +/- 2%. Interestingly, the decrease in relative body fat was solely accounted for by a significant decrease in fat weight, as body free of fat remained constant. Cardiovascular function as evidenced by oxygen uptake, increased 11.3%. Resting systolic and diastolic blood pressure fell significantly from 131/90 +/- 8/9 to 115/76 +/- 2/1 mmHg. Total cholesterol significantly dropped from a mean value of 247 +/- 24 to 183 +/- 20 mg/100 ml (P less than 0.05). Triglycerides significantly decreased from 212 +/- 32 to 45 +/- 10 mg/100 ml (P less than 0.05). It was concluded that a combination of aerobic exercise and hypocaloric diet can favorably improve body composition, cardiovascular function and cardiovascular risk factors.