Effect of packaging thickness and muscle type on ultrasound-assisted beef quality.

High-intensity ultrasound (HIU) can modify muscle structure, leading to improvements in tenderness. However, factors such as packing type and muscle complexity may attenuate the acoustic cavitation. In this research, the effect of packing thickness (40.6-70 µm) on the quality of bovine Gluteus medius and Biceps femoris treated with HIU (37 kHz, 90 W/cm2, 40 min) was evaluated. The hardness of G. medius decreased significantly as the thickness of the packing bag decreased. The wide interfibrillar and intermyofibrillar spaces corroborated the tenderizing effect. These effects are related to damage of cell structure and changes in the collagen content (3.37 ± 0.1 µg/mL). In addition, the HIU decrease the variability in the water holding capacity of the muscle produced by the use of low thickness bags during storage. The trained sensory panel described the sonicated samples in 50.8 µm bags as less hard and juicier. Contrarily, in B. femoris no significant effects were reported in the variables evaluated. B. femoris is a white muscle, with a high amount of collagen (3.59 ± 0.1 µg/mL) and little intramuscular fat. Consequently, the effect of the HIU on muscle quality is associated with the composition of the muscle fibers and the thickness of the packing bag. HIU application is recommended to improve the quality of leg muscles whenever low-thickness bags (50.8 µm or less) are used.

Chronic follicular pancreatitis: a space occupying lesion with spontaneous resolution.

Follicular pancreatitis (FP) is an extremely odd entity characterized by the presence of a pseudotumor that histologically presents lymphoid aggregates and germinal centers. The authors present the case of a 67-year-old woman with epigastric pain and jaundice. Endoscopic ultrasonography (EUS) was performed, revealing a 14x15 mm hypoechoic area with irregular edges in the head of the pancreas. The in situ cytological study showed polymorphic lymphoid cellularity, without atypia suggesting neoplasia. The cell block and the immunohistochemical study showed a polyclonal population with a pattern suggestive of FP. The patient presented spontaneous clinical improvement. The EUS follow up three months later shown pancreatic parenchyma with homogeneous echogenicity and no space occupying lesions were indentified. Since the diagnosis of FP has been reached after surgery in most cases, the treatment is not well established. However, no recurrences have been reported after surgery and spontaneous resolution has been observed in incomplete resections, which suggests the indication for conservative management. Diagnostic EUS has a fundamental role in the differential diagnosis between FP and pancreatic neoplasms, two entities with very different prognosis, and makes it possible to avoid, in the case of FP, unnecessary surgeries with the associated morbidity and mortality.

Multicriteria analysis of critical areas for restoration in a semiarid landscape: A comparison between stakeholder groups.

In landscape-scale ecological restoration, there is an urgent need to develop participatory systematic planning strategies and prioritization schemes that are operational under current technical and legal constraints. Different stakeholder groups may differ in their choice of criteria to define critical areas for restoration. Analyzing the correspondence between stakeholder characteristics and their expressed preferences is key to understand their values and facilitate consensus among the different groups. We analyzed the participatory identification of critical areas for restoration in a Mediterranean semiarid landscape of southeastern Spain by means of two Spatial Multicriteria Analyses. The first one included 33 ecological and socioeconomic prioritization criteria. The second included 24 ecosystem services. Prioritization criteria and services and their weights were based on the preferences of 46 stakeholders. We distinguished three stakeholder groups, according to their approach to ecological restoration. Stakeholders showed similarities regarding the most important criteria and services assessed. Yet, we found contrasted opinions between the group labeled as Biodiversity, who showed preference for Regulating Services and Ecosystem Functions, and the two groups labeled as Environment, and Agriculture & other occupations who assigned the highest importance to Provisioning and Cultural Services, along with highly Anthropized Environments. Maps integrating criteria and services weighted by the different groups of stakeholders were largely coincident, because of their overall agreement and the high number of criteria and services included in the analysis. Our approach allowed the identification of consensual critical areas for restoration, which were mainly covered by shrublands and rainfed crops, and mostly characterized by low to medium supply of ecosystem services. Our study emphasizes the need to recognize and integrate different social perspectives when identifying critical areas for restoration and highlights the importance of using complementary approaches as decision-making support tools to define these areas.

Jejunal varix with a high transfusion requirement: therapy with cyanoacrylate with radiological control by double-balloon enteroscopy.

A jejunal varix with high transfusion requirement is treated by double-balloon enteroscopy with cyanoacrylate/ lipiodol with radiological control. The patient had not gastrointestinal hemorrhage or transfusion requeriment after 8 months follow up. Our recent previous article in Rev Esp Enferm Dig on advanced therapeutics by enteroscopy is referenced, providing this new therapeutic possibility.

Fibre-Wood Laminate Biocomposites: Seawater Immersion Effects on Flexural and Low Energy Impact Properties.

The present paper explores a new concept of a hybrid eco-composite by substituting the natural fibre plies with thin wood veneers. The new composite, named Fibre-Wood Laminate (FWL), is inspired by fibre-metal laminate materials. The studied FWL configuration consisted of a single thin pinewood veneer at each of the outer layers of a flax woven fabric reinforced bio-epoxy composite manufactured by infusion. Three-point bending results showed that wood veneer gives a highly anisotropic nature to the FWL. In the best case, with the grain of the wood at 0°, the stiffness and the strength increased by 28 and 41%, respectively, but reduced the strain-at-break by 27% compared to the flax fibre reinforced bio-epoxy (FFRB). The penetration and perforation energy thresholds and the peak force of the FWL obtained by falling weight impact tests were 32, 29, and 31% lower than those of the FFRB, respectively. This weakening was due to using single wood veneers, so the challenge for improving impact properties will be to explore thicker FWLs with different stacking sequences and orientations. The effect of immersing the FWL in seawater also showed considerable differences. The epoxy matrix filled the cellular structure of the wood veneers, creating a barrier effect and reducing the amount of water absorbed by the flax fibres.

Evaluation of the Anti-Müllerian Hormone and its Association with Embryo Quality in Advanced Reproductive Treatments in a Latin American Population.

OBJECTIVE: Serum anti-Müllerian hormone (AMH) presents a strong positive correlation with quantitative aspects of the ovarian reserve, while its correlation with embryo quality is unclear. This study assessed the association between serum AMH as a marker of ovarian reserve and embryo quality, in women undergoing in vitro fertilization. METHODS: This observational analytical retrospective study included patients seen between 2010 and 2018. In vitro fertilization patients with measured AMH levels were analyzed based on the following parameters: number of retrieved oocytes; number of metaphase II oocytes; embryo quality; and treatment outcome. Statistical analysis was performed using ANOVA, Mann-Whitney U test, linear regression, and Pearson and Spearman correlations. RESULTS: We found a positive correlation between AMH levels, number of retrieved oocytes and number of metaphase II oocytes (r 0.649, p=0.000). The numbers of retrieved and metaphase II oocytes were predicted in 42% (R2: 429) of the cases based on AMH levels (p=0.000). Serum AMH levels were not associated with embryo quality on Day 3 (p=0.151); an association was seen between AMH levels and embryo quality on Day 5 (p=0.006). The distribution of AMH levels was the same across patients, regardless of whether they were able to achieve pregnancy (p=0.767). CONCLUSIONS: AMH levels correlated with embryo quality on Day 5; no association was found between AMH levels and embryo quality on Day 3 or pregnancy rate. The use of AMH levels to predict embryo quality still requires further studies; therefore, AMH should be used to assess the ovarian reserve only.

Vertical transmission: evidence of COVID-19 in a twin pregnancy.

This article reports the case of a 28-year-old female 31.6 weeks pregnant with twins diagnosed with SARS-CoV-2 infection, who delivered a boy and a girl. The newborns underwent RT-PCR testing for SARS-CoV-2; the male tested negative and the female newborn tested positive, in that the female placenta was SARS-CoV-2 positive and the male placenta negative. Clinical and laboratory findings evincing vertical transmission of SARS-CoV-2 were identified. Strict, multidisciplinary prenatal care is recommended for this group of patients. This case report alone does not provide statistical evidence of vertical transmission, but it is an account of a relevant matter.

Surgical approach to uterine myomatosis in patients with infertility: open, laparoscopic, and robotic surgery; results according to the quantity of fibroids.

OBJECTIVE: To compare approaches to myomectomy (laparotomic, laparoscopic, and robotic). To show the relationship between the number of fibroids and the reproduction diagnosis. METHODS: Observational, analytical, retrospective, and cross-sectional study; where the surgical approach used, was evaluated in terms of surgical bleeding, time, number and weight of fibroids and reproductive results. RESULTS: 69 patients were treated through different approaches and divided into 3 groups. The differences found among groups were in favor of laparotomic myomectomy in terms of the number (p=0.000) and weight of fibroids (p=0.004). Robotic surgery was also longer (p=0.000). In the analysis of the influence of the number of fibroids to achieve pregnancy, the result was in favor of the minimally invasive routes, after surgery, both in the group of < 6 fibroids (p=0.017), and that of > 6 fibroids (p=0.001), without differences in the time from surgery to pregnancy (p=0.979). CONCLUSIONS: The surgical approach decision should consider the number and size of resected fibroids, surgical time, and reproductive diagnosis. The minimally invasive route should be offered whenever possible due to its better outcome on achieving pregnancy, without forgetting the benefits of laparotomy, while also accrediting the recently introduced robotic-assisted approach.

Serum estradiol level on the day of trigger as a predictor of number of metaphase II oocytes from IVF antagonist cycles and subsequent impact on pregnancy rates.

OBJECTIVE: This study aimed to examine the association between serum estradiol levels and number of metaphase II oocytes harvested after in vitro fertilization cycles used in embryo transfers and the subsequent impact on pregnancy rates. METHODS: This observational analytical retrospective study was carried out in 2010-2018 at the Angeles del Pedregal Hospital. It included 181 cases and looked into the number of metaphase II oocytes to predict pregnancy rates. Statistical analysis was based on the calculation of correlations between variables and logistic regressions. RESULTS: Estradiol levels increased with the number of oocytes by a median correlation (r=0.482, p=0.000). On the day of trigger, estradiol levels predicted the number of retrieved oocytes with 23% reliability (R2=0.232, p=0.000); a linear trend correlation of r=0.489, p=0.000 was found between estradiol levels on the day of trigger and number of metaphase II oocytes. CONCLUSIONS: Serum estradiol on the day of trigger as a predictor of metaphase II oocytes in antagonist cycles encourages greater oocyte maturity and fertilization, whereas, in isolation, it does not determine the pregnancy achievement.

Prevalencia de hormona antimülleriana en mujeres latinas atendidas en un centro de fertilidad en México / Antimüllerian hormone prevalence in Latin women treated at a fertility center in Mexico

Resumen Antecedentes: La hormona antimüllleriana (HAM) ha sido utilizada como marcador de reserva ovárica, lo cual ayuda a predecir el éxito. Se desconoce si valores de otros países son apicables a México. Objetivo: Determinar los valores de HAM en nuestra población para graficarlas acorde a grupos de edad y evaluar su comportamiento. Metodología: Estudio observacional, descriptivo, retrospectivo y transversal de pacientes del 2008 al 2018, con reporte de nivel de HAM excluyendo a pacientes con enfermedades que alteran su nivel, analizando por grupos de edad en un laboratorio. Resultados: 450 pacientes de 36.93 años, el rango del valor de la HAM fue desde 0.003 ng/ml hasta 9.4 ng/ml, con una media de 1.5, con una disminución anual a partir de los 40 años (0.1-0.3). Correlación de Spearman de -436 (p < 0.000) con una asociación leve entre la edad y el nivel de HAM, pero sí lineal (p < 0.000). Conclusiones: La HAM es útil y sirve para dar recomendaciones personalizadas, así como base de estudios epidemiológicos en pro de una medicina individualizada.

Abstract Background: Antimüllerian hormone (AMH) has been used as a marker of ovarian reserve, which helps predict success. It is unknown if values from other countries are applicable to Mexico. Objective: To determine the AMH values in our population to graph them according to age groups and evaluate their behavior. Methodology: Observational, descriptive, retrospective, and cross-sectional study of patients from 2008 to 2018, with a AMH level report excluding patients with diseases that alter their level, analyzing by age groups in a laboratory. Results: 450 patients of 36.93 years old, the range of the AMH value was from 0.003 ng/ml to 9.4 ng/ml, with a mean of 1.5, with an annual decrease from 40 years of age (0.1-0.3). Spearman's correlation of -436 (p < 0.000) with a slight association between age and AMH level, but it was linear (p < 0.000). Conclusions: AMH is useful and serves to give personalized recommendations, as well as basis of epidemiological studies in favor of an individualized medicine.

A Retrospective Nationwide Non-Interventional Study of an Aqueous Sublingual Immunotherapy Formulation Administered with a 200-µL Dosing Pump.

BACKGROUND: Convenient dosing is a key component of treatment adherence and thus efficacy and safety. Aqueous sublingual immunotherapy (SLIT) formulations can be administered with a dosing pump that delivers 200 µL of volume per actuation. OBJECTIVE: The objective of this study was to describe the use of Staloral® 300 Rapid in its new dosing pump presentation and to evaluate the safety and satisfaction from both the patient and doctor. PATIENTS AND METHODS: We performed a retrospective non-interventional study in a population (aged 5 years or over) of individuals with allergic rhinitis or allergic asthma who were being treated with aqueous 300 index of reactivity SLIT formulations of various allergens (grass pollen, tree pollen, house dust mites). Based on a detailed, SLIT-specific, patient self-questionnaire (Quartis®) and the inspection of medical records, we assessed the characteristics of the SLIT, safety, patient satisfaction and willingness to continue SLIT. The physician's satisfaction with the treatment was measured on a 0-100 visual analogue scale. Adverse events were coded with the Medical Dictionary for Regulatory Activities. RESULTS: A total of 801 valid patients were included (52.4% male; mean ± standard deviation age: 25.9 ± 17.2 years; mean time since diagnosis: 4.56 ± 4.68 years; mean time using the previous dosing pump: 19.2 ± 13.0 months; time using the 200-µL dosing pump: 14.95 ± 3.80 months). Among the study population, 317 subjects comprised the paediatric subgroup (57%: male; mean age: 9.8 ± 2.5 years). Overall, 54 patients (6.7%) reported a total of 68 adverse events (including 51 gastrointestinal adverse events). The large majority of adverse events were mild, local and transient and did not require treatment. There were no severe adverse events. The level of patient satisfaction with the ease of SLIT administration was high (84.3% overall, and 82.6% in the paediatric subgroup). The mean ± standard deviation visual analogue scale score for physician satisfaction with the treatment was 70.6 ± 25.1 out of 100. CONCLUSIONS: Administration of 300 index of reactivity SLIT with a 200-µL dosing pump is safe, well tolerated and associated with good levels of patient satisfaction.

Factores de riesgo cardiovascular y renal, y perfil socioeconómico en individuos de la etnia wichi de "el impenetrable", chaco, argentina / Cardiovascular and renal risk factors and socioeconomics profile in individuals of the wichi ethnia group from "el impenetrable", chaco, argentina

Resumen Introducción: Varios estudios han demostrado en poblaciones indígenas alta prevalencia de obesidad, diabetes mellitus, hipertensión arterial, proteinuria y enfermedad renal crónica. Objetivo: Detectar factores de riesgo cardiovascular y renal, hipertensión arterial, sobrepeso y obesidad, obesidad central, diabetes y proteinuria, y evaluar nivel educativo, situación laboral, nivel socioeconómico y cobertura de salud en sujetos de la etnia wichi, habitantes de "El Impenetrable" chaqueño. Material y métodos: Se realizó un estudio descriptivo observacional, de corte transversal, con muestra aleatoria de sujetos mayores de 18 años. La encuesta semiestructurada, y traducida a lengua wichi, incluyó: edad, sexo, sedentarismo, tabaquismo, nivel educativo, situación laboral, cobertura de salud y nivel socioeconómico. Se midió peso, talla, circunferencia de cintura, presión arterial sistólica y diastólica, glucemia y proteinuria. Se calculó el índice de masa corporal. Resultados: Se evaluaron 156 personas (el 58,3% varones, edad 34 ± 12 años). El índice de masa corporal fue de 27,9 ± 5,3, sin diferencia entre sexos. Presentó hipertensión arterial el 10,8%, sobrepeso el 34,0%, obesidad el 30,9%, obesidad central el 40,1% (mayor en mujeres, p= 0,03), tabaquismo el 17,4%, sedentarismo el 83,3%, y proteinuria el 14,5%. Se registró un único caso de diabetes. Solo 6,4% refirió trabajar, el 49,3% no había finalizado estudios primarios, el 61,7% calificó como marginal en el nivel socioeconómico, y solo el 3,8% tenía cobertura de salud. Conclusión: Este grupo poblacional evidencia un alto grado de vulnerabilidad alimentaria, educativa, laboral, social y sanitaria, reflejado en la alta prevalencia de factores de riesgo cardiovascular y renal (en particular exceso de peso y obesidad central), en el bajo nivel educativo, laboral y socioeconómico, y en la falta de cobertura de salud.

Abstract Introduction: Several studies have shown a high prevalence of obesity, diabetes mellitus, hypertension, proteinuria and chronic kidney disease in indigenous populations. Aim: To detect cardiovascular and renal risk factors, hypertension, overweight and obesity, truncal obesity, diabetes and proteinuria, and to evaluate educational level, employment situation, socioeconomic level and health care coverage in subjects from the Wichi ethnic group who inhabit in "El Impenetrable" in Chaco. Methods: An observational, descriptive, cross-sectional study was carried out, with a random sample of subjects over 18 years of age. The semi-structured survey, translated into the Wichi language, included: age, sex, sedentary lifestyle, smoking habit, educational level, employment situation, health care coverage and socioeconomic level. Weight, height, waist circumference, systolic and diastolic blood pressure, blood glucose and proteinuria were measured. Body mass index was calculated. Results: 156 people were evaluated (58.3% men; age: 34 ± 12 years). The body mass index was 27.9 ± 5.3, with no difference between the sexes. Hypertension was present in 10.8% of individuals; overweight in 34.0%; obesity in 30.9%; truncal obesity in 40.1% (higher in women, p = 0.03); smoking habit in 17.4%; sedentary lifestyle in 83.3%, and proteinuria in 14.5%. A single case of diabetes was registered. Only 6.4% reported having a job, 49.3% had not completed primary studies, 61.7% qualified as marginal in terms of socioeconomic status, and only 3.8% had health care coverage. Conclusion: This population group shows a high degree of food, educational, occupational, social and health vulnerability, reflected in the high prevalence of cardiovascular and renal risk factors (particularly excess weight and truncal obesity), in the low educational, employment and socioeconomic levels, and in the lack of health coverage.

Linkage between Fluorescence and Electrochemical Properties of Imidazolium Compounds in Acetonitrile Solution.

The fluorescence properties of some imidazolium derivatives are relevant in photosensing and therefore, the structural analysis of them is a key point for its rational design, which would be useful to prepare new systems with novel applications. Herein we report a multidisciplinary study of the fluorescence and voltammetric properties of three imidazolium compounds {1,3-bis[(R,R)-1'-chloro-1'-phenylpropan-2'-yl]-imidazolium chloride (1), 1,3-bis[(Z)-1'-phenylprop-1'-en-2'-yl]imidazolium chloride (2) 1,3-bis[(R)-1'-chlorobutan-2'-yl]-imidazolium chloride (3)}. Electronic structure calculations and Bader analyses were used to correlate both fluorescence and the capability of the molecules to be reduced through a heterogeneous electron transfer process. Both properties are strongly dependent on the proton in position two of the imidazolium ring, where the electron transfer as well as the excitation of the electrons are carried out. The reactivity in this position is controlled by the N-substituents on the imidazolium ring and is due to single contacts H⋅⋅⋅Cl- , tricentric contacts Cl⋅⋅⋅Cl- ⋅⋅⋅Cl, π-electronic delocalization and π-stacking interactions.

High-intensity ultrasound applied on cured pork: Sensory and physicochemical characteristics.

This research aimed to evaluate the physicochemical characteristics and their relationship with sensory properties of cured porcine m. longissimus lumborum assisted by high-intensity ultrasound (HIU, 37 kHz, 22 Wcm-2). An experiment was designed with three factors at two levels each: type of curing (immersion or ultrasound-assisted -UA-), immersion time (30 or 90 min), and steak thickness (1.27 or 2.54 cm). After treatment and 7 days of storage at 4°C, the percentage of salt, pH, CIE L* a* b* color, water holding capacity (WHC), and shear force were determined in the samples. A quantitative descriptive analysis was performed using eight trained panelists. The HIU significantly increased the percentage of NaCl (p < .0005) and decreased the color saturation of the meat (p < .05), but did not affect the luminosity, redness (a*), yellowness (b*), pH, WHC, or shear force (all p > .05). The thickness of the steak had significant effects on almost all of the evaluated variables. Samples with 1.27 cm thickness had lower shear force, higher WHC and salt percentage (p < .0001). In agreement with this, the sensory profiles showed that the 1.27 cm samples treated with HIU for 30 min were perceived as less tough (more tender) and juicier.

Renal length and volume prediction in healthy children.

INTRODUCTION: Little information is available regarding the evaluation of renal volume in healthy Latin-American children of different ages. The objective of this work was to establish a predictive model of renal size (volume and length) and develop a web-based calculator. MATERIALS AND METHODS: A selective and representative sample was obtained randomly from the database of healthy children living in Resistencia city, Chaco, Argentina: a) the National Health Program for children under 6 years old; b) school children until 18 years old (primary and middle education). Renal dimensions were obtained by ultrasonography via a single experienced operator at the indicated site (schools or primary health care centers). Renal volume was calculated using Dinkel's formula. A multiple linear regression model was applied using potential predictors. The final model was implemented in a free web-based application. RESULTS: Random selection was made from the database to include 882 subjects with ages between 0.03 and 230.63 months. The data was divided into two sets (one for training and the other for model testing). The training set (423) included 212 (50%) females. Significant predictors included age, height, current weight and birth weight, and the interaction between age and present weight. Using the test dataset, both renal volume and length root mean square errors were 5.06 cm3 and 0.59 cm. CONCLUSION: The prediction model was accurate and allowed for the development a freely-available web app: Renal size prediction (https://porbm28.shinyapps.io/RenalVolume/). Once the models are validated by additional studies, the app could be a useful tool to predict renal volume and length in pediatric clinical practice.

Evaluación de la calidad en el desempeño de la Clínica de Colposcopia del Hospital Militar de Especialidades de la Mujer y Neonatología / Evaluation of quality in the performance of the Colposcopy Clinic of the Hospital Militar de Especialidades de la Mujer y Neonatología

Resumen OBJETIVO: Evaluar la calidad del desempeño de la Clínica de Colposcopia del Hospital Militar de Especialidades de la Mujer y Neonatología, mediante indicadores establecidos, en el periodo 2008-2014 versus 2015 después de la implementación de acciones de mejora. MATERIALES Y MÉTODOS: Estudio observacional, descriptivo, transversal y retrospectivo efectuado en el Hospital Militar de Especialidades de la Mujer y Neonatología en dos periodos (2008-2014 y 2015) en la clínica de Colposcopia. Para la selección de la muestra se utilizó un cálculo no probabilístico de conveniencia. Para el análisis de los datos se utilizó el mapa de ubicación MEDICSUS®. Los resultados se analizaron con el programa Microsoft Excel©; se utilizó estadística descriptiva. RESULTADOS: En el periodo 2008-2014 se analizaron 337 expedientes, con 22 indicadores de calidad, de los que 18 cumplieron en su totalidad. Para la comparación del periodo 2015 se evaluaron los 6 indicadores mínimos, enfocados en la valoración de lesiones de alto grado e invasoras, resultando en una calificación final de 88% mediante el mismo índice ("desempeño sobresaliente"). CONCLUSIONES: La medición de indicadores de calidad mejora el nivel de atención médica y refuerza las políticas de tratamiento en las instituciones de salud. Este tipo de estudios son decisivos para cumplir con las metas propuestas por las organizaciones de salud nacionales e internacionales.

Abstract OBJECTIVE: To evaluate the quality in the performance of the colposcopy clinic, of the "Hospital Militar de Especialidades de la Mujer y Neonatología" using quality indicators, through 2008-2014 and then comparing results with the year 2015. MATERIALS AND METHODOS: Descriptive, observational, cross-sectional retrospective study, held at the Hospital MiIitar de Especialidades de la Mujer y Neonatología in 2008-2014. Medical records of patients that had medical attention at the clinic were analyzed, using a non-probabilistic sample, without age limit and the MEDICSUS© methodology. The results will be analyzed with the Microsoft Excel© program; Be a descriptive statistic. RESULTS: In the 2008-2014 period, 337 files were analyzed, with 22 quality indicators, of which 18 were completed. For the comparison of the 2015 period, the 6 minimum indicators were evaluated, focused on the assessment of high-grade and invasive injuries, resulting in a final rating of 88% through the same index ("outstanding performance"). CONCLUSIONS: Measurement of quality indicators has improved the quality in medical care, and has improved institutional performance. These studies are key to meet the goals proposed by national and international health organizations.

Situación nutricional y factores de riesgo cardiovascular y renal en relación al peso al nacer. Factores de riesgo en Pediatría / Nutritional status and cardiovascular and renal risk factors related to birth weight in children from Gran Resistencia, Chaco, Argentina. Risk factors in Pediatrics

INTRODUCCIÓN: Se carece de datos sobre situación nutricional y factores de riesgo cardiovascular y renal en pediatría en la provincia del Chaco, una de las más pobres y con mayor población pediátrica de Argentina. OBJETIVO: Determinar la prevalencia de factores de riesgo nutricionales (bajo peso/talla, baja talla/edad, bajo peso y sobrepeso), factores de riesgo perinatales (edad materna y edad gestacional al nacimiento), cardiovasculares y renales (sobrepeso, hipertensión arterial y proteinuria), correlacionados con el peso al nacer, en población de un mes a 18 años del conglomerado urbano del Gran Resistencia, provincia del Chaco. MATERIAL Y MÉTODOS: Se realizó un estudio descriptivo observacional de corte transversal. Los participantes se seleccionaron por muestreo probabilístico por conglomerados según peso de la población en cada estrato, de escuelas para niños de 6 a 18 años y de centros de salud para menores de 6.RESULTADOS: Se estudiaron 850 niños. La prevalencia de factores de riesgo fue: 24% alto riesgo por edad materna; 21% nacidos pre-término; 7,2% bajo peso al nacer; 9,1% baja talla/edad; 4,2% bajo peso/talla; 11,8% alto peso/talla; 6,3% bajo peso/edad; 2,4% proteinuria; y 6,8% hipertensión arterial. En menores de 6 años con bajo peso al nacer comparados con nacidos con peso normal, la odd ratio para presentar bajo peso/talla fue de 6,15, y para bajo peso/edad de 5,02; para nacidos con alto peso comparados con nacidos con peso normal, la odd ratio para sobrepeso fue 3,07. CONCLUSIONES: La población pediátrica estudiada presenta una situación de alto riesgo nutricional que correlaciona con el peso al nacer. La prevalencia de proteinuria e hipertensión arterial no se asociaron al peso al nacer

INTRODUCTION: There is a lack of data on nutritional status and cardiovascular and renal risk factors in pediatrics in the province of Chaco, one of the poorest provinces and with the largest pediatric population in Argentina. OBJECTIVE: To determine the prevalence of these risk factors: nutritional (low weight/height, low height/age, low weight and overweight); perinatal (maternal age and gestational age at birth), as well as cardiovascular and renal (overweight, hypertension and proteinuria), correlated with birth weight, in population from one month old to 18 years old in the urban agglomeration of Gran Resistencia, province of Chaco. MATERIAL AND METHODS: An observational descriptive cross-sectional study was conducted. Participants were selected by probabilistic sampling through agglomerations according to population weight in each strata, taken from schools for 6-18 year-old children and from health centers for children under 6. RESULTS: A total of 850 children were studied. The prevalence of risk factors was: 24% with high risk for maternal age, 21% with preterm birth, 7.2% with low birth weight, 9.1% with low height/age, 4.2% with low weight/height, 11.8% with high weight/height, 6.3% with low weight/age, 2.4% with proteinuria and 6.8% with high blood pressure. In children under 6 years of age with low birth weight, compared to those with normal birth weight, the odd ratio for low weight/height was 6.15, and for low weight/age it was 5.02; for those born with a high weight compared to those born with normal weight, the odd ratio for overweight was 3.07. CONCLUSIONS: the pediatric population which was studied presents a situation of high nutritional risk that correlates with birth weight. The prevalence of proteinuria and high blood pressure were not associated with birth weight

Supervivencia a 5 años postratamiento de cáncer de mama: experiencia institucional / Breast cancer survival after 5 years of treatment: Institutional experience

Resumen OBJETIVO: Determinar la supervivencia a 5 años (global y libre de enfermedad) y su relación con las variables: recurrencia, etapa clínica, tipo y grado histológicos, tamaño del tumor, invasión ganglionar axilar e inmunohistoquímica. MATERIALES Y MÉTODOS: Estudio observacional, descriptivo y retrospectivo efec-tuado en pacientes con cáncer de mama atendidas en 2010 en el Hospital Militar de la Mujer, Ciudad de México, confirmado por histopatología. La supervivencia global y libre de enfermedad a cinco años se estableció a partir del tiempo trascurrido desde el diagnóstico hasta la ocurrencia de un evento (recidiva, metástasis o muerte) o fecha del último contacto, con límite a diciembre de 2015. RESULTADOS: Se analizaron 197 expedientes pero se descartaron 78: por repetición de casos (49), por falta de información (21), y debido a recurrencias de años previos (8). Los límites de edad fueron 30 y 84 años, con media de 56.2 años. Los casos en etapa temprana (hasta EC IIA) representaron 40%, la supervivencia global fue de 81% a 5 años. En las pacientes con recurrencias las probabilidades de supervivencia fue-ron de 51%; las pacientes en etapas avanzadas tuvieron menores probabilidades de supervivir. No fue posible demostrar asociación estadísticamente significativa entre el tamaño del tumor, tipo y grado histológico, inmunohistoquímica e invasión ganglionar y la supervivencia. CONCLUSIONES: El estudio demuestra que las pacientes en etapas avanzadas tienen menores probabilidades de supervivir, por lo que es imperativo que se continúen esfuer-zos en promoción de la salud hasta conseguir que la detección sea en etapas curables.

Abstract OBJECTIVE: To determine 5-year survival (global and disease-free) and its relationship with variables: recurrence, clinical stage, histological type and grade, tumoral size, axillary lymph node invasion and immunohistochemistry. MATERIALS AND METHODS: Observational, descriptive and retrospective study carried out in patients with breast cancer attended in 2010 at the Hospital Militar de la Mujer, in Mexico City, confirmed by histopathology. The overall survival and disease-free to five years has been established from the time elapsed since the diagnosis until the occurrence of an event (recurrence, metastasis or death) or date of the last contact, with a limit of December 2015. RESULTS: 197 records were analysed; however 78 were discarded either: by repetition of cases (49), due to lack of information (21) and due to recurrences from previous years (8). The age range were 30 and 84 years, with an average of 56.2 years. The cases in early stage (CS IIA) was 40%, and overall survival 81% at 5 years. In the patients with recurrences the probabilities of survival were 51%; and the patients in advanced stages were less likely to survive. It was not possible demonstrate of statistically significant association between tumoral size, type and histological grade, immunohistochemistry and lymph node invasion and survival. CONCLUSIONS: The study shows that patients in the update stages have less likely to survive, so it is imperative that efforts continue in health promotion until getting the detection in curable stages.

Material Flow Analysis in Indentation by Two-Dimensional Digital Image Correlation and Finite Elements Method.

The present work shows the material flow analysis in indentation by the numerical two dimensional Finite Elements (FEM) method and the experimental two-dimensional Digital Image Correlation (DIC) method. To achieve deep indentation without cracking, a ductile material, 99% tin, is used. The results obtained from the DIC technique depend predominantly on the pattern conferred to the samples. Due to the absence of a natural pattern, black and white spray painting is used for greater contrast. The stress-strain curve of the material has been obtained and introduced in the Finite Element simulation code used, DEFORM™, allowing for accurate simulations. Two different 2D models have been used: a plain strain model to obtain the load curve and a plain stress model to evaluate the strain maps on the workpiece surface. The indentation displacement load curve has been compared between the FEM and the experimental results, showing a good correlation. Additionally, the strain maps obtained from the material surface with FEM and DIC are compared in order to validate the numerical model. The Von Mises strain results between both of them present a 10-20% difference. The results show that FEM is a good tool for simulating indentation processes, allowing for the evaluation of the maximum forces and deformations involved in the forming process. Additionally, the non-contact DIC technique shows its potential by measuring the superficial strain maps, validating the FEM results.