Core content for venous and Lymphatic Medicine: 2022 revision.

The core content for a medical specialty outlines the scope of the discipline as well as the categories of knowledge considered essential to practice in the field. It provides a template for the development of curricula for medical school, graduate, and postgraduate education, as well as for creating certification standards. Venous and Lymphatic Medicine (VLM) is a specialty that has benefitted from contributions from specialists from several medical disciplines. Optimally, the societies, boards, and residency review committees representing these disciplines would uniformly recognize the scope of VLM to develop education and assessment standards to allow training and identification of qualified practitioners. In order to inform the standard setting bodies and other stakeholders of the current scope of VLM, a task force of VLM experts from cardiology, dermatology, emergency medicine, general surgery, interventional radiology, vascular medicine, and vascular surgery was formed to revise a 2014 consensus document defining the core content of the specialty of VLM.

A new technique in the treatment of intestinal malrotation. / Una nueva técnica en el tratamiento de la malrotación intestinal.

INTRODUCTION: Intestinal malrotation is a congenital pathology with potentially catastrophic complications, such as volvulus, whose treatment has barely not changed in nearly 100 years (Ladd's procedure). Dr. Abu-Elmagd recently described a new technique that was applied in one of our patients. CLINICAL CASE: 12-year-old boy who had undergone Ladd's procedure as a result of intestinal volvulus secondary to malrotation when he was 2 days old. He had subocclusion and eventually obstruction, with intestinal volvulus compatible imaging. Intraoperative findings: duodenal subocclusion, volvulus and lymphangiectasias. Kareem's procedure: bowel positioning in normal rotation, duodenopexy (duodenal C posterior to the mesenteric vessels), formation of neo-Treitz, and fixation of the cecum, the ascending colon, and the mesenteric root. The patient was discharged on postoperative day 6 and remains asymptomatic after 1 year of follow-up. DISCUSSION: Kareem's procedure is a safe and effective malrotation repair technique. It can replace Ladd's procedure as it reduces the risk of re-volvulation and improves digestive symptoms.

INTRODUCCION: La malrotación intestinal es una patología congénita con complicaciones potencialmente catastróficas, destacando el vólvulo, cuyo tratamiento no ha variado significativamente en casi 100 años (procedimiento de Ladd). Recientemente el Dr. Abu-Elmagd describió una técnica que hemos aplicado en un paciente. CASO CLINICO: Varón de 12 años, intervenido con 2 días de vida por vólvulo intestinal secundario a malrotación realizándose procedimiento de Ladd. Presenta cuadros suboclusivos y finalmente obstructivo con imágenes compatibles con vólvulo intestinal. Hallazgos intraoperatorios: suboclusión duodenal, vólvulo y linfangiectasias. Procedimiento de Kareem: posicionando intestino en normorotación, duodenopexia (C duodenal posterior a vasos mesentéricos), formación de neoTreitz, fijación de ciego, colon ascendente y raíz mesentérica. Alta hospitalaria al 6º día postoperatorio, asintomático en 1 año de seguimiento. COMENTARIOS: El procedimiento de Kareem es una técnica segura y efectiva que corrige la malrotación, pudiendo reemplazar al procedimiento de Ladd al disminuir el riesgo de revolvulación y mejorar síntomas digestivos.

Una nueva técnica en el tratamiento de la malrotación intestinal / A new technique in the treatment of intestinal malrotation

Introducción: La malrotación intestinal es una patología congénitacon complicaciones potencialmente catastróficas, destacando el vólvulo,cuyo tratamiento no ha variado significativamente en casi 100 años(procedimiento de Ladd). Recientemente el Dr Abu-Elmagd describióuna técnica que hemos aplicado en un paciente.Caso clínico: Varón de 12 años, intervenido con 2 días de vidapor vólvulo intestinal secundario a malrotación realizándose procedimiento de Ladd. Presenta cuadros suboclusivos y finalmente obstructivo con imágenes compatibles con vólvulo intestinal. Hallazgosintraoperatorios: suboclusión duodenal, vólvulo y linfangiectasias.Procedimiento de Kareem: posicionando intestino en normorotación,duodenopexia (C duodenal posterior a vasos mesentéricos), formaciónde neoTreitz, fijación de ciego, colon ascendente y raíz mesentérica.Alta hospitalaria al 6º día postoperatorio, asintomático en 1 año deseguimiento. Comentarios: El procedimiento de Kareem es una técnica seguray efectiva que corrige la malrotación, pudiendo reemplazar al procedimiento de Ladd al disminuir el riesgo de revolvulación y mejorarsíntomas digestivos.(AU)

Introduction: Intestinal malrotation is a congenital pathology withpotentially catastrophic complications, such as volvulus, whose treatment has barely not changed in nearly 100 years (Ladd’s procedure). Dr. Abu-Elmagd recently described a new technique that was appliedin one of our patients. Clinical case. 12-year-old boy who had undergone Ladd’s procedure as a result of intestinal volvulus secondary to malrotation when hewas 2 days old. He had subocclusion and eventually obstruction, withintestinal volvulus compatible imaging. Intraoperative findings: duodenalsubocclusion, volvulus and lymphangiectasias. Kareem’s procedure:bowel positioning in normal rotation, duodenopexy (duodenal C posterior to the mesenteric vessels), formation of neo-Treitz, and fixationof the cecum, the ascending colon, and the mesenteric root. The patientwas discharged on postoperative day 6 and remains asymptomatic after1 year of follow-up. Discussion: Kareem’s procedure is a safe and effective malrotationrepair technique. It can replace Ladd’s procedure as it reduces the riskof re-volvulation and improves digestive symptoms.(AU)

Impact of the COVID-19 pandemic on the mental health of the general population and health care workers.

The Health Sciences Foundation has assembled a multidisciplinary group around a series of questions about the impact of the COVID-19 pandemic on the mental health of the general population and specific groups within that population, particularly healthcare workers. In the general population, the most prevalent mental disorders have been anxiety, sleep disorders and affective disorders, primarily depression. There has been a considerable increase in suicidal behavior, especially in young women and men over 70 years of age. There has been an increase in alcohol abuse and nicotine, cannabis and cocaine use. In contrast, the use of synthetic stimulants during periods of confinement has decreased. With regard to non-substance addictions, gambling was very limited, pornography consumption increased significantly and there was an increase in compulsive shopping and the use of video games. Particularly vulnerable groups include adolescents and patients with autism spectrum disorders. Healthcare workers suffered an increase in depression, anxiety and post-traumatic stress, especially those who were exposed during the early stages of the pandemic. Female sex, being a nurse, proximity to patients with COVID-19, working in a rural environment and having previous psychiatric or organic illnesses were some of the most frequently repeated factors in various studies in this population group. The media have shown a good degree of knowledge about these problems and have dealt with them frequently and from the point of view of ethics, crisis situations, such as the one experienced, have triggered not only physical but also moral claudications.

Prevalence of pulmonary hypertension in COPD patients living at high altitude.

BACKGROUND: Pulmonary hypertension (PH) is associated with poor prognosis for patients with chronic obstructive pulmonary disease (COPD). Most of the knowledge about PH in COPD has been generated at sea level, with limited information associated with high altitude (HA). OBJECTIVES: To assess the prevalence and severity of PH in COPD patients living in a HA city (2,640 m). METHODS: Cross-sectional study in COPD patients with forced expiratory volume in the first second / forced vital capacity ratio (FEV1/FVC) post-bronchodilator <0,7. Transthoracic echocardiography (TTE), spirometry, carbon monoxide diffusing capacity, and arterial blood gasses tests were performed. Patients were classified according to the severity of airflow limitation. PH was defined by TTE as an estimated systolic pulmonary artery pressure (sPAP) > 36 mmHg or indirect PH signs; severe PH as sPAP > 60 mmHg; and disproportionate PH as an sPAP > 60 mmHg with non-severe airflow limitation (FEV1 > 50% predicted). RESULTS: We included 176 COPD patients. The overall estimated prevalence of PH was 56.3% and the likelihood of having PH increased according to airflow-limitation severity: mild (31.6%), moderate (54.9%), severe (59.6%) and very severe (77.8%) (p = 0.038). The PH was severe in 7.3% and disproportionate in 3.4% of patients. CONCLUSIONS: The estimated prevalence of PH in patients with COPD at HA is high, particularly in patients with mild to moderate airflow limitation, and greater than that described for COPD patients at low altitude. These results suggest a higher risk of developing PH for COPD patients living at HA compared to COPD patients with similar airflow limitation living at low altitude.

The influence of body composition on the six-minute walk test in Chilean preschool and school children / Influencia de la composición corporal en el test de la caminata de seis minutos en preescolares y escolares chilenos

Background: the six minutes' walk test (6MWT) measures submaximal physical activity. Objective: this study determines the association of children´s nutritional status and body composition with the results of the 6MWT. Methods: a sample of 1419 Chilean children, 4 to 10 years of age, were assessed including anthropometry, body composition by validated equations, the 6MWT test, and in 50 % of the sample heart rate prior the test, at one minute into the test, and at one minute posttest with a Polar watch. Results: the distance walked ranged from 473.1 ± 47.8 meters in preschool children to 584.2 ± 65.7 meters in school children. In heart rate there was a significant difference between obese and eutrophic children. The distance walked in the 6MWT was positively associated with fat-free mass (p < 0.05) and BMI (R2 = 0.49). Body composition influences 6MWT quartile distribution, as well as nutritional status. Age and height explained 49 % of the variance (R2 = 0.42 and 0.47, respectively) in the 6MWT, and there are significant differences in this variable by sex, body composition, and nutritional status. Conclusions: body composition was associated with walking performance in children. Thus, it is important to evaluate height and body composition when assessing the six-minute walk test because of this important relationship (AU)

Introducción: el test de la marcha de seis minutos (TM6M) mide una actividad física submáxima. Este estudio evaluó el efecto del test de la marcha sobre la composición corporal y el estado nutricional en niños. Métodos: en una muestra de 1419 niños chilenos de 4 a 10 años de edad se evaluaron la antropometría, la composición corporal por ecuaciones validadas, el TM6M y, en el 50 % de la muesta, la frecuencia cardíaca mediante un reloj Polar. Resultados: la distancia caminada varió desde 473,1 ± 47,8 metros en los niños preescolares hasta 584,2 ± 65,7 metros en los escolares. En la frecuencia cardíaca hubo una diferencia significativa entre niños obesos y eutróficos. La distancia caminada se asoció positivamente con la masa libre de grasa (R2 = 0,37) y el IMC (R2 = 0,49). Por otra parte, la composición corporal varía en función de los cuartiles de composición corporal y el estado nutricional. La edad y la altura explicaron el 49 % de la varianza de la prueba (R2 = 0,42 and 0,47, respectivamente). Existen diferencias significativas en la distancia recorrida en el TM6M en función del sexo, la composición corporal y el estado nutricional. Conclusiones: composición corporal, talla e IMC se asociaron a la distancia recorrida en el TM6M. Por tanto, se sugiere medir estas variables cuando se evalúe el test de marcha de seis minutos (AU)

Determination of ultra-low concentrations of gaseous 14C-bearing hydrocarbons produced during corrosion of irradiated steel using accelerator mass spectrometry.

Compound-specific radiocarbon analysis (CSRA) was developed to identify and quantify gaseous 14C-bearing carbon compounds at the pico- to femtomolar concentration range and employed in a corrosion experiment with small specimens of irradiated steel. The approach is based on gas chromatographic separation of single 14C-bearing carbon compounds, their oxidation to 14CO2, sampling with a custom-made fraction collector and quantification by accelerator mass spectrometry (AMS). In addition to CSRA, a method allowing the quantification of the total 14C content of the gas phase was developed and tested. After validation of the two set-ups with standards, the gaseous 14C-bearing carbon compounds produced during alkaline anoxic corrosion of irradiated steel were quantified. Small hydrocarbons (HCs) like methane (14CH4) and ethane (14C2H6) were the only 14C-bearing compounds identified in the gas phase above the detection limit. 14CH4 was the main species (on average 5.4 × 10-14 mol L-1 gas) and contributed >90% to the total 14C content, whereas the concentration of 14C2H6 was much lower (7.9 × 10-16 mol L-1 gas). To our knowledge, this is the first study reporting CSRA of gaseous 14C-bearing HCs produced during anoxic corrosion of irradiated metallic radioactive waste at ultra-low concentrations.

[Massive rotator cuff injury: arthroscopic treatment with upper capsular reconstruction]. / Lesión masiva del manguito rotador: tratamiento artroscópico con reconstrucción capsular superior.

Massive rotator cuff injuries (LMMRs) are those breaks of more than 5 cm either the anteroposterior plane, or lateromedial plane. Some authors consider them to be complete ruptures of at least two rotator cuff tendons. The clinical case of a 63-year-old man with this type of injury that was resolved by the superior capsule reconstruction technique is presented, technical details and some of the literature review to carry out the procedure are shown.

Las lesiones masivas del manguito rotador (LMMR) son aquellas roturas de más de 5 cm ya sea el plano anteroposterior o lateromedial. Algunos autores las consideran como roturas completas de al menos dos tendones del maguito rotador. Se presenta el caso clínico de un varón de 63 años con este tipo de lesión que se resolvió mediante la técnica de reconstrucción de cápsula superior, se muestran detalles técnicos y un poco de la revisión de la literatura para llevar a cabo el procedimiento.

Evaluación in Vitro de la Biocompatibilidad de Cuatro Cementos Selladores con Osteoblastos Humanos / In vitro Evaluation of Four Sealer Cements Biocompatibility with Human Osteoblasts

RESUMEN: El correcto sellado apical es un paso importante durante el tratamiento de conductos, para esto, se utilizan puntas de gutapercha y cemento sellador, de este último existen diversas formulaciones químicas en el mercado, por lo cual es importante tomar en cuenta los efectos que estas pueden tener en el proceso de cicatrización periapical. El propósito de este estudio fue evaluar la biocompatibilidad de cuatro cementos selladores con diferente composición química con osteoblastos humanos. Se prepararon extractos de cementos selladores a con dos concentraciones (10 mg/mL y 40 mg/mL) y dos tiempos de exposición (10 min y 8 h), estos fueron colocados en contacto con osteoblastos humanos para evaluar la proliferación y citotoxicidad a 24, 72 y 96 h con sus respectivos controles y blancos. Se realizó un análisis estadístico con ANOVA de un factor y la prueba de comparaciones múltiple de Bonferroni. Los resultados obtenidos, tanto en el ensayo de citotoxicidad como en el de proliferación, indicaron que el cemento a base de resina no es biocompatible con osteoblastos. El cemento a base de poli-dimetilxilosano fue el único que no mostró citotoxicidad a ningún de tiempo de exposición y concentración examinadas en este estudio.

ABSTRACT: Correct apical sealing is an important step during root canal treatment, hence, gutta-percha points and sealant are used. There are several chemical compositions on the market, so it is important to evaluate the effects of these in the periapical healing process. The aim of this study was to evaluate the biocompatibility of four sealer cements with different chemical composition placed in contact with human osteoblast. Different extracts were prepared at two concentrations (10 mg/mL and 40 mg/mL) and two exposure times (10 min and 8 h) these were placed in contact with human osteoblast to evaluate cytotoxicity and proliferation at 24, 48 and 72 h with their respective controls and blanks. A statistical analysis was performed with ANOVA of one factor and Bonferroni post hoc. Results obtained in cytotoxicity and proliferation assays, indicated that the resinbased cement is not biocompatible with osteoblast. The poly-dimethylxilosanbased cement was the only that did not show cytotoxicity at any time of exposure and concentration examined in this study.

Crescendo, diminuendo and subito of the trumpets: winds of change in the concerted evolution between flowers and pollinators in Salpichroa (Solanaceae).

'Gradual' vs 'punctuated' and 'unidirectional' (only lengthening) vs. 'bidirectional'(lengthenings and shortenings) modes of evolution are explanations that compete to explain adaptive changes of flower tube length in angiosperm. The nightshade genus Salpichroa Miers, with 21 species mostly growing in the tropical Andes of southern South America, has the opportune qualities of including nearly 15-fold inter-specific variation in corolla tube length, as well as one species that is a candidate for participating in evolutionary escalation with the longest-billed hummingbird, Ensifera ensifera. We reconstructed the phylogenetic relationships using five molecular markers, the two plastid markers trnD-trnT and trnL, and three nuclear markers, ITS and two COSII, and estimated divergence times of the genus in order to reconstruct the history of both corolla tube length and pollination mode (i.e. hummingbirds, moths or multiple). We used comparative methods to determine whether corolla tube elongation/shortening is associated with shifts in pollination mode and to test, modes and rates of corolla tube change. We found evidence of both lengthening and shortening of corolla tubes. Evolutionary rates are consistent with rapid corolla tube length transitions that are only partly associated with shifts in pollination mode. Though 'punctuated' evolution (i.e. large changes predominantly at speciation events) explained corolla changes in the whole genus, 'gradual' evolution (i.e. gradual changes during a coevolutionary race with the same pollinator) was a better explanation for the change in the long-flowered clade, mostly pollinated by hummingbirds.

Técnica de embalsamiento de cadáver según Thiel: un método valioso para entrenar y mejorar las destrezas quirúrgicas en el campo de la otorrinolaringología / Thiel embalming technique for cadáver preservation: an overview of a valuable method for training and improvement of the surgical skills in otolaryngology

RESUMEN Los tiempos modernos nos obligan a que la formación de un médico cirujano no se base sólo en conocimientos teóricos, sino que adquiera las mayores habilidades quirúrgicas para así evitar riesgos innecesarios en una sociedad altamente exigente. La disección y el entrenamiento de los procedimientos quirúrgicos juegan un papel primordial para cumplir este objetivo, por lo que recientemente se ha promovido una forma de preservación cadavérica que permite realizar mediante situaciones bastantes realistas dichos adiestramientos. Se realizó una búsqueda bibliográfica electrónica, restringida al idioma inglés en Pubmed, Scopus y WOS donde se pretende describir y analizar las aplicaciones de esta técnica. La revisión ofreció artículos de relevancia que demuestran la aplicación de esta técnica novedosa en la preservación de cadáveres y sus posibles aplicaciones en el campo de otorrinolaringología.

ABSTRACT Nowadays, it is not possible to train a healthcare professional only based on theoretical knowledge, but acquiring the highest surgical skills to avoid unnecessary risks in a highly demanding society, therefore dissection and training of surgical procedures play a key role in fulfilling this objective, which is why a form of cadaveric preservation has recently been promoted, which allows realizing such training through realistic situations. An electronic literature search was carried out, restricted to the English language in MEDLINE, where it is intended to describe and analyze the applications of this technique. The review offered articles of relevance that demonstrate the application of this novel technique in the preservation of corpses and their possible applications in the field of otorhinolaryngology.

Analysis of 14C-bearing compounds released by the corrosion of irradiated steel using accelerator mass spectrometry.

The combination of ion chromatography (IC) with accelerator mass spectrometry (AMS) was developed to determine the speciation of 14C-(radiocarbon) bearing organic compounds in the femto to pico molar concentration range. The development of this compound-specific radiocarbon analysis (CSRA) of carboxylic acids is reported and the application of the method on a leaching solution from neutron-irradiated steel is demonstrated. The background and the dynamic range of the AMS-based method were quantified. On using 14C-labelled standards, the measurements demonstrate the repeatability of the analytical method and the reproducible recovery of the main target carboxylic acids (i.e., acetate, formate, malonate, and oxalate). The detection limit was determined to be in the mid fmol 14C per L level while the dynamic range of the analytical method covers three orders of magnitude from the low fmol to the mid pmol 14C per L level. Cross contamination was found to be negligible during IC fractionation and was accounted for during eluate processing and 14C detection by AMS. The 14C-bearing carboxylates released from an irradiated steel nut into an alkaline leaching solution were analysed using the CSRA-based analytical method with the aim to check the applicability of the approach and develop appropriate sample preparation. The concentrations of 14C-bearing formate and acetate, the main organic corrosion products, were at a low pmol 14C per L level for convenient dimensions of the alkaline leaching experiment which demonstrates that compound-specific 14C AMS is an extremely sensitive analytical method for analysing 14C-bearing compounds. The content of total organic 14C in solution (TO14C) determined by the direct measurement of an aliquot of the leaching solution agrees well with the sum of the 14C concentrations of the individual carboxylates within the uncertainty of the data. Furthermore, the TO14C content is in good agreement with the calculated value using the corrosion rate determined from the 60Co release and the 14C inventory of the irradiated steel specimen.

pH del agua potable que consumen estudiantes del segundo año de la Carrera de Medicina, Universidad Mayor de San Andrés Gestión 2017 / pH of drinking water that second year students of medicine of the Universidad Mayor de San Andres consume term 2017

INTRODUCCIÓN: El pH es una propiedad básica del agua potable y cuyos valores extremos pueden originar reacciones secundarias dañinas, entendiéndose por agua potable aquel que puede ser consumido sin restricción para el consumo humano, OBJETIVO: Determinar el valor del pH de agua potable que consumen los estudiantes de segundo año de la carrera de medicina de la Universidad Mayor de San Andrés (UMSA). MATERIAL Y MÉTODOS: Se analizaron 388 muestras de agua potable del domicilio de estudiantes regulares de segundo año cátedra de bioquímica entre los meses de julio y agosto del 2017, realizándose un estudio de tipo descriptivo con un enfoque transeccional. RESULTADOS: Se obtuvieron los siguientes resultados, 1) la media del pH total fue de 7,24; con x=7,22 en la ciudad de la Paz y x=7,28 en la ciudad de el Alto. 2) en cuanto al sistema de potabilización se obtuvo: x=7,34 en la planta el Alto, x=7,21 en la planta de Tilata, x=7,15 en la planta de Achachicala y de x=7,20 en la planta de Pampahasi. CONCLUSIONES: El pH del agua potable consumida se encontró dentro de parámetros establecidos con un valor medio de 7,24.

INTRODUCTION: The pH is a basic property of potable water and whose extreme values may cause harmful secondary reactions. It is understood that potable water can be consumed without any restriction by human beings. OBJECTIVE: To determine the pH value of potable water consumed by medicine students of second year at UMSA university. MATERIAL AND METHODS: 388 samples of potable water were analyzed which were taken from the homes of the second year students of the biochemistry department between July and August 2017, developing a descriptive study with a cross-sectional approach. RESULTS: The following results were obtained: 1) the average of the pH was 7.24; with x = 7.22 in La Paz city and x = 7.29 in El Alto city. 2) in relation to the drinking water was obtained: x=7.34 in El Alto plant, x=7.21 in Tilata plant, x=7.16 in Achachicala plant and x=7.21 in Pampahasi plant. CONCLUSION: The pH of the drinking water drunk is established within parameters with an average value of 7.24.

Apomorfina en bomba de perfusión continua en pacientes con enfermedad de Parkinson avanzada con diferente grado de afectación funcional / Continuous infusion of apomorphine in patients with advanced Parkinson's disease and different degrees of functional disability

No disponible

Zinc regulates Nox1 expression through a NF-κB and mitochondrial ROS dependent mechanism to induce senescence of vascular smooth muscle cells.

AIMS: The role of oxidative stress and inflammation in the development and progression of cardiovascular diseases (CVD) is well established. Increases in oxidative stress can further exacerbate the inflammatory response and lead to cellular senescence. We previously reported that angiotensin II (Ang II) and zinc increase reactive oxygen species (ROS) and cause senescence of vascular smooth muscle cells (VSMCs) and that senescence induced by Ang II is a zinc-dependent process. Zinc stimulated NADPH oxidase (Nox) activity; however, the role of Nox isoforms in zinc effects was not determined. RESULTS: Here, we show that downregulation of Nox1, but not Nox4, by siRNA prevented both Ang II- and zinc-induced senescence in VSMCs. On the other hand, overexpression of Nox1 induced senescence, which was associated with reduced proliferation, reduced expression of telomerase and increased DNA damage. Zinc increased Nox1 protein expression, which was inhibited by chelation of zinc with TPEN and by overexpression of the zinc exporters ZnT3 and ZnT10. These transporters work to reduce cytosolic zinc, suggesting that increased cytosolic zinc mediates Nox1 upregulation. Other metals including copper, iron, cobalt and manganese failed to upregulate Nox1, suggesting that this pathway is zinc specific. Nox1 upregulation was inhibited by actinomycin D (ACD), an inhibitor of transcription, by inhibition of NF-κB, a known Nox1 transcriptional regulator and by N-acetyl cysteine (NAC) and MitoTEMPO, suggesting that NF-κB and mitochondrial ROS mediate zinc effects. Supporting this idea, we found that zinc increased NF-κB activation in the cytosol, stimulated the translocation of the p65 subunit to the nucleus, and that zinc accumulated in mitochondria increasing mitochondrial ROS, measured using MitoSox. Further, zinc-induced senescence was reduced by inhibition of NF-κB or reduction of mitochondrial ROS with MitoTEMPO. NF-κB activity was also reduced by MitoTEMPO, suggesting that mitochondrial ROS is upstream of NF-κB. INNOVATION AND CONCLUSION: Our data demonstrate that altered zinc distribution leading to accumulation of zinc in the mitochondria increases mitochondrial ROS production causing NF-κB activation which in turn upregulates Nox1 expression inducing senescence of VSMCs.

Prevalence of traffic rule infractions in Cali, Colombia, at sites where injury crashes occurred.

This study aim to determine the proportion of traffic rule infractions in Cali, Colombia, in places where a road traffic injury (RTI) occurred. Description of videotaping of sites where a person was injured in an RTI in 2009. Counts of road users and infractions were established for each road user group and were compared using a Z-test. They were found 13,491 users, distributed as follow: 8.9% were pedestrians, 4.6% cyclists, 24.6% motorcyclists, and 61.8% were automobile drivers. The most frequent traffic violation among motorcyclists was transiting on lines designated for other vehicles (55.2%). Among cyclists, the most frequent violations were transiting without a helmet (99.2%) and not wearing the designated vest (100%). Among pedestrians, crossing streets at prohibited places (77.3%), even at sites where a pedestrian bridge was present (72.7%), represented two common violations. Vulnerable road users committed more traffic infractions than automobile drivers (p < 0.001). High rates of traffic rule infractions among vulnerable road users were observed. Studies to better understand the occurrence of these behaviours and the promotion of effective interventions are warranted.

UVER and UV index at high altitude in Northwestern Argentina.

Measurements of ultraviolet erythemal radiation (UVER) made during two years at three sites located at altitudes over 1000ma.s.l. in Northwestern Argentina (Salta, San Carlos, and El Rosal) have been used to estimate and analyze the UV Index (UVI) and the cumulative doses at these locations. For the UVER irradiance, data of January (maximum values) and June (minimum values) have been analyzed as representative of the year for all locations. The UVI reaches extreme (>11) values in >20% of the analyzed days in Salta (1190ma.s.l.), while these are reached in San Carlos (1611ma.s.l.) and El Rosal (3355ma.s.l.) in >40% of the analyzed days. Finally, the cumulative doses over an average year have also been studied for each location. The doses received during austral summer and autumn are of the same order, and represent one third of the annual dose, while the doses received during austral winter and spring represent one sixth of the annual dose approximately.

[Subsequent reoperation obstetric hysterectomy and selective ligation of hypogastric arteries]. / Reintervención posterior a histerectomía obstétrica y ligadura selectiva de arterias hipogástricas.

Background: Bleeding in pregnancy, childbirth or postpartum period is an emergency. Selective internal iliac (hypogastric) arteries ligation is a surgical therapy in selected cases of obstetric massive hemorrhage. It had proven to be safe. Objetive: To evaluate the risk for re-intervention for post-operatory bleeding in patients with obstetric hysterectomy and selective hypogastric arteries ligation. Material and method: Cross-sectional study including women diagnosed with obstetric hysterectomy with and without selective arterial ligation as a factor to assess the risk of re-intervention, from December 2013 to December 2014, at High Specialty Medical Unit 23 of Gynaecology and Obstetrics, in Monterrey, which is a tertiary care medical center. Those patients with 28 weeks of gestation or more were selected. The postoperative blood loss was quantified by open drainage system (Penrose). Results: We performed 88 hysterectomies in the study period. We included 45 women according to selection criteria. The average was 31.9 ± 5.48 years old. Performing a selective hypogastric arteries ligation may be a protective factor (p<0.05) for re-intervention as a consequence of postoperative bleeding. Conclusion: Selective arterial ligation is a factor that could help to prevent a re-intervention. A continuous training of physicians and residents of Gynecology and Obstetrics is essential to ensure the reduction in morbidity and maternal mortality.

Characterization of the Axial Jet Separator with a CO2/Helium Mixture: Toward GC-AMS Hyphenation.

Development of interfaces for sample introduction from high pressures is important for real-time online hyphenation of chromatographic and other separation devices with mass spectrometry (MS) or accelerator mass spectrometry (AMS). Momentum separators can reduce unwanted low-density gases and introduce the analyte into the vacuum. In this work, the axial jet separator, a new momentum interface, is characterized by theory and empirical optimization. The mathematical model describes the different axial penetration of the components of a jet-gas mixture and explains the empirical results for injections of CO2 in helium into MS and AMS instruments. We show that the performance of the new interface is sensitive to the nozzle size, showing good qualitative agreement with the mathematical model. Smaller nozzle sizes are more preferable due to their higher inflow capacity. The CO2 transmission efficiency of the interface into a MS instrument is ∼ 14% (CO2/helium separation factor of 2.7). The interface receives and delivers flows of ∼ 17.5 mL/min and ∼ 0.9 mL/min, respectively. For the interfaced AMS instrument, the ionization and overall efficiencies are 0.7-3% and 0.1-0.4%, respectively, for CO2 amounts of 4-0.6 µg C, which is only slightly lower compared to conventional systems using intermediate trapping. The ionization efficiency depends on to the carbon mass flow in the injected pulse and is suppressed at high CO2 flows. Relative to a conventional jet separator, the transmission efficiency of the axial jet separator is lower, but its performance is less sensitive to misalignments.