Development and ELISA Characterization of Antibodies against the Colistin, Vancomycin, Daptomycin, and Meropenem: A Therapeutic Drug Monitoring Approach.

More than 70% of bacteria are resistant to all or nearly all known antimicrobials, creating the need for the development of new types of antimicrobials or the use of "last-line" antimicrobial therapies for the treatment of multi-resistant bacteria. These antibiotics include Glycopeptide (Vancomycin), Polymyxin (Colistin), Lipopeptide (Daptomycin), and Carbapenem (Meropenem). However, due to the toxicity of these types of molecules, it is necessary to develop new rapid methodologies to be used in Therapeutic Drug Monitoring (TDM). TDM could improve patient outcomes and reduce healthcare costs by enabling a favorable clinical outcome. In this way, personalized antibiotic therapy emerges as a viable option, offering optimal dosing for each patient according to pharmacokinetic (PK) and pharmacodynamic (PD) parameters. Various techniques are used for this monitoring, including high-performance liquid chromatography (HPLC), gas chromatography-mass spectrometry (GC-MS), and immunoassays. The objective of this study is the development and characterization by ELISA of specific polyclonal antibodies for the recognition of the antibiotics Vancomycin (glycopeptide), Colistin (polymyxin), Daptomycin (lipopeptide), and Meropenem (carbapenem) for future applications in the monitoring of these antibiotics in different fluids, such as human plasma. The developed antibodies are capable of recognizing the antibiotic molecules with good detectability, showing an IC50 of 0.05 nM for Vancomycin, 7.56 nM for Colistin, 183.6 nM for Meropenem, and 13.82 nM for Daptomycin. These antibodies offer a promising tool for the precise and effective therapeutic monitoring of these critical antibiotics, potentially enhancing treatment efficacy and patient safety.

Bases neurobiológicas de la epilepsia neonatal y sus comorbilidades / Neurobiological basis of neonatal epilepsy and its co morbilities

Resumen La aparición de convulsiones es frecuente durante el periodo neonatal debido a las características de inma durez funcional del cerebro es este periodo. La aparición de estas convulsiones puede llevar a un diagnóstico de epilepsia neonatal, que suele estar asociado a alteracio nes estructurales del cerebro durante el neurodesarrollo. Aproximadamente el 50% de las personas con epilepsia activa padecen al menos un trastorno médico comórbi do, y esto hace que cambie la evolución de la epilepsia. La presencia de trastornos neurológicos que preceden a la aparición de la epilepsia indica que alteraciones es tructurales y/o funcionales del cerebro subyacentes pue den ser causa de la predisposición a padecer epilepsia y de los procesos comórbidos de manera independiente. En esta revisión describimos los procesos cerebrales estructurales y funcionales que subyacen a la aparición de epilepsia neonatal y sus comorbilidades.

Abstract The occurrence of seizures is frequent during the neonatal period due to the functional immaturity of the brain.The presence of these seizures may lead to a diagnosis of neonatal epilepsy, which is usually as sociated with structural alterations of the brain during neurodevelopment. Approximately 50% of people with active epilepsy have at least one comorbid medical di sorder, and the existence of a comorbid process changes the course of the epilepsy. The presence of neurologic disorders preceding the onset of epilepsy indicates that underlying neurobiological alterations may indepen dently cause the predisposition to epilepsy and comor bid processes. In this review we describe the structural and functional brain processes underlying the onset of neonatal epilepsy and its comorbidities.

[Neurobiological basis of neonatal epilepsy and its comorbilities]. / Bases neurobiológicas de la epilepsia neonatal y sus comorbilidades.

The occurrence of seizures is frequent during the neonatal period due to the functional immaturity of the brain.The presence of these seizures may lead to a diagnosis of neonatal epilepsy, which is usually associated with structural alterations of the brain during neurodevelopment. Approximately 50% of people with active epilepsy have at least one comorbid medical disorder, and the existence of a comorbid process changes the course of the epilepsy. The presence of neurologic disorders preceding the onset of epilepsy indicates that underlying neurobiological alterations may independently cause the predisposition to epilepsy and comorbid processes. In this review we describe the structural and functional brain processes underlying the onset of neonatal epilepsy and its comorbidities.

La aparición de convulsiones es frecuente durante el periodo neonatal debido a las características de inmadurez funcional del cerebro es este periodo. La aparición de estas convulsiones puede llevar a un diagnóstico de epilepsia neonatal, que suele estar asociado a alteraciones estructurales del cerebro durante el neurodesarrollo. Aproximadamente el 50% de las personas con epilepsia activa padecen al menos un trastorno médico comórbido, y esto hace que cambie la evolución de la epilepsia. La presencia de trastornos neurológicos que preceden a la aparición de la epilepsia indica que alteraciones estructurales y/o funcionales del cerebro subyacentes pueden ser causa de la predisposición a padecer epilepsia y de los procesos comórbidos de manera independiente. En esta revisión describimos los procesos cerebrales estructurales y funcionales que subyacen a la aparición de epilepsia neonatal y sus comorbilidades.

Coastal sharks supply the global shark fin trade.

Progress in global shark conservation has been limited by constraints to understanding the species composition and geographic origins of the shark fin trade. Previous assessments that relied on earlier genetic techniques and official trade records focused on abundant pelagic species traded between Europe and Asia. Here, we combine recent advances in DNA barcoding and species distribution modelling to identify the species and source the geographic origin of fins sold at market. Derived models of species environmental niches indicated that shark fishing effort is concentrated within Exclusive Economic Zones, mostly in coastal Australia, Indonesia, the United States, Brazil, Mexico and Japan. By coupling two distinct tools, barcoding and niche modelling, our results provide new insights for monitoring and enforcement. They suggest stronger local controls of coastal fishing may help regulate the unsustainable global trade in shark fins.

Frequency of Toxocara canis antibodies in Mexican paediatric patients with epilepsy.

The relationship between epilepsy and the presence of visceral larva migrans caused by Toxocara canis in Mexican children remains uncertain; however, this relationship needs to be elucidated because these parasite larvae can invade the human central nervous system. Accordingly, this study aimed to determine the frequency and specificity of anti-T. canis antibodies in the sera of children with epilepsy to determine the relationship between this parasite and epilepsy. The sera samples of 214 children were examined: 111 children diagnosed with epilepsy and 103 clinically healthy children without neurological disorders. In the sera of each group, the presence and specificity of anti-T. canis and anti-Ascaris lumbricoides antibodies, as well as the cross-reactivity between them, were assessed using enzyme-linked immunosorbent assay and Western blotting analysis. Among the children with epilepsy, 25.2% exhibited seropositivity to T. canis. Cross-reactivity against the A. lumbricoides antigen was present in 46.8% of the children with epilepsy, whereas 11.7% of the children with epilepsy and anti-T. canis antibodies did not exhibit cross-reactivity against this antigen. The Western blotting analysis of the sera from the children with epilepsy demonstrated the presence of T. canis proteins, with molecular weights of 24, 35, 55, 70, 120 and 210 kDa, and A lumbricoides proteins with molecular weights of 70, 80 and 110 kDa. Our results revealed the presence of anti-T. canis antibodies in the children with epilepsy; furthermore, cross-reactivity tests with A. lumbricoides showed the importance of the presence of anti-T. canis antibodies in revealing the relationship between this parasite and epilepsy in children.

Cost minimization analysis of treatment with intravenous or subcutaneous trastuzumab in patients with HER2-positive breast cancer in Spain.

PURPOSE: To describe healthcare professional (HCP) and patient time and related costs associated with trastuzumab intravenous infusion (IV) and trastuzumab subcutaneous (SC) formulations in patients with HER2-positive early breast cancer. METHODS: This prospective, observational time, and motion study in three Spanish centers was run as a substudy of the PrefHer trial. We recorded active HCP time for trastuzumab SC and IV-related tasks and calculated HCP time as the mean sum of task times over 154 administrations (80 IV, 74 SC). We calculated mean patient infusion chair time and treatment room time. Staff costs were calculated using fully loaded salary costs based on Spanish salaries (€ 2012). RESULTS: The transition from trastuzumab IV to SC led to a 50% reduction in active HCP time [27.2 min (95% CI 21.8-32.6) vs. 13.2 min (95% CI 8.9-17.5) per cycle]. Time savings resulted from avoiding IV catheter installation and removal, line flushing, and drug reconstitution. SC administration led to a fivefold reduction (78-85%) in chair time and a fourfold reduction (59-81%) in patient treatment room time, resulting in 24 h free-up time in the total treatment course (18 cycles). Total estimated direct costs were € 29,431.75 and € 28,452.12 for IV and SC, respectively, a saving of € 979.60 over a full treatment course. CONCLUSIONS: Trastuzumab SC provided substantial time savings for HCP and patients, and reduced staff costs vs. trastuzumab IV. Reducing the use of hospital facilities may result in further savings and improved quality of medical care.

Adaptación acústica del canto de Turdus leucomelas (Passeriformes: Turdidae) a diferentes niveles de ruido antrópico, en el área metropolitana de Belém, Pará, Brasil / Acoustic adaptation in Turdus leucomelas (Passeriformes: Turdidae) songs to different levels of anthropogenic noise, in the metropolitan area of Belem, Para, Brazil

ResumenEl ruido antropogénico en entornos urbanos supone un importante reto para aquellas especies que dependen de la transmisión de señales acústicas para comunicarse. Para evitar ser enmascaradas por el ruido de fondo, algunas especies de aves son capaces de realizar ajustes vocálicos en sus cantos. Los estudios sobre ajustes vocálicos para aves tropicales son aún escasos y resultan de interés ya que tanto la estructura urbana como la propia vegetación asociadas a los hábitats urbanos difieren de forma notable respecto a las ciudades de climas templados. En este estudio se pretende describir posibles cambios en los parámetros de canto del zorzal sabiá (Turdus leucomelas) en un entorno urbano, el área metropolitana de Belém (Brasil). Para ello, se grabaron los cantos de la especie entre septiembre y noviembre 2008 y se midió el ruido ambiental en tres diferentes ambientes acústicos (urbano, periurbano y rural) a lo largo de un gradiente urbano. Se seleccionaron los cantos de 12 individuos por cada ambiente (un total de 36). Las posibles diferencias entre los parámetros del canto se analizaron mediante ANOVAs. Para evaluar el impacto acústico sobre el canto, sólo se tuvo en cuenta el espectro del ruido ambiental dentro del rango de vocalización de la especie. En general, las aves de hábitats urbanos presentaron cantos con frecuencias máximas más elevadas y con una mayor diversidad de notas que sus congéneres de zonas periurbanas y rurales. Las diferencias fueron más acusadas en relación a las zonas rurales. No se encontraron diferencias en cuanto a las frecuencias mínimas, la concentración de la energía, o la duración media de las notas. Estos resultados difieren de otros estudios y quizás podrían indicar variaciones en la forma en la que las aves intentan desenvolverse en hábitats con un elevado ruido ambiental. Debe profundizarse sobre el papel de estas modificaciones en la mejora efectiva de la comunicación intra-específica para la especie en dichos ambientes.

AbstractAnthropogenic noise in urban environments is a major challenge for those species that depend on the transmission of acoustic signals to communicate. To avoid being masked by background noise, some bird species are able to make adjustments in their songs. Studies on vocal adjustment for tropical birds are still scarce and are of interest since both the urban structure and the vegetation associated with urban habitats differ significantly with respect to the cities of temperate climates. In this research we studied the changes in the song parameters of the pale-breasted thrush (Turdus leucomelas) in an urban environment of the metropolitan area of Belém (Brazil). To this end, bird songs were recorded and ambient noise was measured between September and November 2008, in three different acoustic environments (urban, suburban and rural) along an urban gradient. The songs of 12 individuals per area were selected (a total of 36). Possible differences between song parameters were analyzed by ANOVAs. To assess the noise impact on bird song, we only considered the spectrum of environmental noise within the range of vocalizations of the species. In general, birds of urban habitats presented songs with higher maximum frequencies and with a wider range of notes, than their counterparts in suburban and rural areas. The differences were more pronounced in relation to rural areas. No differences in the minimum frequencies, the concentration of energy, or the average duration of the notes were found. These results differ from other studies and could possibly indicate variations in the way birds try to succeed in habitats with high ambient noise. It is necessary further exploration on the role of these changes in the effective improvement of intra-specific communication for the species in such environments.

Final results of a phase II study of paclitaxel, bevacizumab, and gemcitabine as first-line therapy for patients with HER2-negative metastatic breast cancer.

BACKGROUND: Efficacy and safety data for combining bevacizumab, gemcitabine, and paclitaxel for locally advanced/metastatic breast cancer are limited. PATIENTS AND METHODS: AVALUZ trial evaluates the combination of bevacizumab 10 mg/kg, gemcitabine 2,000 mg/m(2) plus paclitaxel 150 mg/m(2), on days 1 and 15 of each 28-day course in previously untreated HER-2 negative patients. RESULTS: Median progression-free survival (PES): 12.3 months. The overall response and clinical benefit rate (CR + PR + SD) were 72 % (95 % CI 60.9-82.0 %) and 89 % (95 % CI 80.3-95.3 %), respectively. Median overall survival: 27.4 mo. Baseline circulating tumor cell (CTCs) ≥2 versus CTCs <2 was associated with lower PFS, p = 0.046. Overall response was significantly greater in patients with intense angiotensin type 1 receptor (AGTR1) expression (99 vs. 60 % [p = 0.021]). The most frequent grade 3/4 adverse events were: neutropenia (10 %); febrile neutropenia (1 %); sensory neuropathy (13 %); and asthenia (6 %). Grade 3 adverse events of interest with bevacizumab included bleeding (1 %) and hypertension (4 %). One patient developed cardiac ischemia (1 %). CONCLUSIONS: Adding bevacizumab to chemotherapy appeared feasible and well tolerated, producing toxicity comparable to other effective combined first-line regimens. Baseline circulating endothelial cells and AGTR1 expression are predictive of PFS and response.

Convergent evolution in locomotory patterns of flying and swimming animals.

Locomotion is one of the major energetic costs faced by animals and various strategies have evolved to reduce its cost. Birds use interspersed periods of flapping and gliding to reduce the mechanical requirements of level flight while undergoing cyclical changes in flight altitude, known as undulating flight. Here we equipped free-ranging marine vertebrates with accelerometers and demonstrate that gait patterns resembling undulating flight occur in four marine vertebrate species comprising sharks and pinnipeds. Both sharks and pinnipeds display intermittent gliding interspersed with powered locomotion. We suggest, that the convergent use of similar gait patterns by distinct groups of animals points to universal physical and physiological principles that operate beyond taxonomic limits and shape common solutions to increase energetic efficiency. Energetically expensive large-scale migrations performed by many vertebrates provide common selection pressure for efficient locomotion, with potential for the convergence of locomotory strategies by a wide variety of species.

Do precipitation and food affect the reproduction of brown brocket deer Mazama gouazoubira (G. Fischer 1814) in conditions of semi-captivity?

The births of brown brocket deer ( Mazama gouazoubira) in a secondary lower montane forest called "yunga" in northwestern Argentina were compared with rainfall. Analyses were performed with rainfall and flower-fruit fall in an attempt to determine the possible importance of these seasonal variables in birthing. The births were not directly correlated with rainfall, but rather with the flower and fruit fall of exotic plant species. This may be related to favor the development of fawns, which eat the new and more digestible plant parts, accessible one month after their births.The non-seasonal births observed around the year could be related to the selection by the deer of some plant species that have been introduced into the region ( Prunus, Morus and Psidium), have a longer fruiting span than the scarce native plant species.

Os nascimentos de veados-catingueiros marrons ( Mazama gouazoubira) na floresta montana secundária chamada "yunga" no noroeste da Argentina foram comparados com a ocorrência de chuva. As análises foram conduzidas com chuva e com queda de flores e frutos em uma tentativa para determinar a possível importância dessas variáveis com o nascimentodestes animais. Os nascimentos não foram diretamente correlacionados com a chuva, mas sim com a queda de flores e frutos das espécies de plantas exóticas. Isto pode estar relacionado ao favorecimento do desenvolvimento de filhotes, que comem as plantas novas e as partes mais digeríveis, que estão acessíveis um mês após seus nascimentos. Os nascimentosnão sazonais observados ao longo do ano poderiam estar relacionados com a seleção pelo veado de algumas espécies de plantas que foram introduzidas na região ( Prunus, Morus e Psidium), as quais possuem um período frutífero mais longo do que as escassas espécies de plantas nativas da região.

Do precipitation and food affect the reproduction of brown brocket deer Mazama gouazoubira in conditions of semi-captivity?

The births of brown brocket deer ( Mazama gouazoubira) in a secondary lower montane forest called "yunga" in northwestern Argentina were compared with rainfall. Analyses were performed with rainfall and flower-fruit fall in an attempt to determine the possible importance of these seasonal variables in birthing. The births were not directly correlated with rainfall, but rather with the flower and fruit fall of exotic plant species. This may be related to favor the development of fawns, which eat the new and more digestible plant parts, accessible one month after their births.The non-seasonal births observed around the year could be related to the selection by the deer of some plant species that have been introduced into the region (Prunus, Morus and Psidium), have a longer fruiting span than the scarce native plant species.

[Vulvovaginitis caused by Candida spp. and Trichomonas vaginalis in sexually active women]. / Vulvovaginitis por Candida spp. y Trichomonas vaginalis en mujeres sexualmente activas.

Vulvovaginitis accounts for 20 to 30% of gynecological diseases and it is observed in women from 20 to 30 years of age. It has a higher frequency in women using oral contraceptives and during the third trimester of pregnancy. The aim of this research was to assess the prevalence of Candida spp and Trichomonas vaginalis in patients with the diagnosis of vulvovaginitis from the Gynecology Service in Hospital Universitario "Ruiz y Páez" in Ciudad Bolívar and Hospital "Raúl Leoni" in San Félix (Bolívar State, Venezuela). Two hundred women with symptoms of vulvovaginitis were examined, and samples were taken from the uterocervical cul-de-sac. Each patient was asked to fill a questionnaire. The following studies were made in each sample: a) fresh wet mount examination, b) orange acridine and Giemsa stains for Trichomonas and c) culture for the identification of yeasts. The latter were identified by means of the germinal tube assay, resistance to actidione and the presence of clamidospores in rice-cream agar and sugar utilization test, using the commercial kit ID32C (BioMérieux). Only in 57 women of 200 patients with vulvovaginitis the causative agent was demonstrated; Candida spp was present in 84.2% (n = 48) and Trichomonas vaginalis in 14% (n = 8). A single case of Zygosaccharomyces spp (1.8%) was detected. The age group mainly affected was that of 25-35 years old, the 38.6% of the studied population. Candida species detected were: C. albicans in 87% of cases (n = 42), C. glabrata, in 10.42% (n = 5), and C. guillermondii, in 2.08 (n = 1). Vaginal flux, vulvar pruritus and leucorrhoea were observed in significant number of patients with vulvovaginal candidiasis. The use of antibiotics was considered predisposing factor for Trichomonas vaginalis infection. The relationship between age and the etiological agent was not statistically significant. Due to the low specificity of clinical manifestations of infections caused by Candida spp and Trichomonas vaginalis, we conclude that performing the etiologic diagnosis of vulvovaginitis is necessary in order to take the appropriate therapeutic and preventive measures, specially in those patients with a recurrent disease.

Vulvovaginitis por Candida spp. y Trichomonas vaginalis en mujeres sexualmente activas / Vulvovaginitis caused by Candida spp. and Trichomonas vaginalis in sexually active women

Vulvovaginitis accounts for 20 to 30 of gynecological diseases and it is observed in women from 20 to 30 years of age. It has a higher frequency in women using oral contraceptives and during the third trimester of pregnancy. The aim of this research was to assess the prevalence of Candida spp and Trichomonas vaginalis in patients with the diagnosis of vulvovaginitis from the Gynecology Service in Hospital Universitario "Ruiz y Pßez" in Ciudad BolÝvar and Hospital "Raúl Leoni" in San FÚlix (BolÝvar State, Venezuela). Two hundred women with symptoms of vulvovaginitis were examined, and samples were taken from the uterocervical cul-de-sac. Each patient was asked to fill a questionnaire. The following studies were made in each sample: a) fresh wet mount examination, b) orange acridine and Giemsa stains for Trichomonas and c) culture for the identification of yeasts. The latter were identified by means of the germinal tube assay, resistance to actidione and the presence of clamidospores in rice-cream agar and sugar utilization test, using the commercial kit ID32C (BioMÚrieux). Only in 57 women of 200 patients with vulvovaginitis the causative agent was demonstrated; Candida spp was present in 84.2 (n = 48) and Trichomonas vaginalis in 14 (n = 8). A single case of Zygosaccharomyces spp (1.8) was detected. The age group mainly affected was that of 25-35 years old, the 38.6 of the studied population. Candida species detected were: C. albicans in 87 of cases (n = 42), C. glabrata, in 10.42 (n = 5), and C. guillermondii, in 2.08 (n = 1). Vaginal flux, vulvar pruritus and leucorrhoea were observed in significant number of patients with vulvovaginal candidiasis. The use of antibiotics was considered predisposing factor for Trichomonas vaginalis infection. The relationship between age and the etiological agent was not statistically significant. Due to the low specificity of clinical manifestations of infections caused by Candida spp and Trichomonas vaginalis, we conclude that performing the etiologic diagnosis of vulvovaginitis is necessary in order to take the appropriate therapeutic and preventive measures, specially in those patients with a recurrent disease.

Adult T-cell leukemia/lymphoma and cluster of HTLV-I associated diseases in Brazilian settings.

We studied the transmission routes of human T-cell lymphotropic virus type I (HTLV-I) within families of 82 Brazilian patients diagnosed with adult T-cell leukaemia/lymphoma (ATL). Diagnosis of ATL in 43 male and 39 female patients was based on clinical and laboratory criteria of T-cell malignancy and detection of HTLV-I monoclonal integration. Samples were tested for HTLV antibodies and infection was confirmed as HTLV-I by Western Blot and/or polymerase chain reaction (PCR) assays. Overall 26/37 (70%) of mothers, 24/37 (65%) of wives, 8/22 (36%) of husbands, 34/112 (30%) of siblings and 10/82 (12%) offspring were HTLV-I infected. In 11 ATL patients, mothers were repeatedly HTLV-I seronegative, but HTLV-I pol or tax sequences were detected in 2 out of 6 cases tested by PCR. ATL patients with seronegative mothers related the following risk factors for HTLV-I infection: 6 were breast-fed by surrogate mothers with unknown HTLV-I status, 4 had a sexually promiscuous behaviour and 1 had multiple blood transfusions at a young age. Familial aggregation of ATL and other HTLV-I associated diseases such as HTLV-I myelopathy (HAM/TSP) and or uveitis, ATL in sibling pairs or in multiple generations was seen in 9 families. There were 6 families with ATL and TSP sibling pairs. In 3 families at least one parent had died with lymphoma or presenting neurological diseases and 2 offspring with ATL. Further to the extent of vertical and horizontal transmission of HTLV-I infection within ATL families, our results demonstrate that mothers who provide surrogate breast-milk appear to be an important source of HTLV-I transmission and ATL development in Brazil.

Growth and growth hormone secretion in children with cancer treated with chemotherapy.

OBJECTIVE: To evaluate the effect of chemotherapy on growth and growth hormone (GH) secretion. METHODS: We analyzed growth and GH secretion in 60 children in complete remission after treatment by chemotherapy and surgery for malignant solid tumors. None of them received cranial radiotherapy. Growth hormone reserve was assessed by at least two stimulation tests (clonidine, L-dopa, growth hormone-releasing hormone). In 12 children the reserve of GH pretreatment was also evaluated. RESULTS: Growth hormone deficiency (GHD) was observed in 27 of 60 patients (45%). At diagnosis, mean standing height was +0.23 +/- 0.11 standard deviation score (SDS) in the GHD group and +0.16 +/- 0.10 SDS in the non-GHD group. After chemotherapy, mean standing height in the GHD group was -0.28 +/- 0.15 SDS and -0.14 +/- 0.11 in the non-GHD group (p < 0.05), and the growth rate was +0.13 +/- 0.07 SDS in the GHD group and +0.22 +/- 0.18 SDS in the non-GHD group. For a mean follow-up of 30 months, the mean standing height was -0.46 +/- 0.29 SDS in the GHD group and -0.24 +/- 0.16 SDS for the non-GHD group (p < 0.05), and the growth rate was -0.27 +/- 0.19 SDS in the GHD group and -0.16 +/- 0.12 SDS in the non-GHD group (p < 0.05). The GH response to clonidine was significantly less than that found with the other stimuli. There was correlation between the dose intensity of some drugs and the subsequent GH response to stimulation tests. The GHD group was found to have received significantly higher doses of actinomycin D than the non-GHD group (p < 0.05). Growth impairment and GHD were not found to be correlated with duration of treatment and follow-up, tumor type, sex, or age. CONCLUSIONS: Chemotherapy as the sole form of treatment in children with cancer interferes with growth. The observed impairment of growth depends, at least in part, on a GHD related to chemotherapy. The growth rate in conjunction with the GH response to clonidine provides a sensitive measure of GHD associated with chemotherapy.

Sintomas de deficiências nutricionais em cupuaçuzeiro (Theobroma grandiflorum) cultivado em solução nutritiva

With the objective of obtaining the visual symptoms of cupuaçu nutricional deficiencies, seedlings were grown in a greenhouse, in nutrient solution, omitting N, P, K, Ca, Mg, S, B, Cu, Fe, Mn and Zn, in comparison to a complete treatment. All symptoms were described and presented as an identification table, which shows great similarity with cocoa plants. To asses nutrient concentrations, leaves were collected at different parts of the plants, in two samplings. Concentrations found in leaves from plants in which an dement was omitted were always lower than those found in the complete treatment, thereby demonstrating that the symptoms were really due to the induced deficiency. Although the mineral contents of leaves with deficiency symptoms were always lower than those found in other samplings, the reference leaf, recommended in the literature for cocoa (3rd leaf starting from tip), was also adequate for cupuaçu, except in the case of Cu.

Com a finalidade de induzir os sintomas visuais de deficiência nutricional no cupuaçuzeiro, realizou-se em casa de vegetação, um experimento com solução nutritiva onde omitiu-se os seguintes elementos: N, P, K, Ca, Mg, S, B, Cu, Fe, Mu e Zn. Um tratamento completo serviu de comparação. Todos os sintomas foram caracterizados e apresentaram semelhanças com os observados para o cacaueiro, sendo relacionados em tabela para a identificação. Para determinar as concentrações de nutrientes, foram coletadas folhas em diversas partes da planta e em duas épocas de amostragem. Os teores encontrados nas folhas em que o elemento foi omitido foram sempre inferiores daqueles encontrados no tratamento completo, demonstrando que os sintomas descritos foram realmente devidos ao efeito da omissão. Embora os teores apresentados nas folhas com sintomas de deficiência tenham sido sempre menores que os obtidos nas demais amostragens, a folha de referência indicada pela literatura para o cacaueiro (3ª a partir do ápice), mostrou-se adequada para identificar deficiências nutricionais no cupuaçuzeiro, exceto para o cobre.

Sintomas de deficiências nutricionais em cupuaçuzeiro (Theobroma grandiflorum) cultivado em solução nutritiva

With the objective of obtaining the visual symptoms of cupuaçu nutricional deficiencies, seedlings were grown in a greenhouse, in nutrient solution, omitting N, P, K, Ca, Mg, S, B, Cu, Fe, Mn and Zn, in comparison to a complete treatment. All symptoms were described and presented as an identification table, which shows great similarity with cocoa plants. To asses nutrient concentrations, leaves were collected at different parts of the plants, in two samplings. Concentrations found in leaves from plants in which an dement was omitted were always lower than those found in the complete treatment, thereby demonstrating that the symptoms were really due to the induced deficiency. Although the mineral contents of leaves with deficiency symptoms were always lower than those found in other samplings, the reference leaf, recommended in the literature for cocoa (3rd leaf starting from tip), was also adequate for cupuaçu, except in the case of Cu.

Com a finalidade de induzir os sintomas visuais de deficiência nutricional no cupuaçuzeiro, realizou-se em casa de vegetação, um experimento com solução nutritiva onde omitiu-se os seguintes elementos: N, P, K, Ca, Mg, S, B, Cu, Fe, Mu e Zn. Um tratamento completo serviu de comparação. Todos os sintomas foram caracterizados e apresentaram semelhanças com os observados para o cacaueiro, sendo relacionados em tabela para a identificação. Para determinar as concentrações de nutrientes, foram coletadas folhas em diversas partes da planta e em duas épocas de amostragem. Os teores encontrados nas folhas em que o elemento foi omitido foram sempre inferiores daqueles encontrados no tratamento completo, demonstrando que os sintomas descritos foram realmente devidos ao efeito da omissão. Embora os teores apresentados nas folhas com sintomas de deficiência tenham sido sempre menores que os obtidos nas demais amostragens, a folha de referência indicada pela literatura para o cacaueiro (3ª a partir do ápice), mostrou-se adequada para identificar deficiências nutricionais no cupuaçuzeiro, exceto para o cobre.

[Ovarian cancer (experience with 186 patients)]. / Cáncer de ovario (experiencia con 186 pacientes).

An experience with 186 ovarian carcinomas seen at the Oncology Service of The General Hospital of Mexico, between 1981 to 1990 is reported. Fifty patients, (26.9%) were in stage I; 2, (1.0%) were in stage II; 113 in stage III, (60.7%) and 21, (11.2%) were in stage IV. Epidemiological and clinical aspects are reviewed as well as results of treatment. In 137 cases, (73.6%) we have follow up and it was without evidence of disease between 12 and 60 months with a mean of 18 months in 32, (23.3%). This number includes 22 of 26 patients in stage I, (84.6%); 1 of 2 in stage II; 9 of 89, (10.1%) in stage III and 0 of 20 in stage IV. There were not significant differences in prognosis for stage I with the schemes of treatment employed: only surgery, postoperative radiotherapy and postoperative chemotherapy. Patients in stage III evolutioned without evidence of disease when the surgery left residual disease of 2 cms or less for unit: There were 1 of 59 patients treated only with surgery (1.6%); 3 of 15, (20%) treated with radiotherapy to whole abdomen plus over dosage to pelvis and 5 of 15, (33.3%) treated with two agents of chemotherapy. (cyclophosphamide plus adriamycin of cyclophosphamide plus cisplatin). In 3 of 11 stage III patients, (27.2%) with second look surgeries, we found macroscopic residual tumor.

[A bio-psycho-social approach to acute hypertensive disease in pregnancy]. / Un enfoque bio-psico-social de la enfermedad hipertensiva aguda del embarazo.

In this paper, the approach to the genesis of the acute hypertension of pregnancy, uses a conceptual and methodological perspective adjusted to its multifactorial nature; a set of questions with epidemiologic focus is proposed, in order to vinculate psychosocial factors with the biologic processes characteristic of this health problem.