Application of CMO (capacity, motivation, and opportunity) methodology in pharmaceutical care to optimize the pharmacotherapy in older people living with HIV. DISPIMDINAC project.

OBJECTIVE: To determine the effectiveness of a pharmaceutical intervention, based on the CMO methodology (capacity, motivation and opportunity), to decrease the prevalence of the PIMDINAC concept (potentially inappropriate medication+drug interactions+non-adherence to concomitant medication) in people living with HIV infection. METHODS: Longitudinal prospective multicenter study, conducted between October 2021 and October 2022. Patients living with HIV older than 65 years, on antiretroviral treatment and concomitant drug prescription were included. Demographic, clinical, and pharmacotherapeutic variables were collected. Pharmaceutical care was provided for6 months according to the CMO model in each patient. The main variable was the percentage of patients who simultaneously fulfilled the PIMDINAC concept, comparing the baseline value with the same value at the end of the study. In addition, the percentage of patient's adherent to concomitant and antiretroviral treatment and the percentage of patients meeting the pharmacotherapeutic targets established for the prescribed medicationat 24 weeks of follow-up were compared. RESULTS: Sixty-eight patients were included. Seventy-two percent were men, with a median age of 68 years. The median number of concomitant drugs was 7. A 60.6% of the patients had polypharmacy. The prevalence of the presence of the PIMDINAC concept decreased significantly (10.3 vs. 0%). In isolation, each of the aspects also decreased significantly (p<0.031). The percentage of patients who met the objectives improved significantly from 48,5 at baseline to 88.2 (p<0.001). CONCLUSIONS: The pharmaceutical intervention based onarmaceutical intervention based on the CMO methodology significantly decreased the prevalence of the PIMDINAC concept and increased the number of patients who achieved the objectives, optimising their pharmacotherapy.

Estrategia de captación para vacunación en una zona de transformacion social / Recruitment strategy for vaccination in a social transformation area

En zona de transformación social del sur de España, se realiza una estrategia de captación para vacunación COVID-19 de personas que cumplen con los requisitos establecidos. Se realiza captación en zona de 360 personas de etnia gitana, mediante un equipo de asistencia social apoyado por Protección Civil. Se reparten mascarillas como reclamo para entablar contacto y dar información del proceso de vacunación. Posteriormente, se procede a la vacunación. Se consiguió vacunar al 40% de la población. Un 14% correspondían a aquellos con enfermedad reciente o vacunados; el resto eran menores. Se recogió, el argumento que tenían para rechazar vacunarse. La organización, y buena integración de los servicios sociales en programas de Salud Pública, ha tenido un importante papel en la creación y aceptación de programas específicos con, resultados evaluables. Tanto la estrategia de captación como la respuesta obtenida se consideraron buenas. Encontramos necesarias este tipo de intervenciones en determinados colectivos.(AU)

In an area of social transformation in southern Spain, a recruitment strategy for COVID-19 vaccination of people who meet the established requirements. A social assistance team, supported by Civil Protection, is recruiting 360 gypsy people in the area. Masks are distributed as a lure to establish contact and provide information on the vaccination process. Subsequently, vaccination is carried out. We managed to vaccinate 40% of the population. Some 14% corresponded to those with recent disease or vaccinated; the rest were minors. The argument they had for refusing to be vaccinated was collected. The organization and good integration of social services in Public Health programs has played an important role in the creation and acceptance of specific programs with evaluable results. Both the recruitment strategy and the response obtained were considered good. We found this type of intervention necessary in certain groups.(AU)

Evaluation of the effect of 1,3-bis-(4-phenyl-[1,2,3] triazole-1-il)2-propanol in comparison with metronidazole in an in vitro culture of Blastocystis in samples of patients with irritable bowel syndrome.

Metronidazole is the most-used pharmaceutical for the treatment of infection by Blastocystis. However, studies have reported resistance of the microorganism towards this pharmaceutical. In Mexico, studies concerning the prevalence of this parasite and its relationship to Irritable Bowel Syndrome have been carried out. To evaluate the in vitro effect of metronidazole and the compound 1,3-bis-(4-phenyl-[1,2,3] triazole-1-il)2-propanol over Blastocystis, as well as the prevalence of Blastocystis in patients with Irritable Bowel Syndrome. A prospective, transversal design study (April 2016-April 2017) of 51 samples of patients with Irritable Bowel Syndrome, obtained from the ISSEMyM Medical Center in Toluca, Mexico. For the identification of Blastocystis was done in three serial stool samples through direct microscopic examination and the Ritchie technique. The in vitro susceptibility test towards metronidazole and the triazolic compound was done through a microculture in concentrations of 1 to 1000 µg/mL, each one in triplicate. A 31.3% prevalence of Blastocystis was observed in the population, with greater prevalence in women (30.2%) than in men (25%). In the susceptibility test, a CL50 of 64 µg/mL was obtained for metronidazole, in comparison to the CL50 of 250 µg/mL for 1,3-bis-(4-phenyl-[1,2,3] triazole-1-il)2-propanol. This molecule in development has an effect for the treatment of infection by Blastocystis in vitro in patients with IBS and therefore, more studies should be performed.

High burden of copy number alterations and c-MYC amplification in prostate cancer from BRCA2 germline mutation carriers.

BACKGROUND: Germline BRCA2 mutations are associated with poorer outcome prostate cancer (PCa) compared with sporadic tumours but this association remains to be characterised. In this study, we aim to assess if there is a signature set of copy number alterations (CNA) that could aid to the identification of BRCA2-mutated tumours and would assist us to understand their aggressive clinical behaviour. METHODS: High-resolution array comparative genomic hybridisation profiling of DNA from PCa and matched morphologically normal prostate samples from 9 BRCA2 germline mutation carriers and 16 non-carriers in combination with unsupervised analysis was used to define copy number features. RESULTS: PCa from BRCA2 germline mutation carriers (B2T) harbour significantly more CNA than non-carrier tumours (NCTs) (P = 14 × 10(-6)). A hundred and sixteen regions had a significantly different distribution with both false discovery rate (FDR) and P value <0.01, including CNA in the genomic region containing c-MYC that was present in 89% B2T versus 12.5% NCT (P = 3 × 10(-4)). Loss of heterozygosity (LOH) at the BRCA2 locus was observed in 67% of B2T. Elevated CNA are already present in 50% of the morphologically normal prostate tissue from BRCA2 carriers. CONCLUSION: The relative high amount of CNAs in morphologically normal prostate tissue of BRCA2 carriers implies a field effect and together with the observed LOH could be used as a marker of PCa risk in these men. Several features previously associated with poor PCa outcome have been found to be significantly more common in BRCA2-mutated PCa than in sporadic tumours and may help to explain their adverse prognosis and be of relevance for targeted therapies.

Energy requirements for maintenance and growth of male saanen goat kids.

The aim of study was to determine the energy requirements for maintenance and growth of forty-one Saanen, intact male kids with initial body weight (BW) of 5.12±0.19 kg. The baseline (BL) group consisted of eight kids averaging 5.46±0.18 kg BW. An intermediate group consisted of six kids, fed for ad libitum intake, that were slaughtered when they reached an average BW of 12.9±0.29 kg. The remaining kids (n = 27) were randomly allocated into nine slaughter groups (blocks) of three animals distributed among three amounts of dry matter intake (DMI; ad libitum and restricted to 70% or 40% of ad libitum intake). Animals in a group were slaughtered when the ad libitum-treatment kid in the group reached 20 kg BW. In a digestibility trial, 21 kids (same animals of the comparative slaughter) were housed in metabolic cages and used in a completely randomized design to evaluate the energetic value of the diet at different feed intake levels. The net energy for maintenance (NEm) was 417 kJ/kg(0.75) of empty BW (EBW)/d, while the metabolizable energy for maintenance (MEm) was 657 kJ/kg(0.75) of EBW/d. The efficiency of ME use for NE maintenance (km) was 0.64. Body fat content varied from 59.91 to 92.02 g/kg of EBW while body energy content varied from 6.37 to 7.76 MJ/kg of EBW, respectively, for 5 and 20 kg of EBW. The net energy for growth (NEg) ranged from 7.4 to 9.0 MJ/kg of empty weight gain by day at 5 and 20 kg BW, respectively. This study indicated that the energy requirements in goats were lower than previously published requirements for growing dairy goats.

Integrated ecotoxicological assessment of marine sediments affected by land-based marine fish farm effluents: physicochemical, acute toxicity and benthic community analyses.

An integrated ecotoxicological assessment of marine sediments affected by land-based marine fish farm effluents was developed using physicochemical and benthic community structure analyses and standardised laboratory bioassays with bacteria (Vibrio fischeri), amphipods (Ampelisca brevicornis) and sea urchin larvae (Paracentrotus lividus). Intertidal sediment samples were collected at five sites of the Rio San Pedro (RSP) creek, from the aquaculture effluent to a clean site. The effective concentration (EC50) from bacterial bioluminescence and A. brevicornis survival on whole sediments and P. lividus larval developmental success on sediment elutriates were assessed. Numbers of species, abundance and Shannon diversity were the biodiversity indicators measured in benthic fauna of sediment samples. In parallel, redox potential, pH, organic matter and metal levels (Cd, Cu, Ni, Pb and Zn) in the sediment and dissolved oxygen in the interstitial water were measured in situ. Water and sediment physicochemical analysis revealed the exhibition of a spatial gradient in the RSP, evidenced by hypoxia/anoxia, reduced and acidic conditions, high organic enrichment and metal concentrations at the most contaminated sites. Whereas, the benthic fauna biodiversity decreased the bioassays depicted decreases in EC50, A. brevicornis survival, P. lividus larval success at sampling sites closer to the studied fish farms. This study demonstrates that the sediments polluted by fish farm effluents may lead to alterations of the biodiversity of the exposed organisms.

Morfología de la Piel y Producción de Lana en Cruzamiento Absorbente con Merino Multipropósito / Skin Morphology and Wool Production on Merino Multipurpose from Absorbent Crosses

Las tendencias del mercado de fibras textiles muestran que las lanas finas son las que se adaptan a las preferencias de la industria textil. En Argentina, la producción de lanas finas es insignificante y esto representa una limitante para el crecimiento lanero del país. La necesidad de desarrollar una alternativa de producción ovina lleva a considerar al Merino Multipropósito como una opción interesante. En la provincia de Corrientes, se iniciaron cruzamientos con estos animales, pero existen inquietudes con respecto a lograr una disminución en el diámetro de la fibra y que repercuta en el peso del vellón. El objetivo del trabajo fue evaluar el efecto del cruzamiento de ovejas Corriedale con machos MPM, sobre las características de la piel y la producción y calidad de lana. Los parámetros evaluados fueron diámetro de fibra, densidad de folículos y relación S/P. Para el recuento de folículos primarios y secundarios se realizaron biopsias de piel con auxilio de un sacabocado. Las características en relación con la producción y calidad de lana se consideraron entre borregas contemporáneas. La comparación realizada en este trabajo permitiría atribuir la disminución del diámetro de fibra, al cruzamiento con MPM. La densidad de folículos en las madres Corriedale, en las borregas Corriedale y en la F1 (Corriedale x MPM) fueron diferente significativamente. La relación S/P fue 9,08 ± 2,32, 9,46 ± 1,57, y 11,93± 2,18, respectivamente. El peso del vellón en borregas de la F1 (Corriedale x MPM) fue inferior y significativamente diferente de sus contemporáneas Corriedale. El rinde al lavado en las borregas Corriedale fue superior al de las borregas nacidas del cruzamiento con MPM. Las diferencias fueron significativas en el largo de mecha entre borregas Corriedale y Corriedale x MPM. En las condiciones realizadas no se pudo comprobar todas las expectativas esperadas con el cruzamiento. Nuevas experiencias serán necesarias para respaldar morfológica y productivamente la posible inversión.

Textile market trends show that fine wools are more suitable to reach the preferences of textile industry. Production of fine wool in Argentina are insignificant, which is a limitation on the development of the country. The need to develop new alternatives of production leads us consider the Multipurpose Merinos as an option. Crossbreeding with these animals began at Corrientes state in order to achieve a reduction in the diameter of fiber and an impact on the weight of the fleece. These crossbreedings with Corriedale sheep were carried out with the objective of analyzing changes on wool production, quality and skin characteristics. Evaluation parameters were fiber diameter, density of follicles and Secondary/Primary relation. Follicle count primary and secondary were made from skin biopsies and were performed with the aid of a punch. Features regarding the production and quality of wool from sheep were considered in contemporary animals, evaluating fleece weight and clean dirty, length of strands, washing yields, coefficient variation of fiber and W / D3. The comparison made in this paper would attribute the decrease in fiber diameter to the crossing with MPM. The follicle density on Corriedale ewes, Corriedale ewe lambs in and the F1 (Corriedale x MPM) were significantly different. The S / P was 9,08 ± 2,32 ; 9.46 ± 1.57 and 11,93 ± 2,18 respectively. The fleece weight in the F1 ewe lambs (Corriedale x MPM) was lower and significantly different from its Corriedale contemporaries. The yield on wash fleece at Corriedale ewe lambs was higher than ewe lambs crossbred with MPM. The differences were significant in length of strands between Corriedale and Corriedale sheep x MPM. Expected results from the crossbreeding could not be substantiated under the conditions realized. Additional studies will be needed to support possible morphological and productive investment.

Assessing a bioremediation strategy in a shallow coastal system affected by a fish farm culture--application of GIS and shellfish dynamic models in the Rio San Pedro, SW Spain.

An integrated multi-trophic aquaculture assessment for Pacific oyster (Crassostrea gigas) aquaculture as a bioremediation strategy in areas impacted by fish farm effluents in Rio San Pedro was assessed by combining geographic information system with carrying capacity models. Sites of 0.44 km(2) were evaluated considering constraints; physical factors, growth and survival factors, environmental quality factors, water and sediment quality criteria, factor suitability ranges, and Multi-Criteria Evaluation. Isleta and Flamenco are promising sites for oyster production, and Dorada is of marginal interest. Carbon and nitrogen removal from the water by algae and through detritus filtration was estimated. The biodeposition of organic material from longline leases was found to have little negative impact on sediment. The eutrophication results indicate that phytoplankton removal had a positive impact on water quality at the Dorada. This case study quantified the direct profitability and bioremediative environmental service advantages that fish-shellfish farms can have relative to fish monocultures.

Progressive reduction of sleep time and quality in rats with hepatic encephalopathy caused by portacaval shunts.

Patients with liver cirrhosis show sleep disturbances. Insight into their relationship with hepatic encephalopathy (HE) can be obtained using animal models of HE. The aims of this work were to assess (1) whether rats with portacaval shunts (PCS), a model of HE, show alterations in sleep and if they are similar to those in patients with HE; (2) Whether hyperammonemia plays a role in these sleep alterations; and (3) the time course of sleep alterations in these animal models. Rats were subjected to PCS to induce HE. Another group of rats was fed an ammonium-containing diet to induce hyperammonemia. Polysomnographic recordings were acquired for 24 h and sleep architecture was analyzed in control, PCS, and hyperammonemic rats at 4, 7, and 11 weeks after surgery or diet, respectively. PCS rats show a significant reduction in rapid eye movement (REM) and non-rapid eye movement (NREM) sleep time and increased sleep fragmentation, whereas reduced sleep occurs at 4 weeks and worsens at 7 and 11 weeks, sleep fragmentation appears at 7 weeks and worsens at 11 weeks. Hyperammonemic rats show decreased REM sleep, starting at 7 weeks and worsening at 11 weeks, with no changes in NREM sleep or sleep fragmentation. Therefore, PCS rats are a good model to study sleep alterations in HE, their mechanisms, and potential treatment. Mild hyperammonemia mainly impacts mechanisms involved in REM generation and/or maintenance but does not seem to be involved in sleep fragmentation.

[Acrysof(®) toric intraocular lens implantation in cataract surgery]. / Implante de lentes intraoculares tóricas Acrysof(®) en cirugía de la catarata.

AIM: To assess the medium term outcomes of Acrysof(®) toric intraocular lens implantation in 54 patients (54 eyes). METHODS: Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), preoperative astigmatism, residual postoperative astigmatism, and global average and model-specific intraocular lens (IOL) rotation grade were analyzed. RESULTS: At 2-months of follow-up,the mean UCVA was 0.83 (SD: 0.14) Snellen scale, with 73.9% of the patients ≥0.8, and 32.6% with 1.0. Mean BCVA achieved was 0.94 (SD: 0.10). Mean preoperatory astigmatism was -2.25 diopters (D) (SD: 0.78), and mean postoperative astigmatism was -0.32 D (SD: 0.56), with significant differences between both groups (p<0.001). Model-specific mean residual astigmatism was -0.1 D for T3, -0.27 D for T4 and -0.43 D for T5, without significant differences between the three models (p=0.483). Mean IOL-axis rotation grade was 3.87±3.25 degrees, with 91.6% of implanted lens within 10° of predicted axis. DISCUSSION: T3, T4 and T5 Acrysof(®) Toric intraocular lenses can correct preoperative astigmatism with a high success rate in terms of UCVA, and residual postoperative astigmatism, with minimum IOL-rotation grade at 2 months follow-up period.

Implante de lentes intraoculares tóricas Acrysof® en cirugía de la catarata / Acrysof® toric intraocular lens implantation in cataract surgery

PropósitoValorar los resultados a medio plazo del implante de lentes intraoculares tóricas Acrysof en 54 pacientes (54 ojos).MétodoLos parámetros analizados fueron mejor agudeza visual sin corrección (AVSC) y agudeza visual mejor corregida (AVMC), astigmatismo preoperatorio y residual postoperatorio, y rotación de la lente globalmente y en cada modelo de lente intraocular empleado.ResultadosA los 2 meses del seguimiento, la AVSC media total fue de 0,83 (DS: 0,14) Snellen, estando el 73,9% de ellos con AVSC ≥0,8 y el 32,6% en 1,0. La AVMC fue de 0,94 (DS: 0,10). El astigmatismo medio preoperatorio fue de -2,25 dioptrías (D) (DS: 0,78), siendo el astigmatismo medio postoperatorio total de -0,32 D (DS: 0,56), con diferencia estadísticamente significativa entre ambos grupos (p<0,001). Desglosado por tipo de lente el astigmatismo fue -0,1 para las lentes T3, -0,27 D para las T4, y -0,43 para las T5, sin diferencias significativas entre los grupos estudiados (p=0,483). La rotación media del eje de la LIO respecto al eje previsto fue de 3,87±3,25 grados, con rotación menor a 10° en el 91,6% de las LIO implantadas.DiscusiónLas lentes tóricas modelo Acrysof T3, T4 y T5 permiten corregir el astigmatismo preoperatorio con un porcentaje elevado de éxito en lo que a AVSC y astigmatismo residual postoperatorio se refiere, con un mínimo grado de rotación de la lente a los 2 meses(AU)

AimTo assess the medium term outcomes of Acrysof® toric intraocular lens implantation in 54 patients (54 eyes).MethodsUncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), preoperative astigmatism, residual postoperative astigmatism, and global average and model-specific intraocular lens (IOL) rotation grade were analyzed.ResultsAt 2-months of follow-up,the mean UCVA was 0.83 (SD: 0.14) Snellen scale, with 73.9% of the patients ≥0.8, and 32.6% with 1.0. Mean BCVA achieved was 0.94 (SD: 0.10). Mean preoperatory astigmatism was -2.25 diopters (D) (SD: 0.78), and mean postoperative astigmatism was -0.32 D (SD: 0.56), with significant differences between both groups (p<0.001). Model-specific mean residual astigmatism was -0.1 D for T3, -0.27 D for T4 and -0.43 D for T5, without significant differences between the three models (p=0.483). Mean IOL-axis rotation grade was 3.87±3.25 degrees, with 91.6% of implanted lens within 10° of predicted axis.DiscussionT3, T4 and T5 Acrysof® Toric intraocular lenses can correct preoperative astigmatism with a high success rate in terms of UCVA, and residual postoperative astigmatism, with minimum IOL-rotation grade at 2 months follow-up period(AU)

DIU de levonorgestrel como método anticonceptivo: aceptación, continuidad y asesoramiento en España / The levonorgestrel intrauterine device as a contraceptive method: acceptance, continuation rates and counselling in Spain

Objetivo: Valorar la aceptación y la continuidad del uso como anticonceptivo del DIU de levonorgestrel (DIU-LNG, Mirena®) en mujeres españolas que optan por anticoncepción intrauterina, prestando especial atención al asesoramiento. Métodos: Se informa sobre las opciones disponibles, entre ellas el DIU-LNG. Se valoran variables relevantes para la elección del método, incluido el asesoramiento. Seguimiento durante 1 año del grupo que opta por Mirena®. Resultados: De las 944 mujeres incluidas, 542 optaron por el DIU-LNG. Se constató un descenso progresivo del sangrado, en días y medidas higiénicas (de 21,00 ± 14,22, medidas en la visita de inserción, a 3,59 ± 4,86 al año). Presentaron efectos secundarios el 21,75, el 16,03 y el 13,67% de las mujeres en las sucesivas visitas (2, 3 y 4), respectivamente. En general, Mirena® fue bien tolerado, sin efectos secundarios graves. No se objetivaron gestaciones ni complicaciones graves. Al año, el grado de satisfacción fue bueno-muy bueno en el 93% de usuarias y la continuidad fue superior al 90%. Conclusiones: El DIU-LNG es un método adecuado para las mujeres españolas interesadas en anticoncepción intrauterina y especialmente con sangrado menstrual más intenso, y muestra alto grado de satisfacción y tasa de continuidad. Los efectos secundarios que aparecen son leves, generalmente bien tolerados y pueden persistir durante el primer año. Un cuidado asesoramiento permite una elevada aceptación y tasa de continuidad de este método

Objective: To evaluate acceptability and continuity of use of the levonorgestrel intrauterine device (LNG-IUD, Mirena®) as a contraceptive method among Spanish women choosing intrauterine contraception, with special attention paid to counselling. Methods: Women requesting contraception were informed of the available choices, including the LNG-IUD. Variables involved in the choice of method, including counselling, were evaluated. Women who chose Mirena® were followed-up for 1 year. Results: Of the 944 women included in this study, 542 chose the LNG-IUD. We observed a significant and progressive decrease in bleeding and in the number of bleeding days and sanitary pads used (from 21.00 + 14.22 sanitary pads at insertion to 3.59 ± 4.86 after 1 year). Adverse effects were reported by 21.75%, 16.03% and 13.67% of women at visits 2, 3 and 4 respectively. In general, Mirena® was well tolerated, producing no major adverse effects. No pregnancies or major complications were observed. Alter 1 year of use, satisfaction was good-very good in 93% of users and the continuation rate was over 90%. Conclusions: The LNG-IUD is a suitable contraceptive method for Spanish women interested in intrauterine contraception, especially those with heavy menstrual bleeding. Satisfaction and continuation rates are high. Adverse effects are minor, generally well tolerated, and can last for the first year. Careful counselling produces high acceptability and continuation rates with this method

Secreciones mamarias y su estudio citopatológico: utilidad clínica basada en la evidencia de nuestra experiencia / Cytopathological study of mammary secretions: their clinical used based on the evidence of our experience

Se presenta una casuística de 736 casos de secreción mamaria unilateral y uniorificial que fue estudiada citológica y, en su mayor parte, histopatológicamente. Cabe destacar que la mayoría de los casos fueron secreciones de tipo cremoso (43,5 por ciento), y que la mayoría de ellas correspondieron citológicamente a diagnósticos benignos (145 acelulares o células normales, y las restantes 43 a procesos inflamatorios).En cuanto a la patología confirmada de los casos con derrame por el pezón, hemos encontrado que en 30 casos hubo procesos papilares (un 2,3 por ciento en las secreciones serosas y un 86,6 por ciento en las de tipo hemorrágico).En relación con el cáncer de mama, hubo 6 casos diagnosticados por el estudio de la secreción mamaria: 1 en secreción serosa (0,6 por ciento), 1 en secreción purulenta (2,7 por ciento) y 4 en secreciones hemáticas (13,4 por ciento).Se concluye que, aunque no siempre se diga, debe hacerse un estudio citológico en todos los casos de derrame por el pezón, sobre todo de los unilaterales y, especialmente de los uniorificiales y hemorrágicos, dada la facilidad de la toma de la muestra, lo rápido del procesado y la facilidad de lectura. Hay que tener en cuenta que, al menos en nuestra casuística -una de las más amplias publicadas-, hay un número de procesos patológicos constatados posteriormente por el estudio histopatológico: 89 procesos inflamatorios (12,1 por ciento), 30 procesos papilares (4,01 por ciento) y, lo que no es de desdeñar, 6 procesos neoplásicos, lo que representó el 7,4 por ciento de las muestras recogidas y analizadas. Por tanto, se puede concluir, a pesar de lo que manifiesten algunos autores, que el estudio citológico de la secreciones por el pezón, espontáneas o provocadas, especialmente las unilaterales y uniorificiales, debe hacerse siempre, aun sabiendo que en la mayoría de los casos se van a obtener resultados normales (AU)

Caracterización químico nutricional del musgo Sphagnum magellanicum / Chemical-nutritional characterization of the moss Spagnum magellanicum

The goal of the present study was to know the chemical characteristics of the moss Sphagnum magellanicum (S.M.) growing in the southern part of Chile, spreading approximately. in a geographic area of 500.000 Has. Very few antecedents are reported in the literature concerning the functional properties of this resource, with the exception of the water absorption and holding capacity. Many of the industrial or agricultural uses of this moss are strongly related with this characteristic. Looking for other alternatives of utilization, it has been planned its incorporation to staple foods as a source of dietary fiber. But first it is necessary to know its chemical characteristics Representative samples of this material were submitted to different chemical analysis such as proximal analysis, fractional fiber analysis and anti nutrient factors.. Results of those analysis show the high amount of dietary fiber founded in this resource (77 per cent), higher than reported data for other traditional fiber sources such as lupin bran, rice hull, barley hull, oat bran, etc. Finally it is important emphasize the absence of antinutrient factor in this moss, that could make feasible its use for human nutrition.

Validación de las guías y de la pirámide alimentaria en escolares de 5º a 8º básico / Validation of food guidelines and food pyramid in school age children

Con el fin de facilitar el uso de las Guías y de la Pirámide alimentaria en el sistema escolar, ambos instrumentos educativos fueron validados en escolares de segundo ciclo de enseñanza básica de Copiapó (norte), Melipilla (centro) y Dalcahue (sur). En la validación se utilizó la técnica de grupos focales. Los resultados de este estudio cualitativo se presentan en forma descriptiva por grupos de edad, por curso (5º a 6º y 7º a 8º básico) y por comuna. Los comentarios y sugerencias se describen según lo expresado por los 51 participantes en los grupos focales. El significado de las Guías Alimentarias fue parcialmente comprendido por los niños, quienes sugirieron precisar la cantidad recomendada en verduras y frutas, explicar que se recomienda el consumo de pescado, pavo y pollo porque tienen menos grasa y aclarar con ejemplos que se entiende por aceites vegetales y cereales. Las porciones de la pirámide originaron confusión y una variedad de respuestas, en general más cercanas al consumo habitual de los niños y más altas que las cantidades recomendadas. Se concluye que para ser utilizadas en la educación en nutrición en la escuela primaria, las guías alimentarias y las porciones recomendadas en la pirámide alimentaria requieren adaptaciones para hacerlas más comprensibles y motivadoras para los escolares

[Fat substitutes in human diet]. / Sustitutos de grasa en la alimentación humana.

Fat consumption in developed countries has increased steadily during this century reaching values higher than 40% of the daily total calorie intake. This situation has resulted in a high prevalence of obesity, cardiovascular disease, diabetes and some types of cancer. The health agencies in these countries have made strong recommendations for the population to reduce dietary fat intake in order to reduce total fat intake to les than 30% of the total calories, with a maximum of 10% calories derived from saturated fats. The food industry has taken a very active role developing a number of low fat foods and opening a new area of products called fat substitutes in order to help the consumers reduce their fat consumption. One of these substitutes is a synthetic product obtained by reacting fatty acids from natural sources and sucrose. The product is a polyester of sucrose and has been named olestra. Olestra has been approved by the US Food and Drug Administration (FDA) to be used in snacks and fried chips. Due to its lipophilic nature olestra has a negative effect on the absorption of fat soluble vitamins and nutrients. However, this problem may be solved by supplementation of the nutrients affected. In addition, olestra may cause gastrointestinal effects such as abdominal cramping and stool softening. The Company that developed olestra claims to have solved this problem by modifying the composition of fatty acids of the product. Olestra is being marketed in the USA under the name of Olean.

Preoperative chemoradiotherapy in the treatment of gallbladder cancer.

Gallbladder cancer is generally associated with a poor prognosis, with local recurrence being the main pattern of failure. In an attempt to improve on the present status of management, we evaluated a prospective Phase II study involving preoperative 5-fluorouracil and radiation. Among 27 eligible patients with a potentially resectable gallbladder cancer detected after cholecystectomy, 18 were treated with preoperative radiation (4500 cGy; 180 cGy/fraction, 5 days/week) concurrent with a continuous infusion of 5-fluorouracil (350 mg/m2/day, days 1-5 and 21-25). Toxicity included leukopenia (8 patients) and thrombocytopenia (7 patients). Delay in surgery due to hematological toxicity was seen in 6 patients. Of the 18 patients, 15 underwent a reoperation. Resection was performed in 13 (86%). Pathologic findings after reoperation revealed residual tumor in both liver and lymph nodes in 3 patients. At a median follow-up of 24 months, 7 patients are alive. Among the patients who died after curative resection, local recurrence was demonstrated in only 1. This is the first report concerning preoperative chemoradiation in gallbladder cancer. To assess its effect on survival, a prospective randomized trial will be necessary.

[Reliability of optic density at 650 nm in determining lung maturity in children of diabetic mothers]. / Confiabilidad de la densidad óptica a 650 nm en la determinación de madurez pulmonar en el hijo de madre diabética.

The Diabetes Mellitus is the pathology that frequently is associated to the pregnancy and it is responsible for perinatal mobility specially by the respiratory distress syndrome since exists delay in the conversion of myoinositol-phosphatidyl inositol-phosphatidyl glycerol. To demonstrate the reliability of the DO tho 650 nm with standard of 20 in the determination of fetal lung maturity of the infant of diabetic mother. There were included 143 patient with pregnancy > or = 37 weeks with amenorrhea reliable and gestational age confirmed by ultrasound, of those 94 corresponded to gestational Diabetes Mellitus, 49 to pregestational (46 non insulin-dependent and 3 insulin-dependent). In all of them amniotic fluid studies was perform at 37 week and the resolution of the pregnancy was when DO to 650 nm showed fetal lung maturity. It was found a correlation among the DO to 650 nm of 20 and absence of RDS in 130 cases (true positive); there were seven cases with immaturity results by DO that they did not express RDS (false negative) and six cases with results that showed immaturity by DO and there were manifestations of RDS (true negative). We did not find results of false positive. The frequency of RDS was of 4.9% with a positive predictive value of the 100% an negative predictive value of 46%, a specificity of 100% and a sensitivity of 94%. An interesting finding was the fact that six cases true negative cases had poor maternal metabolic control of different degrees. For our results can be deduced that DO to 650 nm with standard of .20 it is reliable for the diagnosis of fetal lung maturity in the pregnancies complicated with Diabetes Mellitus, in addition to be an easy elaboration test and low cost.