Tomographic findings and mortality in patients with severe and critical pneumonia with COVID-19 diagnosis.

Introduction: A high percentage of patients with non-severe (17.9%) and severe (2.9%) atypical pneumonia do not display pulmonary tomographic findings upon hospital admission; furthermore, lesion associated with COVI-19 are peripherally distributed in a multifocal ground-glass pattern, as well as displaying an irregular consolidation pattern, with a posterior or lower lobe predilection. The main objective of this study was to identify the pulmonary radiological patterns in patients diagnosed with SARS-CoV-2 pneumonia, the factors associated with the need for mechanical ventilation, as well as their survival rates at 30 days. Methods: We report the pulmonary tomographic findings of 490 consecutive patients with severe and critical pneumonia due to SARS-CoV-2. The patients were classified according to the tomography and demographic findings, sepsis severity prognostic scales, Charlson comorbidity index (CCI), the Sequential Organ Failure Assessment (SOFA), and the Acute Physiology and Chronic Health Evaluation (APACHE IV). The Kaplan-Meier method was used to calculate survival distributions. Results: 89.80% of patients had ground-glass opacities, 81.63% radiologic consolidation sign, 42.45% vascular thickening pattern, 37.55% lymphadenopathies, 14.90% pleural effusion, and 2.65% pulmonary thrombosis; meanwhile, 91.02% had bilateral lesions, 85.51% had peripheral lesions, and 75.92% had basal lobe lesions. APACHE IV (HR, 1.191, 95% CI [1.126, 1.260]), SOFA (HR, 5.178, 95%CI [3.103, 8.641]), and CCI (HR, 0.673, 95%CI [0.510, 0.889]), as well as the pulmonary damage severity index (HR, 1.282, 95%CI [1.151, 1.428]), predict the need for invasive mechanical ventilation. Only moderate ARDS patients with mild and severe lung disease showed different 30-day mortality distributions (χ2 = 7.00, p = 0.008). Discussion: Although the survival distributions did not vary significantly, an overwhelming majority of patients (i.e., 84.35%) with a higher pulmonary damage severity index (i.e., 23>) died within 30 days of hospital admission, while only 25.91% with moderate lung damage and 2.42% with mild lung damage.

Intestinal parasites: Associations with intestinal and systemic inflammation.

The aim of the present study was to evaluate associations between intestinal parasitic infection with intestinal and systemic inflammatory markers in school-aged children with high rates of obesity. Plasma concentrations of C-Reactive Protein (CRP), leptin, TNF-α, IL-6 and IL-10 were measured as systemic inflammation markers and count of stool leukocytes as marker of intestinal inflammation in 291 children (6-10 years). Intestinal parasitic infection was measured by stool examination. Logistic regression analyses were performed to determine the odds of having high inflammatory markers for each parasite or group of parasites as compared to parasite-free children while adjusting for sex, age, mother's educational level and percentage of body fat. The prevalence of soil-transmitted helminths and intestinal protozoa infections was 12% and 36%, respectively. Parasitic infection was not associated with CRP, IL-6, IL-10 or TNF-α. Children infected with Ascaris lumbricoides (aOR: 5.91, 95% CI: 1.97-17.70) and Entamoeba coli (aOR: 8.46, 95% CI: 2.85-25.14) were more likely to have higher stool leucocytes than parasite-free children. Children with multiple infections (aOR: 10.60, 95% CI: 2.85-25.14) were more likely to have higher leptin concentrations than parasite-free children. Intestinal parasitic infection was not associated with systemic inflammation, but was associated with intestinal inflammation. Having multiple infections were associated with higher leptin concentrations.

Children with moderate-high infection with Entamoeba coli have higher percentage of body and abdominal fat than non-infected children.

BACKGROUND: Intestinal parasites, virus and bacterial infections are positively associated with obesity and adiposity in vitro and in animal models, but conclusive evidence of this relationship in humans is lacking. The aim of this cross-sectional study was to determine differences in adiposity between infected and non-infected children, with a high prevalence of intestinal parasitic infection and obesity. SUBJECTS: A total of 296 school-aged children (8.0 ± 1.5 years) from a rural area in Querétaro, Mexico, participated in this study. Anthropometry (weight, height and waist circumference) and body fat (DXA) were measured in all children. A fresh stool sample was collected from each child and analysed for parasites. Questionnaires related to socioeconomic status and clinical history were completed by caretakers. RESULTS: Approximately 11% of the children were obese, and 19% were overweight. The overall prevalence of infection was 61%. Ascaris lumbricoides was the most prevalent soil transmitted helminth (16%) followed by hookworm. Entamoeba coli was the predominant protozoa (20%) followed by Endolimax nana, Balantidium coli, Entamoeba histolytica/dispar, Iodamoeba bütschlii and Giardia lamblia. Children with moderate-heavy infection of E. coli had significantly higher waist circumference, waist-to-height ratio, body and abdominal fat than children not infected or with light-intensity infection (p < 0.05). CONCLUSION: These findings raise the possibility that a moderate or heavy infection with E. coli may contribute to fat deposition and thereby have long-term consequences on human health. Further studies are needed to better understand if E. coli contributes directly to fat deposition and possible mechanisms.

El alivio del dolor ¿es un derecho humano? / No disponible

En este trabajo se analiza el artículo titulado "El alivio del dolor como un derecho humano", escrito por F. Brennan y M. Cousins, en donde los autores proclaman la formulación de un novedoso derecho fundamental y revisan diversos instrumentos internacionales de Derechos Humanos, para sustentar el argumento de que el paciente debe ser protegido contra el insuficiente tratamiento del dolor. Diversos autores y organizaciones han denunciado las causas, debidas a diversos factores, por las cuales el dolor no es tratado en toda su extensión. Los factores normativos estriban en la autorización y/o prohibición de la distribución, consumo, uso y comercialización de fármacos, por parte de las agencias gubernamentales. Los factores económicos son multicausales puesto que se relacionan directamente con el acceso a servicios de salud y a medicamentos. Se identifica como un serio problema de salud pública, el que no se destinen suficientes recursos para la implementación de unidades para tratamiento del dolor crónico o temporal o para la investigación relativa al tema. La falta de educación y actualización de los profesionales de salud es otro problema importante. Dentro de las causas sociales se encuentran entre otras, la desigualdad en el acceso a los servicios de salud, la pobreza, la falta de cobertura médica y la discriminación hacia ciertos grupos sociales. En el texto se hace un sucinto recorrido por los principales instrumentos internacionales de Derechos Humanos. Se retoman los instrumentos examinados por Brennan y Cousins, con la aportación de agregar documentos regionales del Sistema Interamericano de Derechos Humanos. Para los Estados Miembros de la Organización de los Estados Americanos (OEA), que padecen la problemática propia de los países en vías de desarrollo: muchas necesidades, alta densidad de población y escasez de recursos, se torna urgente plantearse el Derecho a la Salud bajo nuevas perspectivas. Pensar soluciones que no solo giren en torno al factor económico, sino que impacten sobre los aspectos culturales, sociales, legislativos y de políticas públicas, relativos al tema del dolor. Consideramos que el alivio del dolor es y, ha sido a lo largo de la historia de la Medicina, una de las grandes aspiraciones humanas, pero que su formulación como derecho podría quedarse en un grado abstracto e inalcanzable; mientras que el derecho al acceso al manejo del dolor es un derecho más asequible, que se relaciona con los derechos a la salud, a la integridad personal, a no ser tratado inhumanamente y a alcanzar un nivel de vida adecuado y con calidad, que ya han sido reconocidos y firmados por los países, mediante los tratados internacionales. Esto significa que cuentan con mecanismos de protección de Derechos Humanos y formas por las cuales pueden hacerse valer frente al Estado (AU)

This paper analyzes the article "Pain relief a human right," written by F. Brennan and M. Cousins, in which the authors claim the formulation of a new fundamental right, and review various international human rights instruments, to support the argument that the patient should be protected from the inadequate treatment of pain. Several authors and organizations have denounced the reasons, due to various factors, why the pain is not treated in its entirety. Regulatory factors lie in the authorization and/or prohibition of the distribution, consumption, use and marketing of drugs by government agencies. Economic factors are related to many causes such as access to health services and medicines. It is identified as a serious public health problem, as not enough resources are allocated for the implementation of units for the treatment of chronic or temporary pain or for research on this topic. Lack of education and updating of health professionals is another major problem. Among the social causes are the inequality in access to health services, poverty, lack of medical coverage and discrimination against certain social groups. The text is a brief tour of the main international human rights instruments. The instruments reviewed by Brennan and Cousins, are taken into consideration, adding up the regional documents of the American System of protection of Human Rights. For Member States of the Organization of American States (OAS), which suffer from problems typical of developing countries: large number of necessities, high population density and scarcity of resources, it becomes urgent to raise the Right to Health under new perspectives. Think solutions that not only revolve around the economic factor, but that impact on the cultural, social, legislative and public policy relating to the subject of pain. We believe that pain relief is and has been throughout the history of medicine, one of the great human aspirations, but its formulation as a legal right could stay such as abstract and unreachable, while the right to access pain management is a more attainable right that relates to other rights to health, to integrity, to not be treated inhumanely and to enjoy an adequate level of living and quality, which have been recognized and signed by the countries in the international treaties. This means that these Human Rights have already mechanisms of protection and legal ways in which may be asserted against the State (AU)

Metastatic melanomas in young broiler chickens (Gallus gallus domesticus).

Four young broiler chickens affected by multiple melanotic tumors are described. Grossly, there were multiple tumors composed of melanocytes within the skin, skeletal muscle, and multiple visceral organs. Tumors ranged from flattened macules to masses that extensively replaced viscera. Microscopically, melanocytes were often well pigmented, and while there was moderate nuclear anisokaryosis, mitotic rates were low. Immunohistochemical staining of some melanomas with antibodies to S100 proteins, Melan-A, vimentin, or neuron-specific enolase after bleaching of tumor cells with potassium permanganate revealed lack of immunostaining of tumor cells with antibodies to S100, strong positive staining of tumor cells for neuron-specific enolase, moderate staining with antibodies to vimentin, and faint staining for Melan-A. Only neuron-specific enolase staining was evident in unbleached tumor cells. Attempts to identify exogenous avian leukosis viruses in these tumors were unsuccessful.

Bio-synthesis of gold nanoparticles by human epithelial cells, in vivo.

Healthy epithelial cells, in vivo, have the ability to synthesize gold nanoparticles when aqueous tetrachloroauric acid is made to react with human skin. Neither a reducing agent nor a protecting chemical is needed for this bio-synthesis method. The first indication of gold nanoparticle formation is the staining of the skin, which turns deep purple. Stereoscopic optical micrographs of human skin tissue in contact with aqueous tetrachloroauric acid clearly show the staining of the epithelial cells. The UV-Vis spectrum of these epithelial cells shows an absorption band with a maximum at 553 nm. This absorption peak is within the wavelength region where the surface plasmon resonance (SPR) band of aqueous colloidal gold exhibits a maximum. Transmission electron micrographs show that gold nanoparticles synthesized by epithelial cells have sizes between 1 and 100 nm. The electron diffraction pattern of these nanoparticles reveals a crystalline structure whose interplanar distances correspond to fcc metallic gold. Transmission electron micrographs of ultra-thin (70 nm thick) slices of epithelial cells clearly and undoubtedly demonstrate that gold nanoparticles are inside the cell. According to high resolution transmission electron micrographs of intracellular single gold nanoparticles, they have the shape of a polyhedron.

Establishment of a cross-European field site network in the ALARM project for assessing large-scale changes in biodiversity.

The field site network (FSN) plays a central role in conducting joint research within all Assessing Large-scale Risks for biodiversity with tested Methods (ALARM) modules and provides a mechanism for integrating research on different topics in ALARM on the same site for measuring multiple impacts on biodiversity. The network covers most European climates and biogeographic regions, from Mediterranean through central European and boreal to subarctic. The project links databases with the European-wide field site network FSN, including geographic information system (GIS)-based information to characterise the test location for ALARM researchers for joint on-site research. Maps are provided in a standardised way and merged with other site-specific information. The application of GIS for these field sites and the information management promotes the use of the FSN for research and to disseminate the results. We conclude that ALARM FSN sites together with other research sites in Europe jointly could be used as a future backbone for research proposals.

Análisis crítico de un artículo: ¿podemos descartar la presencia de hemorragia subaracnoidea con la combinación de tomografía computada cerebral y punción lumbar negativas? / Critically appraised article: is the combination of negative computed tomography result and negative lumbar puncture result sufficient to rule out subarachnoid hemorrhage?

Study objective: Current clinical practice assumes a negative computed tomography (CT) head sean result and a negative lumbar puncture result together are adequate to rule out subarachnoid hemorrhage in patients with acute headache. Our objective is to determine the sensitivity of a negative CT result combined with a negative lumbar puncture result to exelude subarachnoid hemorrhage. Methods: This prospective cohort study was conducted at 2 tertiary care emergency departments (EDs) during 3 years. We enrolled all patients who were older than 15 years, had a nontraumatic acute headache and normal neurologic examination result, and who had a CT head sean and a lumbar puncture ifthe CT result was negative (ie, no blood in the subarachnoid space). Patients were followed up with a structured telephone questionnaire 6 to 36 months añer their ED visit and electronic hospital records review to ensure no missed subarachnoid hemorrhage. We calculated sensitivity, specificity, and likelihood ratios of the strategy of CT and then lumbar puncture for subarachnoid hemorrhage. Results: Five hundred ninety-two patients were enrolled, including 61 with subarachnoid hemorrhage. The mean patient age was 43.6 years, with 59.1 percent female patients. Aneases of subarachnoid hemorrhage were identified on initial CT or lumbar puncture. One patient without subarachnoid hemorrhage was subsequently diagnosed with cerebral aneurysm, requiring surgery. The strategy classified patients with subarachnoid hemorrhage with sensitivity, specifícity, and positive and negative likelihood ratios (with 95 percent confidence intervals fCIsJ) of 100 percent (95 percent CI94 percent to 100 percent), 67 percent (95 percent CI 63 percent to 71 percent), 3.03 (95 percent CI 2.69 to 3.53), and 0. For diagnosis of subarachnoid hemorrhage or aneurysm, these were 98 percent (95 percent CI91 percent to 100 percent), 67 percent (95 percent CI63 percent to 71 percent), 2.98...

Análisis descriptivo de la adquisición del decúbito supino desde posición bípeda en niños, adolescentes, adultos jóvenes y adultos mayores / Descriptive analysis of the acquisition of the supine position from erect position in children, adolescents, young adults and older adults

Objetivos: El propósito del estudio fue analizar y describir posiciones, estrategias y patrones utilizados por niños (N), adolescentes (A), adultos jóvenes (AJ) y adultos mayores (AM) en la adquisición de un decúbito supino (ADS) desde posición bípeda, considerando además el tiempo de ejecución. Diseño y muestra: Estudio observacional descriptivo de tipo exploratorio a través de una investigación transversal. Se evaluaron 140 sujetos, elegidos por conveniencia en establecimientos educacionales y asociaciones comunitarias (clubes y agrupaciones) de la Región Metropolitana. Determinándose finalmente una muestra total (MT) de 120 sujetos divididos en 4 grupos, los cuáles fueron evaluados y registrados en video. Resultados: La secuencia de ADS para N, A Y AJ se concentran en 2 posiciones, AM en 3 posiciones. Se identificaron 40 estrategias distintas para adquirir el decúbito supino. AM presentó diferencias significativas con respecto a los demás grupos en cuanto a variabilidad de las estrategias y tiempo de ejecución. En los grupos más jóvenes la estrategia BA fue la más utilizada, y en AM fue BPA. La presentación de patrones de supinación fue menor para N y AM. Conclusión: Existe variabilidad de estrategias al momento de adquirir un decúbito supino desde posición bípeda, en distintas etapas de la vida registradas en la muestra, especialmente en los adultos mayores. Las investigaciones, en su mayoría se han enfocado en la adquisición de la posición bípeda desde decúbito supino, si se tiene en cuenta los resultados obtenidos, ambas ejecuciones debieran considerarse relevantes especialmente para los adultos mayores en el ámbito preventivo.

Objectives: The purpose of this study was to analyze and describe position, strategies, and patterns used by children (N), adolescents (A), middle-adults (AJ) and older adults (AM) to acquire supine position (ASP) from an erect stance, also considering the time taken to adopt supine position. Design and subjects: The study was designed as a descriptive exploratory cross-sectional survey. 140 subjects were assessed for this study; the sample was recruited by convenience from schools and community associations of Metropolitan Region. Finally, 120 subjects composed the total sample (MT), which was separated in four groups, where the subjects were evaluated and recorded on video tape. Results: In this study APS sequence used by N, A Y AJ to acquire supine position was majorly concentrated in 2 positions, AM in 3. 40 different strategies were identified to acquire supine position. AM, presented significant differences from other groups relative to the variability of strategies and time of performances. In the youngest groups the BA strategy was the most used, and in AM it was BPA. The presentation of supine patterns was lower for N and AM. Conclusions: There is a variety of strategies to acquire supine position, in this sample, from an erect stance along the different stages of life, especially on older adults. Most of the researches have focused in the acquisition of the erect stance from a supine position, noticing the results; both performances should be considered of importance, especially for older adults in the prevention aspect.

[Hierarchical clustering analysis to detect associations between clinical and pathological features of gastric tumors and hypermethylation of suppressor genes]. / Identificación de asociaciones clínico-patológicas e hipermetilación de genes supresores de tumores en cáncer gástrico difuso a través de análisis de Hierarchical clustering.

BACKGROUND: Methylation is an inactivation mechanism for tumor suppressor genes, that can have important clinical implications. AIM: To analyze the methylation status of 11 tumor suppressor genes in pathological samples of diffuse gastric cancer. MATERIAL AND METHODS: Eighty three patients with diffuse gastric cancer with information about survival and infection with Epstein Barr virus, were studied. DNA was extracted from pathological slides and the methylation status of genes p14, p15, p16, APC, p73, FHIT, E-cadherin, SEMA3B, BRCA-1, MINT-2 y MGMT, was studied using sodium bisulphite modification and polymerase chain reaction. Results were grouped according to the methylation index or Hierarchical clustering (TIGR MultiExperiment Viewer). RESULTS: Three genes had a high frequency of methylation (FHIT, BRCA1, APC), four had an intermediate frequency (p15, MGMT, p14, MINT2) and four had a low frequency (p16, p73, E-cadherin, SEMA3B). The methylation index had no association with clinical or pathological features of tumors or patients survival. Hierarchical clustering generated two clusters. One grouped clinical and pathological features with FHIT, BRCA1, and APC and the other grouped the other eight genes and Epstein Barr virus infection. Two significant associations were found, between APC and survival and p16/p14 and Epstein Barr virus infection. CONCLUSIONS: Hierarchical clustering is a tool that identifies associations between clinical and pathological features of tumors and methylation of tumor suppressor genes.

Identificación de asociaciones clínico-patológicas e hipermetilación de genes supresores de tumores en cáncer gástrico difuso a través de análisis de Hierarchical clustering / Hierarchical clustering analysis to detect associations between clinical and pathological features of gastric tumors and hypermethylation of suppressor genes

Background:Methylation is an inactivation mechanism for tumor suppressor genes, that can have important clinical implications. Aim: To analyze the methylation status of 11 tumor suppressor genes in pathological samples of diffuse gastric cancer. Material and methods: Eighty three patients with diffuse gastric cancer with information about survival and infection with Epstein Barr virus, were studied. DNA was extracted from pathological slides and the methylation status of genes p14, p15, p16, APC, p73, FHIT, E-caderin, SEMA3B, BRCA-1, MINT-2 y MGMT, was studied using sodium bisulphite modification and polymerase chain reaction. Results were grouped according to the methylation index or Hierarchical clustering (TIGR MultiExperiment Viewer). Results: Three genes had a high frequency of methylation (FHIT, BRCA1, APC), four had an intermediate frequency (p15, MGMT, p14, MINT2) and four had a low frequency (p16, p73, E-cadherin, SEMA3B). The methylation index had no association with clinical or pathological features of tumors or patients survival. Hierarchical clustering generated two clusters. One grouped clinical and pathological features with FHIT, BRCA1, and APC and the other grouped the other eight genes and Epstein Barr virus infection. Two significant associations were found, between APC and survival and p16/p14 and Epstein Barr virus infection. Conclusions: Hierarchical clustering is a tool that identifies associations between clinical and pathological features of tumors and methylation of tumor suppressor genes.

Development and validation of a real-time Taqman PCR assay for the detection and quantitation of infectious laryngotracheitis virus in poultry.

In this study, the development and validation of a real-time (ReTi) PCR assay is described using a Taqman labeled probe for the detection and quantitation of infectious larygotracheitis virus (ILTV) in chickens. The ReTi ILTV assay was highly specific with a quantitation limit of 100 viral template copies per amplification reaction. In experimentally infected, birds during early acute stages of infection, an average of 6.67 log(10) viral template copies/amplification reaction were detected, while at chronic late stages of infection an average of 2.86-3.27 log(10) viral template copies/amplification reaction were detected. A total of 246 tracheal swab samples collected from natural outbreaks of the disease were tested by virus isolation and the ReTi ILTV assay. Both assays agreed in 37% of the samples tested and the ReTi ILTV assay detected approximately 3.7 times more positives samples than virus isolation. A minimum of 5 log(10) viral template copies/amplification reaction were required from a tracheal swab to render a virus isolation positive result. In conclusion, the ReTi ILTV assay was highly specific, sensitive, reproducible, and capable of reliably quantifying viral nucleic acid directly from clinical samples.

Molecular epidemiology of avian leukosis virus subgroup J and evolutionary history of its 3' untranslated region.

Avian leukosis subgroup J (ALV-J) causes a variety of tumors and mortality in meat-type chickens. Since its discovery in the late 1980s, ALV-J has spread to breeding stock produced by most primary breeding companies of North America, the European Union, and Asia. ALV-J seems to have been eradicated from elite breeding stock produced by most primary breeders, albeit ALV-J still circulates in some commercial poultry. This study was undertaken to examine the molecular epidemiology and evolution of ALV-J detected in breeding stock and broiler chickens representing eight primary breeding companies over a period of approximately 20 yr (1988-2007). The redundant transmembrane region of the envelope gene has been deleted in some isolates, suggesting that this region is dispensable for viral fitness. Within the 3' untranslated region (3' UTR), the direct repeat 1 was present in 100% of the ALV-J isolates studied. In contrast, the E element has undergone substantial deletions in >50% of the ALV-J proviruses studied. Overall, the unique region 3 was the least conserved within the 3' long terminal repeat (LTR), albeit the transcriptional regulatory elements typical of avian retroviruses (CAAT, CArG, PRE, TATA, and Y boxes) were highly conserved. The direct repeat region of the LTR was identical in all of the proviruses, and the 3' unique region 5 was relatively well conserved. Thus, the 3' UTR of ALV-J has evolved rapidly, reflecting significant instability of this region. Some of the mutations in the 3' UTR have resulted in the emergence of moderately distinct genetic lineages representing each primary breeding company from which ALV-J was isolated.

Funcionamiento social del adulto mayor / Social functioning of elderly

Estudio descriptivo relacional, destinado a conocer la autoestima y el funcionamiento social de los ancianos según roles sociales, desde su visión y la de sus cuidadores y la percepción del funcionamiento familiar. Se incluyó a 300 ancianos y sus cuidadores familiares, de los consultorios de atención primaria de Concepción. Se aplicó una encuesta en domicilio, con tres escalas: Groningen Social Disabilities Schedule; Escala de Funcionamiento Familiar de Smilkeinstein y el Test de Autoestima de Rosenberg. Resultados: el 51 por ciento de los ancianos reportan una alta autoestima. La percepción de funcionamiento familiar de éstos se ubica en un 84 por ciento, lo que corresponde a la más alta categoría de esta variable. No se encontró diferencia estadísticamente significativa en la evaluación de la percepción de funcionamiento social, entre la autoevaluación del anciano y la evaluación que hace el cuidador respecto del anciano. Es importante destacar una alta consistencia entre ambas mediciones, correlación de un 74 por ciento. Respecto a la relación entre las mediciones del autorreporte de funcionamiento social de los ancianos y la escala de autoestima, se encontró una correlación positiva, a mejor funcionamiento social obtenido del autorreporte, mayor autoestima. Lo mismo ocurre entre las variables autorreporte de Funcionamiento social de los ancianos y la Escala de Percepción de funcionamiento familiar-Apgar. Los resultados de esta investigación podrán ser considerados por los profesionales de salud para que en el trabajo con ancianos y sus familias se fomente la independencia, la funcionalidad y la calidad de vida.

Relational descriptive study aimed to asses elderly self esteem and social functioning according to the social roles, through their personal and caregiver perceptions and the family functional perception. The sample included 300 elders and the caregivers from Primary Care Centers in the city of Concepción, Chile. It was applied an inquest at home with 3 scales: the Groningen Social Disabilities Schedule; the Smilkeinstein Family Functioning scale and the Rosenberg self esteem test. Results: 51 percent of elders and 84 percent report a high self esteem. The functioning familiar perception of them is at 84 percent, that corresponds to a high level of perception. It was not found estatistically significant difference in social functioning perception between self esteem of elder and the evaluation made by the caregiver. It is important to say that is a high consistence between both measures. Correlation of 74 percent. About the relation between the self social function report of elders and self esteem scale, it was founded a positive correlation. The better the social functioning in the self report, the better the self esteem. The same phenomenon was observed between the elders self reporting social functioning and the APGAR family functioning perception scale. The results of this study could be considered by health professionals so that in working with elders and theirs families, the independence, the functioning and quality of life, could be increased.

Lack of interaction between avian leukosis virus subgroup J and fowl adenovirus (FAV) in FAV-antibody-positive chickens.

Unfounded field speculation has suggested that avian leukosis virus subgroup J (ALV-J) predisposes young meat-type chickens to inclusion body hepatitis caused by fowl adenovirus (FAV). To address this hypothesis, we infected 1-day-old grandparent meat-type chickens carrying maternal antibodies against FAV with a field isolate of FAV associated with inclusion body hepatitis in broilers, ALV-J, or both FAV and ALV-J. We examined the effects of FAV alone or in combination with ALV-J on the basis of clinical signs, overall mortality, growth rate, and gross and microscopic lesions. With such criteria for evaluating possible interactions, we found no significant differences in the dually infected birds in comparison with chickens that received a monovalent challenge with either FAV or ALV-J.

Analysis of nuclear ribonucleoproteic structures during notochordal cell differentiation and maturation in chick embryos.

The ultrastructure of notochordal cells and the quantitative changes of nuclear mRNA-containing particles were studied in several stages of the development of the chick embryo. The modifications in the frequency of perichromatin granules (PCG) were analyzed in embryos at 24 hr to 10 days of incubation (stages 6-36 of Hamburger and Hamilton). The ultrastructural and morphometric data show that notochordal cells undergo changes that can be systematized in four periods. Very early notochordal cells (stages 6-11), are characterized by the presence of large nucleoli and abundant PCG, traits probably related to the frequent mitotic division and the expression of inductive signals reported in numerous papers. During the second period (stages 16-21) the number of PCG and the size of the nucleolus decrease. These changes are coincident with the beginning of vacuolization. In the third period (stages 21-30), the notochordal cells undergo a second cytodifferentiation characterized by a large increase of cytoplasmic vacuolization and secretion of materials that thicken the perichordal sheath. During this period, the nucleolus becomes smaller and the number of PCG increases. Similar features were previously described during functional maturation of embryonic neurons and striated fibers at synaptogenesis, and epidermal cells. The fourth period, beginning at stage 30, is characterized by the decrease of the density of PCG and of the nucleolar volume and corresponds to cessation of mitosis and cell degeneration.

Long-term effects on the olfactory system of exposure to hydrogen sulphide.

OBJECTIVE: To study chronic effects of hydrogen sulphide (H2S) on cranial nerve I (nervi olfactorii), which have been only minimally described. METHODS: Chemosensations (smell and taste) were evaluated in eight men who complained of continuing dysfunction 2-3 years after the start of occupational exposure to H2S. Various bilateral (both nostrils) and unilateral (one nostril at a time) odour threshold tests with standard odorants as well as the Chicago smell test, a three odour detection and identification test and the University of Pennsylvania smell identification test, a series of 40 scratch and sniff odour identification tests were administered. RESULTS: Six of the eight patients showed deficits of various degrees. Two had normal scores on objective tests, but thought that they continued to have problems. H2S apparently can cause continuing, sometimes unrecognised olfactory deficits. CONCLUSION: Further exploration into the extent of such problems among workers exposed to H2S is warranted.

Redes de apoyo médico-social para pacientes con demencia: comunas de Concepción y Quillón: 1996 / Social and medical support for patients with dementia: Concepción and Quillón comunes: 1996

Estudio que muestra percepción y utilización de redes de apoyo médico-social, para pacientes con demencia. El universo fueron familias de pacientes con demencia del Proyecto Demencias Asociadas a Edad OMS-Chile e instituciones que ofrecen atención para ancianos. La muestra fue de 70 familias y 20 instituciones. Se aplicó encuesta estructurada, domiciliaria, a cuidadores y cuestionario a las diferentes instituciones. Los resultados muestran que el apoyo corresponde a consulta hospitalaria (34 por ciento), atención primaria (20 por ciento), control domiciliario (6 por ciento). El cuidado de estos pacientes está dado por familiares (83 por ciento). El apoyo social por amigos (19 por ciento) y grupos religiosos (15 por ciento). El 93 por ciento de los cuidadores no tiene información de apoyos comunitarios, sólo el 11 por ciento ha solicitado ayuda profesional en emergencias, y el 8 por ciento de los cuidadores está satisfecho con los servicios comunitarios entregados. El 90 por ciento de las instituciones no atiende personas con demencia. Los servicios de atención primaria no han implementado programas específicos para ancianos con demencias. Los hogares para ancianos y casas de reposo no tienen infraestructura apropiada y el personal no está debidamente capacitado. Este estudio confirma la necesidad de crear redes de apoyo médico-social para satisfacer requerimientos de atención de los pacientes y familiares, fomentar la agrupación de familiares-cuidadores y crear instituciones especializadas que den atención de calidad, con personal capacitado

Tumores de pulmón

Se realizó una revisión estadística de los pacientes intervenidos quirúrgicamente por tumores pulmonares en el Hospital Provincial Docente Clinicoquirúrgico "Arnaldo Milián Castro" de Villa Clara, entre enero de 1992 y marzo de 1994, ambos inclusive. El total de pacientes operados fue de 30, de los cuales 23 presentaron tumores malignos (76,66) y 7, tumores benignos (23,2). El tipo de tumor má frecuente encontrado fue el carcinoma epidermoide (11 pacientes). Los síntomas predominantes fueron; dolor torácico, tos y disnea. La atelectasia fue la complicación postoperatoria más frecuentes. Hubo bajos índice de sepsis por la utilización profiláctica de antibioticos. Todos los pacientes que fueron operados de tumores benignos están vivos, y hasta la fecha han fallecido 7 pacientes operados por tumores malignos. Se confirma la necesidad e importancia de un diagnóstico precoz para poder ofrecer una mejor asistencia terapeútica y esperar mejor sobrevida