Stereoelectronic interactions are too weak to explain the molecular conformation in solid state of cis-2-tert-butyl-5-(tert-butylsulfonyl)-1,3-dioxane.

cis-2-tert-Butyl-5-(tert-butylsulfonyl)-1,3-dioxane (cis-1) exhibits a high degree of eclipsing in the H-C5-S-C segment in the solid state, the origin of which remains unexplained. The eclipsed conformation that corresponds to an energetic minimum in the solid state practically corresponds to a rotational transition state in solution, which allows an approach to understand transitions states. The difference in the enthalpy of sublimation ΔsubH between cis-1 and the more stable trans-1 is 8.40 kcal mol-1, lets to consider that the intermolecular interactions in the crystalline structure must be responsible for the conformational effect observed in the solid state. The study of the experimental electron density of cis-1 in solid state allowed to establish that CH⋯OS intermolecular interaction is the main contribution to the observed eclipsing. The charge density analysis was also performed using the quantum theory of atoms in molecules to evaluate the nature and relevance of the intermolecular interactions in the crystal structure.

Lupus enteritis: a narrative review.

Lupus enteritis (LE) is a rare manifestation of systemic lupus erythematosus. The pathophysiology of LE has not been fully elucidated, although inflammatory and thrombotic processes are likely important factors. The underlying pathophysiological mechanisms may depend on which portion of the intestine is affected. Over half of the patients with LE also present with renal or haematological complications. The diagnosis of LE is based on clinical, histopathological and imaging findings; abdominal computed tomography (CT) is the gold standard in diagnosis. Abdominal CT can also identify factors that predict complications and could potentially guide pharmacological and nutritional management. Timely identification and prompt treatment initiation are paramount to avoid life and organ threatening complications. Glucocorticoids are often the first-line treatment. Additional therapy including immunosuppressive therapy is utilised on a case-by-case basis as there are no clinical trials to define the optimal therapeutic approach. Surgical intervention may be needed especially if there is bowel perforation or peritonitis. In general, the prognosis of LE is good.

Neuropharmacological Effects of the Dichloromethane Extract from the Stems of Argemone ochroleuca Sweet (Papaveraceae) and Its Active Compound Dihydrosanguinarine.

Argemone ochroleuca Sweet (Papaveraceae) is used in folk medicine as a sedative and hypnotic agent. This study aimed to evaluate the anxiolytic-like, sedative, antidepressant-like, and anticonvulsant activities of a dichloromethane extract of A. ochroleuca stems (AOE), chemically standardized using gas chromatography-mass spectrometry (GC-MS), and its active compound dihydrosanguinarine (DHS). The anxiolytic-like, sedative, antidepressant-like, and anticonvulsant activities of the AOE (0.1-50 mg/kg p.o.) and DHS (0.1-10 mg/kg p.o.) were evaluated using murine models. A possible mechanism for the neurological actions induced by the AOE or DHS was assessed using inhibitors of neurotransmission pathways and molecular docking. Effective dose 50 (ED50) values were calculated by a linear regression analysis. The AOE showed anxiolytic-like activity in the cylinder exploratory test (ED50 = 33 mg/kg), and antidepressant-like effects in the forced swimming test (ED50 = 3 mg/kg) and the tail suspension test (ED50 = 23 mg/kg), whereas DHS showed anxiolytic-like activity (ED50 = 2 mg/kg) in the hole board test. The AOE (1-50 mg/kg) showed no locomotive affectations or sedation in mice. A docking study revealed the affinity of DHS for α2-adrenoreceptors and GABAA receptors. The anxiolytic-like and anticonvulsant effects of the AOE are due to GABAergic participation, whereas the antidepressant-like effects of the AOE are due to the noradrenergic system. The noradrenergic and GABAergic systems are involved in the anxiolytic-like actions of DHS.

Obtaining human teeth for dental education: A cross-sectional study to create ethical and transparent processes.

OBJECTIVES: This study explores the practices of obtaining human teeth for teaching and research in Paraguay. The goal of this research is to understand whether the data supports the need to improve ethical training within dental education, including the creation of a human tooth bank (HTB) METHODS: An observational cross-sectional study was conducted. Three semi-structured questionnaires were developed, one for each target population: dental students, dentists in practice, and the general population. The questionnaires were distributed between February and April 2021, using Google Forms RESULTS: The main places where human teeth were obtained by a student are dental clinics, followed by cemeteries. 94% of students and 91% of dentists paid for teeth on at least one occasion. There is a willingness on the part of students and dentists to donate collections of teeth, and among the general population to donate their teeth if they are extracted, for both teaching and research use. Note that, 31% of students and 6% of the population are aware of what an HTB is, at the same time only 16% of dentists know how it functions CONCLUSION: The number of respondents who obtain teeth from cemeteries and who pay for their acquisition is high. Both of these practices raise ethical concerns. The implementation of informed consent for the donation of extracted teeth is practically nil; although there is a positive attitude towards its implementation. Also, there is a lack of knowledge about the role of an HTB; although the population expressed a willingness to donate extracted teeth.

Desregulación emocional y nivel de riesgo por consumo de sustancias psicoactivas en universitarios colombianos / Emotional dysregulation and risk level for consumption of psychoactive substances in Colombian university students

Resumen El consumo de sustancias psicoactivas [SPA] es un problema de salud pública, y constituye uno de los principales factores de riesgo para la salud. Se ha observado que el consumo de SPA está mediado por diferentes variables, una de ellas es la desregulación emocional, y se requiere mayor investigación del comportamiento de esta variable y su relación con los niveles de riesgo asociado al consumo. El objetivo del presente estudio fue determinar si existen diferencias en la desregulación emocional según el nivel de riesgo asociado al consumo de sustancias en una muestra de universitarios. Para tal efecto se adelantó un estudio descriptivo por comparación de grupos con una muestra de 721 estudiantes. Los resultados indicaron altas prevalencias de consumo de SPA; diferencias en los puntajes de desregulación emocional según el nivel de riesgo para tranquilizantes y cocaína, y que, a nivel general, aquellos universitarios con menor nivel de riesgo son quienes presentan menores puntajes de desregulación emocional, lo que sugiere que la desregulación emocional es una variable predictora de un mayor nivel de riesgo asociado al consumo de SPA.

Abstract The use of psychoactive substances is a public health problem, and it is one of the main health risk factors. It has been observed that the use of drugs is mediated by different variables, one of them is the emotional dysregulation, and more research is required on the behavior of this variable and its relationship with the levels of risk in the consumption. The aim of this study was to determine whether there are differences in emotional dysregulation according to the level of risk associated with substance use in a sample of 721 university students. For this purpose, a descriptive study was carried out by comparing groups. The results indicated high prevalence of PAS consumption, differences in emotional dysregulation scores according to the risk level for tranquilizer pills and cocaine. In general, the students with a lower risk level are those who present lower emotional dysregulation scores, suggesting that emotional dysregulation is a predictor variable of a higher level of risk associated with PAS consumption.

Piperidine-Iodine as Efficient Dual Catalyst for the One-Pot, Three-Component Synthesis of Coumarin-3-Carboxamides.

A simple and efficient one-pot, three-component synthetic method for the preparation of coumarin-3-carboxamides was carried out by the reaction of salicylaldehyde, aliphatic primary/secondary amines, and diethylmalonate. The protocol employs piperidine-iodine as a dual system catalyst and ethanol, a green solvent. The main advantages of this approach are that it is a metal-free and clean reaction, has low catalyst loading, and requires no tedious workup.

Composition-Dependent Cytotoxic and Antibacterial Activity of Biopolymer-Capped Ag/Au Bimetallic Nanoparticles against Melanoma and Multidrug-Resistant Pathogens.

Nanostructured silver (Ag) and gold (Au) are widely known to be potent biocidal and cytotoxic agents as well as biocompatible nanomaterials. It has been recently reported that combining both metals in a specific chemical composition causes a significant enhancement in their antibacterial activity against antibiotic-resistant bacterial strains, as well as in their anticancer effects, while preserving cytocompatibility properties. In this work, Ag/Au bimetallic nanoparticles over a complete atomic chemical composition range were prepared at 10 at% through a green, highly reproducible, and simple approach using starch as a unique reducing and capping agent. The noble metal nanosystems were thoroughly characterized by different analytical techniques, including UV-visible and FT-IR spectroscopies, XRD, TEM/EDS, XPS and ICP-MS. Moreover, absorption spectra simulations for representative colloidal Ag/Au-NP samples were conducted using FDTD modelling. The antibacterial properties of the bimetallic nanoparticles were determined against multidrug-resistant Escherichia coli and methicillin-resistant Staphylococcus aureus, showing a clear dose-dependent inhibition even at the lowest concentration tested (5 µg/mL). Cytocompatibility assays showed a medium range of toxicity at low and intermediate concentrations (5 and 10 µg/mL), while triggering an anticancer behavior, even at the lowest concentration tested, in a process involving reactive oxygen species production per the nanoparticle Au:Ag ratio. In this manner, this study provides promising evidence that the presently fabricated Ag/Au-NPs should be further studied for a wide range of antibacterial and anticancer applications.

Does Twitter Affect Stock Market Decisions? Financial Sentiment Analysis During Pandemics: A Comparative Study of the H1N1 and the COVID-19 Periods.

Investors are constantly aware of the behaviour of stock markets. This affects their emotions and motivates them to buy or sell shares. Financial sentiment analysis allows us to understand the effect of social media reactions and emotions on the stock market and vice versa. In this research, we analyse Twitter data and important worldwide financial indices to answer the following question: How does the polarity generated by Twitter posts influence the behaviour of financial indices during pandemics? This study is based on the financial sentiment analysis of influential Twitter accounts and its relationship with the behaviour of important financial indices. To carry out this analysis, we used fundamental and technical financial analysis combined with a lexicon-based approach on financial Twitter accounts. We calculated the correlations between the polarities of financial market indicators and posts on Twitter by applying a date shift on tweets. In addition, correlations were identified days before and after the existing posts on financial Twitter accounts. Our findings show that the markets reacted 0 to 10 days after the information was shared and disseminated on Twitter during the COVID-19 pandemic and 0 to 15 days after the information was shared and disseminated on Twitter during the H1N1 pandemic. We identified an inverse relationship: Twitter accounts presented reactions to financial market behaviour within a period of 0 to 11 days during the H1N1 pandemic and 0 to 6 days during the COVID-19 pandemic. We also found that our method is better at detecting highly shifted correlations by using SenticNet compared with other lexicons. With SenticNet, it is possible to detect correlations even on the same day as the Twitter posts. The most influential Twitter accounts during the period of the pandemic were The New York Times, Bloomberg, CNN News and Investing.com, presenting a very high correlation between sentiments on Twitter and stock market behaviour. The combination of a lexicon-based approach is enhanced by a shifted correlation analysis, as latent or hidden correlations can be found in data.

Fischer Carbene Complexes: A Glance at Two Decades of Research on Higher-Order Cycloaddition Reactions.

The structure of Fischer carbene complexes (FCCs) is electron deficient. If bearing an α,ß-unsaturated system, it can generate a wide variety of compounds by undergoing many different transformations, including higher-order cycloadditions. The latter are described as pericyclic reactions in which more than six electrons participate. These reactions have been employed in various areas of organic synthesis, resulting in highly selective compounds with a broad range of scaffolds. The first studies on higher-order cycloadditions involving FCCs frequently yielded competing byproducts. Many groups have attempted to increase selectivity by exploring distinct reaction conditions, reagents and co-catalysts (e. g., metal-mediated cycloadditions). The present review is the first to focus exclusively on using higher-order cycloadditions involving FCCs to synthesize carbocycles and heterocycles. Based on two decades of reports, an analysis is made of the main aspects of the mechanisms proposed for higher-order cycloadditions and the structural diversity obtained by the substituent effect.

Ontogeny of the facial phenotypic variability in Mexican patients with 22q11.2 deletion syndrome.

BACKGROUND: 22q11.2 deletion syndrome is a medical condition that results from genomic loss at chromosome 22. Affected patients exhibit large variability that ranges from a severe condition to mild symptoms. In addition, the spectrum of clinical features differs among populations and even within family members. The facial features related to this syndrome are not an exception, and although part of its variation arises through development, few studies address this topic in order to understand the intra and inter-population heterogeneities. Here, we analyze the ontogenetic dynamics of facial morphology of Mexican patients with del22q11.2 syndrome. METHODS: Frontal facial photographs of 37 patients (mean age = 7.65 ± 4.21 SE) with del22q11.2DS and 200 control subjects (mean age = 7.69 ± 4.26 SE) were analyzed using geometric morphometric methods. Overall mean shape and size differences between patients and controls were analyzed, as well as differences in ontogenetic trajectories (i.e. development, growth, and allometry). RESULTS: We found that Mexican patients show typical traits that have been reported for the Caucasian population. Additionally, there were significant differences between groups in the facial shape and size when all the ontogenetic stages were considered together and, along ontogeny. The developmental and allometric trajectories of patients and controls were similar, but they differed in allometric scaling. Finally, patients and controls showed different growth trajectories. CONCLUSION: The results suggest that the typical face of patients with del22q11.2DS is established prenatally; nonetheless, the postnatal ontogeny could influence the dysmorphology and its variability through size-related changes.

Influencia de la altura en los niveles de proteína C reactiva en adultos con adiposidad visceral abdominal / Influence of high altitude on C-reactive protein levels in adults with abdominal visceral adiposity

Objetivo: Evaluar la influencia de la altura en los niveles de proteína C reactiva (PCR) en adultos con adiposidad visceral abdominal. Materiales y métodos: Se realizó un estudio cuantitativo con diseño cuasi-experimental, que incluyó veinticuatro estudiantes de medicina de la Universidad Nacional de Trujillo, sexo masculino, seleccionados de manera no probabilística por conveniencia y sujeto participante, que fueron evaluados a 0 y 4386 m s. n. m. y clasificados de acuerdo al grado de adiposidad visceral abdominal: normal (G1) y elevada (G2). Resultados: El nivel de PCR de G1 en relación a G2 no tuvo diferencia significativa. Respecto a los niveles de PCR de G2 se empleó la prueba no paramétrica de Wilcoxon y para G1 se usó la prueba T-student, evidenciándose una significancia en ambos casos. Conclusiones: Las variaciones de los niveles de PCR en altura con respecto al basal de ambos grupos fueron significativos

Objective: To evaluate the influence of high altitude on C-reactive protein (CRP) levels in adults with abdominal visceral adiposity. Materials and methods: A quantitative study with quasi-experimental design, which included twenty-four (24) male medical students from the National University of Trujillo, selected by non-probability convenience sampling and study subject, evaluated at 0 and 4,386 m.a.s.l., and classified according to their degree of abdominal visceral adiposity: normal (G1) and high (G2). Results: The CRP level of G1 in relation to G2 showed no significant difference. Regarding CRP levels, Wilcoxon rank-sum (non-parametric) test was used for G2 and Student´s t-test was used for G1, with significance being shown in both cases. Conclusions: Variations on CRP levels in high altitude compared to sea level in both groups were significant

La hipertensión arterial: un problema de salud internacional / Arterial hypertension: an international health problem

En el mundo actual la hipertensión arterial una de las enfermedades más comunes que afectan la salud humana, siendo patología y factor de riesgo importante para otras enfermedades, por lo que las estrategias de intervención de salud deben estar dirigidas, a la prevención primaria o de ocurrencia y a la secundaria o de progresión. La Organización Mundial de la Salud, en 1974 realizó un proyecto comunitario, en el cual se incluyó a Cuba por sus resultados sanitarios, surge entonces en el Ministerio de Salud Pública, el Primer Programa Nacional para Prevención y Control de la Hipertensión Arterial; en la actualidad coordinado por dicha organización y el Ministerio de Salud se realiza un Programa de Intervención de Salud de esta entidad en la provincia de Matanzas, en un policlínico del municipio cabecera. El objetivo de este trabajo es valorar los contenidos teóricos del tema y con la experiencia acumulada de los autores durante estos años por los roles asistenciales y educativos desempeñados en las Ciencias Médicas, en Cuba y en las misiones internacionalistas (AU).

In the current world, arterial hypertension is one of the most common diseases affecting human health, being pathology and important risk factor for other diseases; therefore the strategies of health intervention should be aimed to the primary or occurrence prevention and to the secondary or progression prevention. In 1974, the World Health Organization developed a community project in which Cuba was included because of its health results. The First National Program for Arterial Hypertension Prevention and Control started then in the Ministry of Public Health. Currently, coordinated by the aforementioned organization and the Ministry of Health, a Program of Health Intervention of this entity is carried out in the province of Matanzas, in one of the policlinics of the capital municipality. The aim of this work is assessing the theoretical contents of the theme on the bases of the experience accumulated by the authors in Medical Sciences, in Cuba and in the international missions (AU).

Experiencia inicial en el tratamiento del síndrome aórtico agudo de la aorta descendente / Initial experience in the treatment of acute aortic syndrome of the descending aorta

RESUMEN Introducción: Es un un proceso de la pared aórtica en el cual se encuentran la disección aórtica, el hematoma intramural y la úlcera penetrante. Cabe destacar que la transección de aorta traumática se considera como parte del síndrome, no reflejado aquí, al no tratar traumatismos.Objetivos: Realizar un relevamiento acerca de las características demográficas, diagnóstico y tratamiento en nuestro equipo de trabajo.Materiales y métodos: Se evaluaron edad, sexo, comorbilidades, cuadro clínico y laboratorio al ingreso, métodos de diagnósticos por imágenes, tratamiento y tiempo de internación. Resultados: Siete pacientes presentaron disección de aorta tipo B, dos pacientes hematomas intramurales; uno junto a una ulcera aórtica y otro a disección crónica tipo B y uno presentó úlcera de aorta torácica doble sintomática asociada a aneurisma de aorta abdominal. El 80% de los pacientes fueron de sexo masculino, con un promedio de edades de 64,7. El promedio de días de internación fue de 19,8. El dolor se presentó en nueve de los pacientes. En todos se realizó angiotomografía axial computada. La totalidad fueron tratados por medio de endoprótesis de aorta. Conclusión: 1- El síndrome aórtico agudo es una patología de elevada mortalidad cuyo diagnóstico puede ser alcanzado en forma rápida por una evaluación básica y un apoyo imagenológico. 2- Consideramos que la tomografía es el método que más precisiones aporta acerca de las características morfológicas, diagnósticas y para las mediciones para el tratamiento endovascular. 3- El tratamiento endovascular es la opción más efectiva que reduce la mortalidad, la estancia nosocomial y las complicaciones. (AU)

Structural and technological characteristics of starch isolated from sorghum as a function of drying temperature and storage time.

The quality of sorghum grains can vary according to the conditions of the drying temperature and storage time. The objective of this study was to evaluate the effects of the drying temperature and storage time of sorghum grain on the structure and technological properties of starch. The sorghum grains were dried at 45, 65, and 85°C and stored for six months. The grains were stored in an environment with a controlled temperature and humidity, and the starch from sorghum grains was isolated in initial time, after three and six months. The sorghum starches grains dried at 45 and 65°C present higher relative crystallinity than the starches of sorghum grains dried at 85°C in three months of storage. A reduction in the solubility of the starches of the sorghum grains dried at 85°C was observed when the grains were stored during six months. The breakdown and swelling power of the starches were reduced with the increase of the drying temperature.

Prognóstico da coronariopatia aterosclerótica não significativa detectada pela tomografia de coronárias / Prognosis of non-significant coronary atherosclerotic disease detected by coronary artery tomography

Introdução: Embora os estudos tenham demonstrado elevada acurácia diagnóstica da tomografia de coronárias (TC)na detecção de doença arterial coronariana (DAC), os dados sobre o valor prognóstico desse método em pacientes com obstrução coronariana não significativa são limitados.Objetivo: Avaliar o valor da TC na predição de eventos adversos em pacientes com suspeita de DAC e obstrução coronária não significativa. Métodos: Foram avaliados prospectivamente 440 pacientes entre janeiro de 2008 e julho de 2013 pela TCMD, diagnosticados com obstrução não significativa ou sem obstrução aterosclerótica coronariana e com seguimento médio de 33 meses. Os desfechos avaliados foram: morte de origem cardíaca, infarto do miocárdio, angina instável associado à hospitalização ou revascularização do miocárdio. Resultados: Dos 440 pacientes estudados, 295 (67%) eram homens, com idade média de 55,9 ± 12,0 anos. Foi encontrada obstrução não significativa em 152 (35%) dos pacientes e ocorreram 49 (11%) desfechos. Na análise multivariada, utilizando-se modelo de regressão de Cox, os preditores de desfechos clínicos foram obstrução não significativa à TC(hazard ratio 3,51; IC 95% 1,73 – 7,8; p < 0,01), idade e hipertensão arterial sistêmica. A obstrução não significativa à TC apresentou associação com desfechos clíncos adversos, e a análise de sobrevida mostrou diferença significativa (log-rank 24,6; p < 0,01) na predição desses desfechos. Conclusão: A detecção de obstrução aterosclerótica não significativa pela TC mostrou associação com a presença de eventos adversos em pacientes com suspeita de DAC, podendo se mostrar útil na estratificação de risco desses pacientes.

Introduction: Although studies have shown high diagnostic accuracy of coronary tomography (CT) in detecting coronary artery disease (CAD),data on the prognostic value of this method in patients with no significant coronary obstruction are limited.Objective: To evaluate the value of CT in predicting adverse events in patients with suspected CAD and no significant coronary obstruction. Methods: We prospectively evaluated 440 patients between January 2008 and July 2013 by MDCT, diagnosed with no significant obstruction or no atherosclerotic coronary obstruction with an average follow-up of 33 months. The outcomes evaluated were: cardiac death, myocardial infarction, unstable angina associated with hospitalization or coronary artery bypass grafting.Results: Of the 440 patients studied, 295 (67%) were men with mean age 55.9 ± 12.0 years. Non-significant obstruction was found in 152 (35%) of the patients and there were 49 (11%) outcomes. In the multivariate analysis using the Cox regression model, the predictors of clinical outcomes werenon-significant obstruction on CT (hazard ratio 3.51; 95% CI 1.73 — 7.8; p <0.01), age and hypertension. Non-significant obstruction on CT wasassociated with adverse clinical outcomes and survival analysis showed a significant difference (log-rank 24.6; p <0.01) in predicting these outcomes.Conclusion: The detection of non-significant atherosclerotic obstruction by CT was associated with the presence of adverse events in patients withsuspected CAD, which may prove useful in the risk stratification of these patients.

Comportamiento de las fístulas arteriovenosas para hemodiálisis en el anciano / Behavior of arteriovenous fistulas for hemodialysis in elderly patients

Introducción: en los últimos años se ha observado un incremento de pacientes ancianos en los servicios de hemodiálisis. Este hecho, unido al número creciente de pacientes diabéticos con lecho vascular deteriorado, ha aumentado la dificultad para la creación de un acceso vascular en esta población en riesgo. Objetivo: observar el comportamiento de las fístulas arteriovenosas en pacientes de 65 años o más en régimen de hemodiálisis. Métodos: se realizó un estudio observacional descriptivo prospectivo en pacientes de 65 años o más a los que se le construyó una fístula arteriovenosa entre marzo de 2011 y marzo de 2013 en el servicio de Hemodiálisis del Instituto de Nefrología de La Habana. El grupo de estudio fue de 58 pacientes. Resultados: Hubo predominio del sexo masculino (55,2 por ciento). Las enfermedades de base que más se observaron fueron la Diabetes mellitus (43,1 por ciento) y la Hipertensión arterial (37,9 por ciento). Las complicaciones que más se registraron fueron: flujo insuficiente (15,2 por ciento) y trombosis (12,1 por ciento). Mostraron mayor supervivencia las fístulas arteriovenosas en hombres (78 %), en pacientes no diabéticos (73 por ciento) y las de localización radiocefálica (73 por ciento). La supervivencia primaria global al año de las fístulas arteriovenosas en nuestros pacientes fue de 69,0 por ciento. Conclusiones: Las fístulas arteriovenosas autólogas pueden ser realizadas como primera opción en pacientes de 65 años o más y se obtienen tasas de supervivencia adecuadas, comparables a las de otros grupos de pacientes(AU)

Introduction: In the last few years, the number of old patients in the hemodialysis service has increased. This fact along with this growing number of diabetic patients that show damaged vascular bed has brought about more difficulties in creating a vascular access in their risk population. Objective: To observe the behavior of arteriovenous fistulae in patients aged 65 years or more subjected to hemodialysis. Methods: Prospective, descriptive and observational study conducted in 65 years old and over whom an arteriovenous fistula was created from March 2011 to March 2013 at the hemodialysis service of the Institute of Nephrology in Havana. The study group was made up of 58 patients. Results: The male sex predominated (55.2 percent). The most observed underlying diseases were diabetes mellitus (43.1 percent) and hypertension (37.9 percent). The most found complications were insufficient flow (15.2 percent) and thrombosis (12.1 percent). The highest survival rate was seen in arteriovenous fistulae in men (78 percent); non-diabetic patients (73 percent) and radiocephalic location (73 percent). The global primary survival rate after one year of the arteriovenous fistulae in our patients was 69 percent. Conclusions: The autologous arteriovenous fistulae may be performed as a first option in patients aged 65 years or more, and adequate survival rates, comparable to those of other groups of patients, were reached(AU)

Rabdomiosarcoma orbitario. Presentación de un caso / Orbital Rhabdomyosarcoma. A Case Report

El rabdomiosarcoma es un tumor maligno originado por células musculares esqueléticas normales y como dichas células están presentes en casi todo el organismo, este tumor puede tener cualquier localización, a pesar de lo cual no es muy frecuente. Se presenta el caso de un paciente de seis años de edad, de Kuito Bie, Angola, que fue atendido por médicos cubanos de misión en ese país, y que acudió a su consulta por aumento de volumen de una masa tumoral que protuía por la cavidad orbitaria. Su padre refería antecedentes de traumatismo ocular por el cual había sido ingresado y llevado tratamiento, pero evolucionó tórpidamente y se le había realizado evisceración del ojo derecho. Se realizaron estudios del tumor y se concluyó como un rabdomiosarcoma orbitario. Por lo poco común de la entidad y la importancia del diagnóstico y tratamiento oportuno, se decidió la presentación del caso.

Rhabdomyosarcoma is a malignant tumor arising from normal skeletal muscle cells. Since these cells are found in almost every part of the body, this type of tumor may develop in any site, though it is not very common. The case of a six-year-old Angolan patient treated by Cuban collaborators serving in this country is presented. The patient sought medical attention due to inflammation and pain in the right eye. His relative mentioned a history of ocular trauma, resulting in the patient’s admission to receive treatment a week before. On eye examination, a whitish spot through the pupil and slight proptosis were found. The patient had an unsatisfactory recovery; consequently an evisceration of the right eye was performed. Three months later, he developed an enlarging mass protruding in the orbital cavity. Several studies were conducted and an orbital rhabdomyosarcoma was diagnosed.

Aneurisma de fístula arteriovenosa para hemodiálisis / Hemodialysis arteriovenous fistula aneurysms

Los aneurismas de fístulas arteriovenosas para hemodiálisis constituyen una complicación que aparece en algunos pacientes y que no siempre se toma una conducta con relación a ellos. En este trabajo presentamos un caso de una mujer de 29 años de edad con nueve años en hemodiálisis a través de una fístula arteriovenosa braquiocefálica izquierda que desarrolló aneurisma gigante con peligro de ruptura espontánea, la cual fue sometida a tratamiento quirúrgico. Se describe la técnica y se revisa la literatura al respecto(AU)

Hemodialysis arteriovenous fistula aneurisms represent a complication that we can observe in some patients and not always is taken a procedure in relation to them. Herein, we report the case of 29 year old woman with nine years of hemodialysis treatment through left brachiocephalic arteriovenous fistula which developed a giant aneurism with the possibility of spontaneous rupture. The patient was submitted to surgical treatment. The technique was described and the literature was review(AU)

Supervivencia de las fístulas arteriovenosas en pacientes en hemodiálisis / Survival of arteriovenous fistulas in hemodialysis patients

Introducción: el tratamiento sustitutivo de la insuficiencia renal crónica en su estadio terminal requiere la creación previa de un acceso vascular permanente cuando se elige como método depurador la hemodiálisis, siendo la fístula arteriovenosa autóloga el angioacceso más usado por las ventajas que ofrece. El objetivo de este estudio fue conocer las características generales de esta población de pacientes y cómo ellas se relacionaron con la supervivencia anual de las fístulas arteriovenosas realizadas en este grupo de enfermos. Métodos: se llevó a cabo un estudio prospectivo, descriptivo y longitudinal para el que se tomaron 109 pacientes en los que se realizaron 115 fístulas arteriovenosas. Estos pacientes asistieron al Instituto de Nefrología de La Habana para realizarse un acceso vascular para hemodiálisis, estos accesos vasculares fueron construidos por el Grupo Básico de Trabajo de Cirugía de dicha institución, en el período comprendido de marzo de 2005 a marzo de 2007. Se analizaron los factores de riesgo que podían influir en la supervivencia de las fístulas. Resultados: en el estudio realizado se observó un ligero predominio del sexo maculino (59 hombres y 50 mujeres), con una edad media de 52,5 años, y en los que predominaron como causa de insuficiencia renal crónica la nefroangioesclerosis seguida de la nefropatía diabética y la enfermedad renal poliquística autosómica dominante. La cifra promedio de filtrado glomerular con que se enviaron los pacientes a realizarse la fístula fue de 18,73 ml/min. De nuestros pacientes, 59 presentaban algún tipo de acceso vascular previo. Encontramos una menor supervivencia o tasa de permeabilidad primaria en los pacientes diabéticos y en las fístulas de localización braquial, fundamentalmente las humerobasílicas, sin presentar una relación estadísticamente significativa este último aspecto (p < 0,05). El 35 por ciento de nuestros pacientes se encontraba en régimen de hemodiálisis al realizarse la fístula arteriovenosa. Conclusiones: la fístula arteriovenosa autóloga continúa siendo el acceso vascular preferido por su menor índice de complicaciones. Es importante la selección previa del sitio adecuado para su creación. La diabetes mellitus es un importante factor de riesgo que influye significativamente en una menor supervivencia de los angioaccesos(AU)

Introduction: in the replacement therapy of end-stage renal disease, the previous creation of a permanent vascular access is required when hemodialysis is chosen as a depurative method. Autologous arteriovenous fistula is the most widely used angioaccess because of its advantages. The objective of the present study was to assess the demographic data of this population and their relationship with the annual survival of arteriovenous fistulae in this group. Methods: a longitudinal prospective and descriptive study was conducted in 109 patients in whom 115 arteriovenous fistulae were created. They had been referred to the Department of Surgery of the Nephrology Institute of Havana in order to create vascular access for hemodialysis in the period from March 2005 through March 2007. The risk factors in the fistula survival were analyzed. Results: males slightly predominated (59 males and 50 females). The average age was 52.5 years. Nephroangiosclerosis followed by diabetic nephropathy and polycystic kidney disease were the predominant causes of end-stage renal disease. Glomerular filtration average for these patients was 18.73 ml/min. Fifty nine had a previous vascular access. A lower survival or primary patency rate was found in diabetic patients and in cases of humerobasilic fistulae, without any statistically significant relation in this last aspect (p>0.05). Thirty five percent of the patients were under hemodialysis therapy at the time of arteriovenous fistula placement. Conclusions: autologous arteriovenous fistula remains as a preferred vascular access due to its lower rate of complications. The selection of the correct placement site prior to the procedure is critical. Diabetes mellitus is an important risk factor which may have a significant effect on lower survival rates of vascular accesses

[Prevalence of Sensitization to the Most Common allergens in Elderly Patients from the Western of Mexico]. / Prevalencias de sensibilizaciÛn a alÈrgenos m·s comunes en adultos mayores del occidente de México.

BACKGROUND: Allergic diseases affect a great proportion of seniors. OBJECTIVE: To determine the prevalence of allergen sensitization in this age group in the western of Mexico. METHODS: A retrolective study related to skin prick tests with a common allergen panel was performed on the first consultation in elderly patients during a period of three years in Guadalajara, Mexico. RESULTS: We included 60 subjects, with an average of 67.7 years old; 83.3% were women. Diagnosis of allergic rhinitis was present in 60%, allergic rhinitis plus asthma in 30%, and asthma alone in 10%. Non atopic comorbidities were present in 56.7% of the cases. Median serum IgE was 124.95 UI/ml, the average of positive skin prick tests was 4 (1 to 21); 13.3% were sensitized to just 1 aeroallergen, and 55% were to more than three aeroallergens. Sensitization to pollens was predominant, even more to tree pollens. One by one, house dust mite, Fraxinus sp and Amaranthus palmeri were the most commonly found. Diabetes was associated to a lower positive prick test (p = 0.021). CONCLUSIONS: The most common sensitizing allergens are similar for other age groups from the same area. Elderly patients with diabetes had lower positive allergen skin tests. Itís recommended to identify the allergen sensitization in seniors with allergic disease symptoms, as part of their clinical evaluation.