[Geographic variability, health inequities and lethality due to COVID-19 in Bariloche, Río Negro, 2020-2021]. / Variabilidad geográfica, inequidades en salud y letalidad por COVID-19 en Bariloche, Río Negro, 2020-2021.

INTRODUCTION: The objective of this study was to analyze the geographic variability and the relationship between social determinants of health and COVID-19 lethality in Bariloche. METHODS: A database from the National Epidemiological Surveillance System was used to analyze COVID-19 positive cases from January 2020 to December 2021. The data were geocoded and incorporated into a geographic information system (GIS). A three-step analytical framework was applied to measure health inequity, using socioeconomic indicators and access to services. A multivariate analysis was conducted to predict fatality. RESULTS: A total of 25 020 COVID-19 cases were diagnosed in Bariloche during the study period. The fatality rate was 2.1%. Significant variability in socioeconomic indicators was observed among different territorial delegations of the city. DISCUSSION: The results showed health inequities and an association between social determinants and COVID-19 lethality in Bariloche. Individuals living in areas with higher socioeconomic vulnerability had a higher risk of mortality. These findings highlight the importance of addressing health inequities in a pandemic response.

Introducción: El objetivo de este estudio fue examinar cómo la variabilidad geográfica y los determinantes sociales de la salud influyen en la tasa de letalidad por COVID-19 en Bariloche. Métodos: Se utilizó una base de datos del Sistema Nacional de Vigilancia Epidemiológica para analizar los casos positivos de COVID-19 desde enero de 2020 hasta diciembre de 2021. Los datos se geo-codificaron y se incorporaron en un sistema de información geográfica (SIG). Se aplicó un marco de análisis en tres pasos para medir la inequidad en salud, utilizando indicadores socioeconómicos y de acceso a servicios. Se realizó un análisis multivariado para predecir la letalidad. Resultados: Se diagnosticaron un total de 25 020 casos de COVID-19 en Bariloche durante el período de estudio. La letalidad fue del 2.1%. Se observó una variabilidad significativa en indicadores socioeconómicos entre las diferentes delegaciones territoriales de la ciudad. Discusión: Los resultados mostraron inequidades en salud y una asociación entre determinantes sociales y letalidad por COVID-19 en Bariloche. Las personas que vivían en áreas con mayor vulnerabilidad socioeconómica presentaron un mayor riesgo de mortalidad. Estos hallazgos resaltan la importancia de abordar las inequidades en salud en la respuesta a una pandemia.

Variabilidad geográfica, inequidades en salud y letalidad por COVID-19 en Bariloche, Río Negro, 2020-2021 / Geographic variability, health inequities and lethality due to COVID-19 in Bariloche, Río Negro, 2020-2021

Resumen Introducción : El objetivo de este estudio fue exami nar cómo la variabilidad geográfica y los determinantes sociales de la salud influyen en la tasa de letalidad por COVID-19 en Bariloche. Métodos : Se utilizó una base de datos del Sistema Nacional de Vigilancia Epidemiológica para analizar los casos positivos de COVID-19 desde enero de 2020 hasta diciembre de 2021. Los datos se geo-codificaron y se incorporaron en un sistema de información geográfica (SIG). Se aplicó un marco de análisis en tres pasos para medir la inequidad en salud, utilizando indicadores socioeconómicos y de acceso a servicios. Se realizó un análisis multivariado para predecir la letalidad. Resultados : Se diagnosticaron un total de 25 020 casos de COVID-19 en Bariloche durante el período de estudio. La letalidad fue del 2.1%. Se observó una variabilidad significativa en indicadores socioeconó micos entre las diferentes delegaciones territoriales de la ciudad. Discusión : Los resultados mostraron inequida des en salud y una asociación entre determinantes sociales y letalidad por COVID-19 en Bariloche. Las personas que vivían en áreas con mayor vulnerabili dad socioeconómica presentaron un mayor riesgo de mortalidad. Estos hallazgos resaltan la importancia de abordar las inequidades en salud en la respuesta a una pandemia.

Abstract Introduction : The objective of this study was to ana lyze the geographic variability and the relationship between social determinants of health and COVID-19 lethality in Bariloche. Methods : A database from the National Epidemiologi cal Surveillance System was used to analyze COVID-19 positive cases from January 2020 to December 2021. The data were geocoded and incorporated into a geo graphic information system (GIS). A three-step analytical framework was applied to measure health inequity, us ing socioeconomic indicators and access to services. A multivariate analysis was conducted to predict fatality. Results : A total of 25 020 COVID-19 cases were diag nosed in Bariloche during the study period. The fatality rate was 2.1%. Significant variability in socioeconomic indicators was observed among different territorial delegations of the city. Discussion : The results showed health inequities and an association between social determinants and COVID-19 lethality in Bariloche. Individuals living in areas with higher socioeconomic vulnerability had a higher risk of mortality. These findings highlight the importance of addressing health inequities in a pan demic response.

Modeling biosurfactant production from agroindustrial residues by neural networks and polynomial models adjusted by particle swarm optimization.

Biosurfactants are molecules with wide application in several industrial processes. Their production is damaged due to inefficient bioprocessing and expensive substrates. The latest developments of strategies to improve and economize the biosurfactant production process use alternative substrates, optimization techniques, and different scales. This paper presents a study to compare the performances of classical (polynomial models) and modern tools, such as artificial intelligence to aid optimization of the alternative substrate concentration (alternative based on beet peel and glycerol) and process parameters (agitation and aeration). The evaluation was developed in two different scales: Erlenmeyer flask (100 mL) and bioreactor (7 L). The intelligent models were implemented to verify the ability to predict the emulsification index and biosurfactant concentration in smaller scale and the biosurfactant concentration and the superficial tension reduction (STR) in bigger scale, resulting in four different situations. The overall results of the predictions led to artificial neural networks as the best performing modeling tool in all four situations studied, with R2 values ranging from 0.9609 to 0.9974 and error indices close to 0. Also, four different models (Wu, Contois, Megee, and Ghose-Tyagi) were adjusted by particle swarm optimization (PSO) in order to describe the kinetics of biosurfactant production. Contois model was the only one to present R2 ≥ 0.97 for all monitored variables. The findings described in this work present an adjusted model for the prediction of biosurfactant production and also state that the most adjusted kinetic model for further studies on this process is Contois model, leading to the conclusion that biomass growth is limited by a single substrate, considering only glucose.

Equol and daidzein decrease migration, invasion and matrix metalloproteinase (MMPs) gene expression in prostate cancer cell lines, DU-145 and PC-3 / Equol y daidzeina disminuyen la migración, invasión y la expresión génica de metaloproteinasa de la matriz(MMPs) en las líneas celulares prostáticas cancerosas DU-145 y PC-3

This search is focused on the study of diet compounds that may have any potential chemopreventive effect against cancer. Some compounds that fulfill this requirement are phytoestrogens. Among them we find genistein (1), the most studied, daidzein (2) and equol (3) (figure 1). To compare the sensitivities of different prostate cancer cells to phytoestrogen treatment, sulphorhodamine B dye assay was performed to determine cell viability. DU-145 and PC-3 prostate cancer cell lines treated with various doses of phytoestrogen (0-12.5-25-50 and 100 μM) for different times (24, 48 and 72h). For cell invasion or migration assay cells were seeded in a Transwell chamber with or without coating Matrigel respectively. DU-145 and PC-3 cells were treated previously with phytoestrogen (50 μM) for 24h. The study showed that equol, daidzein and genistein inhibited migration and invasion in prostate cancer cell lines. Moreover, we analyzed the effects of phytoestrogens in MMP-2 and MMP-9 mRNA expression by RT-PCR. The results indicated that equol, daidzein and genistein diminished the expression of MMP-2 and MMP-9 in a cell-dependent manner. Our data suggested that equol, daidzein and genistein inhibited migration and invasion in prostate cancer cell lines. Moreover, the results also suggest that down-regulation of MMP-2 and MMP- 9 might be involved in the inhibition of invasion of PC-3 and DU-145 cells after genistein, daidzein and equol treatment.

Este trabajo se centra en el estudio de los compuestos de dieta que pueden tener potencial efecto quimiopreventivo contra el cáncer. Algunos de estos compuestos son los fitoestrógenos. Entre ellos encontramos la genisteína (1), el más estudiado, la daidzeína (2) y el equol (3) (figura 1). Para comparar el efecto de estos fitoestrogenos sobre las líneas celulares de cáncer de próstata, DU-145 y PC-3, se utilizó el ensayo de sulforodamina B para determinar la viabilidad celular tras los tratamientos con diferentes concentraciones de fitoestrógenos (0-12.5-25-50-100 μM) durante diferentes tiempos (24, 48, 72 h). Para analizar el efecto sobre la migración celular, las células DU-145 y PC-3 fueron tratadas previamente con una concentración de fitoestrógrno (50 μM) durante 24 horas y sembradas en una cámara Transwell sin recubrir. El estudio mostró que el equol, daidzeína y genisteína inhibió en MMP-2 y MMP-9 expresiones de genes en líneas celulares de cáncer de próstata, la PC-3 y DU-145. Los resultados indicaron que la daidzeína disminuyó la expresión de MMP- 2 y MMP-9 en DU-145 células. Nuestros datos sugieren que equol, daidzeína y genisteína inhiben la migración y la invasión de líneas celulares de cáncer de próstata.

Daidzein-estrogen interaction in the rat uterus and its effect on human breast cancer cell growth.

Sex hormone replacement therapy provides several advantages in the quality of life for climacteric women. However, estrogen-induced cell proliferation in the uterus and mammary gland increases the risk of cancer development in these organs. The lower incidence of mammary cancer in Asian women as compared with Western women has been attributed to high intake of soy isoflavones, including genistein. We have previously shown that genistein induces an estradiol-like hypertrophy of uterine cells, but does not induce cell proliferation, uterine eosinophilia, or endometrial edema. It also inhibits estradiol-induced mitosis in uterine cells and hormone-induced uterine eosinophilia and endometrial edema. Nevertheless, genistein stimulates growth of human breast cancer cells in culture; therefore, it is not an ideal estrogen for use in hormone replacement therapy (HRD). The present study investigated the effect of another soy isoflavone, daidzein (subcutaneous, 0.066 mg/kg body weight), in the same animal model, and its effect on responses induced by subsequent treatment (1 h later) with estradiol-17ß (E(2); subcutaneous, 0.33 mg/kg body weight). In addition, we investigated the effects of daidzein (1 µg/mL) or E(2) on the growth of human breast cancer cells in culture. Results indicate that daidzein stimulates growth of breast cancer cells and potentiates estrogen-induced cell proliferation in the uterus. We suggest caution for the use of daidzein or formulas containing this compound in HRD. Future research strategies should be addressed in the search for new phytoestrogens that selectively inhibit cell proliferation in the uterus and breast.

Genistein selectively inhibits estrogen-induced cell proliferation and other responses to hormone stimulation in the prepubertal rat uterus.

Sex hormone replacement therapy helps improve quality of life in climacteric women. However, estrogen-induced cell proliferation in the uterus and mammary gland increases the risk for cancer in these organs. The lower incidence of mammary cancer in Asian women than in western women has been attributed to high intake of soy isoflavones, including genistein. Our previous work in the prepubertal rat uterus model showed that genistein (0.5 mg/kg body weight subcutaneously) caused an estradiol-like hypertrophy in myometrial and uterine luminal epithelial cells and an increase in RNA content in luminal epithelium; however, it did not induce cell proliferation, uterine eosinophilia, or endometrial edema. The present study investigated, in the same animal model, the effect of genistein administration (0.5 mg/kg body weight subcutaneously) before treatment with estradiol-17ß (0.33 mg/kg body weight subcutaneously) on uterine responses that were not induced by genistein. Pretreatment with this phytoestrogen completely inhibited estradiol-induced mitoses in uterine luminal epithelium, endometrial stroma, and myometrium and partially inhibited estradiol-induced uterine eosinophilia and endometrial edema. These findings indicate that genistein protects against estrogen-induced cell proliferation in the uterus and suggest that future studies should investigate the possibility of using this agent to decrease the risk for uterine cancer after hormone replacement therapy in climacteric women.

Effect of prenatal exposure to lead on estrogen action in the prepubertal rat uterus.

Lead is a widely spread environmental pollutant known to affect both male and female reproductive systems in humans and experimental animals and causes infertility and other adverse effects. The present paper investigated the effects of prenatal exposure to lead on different parameters of estrogen stimulation in the uterus of the prepubertal rat. In prenatally and perinatally exposed rats, estrogen-induced endometrial eosinophilia, endometrial stroma edema, and eosinophil migration towards the endometrium, and uterine luminal epithelial hypertrophy are enhanced while several other responses to estrogen appear unchanged. These effects may contribute to decrease in fertility following prenatal exposure to lead. The striking difference between most of these effects of prenatal exposure and the previously reported effects of chronic exposure to lead suggests that prenatal exposure to lead may neutralize the effects of chronic exposure to lead, providing partial protection of cell function against the adverse effects of chronic exposure to lead. We propose that the mechanism involved, named imprinting or cell programming, persisted through evolution as a nongenetic adaptive mechanism to provide protection against long-term environmental variations that otherwise may cause the extinction of species not displaying this kind of adaptation.

Biological activity of genistein and soy extracts: selective induction of some but not all estrogenic responses in the prepubertal rat uterus / Actividad biológica de Genisteína y extractos de soya: inducción selectiva de algunas pero no todas las respuestas estrogénicas en el útero de la rata prepúber

The existence of multiple kinds of estrogen receptors (ERs), involved in independent groups of responses, allows their dissociation and opens the possibility to selectively induce beneficial responses but not those considered at risk (cell proliferation). Based on the low hormone-dependent cancer mortality in Eastern Asia, attributed to high dietary intake of estrogenic isoflavones, we investigated whether genistein (G) or soybean extracts (S) selectively induce some, but not all estrogenic responses in the rat uterus, comparing its activity to that of estradiol-17 (E2). Prepubertal rats were treated with E2, G, concentrated S (Sc), diluted S (Sd), or vehicle, and uterine responses to estrogen were evaluated. Luminal epithelial and myometrial cell hypertrophy, and luminal epithelial RNA increase, were induced by E2, G or S. Uterine eosinophilia, endometrial edema and proliferation of 4 uterine cell-types were induced by E2 only. Results reveal that G and S induce some responses to estrogen but not others, suggesting their use as agents not displaying carcinogenic risk.

La existencia de múltiples tipos de receptores de estrógeno (ERs), involucrados en el desarrollo de grupos independientes de respuestas a estrógeno, permite su disociación y abre la posibilidad de inducir en forma selectiva respuestas benéficas pero no aquellas consideradas de riesgo (proliferación celular). Basado en la baja mortalidad por cánceres hormono-dependientes en el Este Asiático, atribuidos a una alta ingesta dietaria de isoflavonas estrogénicas, nosotros investigamos si la genisteína (G) o extractos de soja (S) inducen en forma selectiva algunas, pero no todas, las respuestas estrogénicas en el útero de rata, comparando su actividad con la del estradiol-17beta (E2). Ratas prepuberales fueron tratadas con E2, G, S concentrado (Sc), S diluido (Sd) o vehículo, y las respuestas estrogénicas en el útero fueron evaluadas. Las hipertrofias celulares en epitelio luminal y miometrio, y el aumento de ARN en células del epitelio luminal fueron inducidas por E2, G o S. La eosinofilia uterina, el edema en estroma endometrial y la proliferación de 4 tipos celulares uterinos fueron inducidos sólo por E2. Los resultados revelan que G y S inducen algunas respuestas estrogénicas pero no otras, sugiriendo su uso terapéutico como agentes estrogénicos que no presentan riesgo de cáncer.

Exposición prenatal a drogas de abuso: efectos diferidos e imprinting (desprogramación celular) / Prenatal exposure to drugs of abuse: delayed effects and imprinting (Cell Deprogramming)

El uso de drogas de abuso es un grave problema de salud y problema social en todo el mundo. Se conocen muy bien los efectos en salud de la exposición aguda o crónica a drogas de abuso. También que causan efectos directos en la placenta o en órganos en desarrollo de los embriones, causando malformaciones congénitas. Existe sin embargo muy poca información sobre efectos diferidos de la exposición a estos agentes durante las últimas etapas del desarrollo fetal o las primeras etapas de desarrollo postnatal.Estos agentes causan alteraciones irreversibles en la diferenciación y programación celular, que pueden ser consideradas como malformaciones bioquímicas y funcionales, responsables de alteraciones funcionales orgánicas o neuroconductuales que favorecenel desarrollo de enfermedades más tarde en la vida. En el presente trabajo se describen los efectos persistentes de la exposición a drogas de abuso ilícitas (opiáceos, cocaína, ketamina, tolueno, cannabinoides y anfetamina y sus derivados) y a drogas de abusolegalmente permitidas (alcohol etílico - nicotina y consumo de tabaco no se describen por formar parte de publicación previa en Cuadernos). Exposición a estos agentes favorece el desarrollo de una serie de enfermedades y alteraciones de la conducta más tarde en la vida. Además, se presenta evidencia que la exposición prenatal a varios químicos (plomo, el plaguicida malatión, bisfenol) y a varias drogas de abuso (opioides, etanol, cannabinoides) determinan cambios persistentes que favorecen el desarrollo de adicciones a drogas de abuso más tarde en la vida. Se concluye que, además de los problemas sociales y de salud derivadas del uso por adultos de drogas de abuso, la exposición fetal causa cambios que determina el desarrollo de varias enfermedades más tarde en la vida, incluyendo adicción a drogas de abuso. En consecuencia, la legislación gubernamental que restrinja el acceso y uso de estas drogas...

The use of drugs of abuse is a serious health and social problem through all the world. The eff ects of acute and chronic exposure of drugs of abuse on health are well known. They also cause direct eff ects on placenta o the developing embryo organs, causing congenital malformations. There is however very scarce information on the delayed eff ects of exposure to these agents during the last stages of fetal development or the early stages of postnatal development. These agents cause irreversible alterations in cell diff erentiation and programming, that could be considered as biochemical and functional malformations, responsible of functional organic or neurobehavioral alterations that favors the development of diseases later in life. The present report describes persistent effects of prenatal exposure to illicit drugs of abuse (opiates, cocaine, ketamine, toluene, cannabinoids, and amphetamine derivates) and to legal drugs of abuse (ethyl alcohol; nicotine and tobacco smoking are not reviewed since they were analyzed in a previouspublication in Cuadernos). Exposure to these agents favors the development of a myriad of diseases and behavioral alterations later in life. In addition, evidence is presented that prenatal exposure to various chemicals (lead, the pesticide malathion, bisphenol) andseveral drugs of abuse (opioids, ethanol, cannabinoids) determine persistent changes that favor the development of addictions to drugs of abuse later in life. It is concluded that, besides the known health and social problems derived by adults use of drugs of abuse, fetal exposure causes changes that determine the development of various diseases later in life, including drug addiction.Therefore, the dictation of Governmental regulations to decrease access to and use of these drugs, including the “softest” drugs such as cannabinoids, is fundamental to protect future generations health...

Efectos de exposición aguda a cadmio en la acción de estrógenos en útero de rata impúber / Effects of acute exposure to cadmiun on response to estrogen in the prepuberal rat uterus

Background: Few information is available about uterine effects of Cadmium (Cd) exposure, where toxic agents affecting the female genital tract interact with estrogen (E) receptors, modifiying myometrial activity and the menstrual cycle, causing dysmenorrhea, infertility and spontaneous abortion. No information exists whether prenatal or early postnatal exposure may cause any gynecologic persistent adverse effect. Our finding of a second mechanism of E interaction and differences between E receptors in the various uterine cell types suggests that Cd may affect differently E interaction in each cell-type. Objective: Evaluate a possible selective effect of acute Cd exposure on E action in the uterus during prepuber age. Method: Female prepuber rats exposed to Cd 4 mg/kg and 2 hours later, treated with Estradiol-17² 0,3 mg/kg. A myometrial sample was obtained under anaesthesia 24 hours after E treatment and histologically processed for the quantification of E responses on different uterine cell-types. Results: Cd exposure potentiates E-induced uterine eosinophilia and endometrial edema and inhibits E-induced cell hypertrophy in circular myometrium and cell proliferation in luminal myometrium. Cd, in the absence of hormone stimulation, causes a slight cell hypertrophy in circular myometrium. Conclusions: Acute exposure to Cd affects differently various responses to E in the different uterine cell-types. Future studies should verify whether this effect explains Cd-induced infertility, postpubertal sex organ development and whether prenatal or early postnatal exposure to Cd induces delayed persistent effects.

Antecedentes: Existe poca información sobre efectos del cadmio (Cd) en el útero. En mujeres altera la actividad miometrial, el ciclo menstrual y causa dismenorrea, abortos espontáneos, infertilidad y mortinatos. No existe información si la exposición prenatal o postnatal temprana causa efectos ginecológicos diferidos persistentes. Los tóxicos que afectan el útero suelen interactuar con receptores de estrógeno (E). Nuestro hallazgo de un segundo mecanismo de acción de E y de diferencias entre receptores de E de los diversos tipos celulares uterinos hacen posible que el Cd interactúe con los E en forma diferente en cada tipo celular. Objetivos: Buscar un posible efecto selectivo de la exposición aguda a Cd con algunas respuestas a E en útero de rata durante la edad prepuberal. Métodos: Ratas hembra impúberes recibieron 4 mg Cd/kg p.c. y 2 h después se trataron con 0,3 mg estradiol-17(3/kg p.c; los úteros fueron obtenidos bajo anestesia a las 24 h del tratamiento con E. Los úteros se procesaron para la cuantificación de respuestas a E en cada tipo celular por separado. Resultados: La exposición a Cd incrementa la eosinofilia uterina y edema endometrial inducidos por E; inhibe las siguientes respuestas a E: hipertrofia celular en miometrio circular, proliferación celular en epitelio luminal y miometrio. En ausencia de hormona, el cadmio causa una leve hipertrofia celular en miometrio circular. Conclusiones: La exposición aguda a Cd afecta de manera diferente las respuestas a E en los diversos tipos celulares uterinos de rata prepuberal. Futuros estudios deberán verificar si este efecto explica la infertilidad causada por exposición a Cd, afecta el desarrollo postpuberal de los órganos sexuales, e investigar si la exposición prenatal o postnatal temprana induce efectos diferidos persistentes, como puede ocurrir en población infantil prenatalmente expuesta a Cd.

¿Es posible encontrar un fitoestrógeno para la terapia de reemplazo hormonal, que disminuya el riesgo de cáncer?: tema de Proyecto Anillos de Investigación del Programa Bicentenario en Ciencia y Tecnología / Is it possible to find a phytoestrogen for hormone replacement therapy, decreasing cancer risk?: subject of Research Team Grant in Science and Technology from the Bicentennial Program in Science and Technology

Se describe una nueva línea de investigación que tiene como objetivo investigar principios activos presentes en especies vegetales chilenas, para identificar alguna(s) que produzcan los efectos farmacológicos deseables para su uso como terapia de reemplazo hormonal en mujeres peri o postmenopáusicas, pero que no aumenten, o incluso disminuyan, el riesgo de desarrollar cáncer mamario o endometrial. Esta posibilidad se basa en el hallazgo previo de nuestro equipo de investigadores de un nuevo tipo de receptores estrogénicos responsables de respuestas estrogénicas no genómicas y de nuestro hallazgo de diferencias entre los receptores estrogénicos citosólico-nucleares clásicos de los diferentes tipos celulares uterinos. Si existiera, como anteriormente se creía, un solo tipo de receptor de estrógenos, no sería posible el desarrollo de este nuevo fármaco estrogénico selectivo que buscamos, pues todos los receptores tendrían la misma afinidad por este agente, el que en consecuencia, induciría todas las respuestas a la estimulación estrogénica (incluyendo aquellas que deseamos prevenir, como las que presentan riesgo de desarrollo de cáncer), o que actuaría como antiestrógeno, antagonizando todas las respuestas a los estrógenos en el útero.

A new research line aimed at the investigation of active agents from Chilean plant species is described. The purpose is to indentify those agents inducing expected pharmacological effects in a hormone replacement therapy in peri- or post-menopausal women, but not increasing, or even decreasing, the risk for development of mammary or endometrial cancer. This possibility is based on previous findings from our research team of a new kind of estrogen receptors, responsible of non-genomic responses to estrogen, and our finding of differences between the classical cytosol-receptor estrogen receptors from the different uterine cell-types. If there exists one kind of estrogen receptors only in the uterus, as it was formerly accepted, then it is not possible to develop the selective estrogenic drug we search for, because all receptors would display the same affinity for this agent; therefore, it would induce all responses to estrogen stimulation (including those we wish to prevent, such as those presenting risk of cancer development), or would act as antiestrogen, antagonizing all responses to estrogen in the uterus.

Experiencia clínica minilap para la esterilización quirúrgica / Clinical experience minilap for surgical sterilization

El presente trabajo muestra la experiencia clínica en el HBLT con la aplicación de la técnica de Minilap en la esterilización quirúrgica femenina. Se realizó un total de 118 esterilizaciones quirúrgicas, de las cuales 108 (91,5 por ciento del total de casos) fueron bajo anestesia local. En la gran mayoría de los casos (96,3 por ciento) resultó ser un método muy bien tolerado. Se presentaron sólo 2 casos de lesión vesical (1,7 por ciento) que se resolvieron sin inconvenientes y con una evolución favorable

Placenta previa percreta con invasión vesical / Placenta previa percreta with bladder invasion

Se presentan 3 nuevos casos de placenta percreta con invasión a vejiga ocurridos en nuestro Servicio. Uno de ellos fue diagnosticado durante el embarazo, los otros dos casos fueron hallazgos intraoperatorios. La evolución clínica de las tres pacientes fue satisfactoria.

We report three new cases of placenta previa percreta involving the urinary bladder ocurred in our service. One of them was diagnosed antepartum. The other two were found during surgery. All patient had satisfactory outcome.