Normal development of the muscular region of the interventricular septum--I. The significance of the ventricular trabeculations.

The structures that participate in normal ventricular septation, and to what extent they do so, are questions not yet clarified. Even less is known about how much each of the embryonic structures contributes to the topography of the mature interventricular septum (IVS). The aim of the present paper is to investigate the significance of ventricular trabeculations in the normal development of the muscular region (the middle and apical thirds) of the IVS and to determine the direction in which it grows during cardiac septation. Anatomical studies and in vivo labelling were carried out in chicken embryo hearts at stage 18HH, tracing the labels up to stage 36HH. We analysed the results by measuring the distance between the labelled structures at the beginning and end of the experiments. We demonstrate that the muscular region of the septum originates by the fusion of the ventricular trabeculations with evidence that during cardiac development, the IVS as well as the ventricular cavities grow in opposite direction to the atria.

Caracterización molecular de aislamientos de enterobacter cloacae multirresistentes productores de a-lactamasas provenientes de pacientes de un hospital de tercer nivel de Bogotá / Molecular characterization of 20 isolates of resistance enterobacter cloacae from a Hospital of third level in Bogotá

Antecedentes. Las enterobacterias, antaño flora normal del tracto gastrointestinal, han cambiado su biología y emergido como agentes patógenos nosocomiales que se tornan resistentes a los antibióticos conocidos. Objetivo. Realizar la caracterización epidemiológico-molecular de 20 aislamientos de Enterobacter cloacae resistentes a cefalosporinas de tercera generación; provenientes de un hospital de tercer nivel de Bogotá-Colombia. Material y métodos. Los aislamientos fueron identificados mediante sistemas automatizados Microscan y VITEK, se utilizó el Enterobacter asbureae como control externo inter-especie. La confirmación de resistencia se hizo por técnica de difusión en agar, y una vez establecida se realizó BLEE para comprobación. La determinación de puntos isoeléctricos se hizo, mediante lisis por ultrasonido y la genotipificación mediante la metodología para bacterias Gramnegativas propuesta por Versalovic. Resultados: Los aislamientos colectados durante un año fueron causantes de 15 de infección Intrahospitalaria y dos colonizaciones. Todos los aislamientos presentaron resistencia a cefotaxima, ceftazidima, ceftriaxona, aztreonam y ciprofloxacina, 95 por ciento a amikacina, gentamicina y cloranfenicol, 75 por ciento a trimetoprim/sulfametoxazol, 20 por ciento a cefepime y todos fueron sensibles a imipenem. Dos aislamientos fueron confirmados como productores de â-lactamasas de espectro extendido (BLEE) por la técnica microbiológica de disco combinado. Por isoelectroenfoque presentaron dos â-lactamasas con puntos isoeléctricos (pI) de 5,4 y 8,2. En los 18 aislamientos no inhibidos por ácido clavulánico, se detectaron entre 2 y 4 â-lactamasas con pI de 5,4; 6,0; 7,0; 8,2 y mayor que 8,2; la resistencia a cefalosporinas de tercera generación podría ser atribuida a la hiperproducción de AmpC; los valores de pI sugieren la producción simultánea de â-lactamasas tipo SHV y TEM. La genotipificación mediante tres metodologías de rep-PCR (ERIC; REP y BOX) agrupó la población estudiada en siete clones: seis constituidos por un solo aislamiento y el clon predominante E1/B1/R1 agrupó 14 aislamientos causantes de infección en diez pacientes. Conclusión. Se identificó un clon de Enterobacter cloacae multirresistente, endémico en una institución de tercer nivel en Bogotá, causante de infección nosocomial y quirúrgica en particular

[Criteria on the legalization of abortion]. / Algunos criterios para la despenalización del aborto.

We revised ethical concepts related to abortion from the points of view of the mothers; life, health, and considerations are made concerning the embryo or fetus as a biological, ontological, moral, and potential person. Certain religious matters on abortion are described and commented on. Effects of abortion penalization in Mexico and the legislation in the Mexican states are examined, as well as the motives of depenalization in certain countries.

[Acceptance or refusal of abortion for maternal reasons. Survey of 3021 employees of the Federal Government]. / Aceptación o rechazo del aborto por motivos maternos. Encuesta en 3021 empleados del Gobierno Federal.

A survey was conducted among 3021 employees from the Mexican Federal Government regarding their acceptance or rejection of abortion in five different circumstances. Socioeconomic information was obtained from the interviewed and the result was that 23% totally rejected abortion, and 6% accepted abortion in any situation. Abortion was accepted by 61% in case of pregnancy threatens the mother's life; 63% in case a single woman has been raped; 41% if there are so many children and such situation implies economic problems for the family; 13% if the couple prefers to wait for an economic improvement; and 18% if the couple has decided to have no more than two kids. Also from the interviewed, 16% pointed out that abortion must be an exclusive decision from the woman and 29% thought it must be a shared decision with the partner. Abortion is better accepted by young people, by couples with few children or living in free union and by people with higher education level and higher income. It is also better accepted by people with no religion, or people who do not attend religious services or by whom religion does not affect their decisions in life.

[Acceptance or rejection of euthanasia. Survey of 3021 Federal Government employees]. / Aceptación o rechazo de la eutanasia. Encuesta en 3021 empleados del gobierno federal.

A survey was conducted with 3021 employees of the Federal Government using self-administered questionnaires in order to collect data on the socioeconomic background of those surveyed (sex, age, civil status, number of children, religious, affiliation, educational level and monthly income), as well as their opinions about euthanasia. For the purposes of this study, three types of euthanasia were considered: 1) passive (the suspension of life support systems); 2) active (the application of immediate death causing means for people who suffer from incurable illnesses); and 3) active in the medium term (the application of substances which keep a patient sedated and comfortable while all food is withheld). Passive and medium-term active euthanasia were accepted by 40 percent of the population surveyed, while active euthanasia was accepted by 20 percent. These percentages were higher among young people, among those who were not heavily influenced by or did not practice religion, among professionals and among post-graduates.

[Human rights of the physician]. / Los derechos humanos del médico.

The physician rights may be classified in those related with his quality as a person, and those derived from his relationship with his patients and the institution to which he belongs. Among the first, liberty of expression, legal security, right of free association, the right of a dignified social position and neutral attitude towards the commitment of giving medical attention to whomever the patient may be. He has the right to receive a full and up-to-date training oriented to serve the community, supported by health institutions, and to have the means of utmost quality to give medical attention of the highest standard.

[The situational diagnosis of the medical units of Petróleos Mexicanos]. / Diagnóstico situacional de unidades médicas de Petróleos Mexicanos.

The Medical Service Management of Petróleos Mexicanos developed a situational diagnosis of 30 medical units in 1992. This evaluation covered 94 per cent of the institutional population. The basis for this evaluation was a formulary with more than 70 per cent closed questions and instructions with explicit explanations about them. The main points that the formulary investigated were: geography, demography, sociocultural and economics aspects, epidemiology, morbidity, mortality, preventive medicine, service availability and others. With this situational diagnosis we have been able to identify the main problems with a possible solution, presented in terms of planning, organization and execution of actions.

[Bases for the development of teaching, research and maternal and infant care in the rural area. The Temascalcingo plan]. / Bases para el desarrollo de la enseñanza, la investigación y la asistencia materno-infantil en el medio rural. El plan Temascalcingo

The Instituto de Ensenanza e Investigaciones Rurales (Institute for Rural Training and Research) has been established in Solís, Municipality of Temascalcingo, State of Mexico. The institute is part of the Institucion Mexicana de Asistencia a la Ninez, IMAN (Mexican Institution for the Assistance of Childhood). The institute will study a system of healthy delivery in its (rural) zone of activity, based principally in programes with a strong content in the preventive and promotional aspects. For this purpose it will use in a preferential way, auxiliary and technical personnel which is being trained by the institute and that is original from the community where it will serve. At the professional level, the institute will mainly employ pediatricians, nurses and social workers that are completing their residency at the Hospital del Nino IMAN in Mexico City. These professional will obtain important supplementary training through their participation in the rural community health programes that the institute will develop.

[Splenogammography with Anger's camera]. / Esplenogammagrafía con cámara de Anger

Through 230 consecutive studies, 180 from patients and 50 from healthy persons, we obtain simultaneous figures of the spleen and the liver. The best position to obtain better scintigraphies of the spleen was the posterior left oblique. The normal dimensions of the spleen image was 11.1 mm. +/- 1.2 mm. (1 sigma) long diameter, and 6.9 mm. +/- 1.1 mm (1 sigma) broad diameter. In a great number of patients we found an enlargement of the spleen in the scintigraphic image without clinical demonstration. The study is easy, rapid and without troubles for patients; moreover it afford an important knowledge in the study of the spleen and the liver in simultaneous form.