Mucin-1 Gene Mutation and the Kidney: The Link between Autosomal Dominant Tubulointerstitial Kidney Disease and Focal and Segmental Glomerulosclerosis.

Glomerular diseases are one of the most frequent causes of chronic kidney disease, focal and segmental glomerulosclerosis being one of the commonest glomerulopathies. However, the etiology of this glomerular entity, which merely depicts a morphologic pattern of disease, is often not established and, in most of the patients, remains unknown. Nephrologists tend to assume focal and segmental glomerulosclerosis as a definitive diagnosis. However, despite the increasing knowledge developed in the field, genetic causes of glomerular diseases are currently identified in fewer than 10% of chronic kidney disease subjects. Moreover, unexplained familial clustering among dialysis patients suggests that genetic causes may be underrecognized. Secondary focal and segmental glomerulosclerosis due to genetic mutations mainly located in the podocyte and slit diaphragm can occur from childbirth to adulthood with different clinical presentations, ranging from mild proteinuria and normal renal function to nephrotic syndrome and renal failure. However, this histopathological pattern can also be due to primary defects outside the glomerulus. The present report illustrates an adult case of secondary focal and segmental glomerulosclerosis with a dominant tubulointerstitial damage that led to the pursue of its cause at the tubular level. In this patient with an undiagnosed family history of adult kidney disease, a genetic study unraveled a mutation in the mucin-1 gene and a final diagnosis of adult dominant tubular kidney disease-MUC1 was made.

In Acute IgA Nephropathy, Proteinuria and Creatinine Are in the Spot, but Podocyturia Operates in Silence: Any Place for Amiloride?

IgA nephropathy is the most frequent cause of primary glomerulonephritis, portends erratic patterns of clinical presentation, and lacks specific treatment. In general, it slowly progresses to end-stage renal disease. The clinical course and the response to therapy are usually assessed with proteinuria and serum creatinine. Validated biomarkers have not been identified yet. In this report, we present a case of acute renal injury with proteinuria and microscopic hematuria in a young male. A kidney biopsy disclosed IgA nephropathy. Podocyturia was significantly elevated compared to normal subjects. Proteinuria, renal function, and podocyturia improved promptly after steroids and these variables remained normal after one year of follow-up, when steroids had already been discontinued and patient continued on valsartan and amiloride. Our report demonstrates that podocyturia is critically elevated during an acute episode of IgA nephropathy, and its occurrence may explain the grim long-term prognosis of this entity. Whether podocyturia could be employed in IgA nephropathy as a trustable biomarker for treatment assessment or even for early diagnosis of IgA nephropathy relapses should be further investigated.

Eficacia de la formación sobre los conocimientos, actitudes y prácticas de manipulación de alimentos en madres procesadoras de una escuela del estado Nueva Esparta, Venezuela / Effectiveness of training on the knowledge, attitudes and practices in food handling in mothers cookers from a school in Nueva Esparta state, Venezuela

En Venezuela la Corporación Nacional para la Alimentación Escolar, S.A. proporciona comidas en planteles oficiales (Programa PAE). Para evaluar la eficacia de la formación en conocimientos, actitudes y prácticas de manipulación de alimentos se realizó un estudio sobre higiene alimentaria con trece madres procesadoras de una escuela del Estado Nueva Esparta, para aumentar sus conocimientos, estimular actitudes para prevenir enfermedades y aplicar prácticas higiénicas en su trabajo. Se recolectaron datos aplicando cuestionarios pre-intervención y post-intervención (después de transcurridos 9 meses). Comprendían cuatro secciones: Información demográfica; conocimientos (prueba de selección múltiple), actitudes y prácticas (escalas de Likert con 3 y 5 categorías respectivamente). En el intermedio del estudio se dictaron cursos de manipulación de alimentos, supervisaron tareas rutinarias, realizaron conversatorios sobre fallas detectadas, desarrollaron tormentas de ideas para subsanarlas y entrenamientos en tareas de limpieza y desinfección. Los resultados se compararon a través de t-student y Mann Whitney (Wilcoson), con un nivel de significancia de (p < 0,05). En conocimientos (pre-intervención) solo una participante superó 7/10 puntos, siendo 3,7 el promedio grupal. En post-intervención 7 de ellas superaron los 7 puntos, con un promedio grupal de 6,2 puntos. En actitudes, respuestas positivas ascendieron desde 49,5% inicialmente hasta 64,8% (post-intervención). En prácticas de manipulación, inicialmente 28,6% de las respuestas afirmaron que frecuentemente o siempre ejecutaban lo descrito en proposiciones, incrementándose hasta 72,5% al finalizar el entrenamiento. Los resultados determinaron diferencias significativas (p < 0,05) entre puntuaciones de ambas etapas y se comprobó el impacto positivo de formar a madres procesadoras en higiene alimentaria.

In Venezuela country the National Corporation for Scholar´s Food, S.A. (CNAE), undertakes the responsibility for providing balanced meals in official schools (PAE Program). In order to evaluate the effectiveness of training in knowledge, attitudes and practices of food handling, a study in food hygiene was conducted with thirteen cookers from a school in the State of Nueva Esparta. The objective was to increase their knowledge, encourage attitudes to prevent food borne disease and apply hygiene practices in their work. Data were collected with questionnaires both before (pre-intervention stage) and (post-intervention stage) after nine (9) months. The questionnaires consisted of four sections: demographic information, knowledge (multiple choice test, and attitudes and practices that were measured using a scale of Likert with 3/5 categories respectively. Food handling courses were given in the middle of the development of the study, supervising routine procedures in kitchen, talking about several faults detected and also it was taken place storm ideas for rectify and it was given training about cleaning and disinfection tasks. The quantitative results of questionnaires were compared through t-student and Mann Witney (Wilcoson) tests. In the all cases, the significance level was (p <0.05). The knowledge results (pre-intervention) only one cooker overcomes 7/10 points, it was 3.7 points the group media. In the post-intervention, seven cookers obtained more than seven points, and the group media it was 6.2 points. Of relation to attitudes, the positive answers increased from 49.5% (pre-intervention) to 64.8% (post-intervention). As soon as handling practice, in the beginning 28.6% responses confirm that often or ever practicing the described in the questions, reaching to 72.5% in the post intervention phase. The study found significant difference (p < 0.05) among both scores. It was higher in the post-intervention. The survey findings suggest that training to cooker´s mothers hygienic was positive impact and the continuous education is needed to assure change to correct food handling practices and attitudes.

Increased urinary CD80 excretion and podocyturia in Fabry disease.

BACKGROUND: Certain glomerulopathies are associated with increased levels of CD80 (B7-1). We measured the urinary excretion of CD80, podocyturia and proteinuria in controls and in subjects with Fabry disease either untreated or on enzyme replacement therapy (ERT). METHODS: Cross-sectional study including 65 individuals: controls (n = 20) and Fabry patients (n = 45, 23 of them not on ERT and 22 on ERT). Variables included age, gender, urinary protein/creatinine ratio (UPCR), estimated glomerular filtration rate (eGFR), urinary uCD80/creatinine ratio (uCD80) and podocyturia. CD80 mRNA expression in response to lyso-Gb3, a bioactive glycolipid accumulated in Fabry disease, was studied in cultured human podocytes. RESULTS: Controls and Fabry patients did not differ in age, eGFR and gender. However, UPCR, uCD80 and podocyturia were significantly higher in Fabry patients than in controls. As expected, Fabry patients not on ERT were younger and a higher percentage were females. Non-ERT Fabry patients had less advanced kidney disease than ERT Fabry patients: UPCR was lower and eGFR higher, but uCD80 and podocyturia did not differ between non-ERT or ERT Fabry patients. There was a significant correlation between uCD80 and UPCR in the whole population (r 0.44, p 0.0005) and in Fabry patients (r 0.42, p 0.0046). Lyso-Gb3 at concentrations found in the circulation of Fabry patients increased uCD80 expression in cultured podocytes. CONCLUSIONS: Fabry disease is characterized by early occurrence of increased uCD80 excretion that appears to be a consequence of glycolipid accumulation. The potential for uCD80 excretion to reflect early, subclinical renal Fabry involvement should be further studied.

Podocyturia: A Clue for the Rational Use of Amiloride in Alport Renal Disease.

No specific or efficient treatment exists for Alport syndrome, an X-linked hereditary disease caused by mutations in collagen type IV, a crucial component of the glomerular basement membrane. Kidney failure is usually a major complication of the disease, and patients require renal replacement therapy early in life. Microhematuria and subsequently proteinuria are hallmarks of kidney involvement, which are due to primary basement membrane alterations that mainly cause endothelial thrombosis and podocyte contraction and ulterior irreversible detachment. Commonly drug-based approaches include angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, which are employed to reduce proteinuria and thus retard kidney disease progression and cardiovascular morbidity and mortality. However, as any hereditary disease, it is expressed as early as in the intrauterine life, and usually an index case is helpful to detect family-related cases. As no specific treatment exists, pathophysiologically based approaches are useful. The present case illustrates the reduction rate of urinary podocyte loss and proteinuria after amiloride administration and suggests the molecular pathways involved in Alport renal disease. Finally, podocyturia rather than proteinuria should be considered as an earlier biomarker of kidney involvement and disease progression in Alport disease.

Clasificación y significado clínico de las diferentes formulaciones de las cerámicas para restauraciones dentales / Classification and clinical significance of different formulations of ceramics for dental restorations

Durante los últimos 40 años las cerámicas dentales han presentado significativos avances tecnológicos, desde la porcelana feldespática a las cerámicas basadas en zirconio, mejorando sus propiedades mecánicas aumentando aproximadamente en casi 10 veces la resistencia a la flexión y a la fractura. Característica importante, común a todos los sistemas cerámicos es la proporción de la fase vítrea y cristalina y el grado de porosidad dado que ambas afectan las propiedades ópticas y mecánicas de la restauración. Para la mejor comprensión de la diversidad de cerámicas desarrolladas durante los últimos años se proponen dos clasificaciones, una basada en su composición, que permite relacionar el material con sus propiedades físicas y otra basada en el método de fabricación que define las opciones de manejo y que adicionalmente, permite conocer con mayor facilidad las ventajas y limitaciones de las cerámicas dentales además de ayudar a definir la selección del material más indicado para cada requerimiento clínico.

During the last 40 years, dental ceramics had showed significant technological advances, from feldsphatics porcelain to ceramics based on zirconio, improving mechanicals properties, reaching close to 10 foils of flexural and fracture strength. Important characteristics, common to all ceramic systems, are glass phase and crystalline phase proportion, and the amount of porosity, because both affect the mechanicals and optical properties of the final restorations. For better understanding of the wide ceramics options, we propose two ceramics classifications based on composition, which associate the material with their physical properties and the fabrication method, which define the laboratory options and give information related to ceramics advantages and limitations, those information help to make the ceramic selection for each especial clinical requirement.

Profile of patients admitted with infected skin ulcers at Bella Vista Hospital Mayagüez.

UNLABELLED: The purpose of this study is to evaluate the characteristics of patients admitted to Bella Vista Hospital in Mayagüez with a diagnosis of infected skin ulcer, the most common microorganisms recovered in cultures, and their antimicrobial sensitivity patterns. METHODS: All patients discharged with the diagnosis of infected skin ulcer from January 1 through December 31, 2012 were selected. Following variables were extracted: sex, age, hospital stay, morbid conditions, antibiotics used, microorganisms identified on cultures and sensitivity of microorganisms to different antimicrobials. Prevalence rates were estimated for different conditions and different microorganisms. The use of empirical antibiotics were described and compared with the antimicrobial sensitivity of the microorganisms. RESULTS: The study population consisted of 98 subjects (54% female, 46% male). Mean age was 71 years old, with 71% of subjects older than 65 years old. Prevalence rates of diabetes mellitus, peripheral vascular disease, hypertension and osteomyelitis were 74.5%, 74.5%, 79.6%, and 17.5% respectively. The antibiotic most frequently used was piperacyllin-tazobactam (PTZ). The organisms most frequently found on cultures were Staphylococcus (37.8%), distributed as 20.4% methicillin resistant and 17.3 sensitive to methicillin, followed by E. coli (30.6%), Streptococcus (29.6%), and Pseudomonas (27.6%). The majority of microorganisms were sensitive to PTZ. There was a higher prevalence of osteomyelitis in diabetic patients than in non-diabetic patients but the difference was not statistically significant. CONCLUSIONS: Antibiotic sensitivity patterns were consistent with the expected, according to the literature. Empirically used antibiotics were appropriate according to sensitivity patterns shown in the study.

Manipulación del pescado fresco a bordo de embarcaciones de media altura de la isla de Margarita, estado Nueva Esparta (Venezuela) / Fresh fish handling on board half-height fishing ships of Margarita island, Nueva Esparta state (Venezuela)

Disminuir la temperatura del pescado no garantiza una mejor calidad, a no ser que desde su captura hasta el consumidor final sea manipulado de acuerdo a normas higiénicas. La presente revisión tiene por objetivo compilar la información reseñada en trabajos de grado y otros de divulgación restringida, sobre la manipulación del pescado fresco a bordo de embarcaciones de media altura, en Isla de Margarita (Venezuela). Estas embarcaciones utilizan el palangre fondero para pescar lo que permite que los ejemplares lleguen vivos. Se reportaron las siguientes situaciones: Es común observar que los tripulantes lancen bruscamente los pescados durante su clasificación; en la etapa de evisceración, restos de sangre y vísceras se dejan en baldes o sobre cubierta, en contacto directo con otros pescados; no se vigila que el lavado posterior elimine completamente vísceras o sangre. Por otra parte, bodegas presentaban señales de suciedad, corrosión y superficies no lisas. La temperatura del aire de estos locales era de 2,3 °C en horas matutinas y de 2,8 °C en la tarde. En ocasiones, al estibar los pescados en bodega, no se rodeaban de hielo y eran dejados sobre la capa superior de hielo y en contacto de unos con otros. Solo cuando se rodeaban de hielo, la temperatura les descendía a 0°C. Por último, durante el desembarco se exponían a mayores temperaturas (10°C) y algunos se colocaban directamente sobre el piso de los peñeros recibidores. Se concluye que las deficiencias higiénico-sanitarias detectadas pudieran incidir en la calidad y en la inocuidad del pescado.

Lowering the temperature of fish does not assure a better quality, unless its handling from the time of catch to the time it is consumed is in accordance with hygienic norms. The present review’ s objective is to compile information described in grade papers and other references of limited disclosure, about the handling of fresh fish on board half-height fishing ships in Margarita Island (Venezuela). These boats use deep longline as fishing gear which allows specimens to reach the boats while still alive. The following conditions are reported: It is normally noted that crew members throw the fish with brusqueness during their classification; in the stripping step, blood and viscera leftovers are placed directly on board or inside buckets in direct contact with other fish; there is no supervision to make sure that the subsequent washing removes completely viscera and blood. On the other hand, holds had marks of dirtiness, corrosion and uneven surfaces. The air’s temperature in holds was 2.3 °C during morning hours and of 2.8 °C in the evening. Sometimes, when stowing, the fish were not surrounded with ice and were just placed over the superior layer of ice in contact of one with the others. Only when the fish are surrounded with ice, the temperature descended to 0 °C. Finally, during the unloading, fish are exposed to higher temperatures (10 °C) and some specimens are placed directly on the floor of the receiving little ships. It is concluded that the detected insufficiency in hygienic-sanitary measures could influence the quality and safety of fish.

Calidad bacteriológica de comidas listas para su consumo, preparadas y distribuidas en la isla de Margarita (Venezuela), período 1991-2009 / Bacteriological quality of ready to eat meals prepared and distributed in Margarita island (Venezuela) during 1991-2009

Se valoró la calidad bacteriológica de 696 comidas listas para su consumo preparadas desde 1991 a 2009. 454 muestras correspondían a alimentos tratados térmicamente y el resto a alimentos que llevaban ingredientes no so metidos a cocción. Las muestras se escogieron al final de su elaboración, y antes de distribuirlas, en diferentes establecimientos de res tauración (hoteles, empresas de catering, restaurantes, supermercados, panaderías, luncherías, areperas, ventas ambulantes, cantinas y comedores es colares y casas de alimentación). Los criterios considerados fueron NMP/g de Coliformes, Coliformes fecales y Escherichia coli; y recuentos (UFC/g) de aerobios mesófilos y Staphylo coccus aureus (coagulasa +), según normas COVENIN y FONDONORMA. Los resultados se compararon con requisitos internos establecidos por el Laboratorio de Microbiolo gía, Fundación La Salle de C.N. Al momento de la captación el promedio de la temperatura de las comidas servidas en frío fue 13,4 °C y el de las cocinadas 32,2 °C. Los menores porcentajes de cumplimiento a todos los requisitos los tuvieron las rebanadas de jamón y queso (28%), rellenos de arepas y empanadas (28%), pastas italianas (23%), postres horneados (13%) y ensaladas con ingredientes crudos (7%). En este tipo de ensaladas sólo cumplieron los requisitos de Coliformes, Coliformes fecales y re cuentos de aerobios mesófilos el 19%; 31% y 24% de las muestras respectivamente. El menor cumplimiento de S. aureus (72%) se obtuvo en las rebanadas de jamón y queso y de E. coli (45%) en los rellenos de arepas y empanadas. Los establecimientos que presentaron los mayores valores de conformidad fueron las casas de alimentación (66%), comedores escolares (51%) y catering (50%) y los menores, los kioscos y ventas ambulantes (24%), supermercados y panaderías (17%) y cantinas escolares (0%). Las causas por las cuales los resultados bacteriológicos no cumplieron los criterios internos del Laboratorio pudieran estar relacionadas, entre otras, con la calidad de la materia prima, fallas higiénicas en la preparación de los alimentos, temperatura de mantenimiento al igual que tiempo y temperatura de cocción.

The bacteriological quality of 696 samples of ready to eat (RTE) food prepared from 1991 to 2009 was assessed. 454 samples corresponded to food subject to thermal treatment and the remainder carried ingredients that were not subject to cooking. The samples were chosen at the end of their elabo ration and before distributing, from different dinning establishments (hotels, caterers, restaurants, supermarkets, baker shops, luncheon rooms, arepa shops, ambulatory sales, canteens, school lunchrooms, and feeding houses). Total and fecal coliforms, E. coli, aerobic plate count and S. aureus (coagulase +) according to COVENIN and FONDONORMA norms were the criteria used for the investigation. The results were compared with internal requirements established by the microbiology laboratory of La Salle Natural Sciences Foundation. At the moment of sampling, the average temperature of cool dishes was 13.4 °C and of hot dishes was 32.2 °C. The smallest percentage of observance to all requisites were: ham and cheese slices (28%); arepas and turnovers (28%); Italian pasta (23%), baked desserts (13%) and salad with raw ingredients (7%). In these last ones, the requirements of total coliforms, fecal coliforms and aerobic plate count norms were met only by the 19%, 31% and 24% of samples respectively. The lowest compliance with S. aureus (72%) was found in the ham and cheese slices, and with E. coli (45%) were the arepas and turnovers. The establishments that presented the highest compliance values were the feeding houses (66%), school lunchrooms (51%) and caterers (50%); while those with the lowest values were the ambulatory sales (24%), supermarkets and baker shops (17%), and school canteens (0%). The reasons for non compliance with the internal requirements can be related, among other things, with the quality of raw material, hygienic failure in food handling, maintenance temperatures, and time and temperature of cooking.

Quantification of the impact of endometriosis symptoms on health-related quality of life and work productivity.

OBJECTIVE: To quantify the impact of endometriosis-related symptoms on physical and mental health status, health-related quality of life, and work-related aspects (absenteeism, presenteeism, work productivity, and activity impairment). DESIGN: Cross-sectional quantitative study. SETTING: Academic and research institution. PATIENT(S): Women (n = 193) with self-reported surgically diagnosed endometriosis from the Endometriosis Patient Registry at Ponce School of Medicine and Health Sciences (PSMHS). INTERVENTION(S): Anonymous questionnaire divided into three sections consisting of questions from the Patient Health Survey (SF-12), the Endometriosis Health Profile (EHP-5), and the Work Productivity and Activity Impairment Survey (WPAI). MAIN OUTCOME MEASURE(S): Quantification of impact of endometriosis symptoms on physical and mental health status, health-related quality of life, absenteeism, presenteeism, work productivity, and activity impairment. RESULT(S): Patients had SF-12 scores denoting statistically significant disability in the physical and mental health components. They also reported an average of 7.41 hours (approximately one working day) of work time lost during the week when the symptoms are worse. In addition, the WPAI scores showed a high impact on work-related domains: 13% of average loss in work time (absenteeism), 65% of work impaired (presenteeism), 64% of loss in efficiency levels (work productivity loss), and 60% of daily activities perturbed (activity impairment). CONCLUSION(S): Endometriosis symptoms such as chronic, incapacitating pelvic pain and infertility negatively and substantially impact the physical and mental health status, health-related quality of life, and productivity at work of women.

La higiene en la comercialización de moluscos desbullados en el estado Nueva Esparta, Venezuela, período 1992-2007 / Hygiene in marketing shellfish shucked in Nueva Esparta state, Venezuela, period 1992 to 2007

Los moluscos en el Edo. Nueva Esparta (Venezuela) se co mer - cializan principalmente desbullados (sin concha), en mercados populares y en vías públicas. El presente trabajo recopila información sobre análisis realizados durante los años 1992 a 2007 a 161 muestras de: Ostra perla (Pincta da im bricata Roding, 1798), pepitona (Arca zebra Swain son, 1833), mejillón (Perna perna Linnaeus, 1758), vieiras (Amu sium papyraceum Gabb, 1873), guacuco (Tivela mactroides Born, 1778), chipi-chipi (Donax spp Linnaeus, 1758 y 1767) y caracoles: Vaquita (Strom bus pugilis Linné, 1758), Longo (Me lon gena melongena Linnaeus, 1758) entre otros. Para conocer los porcentajes de incumplimiento de los requisitos bacteriológicos, se realizaron determinaciones (NMP/100 g) de coliformes fecales y E. coli y recuentos de aerobios mesófilos (UFC/g) según normas COVENIN. También se evaluó el pH y el olor. En promedio, la prueba con mayor porcentaje de in cumplimiento fue coliformes fecales (88,1%), seguida de E. coli (73,4%), recuentos de aerobios mesófilos (66,9%) y presencia de olores extraños (28,1%). Las causas parecen ser la forma artesanal de su manipulación, la utilización de agua no potable y el mantenimiento de los moluscos a temperatura ambiente (aproximadamente 26°C) después de la cocción y separación de la concha y durante la comercialización. Se encontraron relaciones positivas significativas entre los valores de aerobios mesófilos y los de coliformes fecales y E. coli (r = 0,78 y 0,56; P < 0,05); también entre los coliformes fecales y E. coli (r = 0,64, P < 0,05), indicando que las bacterias presentes son de origen fecal. Se concluye que estos alimentos representaron un riesgo potencial para la salud pública y se recomienda que pescadores y vendedores reciban instrucciones para corregir las prácticas indebidas y que compradores los laven y cocinen antes de consumirlos.

Shellfish in Nueva Esparta state (Venezuela) are commercialized mainly shucked, in popular markets and by vendors along roadsides. This study compiles information about the results of analysis made during the years 1992 to 2007 to 161 samples of ostra perla (Pinctada imbricata Roding, 1798), pepitona (Arca zebra Swainson, 1833), mejillón (Perna perna Linnaeus, 1758), vieiras (Amusium papyraceum Gabb, 1873), guacuco (Tivela mactroides Born, 1778), chipi-chipi (Donax spp Lin - naeus, 1758 y 1767) and caracoles: Vaquita (Strombus pugilis Lin né, 1758), Longo (Melongena melongena Linnaeus, 1758), among other shellfish. In order to find out the percentage of noncompliance with the recommended bacteriological standards, fecal coliforms and E. coli (MPN/100 g) and total aerobic plate count (FCU/g) were evaluated using COVENIN norms. Also pH and odor were studied. Samples most unfit were fecal coliforms (88.1%), followed by E. coli (73.4%), total aerobic plate counts (66.9%) and abnormal odors (28.1%). The causes for this seem to be, among others, handling practices, use of non potable water and storing of shellfish at room temperature (26.0 °C mean) after cooking, shucked and during marketing. It was observed significant positive relations between total plate counts and fecal coliforms and E. coli (r = 0.78 y 0.56; P < 0.05); also between fecal coliforms and E. coli (r = 0.64, P < 0.05) this suggest that bacteria have a fecal source. In conclusion, these foods represented a significant and potential public health risk. It is recommended that fishermen and vendors receive instruction for correct handling practices, and that buyers wash and cook the products before they are consumed.

Potabilidad del agua de uso doméstico en el estado Nueva Esparta, Venezuela / Domestic water potability in Nueva Esparta state, Venezuela

Este trabajo evalúa la potabilidad del agua para uso doméstico en las islas de Margarita y Coche, de muestras captadas entre los años 1999 a 2006. Se analizaron 757 muestras que están registradas en los Libros de Certificado de Ensayo del Laboratorio de Microbiología (Fundación La Salle de Ciencias Naturales). Se hicieron análisis de coliformes totales, coliformes fecales, Escherichia coli, estreptococos fecales y Pseudomonas aeruginosa (NMP/100 ml), y recuentos de organismos heterótrofos aerobios (UFC/ml) según Normas COVENIN y APHA. También se midió pH, tem peratura y cloro residual libre. En el agua recién llegada del continente los porcentajes de incumplimiento fueron inferiores (cloro residual libre 64%; coliformes totales 27% y organismos heterótrofos aerobios 17%) a los promedios encontrados una vez ingresada a la red de distribución estadal (cloro residual libre 84%; coliformes totales 60% y organismos heterótrofos aerobios 40%). Se hallaron relaciones negativas significativas entre los valores de cloro residual y coliformes totales, coliformes fecales, P. aeruginosa y organismos heterótrofos aerobios (r = -0,27; -0,19; - 0,41 y -0,38 respectivamente; p < 0,0001), resaltando la importancia de la cloración para mantener la potabilidad del agua. Por el contrario, relaciones positivas significativas (p < 0,0001) se constatan entre los valores de cada uno de los grupos estudiados, lo que indicaría que tienen un origen común, principalmente de origen fecal. Se concluye que un porcentaje elevado de las muestras de agua evaluadas incumplieron las normas de potabilidad, lo que implica riesgos potenciales a la salud.

This work evaluates the compliance with drinking water norms in 757 samples collected in Margarita and Coche Islands, Venezuela. Samples were analyzed between 1999 and 2006 and the results are registered in the Microbiology Laboratory Certification Books (Fundación La Salle de Ciencias Naturales). Analysis of total coliforms, fecal coliforms, E. coli, faecal streptococci and P. aeruginosa (MPN/100 ml) and heterotrophic plate counts (FCU/ml) were made according to COVENIN and APHA norms. The pH, temperature and free chlorine levels were measured. In the water coming directly from the continent the percentage of data not conforming with norms was lower (free chlorine level 64%; total coliforms 27% and heterotrophic plate count 17%) when compared to the average from the internal distribution net (free chlorine level 84%; total coliforms 60% and heterotrophic plate count 40%). A negative significative relation between free chlorine levels and total coliforms, fecal coliforms, P. aeruginosa and heterotrophic plate count (r = -0.27; -0.19; -0.41 and -0.38 respectively; p < 0.0001), showing chlorine´s importance to maintain microbial safety of drinking water. Equally, a positive significative relation (p < 0.0001) was found between the numbers of evaluated groups, pointing a common source of bacteria. It was concluded that a high percentage of the evaluated samples of water did not fulfill the drinking water norms and it involved potential risks to public health.

Interpretación de resultados de análisis microbiológicos en alimentos: Planes de atributos

Con el fin de evaluar la seguridad y calidad de los alimentos, las autoridades sanitarias establecen normas que fijan los criterios microbiológicos para cada parámetro. La finalidad de esta revisión es facilitar la interpretación de los resultados de los análisis microbiológicos de productos alimenticios cuando se comparan con los criterios vigentes. Se plantea en qué consisten los planes de muestreo de atributos de dos y tres clases, los términos utilizados, además de dos ejercicios con cuyos resultados analíticos se discute el cumplimiento o no de la Norma correspondiente.

In order to asses food safety and quality the sanitary authorities prepare standards that establish the microbiological criterion allowed for each parameter. The objective of the present review is to make easy the interpretation of the results of microbiological examination of food when they are compared to the criterion prevailing. It states what the sampling attributes plans, two-class plan and three-class plan, consist of; a glossary for the better understanding of terms; besides this, two exercises in which their results can help debate the observance or not of the corresponding standard.

Conformidad con las pautas terapéuticas vigentes en pacientes hipertensos usuarios de una sala de emergencias / Compliance with current therapy guidelines in hypertensive patients at an emergency service

Arterial hypertension is one of the most prevalent health problems and one of the most important risk factors for cardiovascular and cerebrovascular disease. The purpose of this study was to identify if hypertensive patients are being treated in accordance to current recommendations (JNC-7) for this condition and to estimate the level of blood pressure control in the subjects at the moment of their participation in the study. A total of 138 patents with previous diagnosis of arterial hypertension were recruited from visitors to the Emergency Room at Dr. Pila Hospital in Ponce, Puerto Rico during the months of November 2003 through April 2004. Data was collected in the form of a questionnaire, administered by interview. The questionnaire included demographic data, blood pressure level, anthropometric variables, reported history of chronic diseases, use of antihypertensive agents and other variables. At the moment of their participation, 77 of the subjects had uncontrolled hypertension. Only 25 of subjects reported present use of diuretic agents, which are highly recommended as first line treatment for hypertension. The majority (54) of subjects were being treated with only one antihypertensive agent. The majority (58) of patients were not being treated in accordance with current recommendations (JNC-7) under the category of [quot ]compelling indications[quot ]. The results of this study could very well indicate tendencies and patterns of treatment in hypertensive patients of our community. This may warrant further research and inquiry for explanations

[Compliance with current therapy guidelines in hypertensive patients at an emergency service]. / Conformidad con las pautas terapéuticas vigentes en pacientes hipertensos usuarios de una sala de emergencias.

Arterial hypertension is one of the most prevalent health problems and one of the most important risk factors for cardiovascular and cerebrovascular disease. The purpose of this study was to identify if hypertensive patients are being treated in accordance to current recommendations (JNC-7) for this condition and to estimate the level of blood pressure control in the subjects at the moment of their participation in the study. A total of 138 patents with previous diagnosis of arterial hypertension were recruited from visitors to the Emergency Room at Dr. Pila Hospital in Ponce, Puerto Rico during the months of November 2003 through April 2004. Data was collected in the form of a questionnaire, administered by interview. The questionnaire included demographic data, blood pressure level, anthropometric variables, reported history of chronic diseases, use of antihypertensive agents and other variables. At the moment of their participation, 77% of the subjects had uncontrolled hypertension. Only 25% of subjects reported present use of diuretic agents, which are highly recommended as first line treatment for hypertension. The majority (54%) of subjects were being treated with only one antihypertensive agent. The majority (58%) of patients were not being treated in accordance with current recommendations (JNC-7) under the category of "compelling indications". The results of this study could very well indicate tendencies and patterns of treatment in hypertensive patients of our community. This may warrant further research and inquiry for explanations.

[The excretion pattern and protective capacity in rabbits orally immunized with attenuated strains of Vibrio cholerae O1 biotype El Tor]. / Estudio del patrón de excreción y la capacidad protectora en conejos inmunizados de forma oral con cepas atenuadas de Vibrio cholerae O1 biotipo El Tor.

In order to study the excretion patterns, colonization and protective capacity of live attenuated strains of Vibrio cholerae O1. El Tor, rabbits were immunized in New Zealand with these strains and their corresponding parental strains. 2 doses were administered by the model of oral inoculation in adult rabbits. Rabbits were rotated 2 weeks after the second dose by the model of ligated intestine with highly virulent strains of V. cholerae O1 Ogawa and Inaba serotypes and O139 serogroup. It was proved that the genetically manipulated strains do not effect the excretion patterns when they are compared with their parental strains. It was observed in the challenge a decrease in the levels of colonization of virulent strains of both serotypes, not only among the rabbits immunized with the attenuated strains, but also among those immunized with the parental strains in comparison with control animals immunized with the strain of Escherichia coli K-12, which means that there was certain degree of protection. In the case of the animals challenged with the O139 strain it was demonstrated that the protection is specific for each serogroup, since in this case there was no reduction of the colonization.

Stressful life events and depressive symptomatology in obstetric patients: a pilot study in a family practice setting.

Several studies have found the presence of stressful life events to be associated with the appearance of postpartum depression. However, many of these previous studies have been conducted in obstetric clinics; relatively little research in this area has been done in a family practice setting. The first objective of this study was to note the prevalence of depressive symptomatology in a family practice clinic's pregnant patients. The second purpose was to evaluate the relationship between stressful life events and depressive symptomatology during pregnancy and the postpartum period. Each subject (n = 27) was given a Beck Depression Inventory (BDI) at three times: second trimester, third trimester, and three weeks postpartum. Each subject also completed a life events scale for obstetric patients after delivery; both weighted and unweighted life events scores were calculated. The correlation between the weighted and unweighted life events scores was 0.85. Postpartum BDI scores were significantly related to life events scores: 0.47 (n = 27, p = .0133) for unweighted scores and 0.58 (n = 27, p = .0015) for weighted scores. Weighted life events scores were more highly correlated with BDI scores at each of the three administration. Finally, 19% of these subjects showed BDI scores consistent with mild depression after delivery. Each of these results is consistent with findings from studies done in other settings.