Resultados funcionales y supervivencia a ocho años de la artroscopia de cadera en pacientes con patología degenerativa de cadera / Functional outcomes and 8-year survival after hip arthroscopy in patients with degenerative hip disease

ANTECEDENTES Y OBJETIVOS: El objetivo de este estudio es evaluar qué factores pueden influir en la supervivencia de la artroscopia de cadera a medio plazo en el contexto de patología degenerativa. MATERIAL Y MÉTODOS: Llevamos a cabo un estudio retrospectivo de 40 casos de una serie de 102 pacientes intervenidos de artroscopia de cadera en nuestro centro, desde agosto de 2007 a octubre de 2011. Al final del seguimiento, todos los pacientes cumplimentaron tres escalas funcionales: Hip Outcome Score-Activites of Daily Life (HOS-ADL), Hip Outcome Score-Sport (HOS-S) y Harris Hip Score modificado (HHSm). RESULTADOS: Finalmente se incluyó un total de 39 pacientes (40 caderas), con una edad media de 43,1 años y un tiempo de seguimiento medio de 6 años (43-130 meses). Los pacientes intervenidos con una edad inferior a 50 años obtuvieron mejor puntuación en las escalas HOS-S (25,2 puntos) y HHS-m (84,1 puntos) en comparación con aquellos intervenidos a partir de dicha edad (HOS-S [25,2 puntos]; HHS-m [84,1 puntos]). El tiempo de evolución también influyó significativamente en el resultado de nuestros pacientes, siendo mejor en aquellos en los que éste era menor a 12 meses (26,6 meses), en comparación con aquellos en los que era mayor (21,3 meses). Por otro lado, aquellos que presentaban una intervención quirúrgica lumbar previa obtuvieron peores resultados de HOS-ADL (49,3 puntos), respecto a aquellos que no presentaban este antecedente (56,5 puntos). El Patient acceptable symptom state (PASS) fue superado por 23 pacientes (57,5%), 22 pacientes (55%) y 25 pacientes (62,5%) en las escalas HHSm, HOS-ADL y HOS-S respectivamente. Ningún paciente presentó ninguna complicación mayor. Cuatro pacientes presentaron complicaciones menores. La supervivencia media obtenida fue de 97,1 meses (IC 95%, 85,1-109,1 meses), asociado con un 81% de pacientes (IC 95%, 69%-93%) que no precisó rescate quirúrgico a los 10 años. CONCLUSIONES: Creemos que los datos obtenidos en nuestra serie sugieren que la artroscopia de cadera en el contexto de patología degenerativa es una intervención quirúrgica segura con un resultado funcional fiable a corto-medio plazo. Por otro lado, dicha indicación debería hacerse con mayor precaución en pacientes sometidos previamente a cirugía lumbar. NIVEL DE EVIDENCIA: Nivel IV. Serie de casos

BACKGROUND AND PURPOSE: The purpose of this study is to identify which variables may have a significant impact in mid-term survivorship following hip arthroscopy. METHODS: This a single-centre single-surgeon retrospective study including 102 patients who underwent a hip arthroscopy procedure between August 2007 and October 2011. Each subject completed three questionnaires at final follow- up: Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sport (HOS-S) and Modified Harris Hip Score (m-HHS). RESULTS: Thirty-nine patients (40 hips) were finally included in our study. Mean age was 43.1 ± 9.9 years with a three-year minimum follow-up (75.43 ± 25.2 months). Younger patients and those with a shorter duration of symptoms obtained significantly higher HOS-S and m-HSS scores. Patients who had undergone previous lumbar spinal surgery obtained significantly worse HOS-ADL scores. Patient acceptable symptom state (PASS) was achieved in 23 patients (57.5%) for m-HHS, 22 patients (55%) for HOS-ADL and 25 patients for HOS-S scores. No major complication was observed. Only four patients had minor complications. Mean survival time was 97.1 months (95% CI, 85.1 to 109.1 months), with a survival at 8 years of 69% (95% CI, 53% to 85%). CONCLUSIONS: Our findings suggest that hip arthroscopy is a safe procedure with acceptable functional outcomes after a long follow-up. Care should be taken when treating patients with prior lumbar surgery. LEVEL OF EVIDENCE: Level IV. Case series

Functional outcomes and 8-year survival after hip arthroscopy in patients with degenerative hip disease. / Resultados funcionales y supervivencia a ocho años de la artroscopia de cadera en pacientes con patología degenerativa de cadera.

BACKGROUND AND PURPOSE: The purpose of this study is to identify which variables may have a significant impact in mid-term survivorship following hip arthroscopy. METHODS: This a single-centre single-surgeon retrospective study including 102 patients who underwent a hip arthroscopy procedure between August 2007 and October 2011. Each subject completed three questionnaires at final follow- up: Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sport (HOS-S) and Modified Harris Hip Score (m-HHS). RESULTS: Thirty-nine patients (40 hips) were finally included in our study. Mean age was 43.1 ± 9.9 years with a three-year minimum follow-up (75.43 ± 25.2 months). Younger patients and those with a shorter duration of symptoms obtained significantly higher HOS-S and m-HSS scores. Patients who had undergone previous lumbar spinal surgery obtained significantly worse HOS-ADL scores. Patient acceptable symptom state (PASS) was achieved in 23 patients (57.5%) for m-HHS, 22 patients (55%) for HOS-ADL and 25 patients for HOS-S scores. No major complication was observed. Only four patients had minor complications. Mean survival time was 97.1 months (95% CI, 85.1 to 109.1 months), with a survival at 8 years of 69% (95% CI, 53% to 85%). CONCLUSIONS: Our findings suggest that hip arthroscopy is a safe procedure with acceptable functional outcomes after a long follow-up. Care should be taken when treating patients with prior lumbar surgery. LEVEL OF EVIDENCE: Level IV.

Evaluación de los niveles de NT-proBNP en los derrames pleurales de origen cardíaco / Evaluation of NT-proBNP levels in pleural effusions of cardiac origin

Objetivo: Evaluar el rendimiento diagnóstico del fragmento amino-terminal del péptido natriurético (NT-proBNP) en líquido pleural (LP) y suero (S) en pacientes con insuficiencia cardíaca congestiva (ICC) y valorar su utilidad en la identificación de derrames pleurales (DPs) de origen cardiogénico, frente a los criterios de Light y gradiente de proteínas (PT). Material y métodos: Se analizaron 21 DPs (42,85% trasudados) de los cuales, siete fueron secundarios a ICC. La precisión diagnóstica del NT-proBNP en LP y S y de los criterios de Light se obtuvo mediante el área bajo la curva (AUC). Resultados: NT-proBNP en S presenta mejor rentabilidad diagnóstica (AUC:0,889) que su determinación en LP, criterios de Light y gradiente de PT. Valores por encima de 1.053 pg/ml identifican la etiología cardíaca del derrame con una sensibilidad del 83% y una especificidad del 100%. De los derrames cardiogénicos clasificados erróneamente por el criterio de Light LDH (LP/S), NT-proBNP en S identifica correctamente la totalidad de los derrames (100%). Conclusión: La determinación de NT-proBNP en LP para diferenciar la naturaleza trasudativa de los DPs de origen cardiogénico, no resulta de utilidad en la práctica clínica. En derrames cuya etiología sea dudosa, las concentraciones séricas de NT-proBNP pueden ser útiles para el diagnóstico de ICC

Objective: To evaluate the diagnostic performance of the N-terminal pro-natriuretic peptide (NT-proBNP) in pleural fluid (PF) and serum, in patients with congestive heart failure (CHF) and assess its usefulness in the identification of cardiogenic pleural effusions, against the Light's criteria and protein gradient (PT). Material and Methods: We analyzed 21 DP (42.85% transudates) of which seven were secondary to CHF. The diagnostic accuracy of NT-proBNP in LP and S and the Light's criteria was obtained using the area under the curve (AUC). Results: The serum determination of NT-proBNP presents the best diagnostic yield (AUC: 0.889) than its determination in PF, Light's criteria and protein gradient. Values above 1,053 pg/ml identify the cardiac etiology of the effusion with a sensitivity of 83% and a specificity of 100%. Of the patients misclassified by the Light LDH criteria (LP/S), NT-proBNP in S correctly identifies all of the effusions (100%). Conclusion: The determination of NT-proBNP in pleural fluid to differentiate the transudative nature of cardiogenic pleural effusions, is not useful in clinical practice. In effusions whose etiology is doubtful, seric concentrations of NT-proBNP may be useful for the diagnosis of CHF

Perfil epidemiológico da cisticercose bovina e suína em três regiões do estado de Minas Gerais, Brasil / Epidemiological profile of bovine and swine cysticercosis in three regions of Minas Gerais State, Brazil

Com o objetivo de avaliar a situação epidemiológica da cisticercose suína e bovina na zona rural de cinco municípios, distribuídos em três distintas regiões do estado de Minas Gerais, foi determinada a prevalência das cisticercoses bovina e suína nas propriedades rurais e os principais fatores de risco que poderiam favorecer a transmissão e manutenção da doença nas referidas propriedades. A pesquisa abrangeu 388 propriedades, localizadas em 91 diferentes comunidades rurais, sendo coletadas 1.792 amostras de sangue bovino e 554 de suíno. Além da avaliação das referidas amostras laboratoriais (ELISA indireto e imunoblot), também foram analisados os dados obtidos da aplicação de um questionário para cada propriedade, no qual constava as informações sobre as condições socioeconômicas, higiênico-sanitárias e as relacionadas ao sistema de criação animal. A prevalência da cisticercose variou de 0,3 a 5,9% nos bovinos e de 0 a 2,8% nos suínos criados artesanalmente nesses municípios pesquisados. Os principais fatores de risco de transmissão identificados foram a fonte de água consumida, a origem da carne, a natureza do município e da região, para a cisticercose bovina, e o destino do esgoto e o sistema de criação, para a cisticercose suína.(AU)

In order to evaluate the epidemiological situation of porcine and bovine cysticercosis in the rural area of five municipalities, distributed in three different regions of the state of Minas Gerais, Brazil, the prevalence of bovine and porcine cysticercosis was determined in the rural properties as well as the main risk factors that may favor the transmission and maintenance of the disease in these properties. The research covered 388 farms, located in 91 different rural communities, with 1,792 samples of bovine blood and 554 of swine collected. In addition to the evaluation of these laboratory samples (indirect ELISA and Imunoblot), the data obtained from the application of a questionnaire for each property were also analyzed, with information on socioeconomic, hygienic-sanitary and animal-related conditions. The prevalence of cysticercosis ranged from 0.3 to 5.9% in cattle and from 0 to 2.8% in the pigs raised in these municipalities. Among the main risk factors for transmission of bovine cysticercosis were the source of water consumed, the origin of the meat, the nature of the municipality and the region. Regarding the pigs, risk factors were the sewage disposal and animal management system.(AU)

Association between completed suicide and bipolar disorder: A systematic review of the literature.

BACKGROUND: Completed suicide is a major cause of death in bipolar disorder (BD) patients. OBJECTIVE: The aim of this paper is to provide an overall review of the existing literature of completed suicide in BD patients, including clinical and genetic data DATA SOURCES: We performed a systematic review of English and non-English articles published on MEDLINE/PubMed, PsycInfo and Cochrane database (1970-2017). Additional studies were identified by contacting clinical experts, searching bibliographies, major textbooks and website of World Health Organization. Initially we did a broad search for the association of bipolar disorder and suicide and we were narrowing the search in terms included "bipolar disorder" and "completed suicide". STUDY SELECTION: Inclusion criteria were articles about completed suicide in patients with BD. Articles exclusively focusing on suicide attempts and suicidal behaviour have been excluded. We used PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) consensus for drafting this systematic review. RESULTS: The initial search generated 2806 articles and a total of 61 meeting our inclusion criteria. We reviewed epidemiological data, genetic factors, risk factors and treatment of completed suicide in BD. Suicide rates in BD vary between studies but our analyses show that they are approximately 20-30-fold greater than in general population. The highest risk of successful suicide was observed in BD-II subjects. The heritability of completed suicide is about 40% and some genes related to major neurotransmitter systems have been associated with suicide. Lithium is the only treatment that has shown anti-suicide potential. LIMITATIONS: The most important limitation of the present review is the limited existing literature on completed suicide in BD. CONCLUSIONS: BD patients are at high risk for suicide. It is possible to identify some factors related to completed suicide, such as early onset, family history of suicide among first-degree relatives, previous attempted suicides, comorbidities and treatment. However it is necessary to promote research on this serious health problem.

Difference in the deactivation of Au catalysts during ethanol transformation when supported on ZnO and on TiO2.

Au nanoparticles of different sizes were supported by the deposition-precipitation method on two metal oxides: ZnO and TiO2. The resulting catalysts were tested in the ethanol catalytic transformation reaction. Both metal oxide support materials exerted a different influence on the achieved Au particle size as well as on the behavior of the subsequent catalyst, with regard to their initial conversion values, product distribution and stability. While TiO2 favors the formation of smaller nanoparticles, ZnO offers larger Au particle sizes when prepared under similar conditions. At the same time, TiO2 produced catalysts which displayed higher initial conversions in comparison with AuZnO catalysts, even when observing catalysts of each series with similar particle sizes. At the same time, catalysts supported on ZnO exhibited higher resistance to deactivation caused by coke formation. These results were evidenced employing different characterization techniques on both used and fresh catalyst samples. The decline in deactivation was generally accompanied by an increase in the carbon content on the catalyst's surface.

Schwannoma en la lengua: tumoración insólita en la infancia / Schwannoma of the tongue: rare tumor in infancy

El schwannoma o neurilemmoma de la lengua es un tumor benigno muy poco frecuente en las edades pediátricas. Varón, de 8 años, que presenta una tumoración situada en la punta de la lengua, asintomática, de crecimiento progresivo durante 6 meses. La tumoración es dura, de 1,5 cm de longitud, de aspecto grisáceo y sin síntomas acompañantes. Tras una exploración y una impresión clínica de tumoración benigna, se realiza una resección completa de la masa, no observándose nuevo crecimiento en los más de 5 años de evolución ni aparición de nuevos síntomas (AU)

The schwannoma or neurilemmoma of the tongue is a benign tumor which is very rare in the pediatric age. Eight year old male, with a tumor located at the tip of the tongue, asymptomatic, that has been growing progressively for 6 months. The tumor is hard, 1.5 cm in length, gray, without accompanying symptoms. After an examination and clinical impression of a benign tumor, a complete resection of the mass was performed, with no new growth observed in more than 5 years of evolution or the appearance of new symptoms (AU)

DNA Damage in Vicia faba by Exposure to Agricultural Soils from Tlaxcala, Mexico.

The aim of this research was to quantify some POPs, such as p,p' DDT, p,p' DDE, and PCBs in agricultural soils of Tlaxcala, Mexico and evaluate their capacity for eliciting DNA damage, using Vicia faba as bioindicator. The values of ΣDDTs and ΣPCBs ranged from 8-24 to 118-26,983 µg/kg, respectively. The samples T1 (HQ = 9.3) and T2 (HQ = 53.9) showed concentrations of ΣPCBs higher than Canadian guidelines (SQGE = 500 µg/kg). The genotoxicity testing produced percentages of DNA fragmentation higher than negative control and statistically significant (p < 0.05), both in agricultural soils and organic extracts. The soils T2, T3, N4, and N5 showed a DICA from 2.6 to 3.1 times, statistically higher (p < 0.05) than negative control. In general, the agricultural soils have greater genotoxic capacity than the organic extracts, suggesting a potential risk to biota that depends upon this ecosystem.

Relevant peptides of Taenia crassiceps for the diagnosis of bovine cysticercosis by immunoblot / Peptídeos relevantes de Taenia crassiceps para o diagnóstico da cisticercose bovina pelo immunoblot

Given the limited knowledge about the diagnosis of bovine cysticercosis by immunoblot, the aim of this study was to assess the applicability of this test, identifying key peptides with diagnostic value. Immunoblot assays were performed using total larval antigen of Taenia crassiceps and 60 sera of positive bovines for cysticercosis (30 naturally and 30 experimentally infected with T. saginata eggs), 30 sera of negative bovines for cysticercosis and 30 sera of bovines with other diseases (fascioliasis, hydatidosis and tuberculosis). The peptides of greater diagnostic importance, in descending order of accuracy (%), were as follows: 6-8kDa (90.8%), 129-143kDa (74.2%), 99-105kDa (71.7%) and 14-19kDa (71.1%). Cross-reactions, due to fascioliasis and hydatidosis, were observed in the four intervals of peptides highlighted. The results demonstrate that the total antigen of T. crassiceps has peptides with a high diagnostic potential; therefore, the immunoblot is useful in the diagnosis of bovine cysticercosis.

Tendo em vista o conhecimento limitado sobre o diagnóstico da cisticercose bovina pelo immunoblot, o objetivo deste trabalho foi avaliar a aplicabilidade desse teste, identificando os principais peptídeos com valor diagnóstico. Foram realizados ensaios de immunoblot, utilizando antígeno total de larva de Taenia crassiceps e 60 soros de bovinos positivos para a cisticercose (30 naturalmente e 30 experimentalmente infectados com ovos de T. saginata), 30 soros de bovinos negativos para a cisticercose e 30 soros de bovinos com outras patologias (fasciolose, hidatidose e tuberculose). Os peptídeos de maior importância diagnóstica, em ordem decrescente de acurácia (%), foram os seguintes: 6-8 kDa (90,8%), 129-143 kDa (74,2%), 99-105 kDa (71,7%) e 14-19 kDa (71,1%). Reações cruzadas, em decorrência da fasciolose e hidatidose, foram observadas nos quatro intervalos de peptídeos ressaltados. Os resultados demonstram que o antígeno total de T. crassiceps possui peptídeos com alto potencial diagnóstico, sendo, portanto, o immunoblot útil no diagnóstico da cisticercose bovina.

Asenapine prescribing patterns in the treatment of manic in- and outpatients: Results from the MANACOR study.

BACKGROUND: Asenapine is the most recent compound that has been FDA- and EMA-approved for treatment of mania. Its efficacy and safety have been assessed in placebo-controlled trials, but little is known about its performance in routine clinical conditions. In this study, we compared features of patients treated with adjunctive asenapine or other adjunctive antipsychotics and the costs of the treatment. METHODS: A combined prospective and retrospective data collection and analysis was conducted from January 2011 to December 2013 following a clinical interview and assessment of manic and depressive symptoms (YMRS, HDRS-17), clinical state (CGI-BP-M), psychosocial functioning (FAST), sexual dysfunction (PRSexDQ) and health resource costs associated with treatment with adjunctive asenapine versus other adjunctive antipsychotics. RESULTS: Hundred and fifty-two patients from different university hospitals were included. Fifty-three patients received adjunctive asenapine and 99 received other adjunctive antipsychotics concomitantly to mood stabilizers. Considering inpatients, those treated with adjunctive asenapine presented a significantly less severe manic episode (P=0.001), less psychotic symptoms (P=0.030) and more comorbid personality disorder (P=0.002). Regarding outpatients, those treated with adjunctive asenapine showed significantly less severe manic episode (P=0.046), more previous mixed episodes (P=0.013) and more sexual dysfunction at baseline (P=0.036). No significant differences were found in mean total costs per day. CONCLUSION: Clinicians tended to use adjunctive asenapine in patients with less severe manic symptoms but more complex clinical profile, including more mixed episodes in the past, concomitant personality disorder, and sexual problems. Treatment with adjunctive asenapine was not associated with higher costs when compared to other options.

Feral finfish, and their relationships with sediments and seawater, as a tool for risk assessment of PAHs in chronically polluted environments.

An integrated study has been carried out of the fate and effects of PAHs in fish living in a chronically polluted environment. Total PAH concentrations in different target organs (muscle, liver and gills), have been determined in five species of feral fish and possible histopathological effects and correlations of all these values with concentrations found in sediments and water column have been studied in two of these species. The Potency Equivalent Concentrations and Screening values (SVs), the Biota-to-sediment accumulation factors (BSAFs) and the Toxic Potency Assessment (TEQ) of sediment for fish have been calculated. Results show that levels found in target organs, the TEQs of sediment calculated for fish related to the SVs for fish consumption are of special concern. However, the index of pathologies shows a relatively low impact of PAHs on fish health. The use of feral finfish in risk assessment for PAHs in chronically polluted environments has been proved to be a useful tool to complement environmental diagnoses and improve their accuracy. This approach combines the measurement of total concentrations in different target organs of several appropriate species, the study of histopathological effects, and correlations between all these results and the concentrations found in associated sediments and column water.

Puente adhesivo en paciente con labio leporino y fisura velopalatina: una solución temporal con compromiso estético / Adhesive bridge in a patient with cleft lip and palate: a temporary solution with esthetic commitment

En la actualidad el aumento de la demanda estética y la necesidad de procedimientos mínimamente invasivos ha llevado a un aumento de la técnica adhesiva. Ribbond® es una marca de fibra de polietileno que permite un eficiente traspaso de fuerzas, es virtualmente plegable y se adapta fácilmente a la morfología dentaria y al contorno del arco dentario. Dentro de sus principales características podemos encontrar: Biocompatibilidad, inerte, translúcido y durable. Dentro de la odontología se le han dado distintos usos para esta fibra, ya sea como mantenedor de espacio, puente adhesivo, poste y núcleo endodóntico, ferulización, restauraciones tipo inlay y estabilización postortodóncica. En el caso de los pacientes fisurados se ha hecho relevante el uso de Ribbond® como puente adhesivo ya que permite mejorar la estética y rehabilitar temporalmente los espacios desdentados causados por la ausencia de un incisivo, principalmente una vez terminado el tratamiento de ortodoncia y en espera de una rehabilitación definitiva, aún más cuando el paciente no ha terminado su crecimiento y desarrollo. En este artículo se presenta un caso clínico de un paciente con labio leporino y fisura velopalatina operado demostrativo de la técnica de rehabilitación con Ribbond®.

Today the increasing demand of aesthetic and minimally invasive procedures has led to a boom of the adhesive technique. Ribbond® is a polyethylene fiber that allows an efficient transfer of forces, is virtually foldable and is easily adapted to tooth morphology and dental arch contour. Among its main features we can find: Biocompatibility, inert, translucent and durable. In dentistry, different uses have been given to this fiber, whether as space maintainer, adhesive bridge, endodontic post and core, splinting, inlay type restorations and postorthodontic stabilization. In the case of cleft lip and palate patients the use of Ribbond® as an adhesive bridge has become relevant, as it improves aesthetics and temporarily rehabilitates the edentulous spaces caused by the absence of an incisor. It is used especially after completion of the orthodontic treatment and waiting for a final rehabilitation, even when the patient has not completed their growth and development. This article presents a clinical case of a patient with lip and cleft palate operated with the rehabilitation technique using Ribbond®.

Recreating the seawater mixture composition of HOCs in toxicity tests with Artemia franciscana by passive dosing.

The toxicity testing of hydrophobic organic compounds (HOCs) in aquatic media is generally challenging, and this is even more problematic for mixtures. The hydrophobic properties of these compounds make them difficult to dissolve, and subsequently to maintain constant exposure concentrations. Evaporative and sorptive losses are highly compound-specific, which can alter not only total concentrations, but also the proportions between the compounds in the mixture. Therefore, the general aim of this study was to explore the potential of passive dosing for testing the toxicity of a PAH mixture that recreates the mixture composition found in seawater from a coastal area of Spain, the Bay of Algeciras. First, solvent spiking and passive dosing were compared for their suitability to determine the acute toxicity to Artemia franciscana nauplii of several PAHs at their respective solubility limits. Second, passive dosing was applied to recreate the seawater mixture composition of PAHs measured in a Spanish monitoring program, to test the toxicity of this mixture at different levels. HPLC analysis was used to confirm the reproducibility of the dissolved exposure concentrations for the individual PAHs and mixtures. This study shows that passive dosing has some important benefits in comparison with solvent spiking for testing HOCs in aquatic media. These include maintaining constant exposure concentrations, leading to higher reproducibility and a relative increase in toxicity. Passive dosing is also able to faithfully reproduce real mixtures of HOCs such as PAHs, in toxicity tests, reproducing both the levels and proportions of the different compounds. This provides a useful approach for studying the toxicity of environmental mixtures of HOCs, both with a view to investigating their toxicity but also for determining safety factors before such mixtures result in detrimental effects.

Assessment of dioxin-like soil contamination in Mexico by enzyme-linked immunosorbent assay.

In this work, we describe the results of a preliminary soil assessment program for the detection of dioxins at different sites in Mexico performed by immunoassay. We studied five different sectors considered relevant sources of dioxins: Anaversa and Tekchem industrial areas where organochlorine pesticides were manufactured and released by accidental explosions, secondary smelters, brick kilns, and rural dwellings. In the context of the Agency for Toxic Substances and Disease Registry (ATSDR) guidelines, only the brick kilns sites can be considered as low-risk areas. The dioxin concentrations detected in the vicinity of the Anaversa and Tekchem chemical plants and secondary smelters exceed the screening level of 0.05 ppb set by the ATSDR, and therefore further site-specific studies are needed. The dioxin levels found in all soot samples from indigenous dwellings where wood is used for indoor cooking were above the evaluation level. Considering that the studied areas are representative examples of dioxin sources in less developed countries, our work demonstrates the useful application of dioxin immunoassays as a tool for dioxin screening for environmental assessment programs in developing countries.

Mastopatía diabética en una mujer joven / Diabetic mastopathy in a young woman

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