Structural improvement of higher education in environmental toxicology in Latin America and Europe.

Industrial development has resulted in an increased release of chemicals and other agents into the environment, resulting in damage to the environment as well as increasing the risk of adverse effects on human health. Environmental toxicology (ET) is the discipline responsible for assessing the risks to human health and the environment from the effects of new chemicals and those already present in the environment. The development of human resources in toxicology is therefore a priority in both Latin America (LA) and the European Union (EU), although LA professionals are more involved in risk evaluation than in risk assessment compared to their EU colleagues. A solid background in general toxicology will enable those interested in environmental issues to tackle local problems. Moreover, the increasing globalization of markets and, therefore, of the necessary regulations, requires harmonisation of postgraduate programmes to ensure that risk assessment and management related to the environment are dealt with uniformly and by highly qualified scientists. The Inaugural Meeting of the ALFA-OMET Toxicology', a 2-year programme supported by the European Commission, offered the opportunity to discuss a number of these issues. The present status of existing ET courses in the EU and LA and the corresponding professional profiles in the two regions were examined, and a harmonized academic curriculum for a postgraduate professional profiles in the two regions were examined, and a harmonized academic curriculum for a postgraduate course in environmental toxicology was developed. Finally, a course programme for toxicology and a specialization in environmental toxicology designed by a panel of experts was discussed, and its relevance as a model for other specialisation programmes was analysed. Exercises such as those performed by ALFA-OMET may be useful not only in promoting discussion for the implementation of national and international professional registers in LA, but also in encouraging the same, ongoing process in the EU.

[Annual rhythm of menarche in Medellín, Colombia]. / Ritmo anual de la menarquia en Medellín, Colombia.

Hypotheses on seasonal, phylogenetic and ontogenetic factors or imprinting that may produce menarcheal rhythm were tested in a sample of school girls from Medellín, Colombia. The questionnaire included a net of important religious or national feasts and periods of vacation or study to prevent memory biases. European, Asian and Chilean samples showed peaks of menarche in December and January, but a few samples showed a second one in June, July and August. The winter short photoperiod and low temperature were assumed to be the cause of the winter peak in most European samples. However, this seasonal hypothesis was refuted when a Chilean sample also showed a peak in December, January and February (Summer). In the present study performed in a sample from a tropical country we found two peaks of menarche, one in July and the other in November, December and January; thus, the seasonal bypothesis can be hardly supported. Moreover, this sample showed a high coincidence between the month of menarche and the month of birth, and a different pattern of menarche when menarches are distributed according to their coincidence with the gestational development. Both facts affirm the ontogenetic hypothesis, because they were also found in several samples. Since this population is different from those already studied and its monthly distribution of menarches and births is also different from those other ones, the hypothetical phylogenetic factors find additional support. The possible influence of school stress and other environmental factors in the menarcheal rhythm are discussed.

Detección precoz del cáncer de cuello uterino mediante colposcopia Informe de 559 casos

Con el propósito de efectuar diagnóstico precoz y tratamiento del cáncer de cuello uterino en el Departamento de Caldas, Colombia, S.A. se creó un grupo interdisciplinario o institucional descentralizado, que desde junio de 1989 se desplaza periódicamente y en forma continua a los Hospitales Regionales del Departamento de Caldas, para hacer actividades de prevención, educación a la población de riesgo, adolescentes y detección del cáncer del cuello uterino. El ginecólogo practica colposcopia a todas las mujeres con citología anormal compatible con NIC o infección por VHP. Entre junio de 1989 y junio de 1992, se realizaron 559 colposcopias de primera vez; se diagnosticaron 152 casos de NIC y 21 casos de cáncer avanzado. La edad promedio para Ca microinvasivo e invasivo es de 47.5 años; de 33.9 años para lesiones preinvasoras. El 79.5 por ciento de mujeres tuvo relaciones sexuales antes de los 20 años y en la colposcopia se encontraron lesiones en el 60 por ciento de los casos, siendo el punteado y la zona acetoblanca los cambios más frecuentes. En 41 colposcopias se observaron vasos atípicos o lesiones clínicamente invasoras. De 404 biopsias tomadas se detectaron 21 carcinomas de tipo escamocelular, 4 microinvasoras y 17 invasoras. El 88 por ciento de las lesiones fueron intraepiteliales. La sensibilidad de la colposcopia frente a la biopsia fue de 94 por ciento y la especificidad del 46 por ciento. El 97 por ciento de los pacientes con PAP compatible con NIC-CA, presentaron algún tipo de lesión colposcopica. El promedio de edad de los pacientes con NIC fue de 13.8 años menor que los pacientes con carcinoma invasor. EL 100 por ciento de la población estudiada es de clase económica baja y 42 por ciento de zona rural. Se efectuaron tratamientos en el Hospital Regional consistentes en Crioterapia conización, histerectomía simple o ampliada; según el caso o radioterapia a nivel central. El programa ha posibilitado detectar un gran número de lesiones pre-invasoras, cuyo tratamiento oportuno ha permitido mejorar las condiciones de salud de la población y racionalizar los recursos, demostrándose los beneficios de una atención regionalizada con colposcopia. Además ha permitido determinar características colpo-histológicas y epidemiológicas

Reduction mammaplasty and correction of ptosis with a short inframammary scar.

The main sequelae of mammaplasties are scars, particularly visible when they trespass the breast limits. If the new inframammary fold is located higher than the original, the horizontal limb of the T-suture can be kept short and can be hidden beneath the breast. The glandular tissue is split vertically and overlapped for ptosis. For reduction, an inferior resection with medial or lateral remodeling is performed. The results are very satisfactory for ptosis and mild to moderate hypertrophy. High conical breasts with minimal scars are produced.