[Assessment of control of cardiovascular risk factors in obese posmenopausal women after monitoring a structured dietary education and exercise program. (SÍSIFO Program)]. / Valoración del control de los factores de riesgo cardiovascular en mujeres menopáusicas obesas tras el seguimiento de un programa estructurado de educación dietética y ejercicio físico. (Programa SÍSIFO).

OBJECTIVE: Evaluate the influence of a specific program of physical exercise on cardiovascular risk, quality of life and eating habits of menopausal women. METHOD: Prospective, intervention study previous-after without control group for three months. 66 menopausal women were included. The intervention consisted of a structured diet and exercise program. Biochemical, anthropometric, dietary and life quality parameters were determined before and three months after surgery. RESULTS: After the intervention a decrease in weight (4.4±2,3kg) and BMI (1.83±0.84kg/m(2)) (p<.05) occurs. A decrease in SBP (p<.05) was also observed. The fasting glucose went down 13.75±11.11mg/dl and HbA1c fell by 0.19±0,12%, both with p<.05. The lipid profile follows a similar behavior, highlighting a decline of 8± 6.2mg/dl in LDL cholesterol values (p<.05). The score on the measured cardiovascular risk by the Framingham tables decreases by 3% postoperatively (p<.05). Regarding the quality of life, it is significantly improved in all analyzed areas. CONCLUSIONS: The application of a structured exercise and diet program improves close monitoring parameters associated with cardiovascular risk of the women studied. It also improves the quality of life and dietary habits.

Epidemiology of hemopoietic system neoplasms in Argentina.

The mortality caused by blood neoplasms in Argentina shows great irregularity. This was found to be caused in certain ways by (a) differences in the sexes and ages of the populations studied; (b) differences in available health services; and (c) environmental factors. Thus high rates and clusters of lymphomas and multiple mylomas were observed in zones with arsenical water, for example.In rural districts, the rates are lower, especially among old-aged people.Lower rates of leukemias were also observed among Spaniards compared to Italians (p=0.001) residing in Argentina. Turkish, Syrian, and Lebanese showed higher rates than Argentinians, Spaniards, or Italians.The results of a case-control study are given in which the following were observed: (a) Among the ancestors of cases HSN there are fewer Spaniards (not significant) and Latin-Americans (p=0.03) and more people who were born in Central or Eastern Europe (p=0.01). (b) In case group, there was more frequent contact with animals, especially dogs; and a greater exposure to petroleum and its products, and to insecticides.

[Methodology of care for children with phenylketonuria and maple-syrup urine disease]. / Metodología de atención de niños con fenilcetonuria (FC) y enfermedad de la orina con olor a miel de arce (EOMA).

Maple Syrup Urine Disease (MUSD) and Phenylketonuria (PKU), are two metabolic disease in which the nutritional management are essential. Nevertheless, in Costa Rica and the rest of Central America, the dietetical attention of the children with this illness aren't normalized. These work was developed to fill this necessity. The nutritional management was separate in three steps: 1-Initial diet: is the feeding that the children must receive while the blood amino acid level falls, 2-Stabilization diet: is the one where the requirement of limits amino acid are defined, 3-Follow up diet: this is the diet that is prescribed for the rest of his life. This attention methodology, was very important to an adequate physical and neurological development of the children with PKU and MSUD.

[Lists of food exchanges for use in phenylketonuria and maple-syrup urine disease]. / Listas de intercambio de alimentos para usar en la fenilcetonuria y en la enfermedad de la orina con olor a miel de arce.

Phenylketonuria (PKU) and maple syrup urine disease (MSUD) are disorders of the amino acid metabolism. Treatment of PKU and MSUD, is based on the restriction of the involved amino acids. Diet must begin very early in life in order to prevent neurological sequelae. A wrong dietary produce central nervous system damage. The first clinical manifestations are unexplained failure to thrive, vomiting, feeding difficulties, lethargy, coma, acidosis and irritability. The most severe consequence is impaired mental development. The standard exchange foods list (EFL) used in outpatient clinics, is designed for developed countries, and contains foods that are not available in our countries. Therefore, we provide in this article a EFL, based on food that are frequently used in Central America, with data of existing food composition tables. This list is currently being used by the Costa Rica national Children's Hospital Metabolic Disease Unit.

Synchronous pulmonary cryptococcosis and histoplasmosis.

A chronically immunosuppressed patient receiving oral steroid therapy had a cavitary lesion; both Histoplasma capsulatum and Cryptococcus neoformans were found in samples of respiratory secretions. C neoformans was also found in specimens taken from skin lesions and blood. This is the first reported instance of synchronous infection by these two fungi.

[Treatment of the child with growth retardation (failure to thrive)]. / Tratamiento del niño con retardo en el crecimiento (falla para progresar).

This paper presents a multidisciplinary approach to treat children with failure to thrive (FTT). The FTT team of the Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA) is composed of professional staff, including pediatrician, nutritionist, psychologist and social worker. They evaluate each patient and provide an integrated treatment. The early detection and the appropriate management of children with FTT will improve the physical and psychosocial condition of these patients.

Características de la población de roedores y pulgas en áreas de diferente riesgo para peste de tres provincias del departamento de Piura- Perú / Characteristics of rodent and flea population in areas of different risk for plague in three provinces of Piura departament - Perú

Objetivo: Identificar las especies de roedores y pulgas en áreas de bajo, mediano y alto riesgo para peste de tres provincias de Piura, determinando su distribución geográfica y densidad poblacional. Materiales y métodos: En este estudio transversal analítico del 2000 y febrero del 2001, realizándose la identificación de sus especies. Las localidades fueron agrupadas en tres áreas: bajo, mediano y alto riesgo para peste. Se tomaron muestras de vísceras de 382 roedores para el aislamiento de Yersinia pestis, mediante cultivo e inmunofluorescencia directa, y muestras de sangre en tiras de Nobuto a 376 roedores y 286 perros para evaluar la presencia de anticuerpos contra Yersinia pestis, a través de la prueba de aglutinación en látex. Se calcularon indicadores de densidad poblacional para roedores y pulgas. Resultados: Akodon sp. (50,4 por ciento) y Rattus rattus (32,5 por ciento) fueron las especies de roedores predominantes. 23 localidades tuvieron un índice de atrape de roedores (IAR) mayor a 5 por ciento. Pulex irritans y Ctenonophalides felis fueron las especies de pulgas más frecuentes. Xenopsilla cheopis sólo alcanzó un porcentaje de 0,2 por ciento no encontrándose Polygenes litargus. Los indicadores de densidad poblacional de pulgas fueron bajos. Todas las muestras para cultivo, inmunoflorescencia y serología resultaron negativas. Conclusiones: La población de roedores fue alta en 23 localidades, sin embargo, la densidad poblacional de pulgas y la ausencia de circulación de Yersinia pestis no indican riesgo para la aparición de brotes de peste.

Objective: To identify rodent and flea species in low, medium and high risk areas for plague in three provinces in Piura, determining their geographic distribution and population density. Materials and methods: In this transversal analytic study, rodents and fleas were caught in 80 sites from three provinces in Piura, Peru, between March 2000 and February 2001, and their species were identified. The sites were grouped according to three categories: low, medium, and high risk for plague. Samples from internal organs from 382 rodents were taken in order to isolate Yersinia pestis using culture and direct immunofluorescence techniques; and blood samples using Nobuto strips were taken from 376 rodents and 286 dogs in order to determine the presence of antibodies against Yersinia pestis, using the latex agglutination test. Population density indicators were calculated for both rodents and fleas. Results: Akodon sp. (50.4%), and Rattus rattus (32.5%) were the predominant rodent species. 23 sites had a rodent trapping index (RTI) higher than 5%. Pulex irritans and Ctenophalides felis were the most prevalent flea species. Xenopsilla cheopis reached 0.2%, and Polygenes fitargus was not found. The population density indicators for fleas had low values. All samples for culture, immunofluorescence, and serology were negative. Conclusions: The rodent population was high in 23 sites; however, flea population density and the absence of Yersinia pestis circulation do not indicate a risk for plague outbreaks.