Clinical Conundrum: Spontaneous Paravaginal Venous Plexus Thrombosis Presenting as Acute Lower Pelvic Pain.

Acute pelvic pain due to venous thrombosis can be encountered in the context of pelvic congestion syndrome. Some vascular anomalies such as nutcracker syndrome or May-Thurner syndrome may cause left ovarian vein or left iliofemoral vein thrombosis. Smaller parametrial or paravaginal vein thrombi have rarely been reported as aetiologies of acute pelvic pain. We present a case of spontaneous paravaginal venous plexus thrombosis presenting as acute lower pelvic pain in which thrombophilia was diagnosed. Small vein thrombosis or an unusual location of thrombus should prompt vascular studies and a thrombophilia work-up.

Isolation and characterization of high affinity and highly stable anti-Chikungunya virus antibodies using ALTHEA Gold Libraries™.

BACKGROUND: More than 3 million infections were attributed to Chikungunya virus (CHIKV) in the 2014-2016 outbreak in Mexico, Central and South America, with over 500 deaths directly or indirectly related to this viral disease. CHIKV outbreaks are recurrent and no vaccine nor approved therapeutics exist to prevent or treat CHIKV infection. Reliable and robust diagnostic methods are thus critical to control future CHIKV outbreaks. Direct CHIKV detection in serum samples via highly specific and high affinity anti-CHIKV antibodies has shown to be an early and effective clinical diagnosis. METHODS: To isolate highly specific and high affinity anti-CHIKV, Chikungunya virions were isolated from serum of a patient in Veracruz, México. After purification and characterization via electron microscopy, SDS-PAGE and binding to well-characterized anti-CHIKV antibodies, UV-inactivated particles were utilized as selector in a solid-phase panning in combination with ALTHEA Gold Libraries™, as source of antibodies. The screening was based on ELISA and Next-Generation Sequencing. RESULTS: The CHIKV isolate showed the typical morphology of the virus. Protein bands in the SDS-PAGE were consistent with the size of CHIKV capsid proteins. UV-inactivated CHIKV particles bound tightly the control antibodies. The lead antibodies here obtained, on the other hand, showed high expression yield, > 95% monomeric content after a single-step Protein A purification, and importantly, had a thermal stability above 75 °C. Most of the antibodies recognized linear epitopes on E2, including the highest affinity antibody called C7. A sandwich ELISA implemented with C7 and a potent neutralizing antibody isolated elsewhere, also specific for E2 but recognizing a discontinuous epitope, showed a dynamic range of 0.2-40.0 mg/mL of UV-inactivated CHIKV purified preparation. The number of CHIKV particles estimated based on the concentration of E2 in the extract suggested that the assay could detect clinically meaningful amounts of CHIKV in serum. CONCLUSIONS: The newly discovered antibodies offer valuable tools for characterization of CHIKV isolates. Therefore, the strategy here followed using whole viral particles and ALTHEA Gold Libraries™ could expedite the discovery and development of antibodies for detection and control of emergent and quickly spreading viral outbreaks.

Facilitating the design of HL7 domain models through a model-driven solution.

BACKGROUND AND GOAL: Health information systems are increasingly sophisticated and developing them is a challenge for software developers. Software engineers usually make use of UML as a standard model language that allows defining health information system entities and their relations. However, working with health system requires learning HL7 standards, that defines and manages standards related to health information systems. HL7 standards are varied, however this work focusses on v2 and v3 since these are the most used one on the area that this work is being conducted. This works aims to allow modeling HL7 standard by using UML. METHODS: Several techniques based on the MDE (Model-Driven Engineering) paradigm have been used to cope with it. RESULTS: A useful reference framework, reducing final users learning curve and allowing modeling maintainable and easy-going health information systems. CONCLUSIONS: By using this approach, a software engineer without any previous knowledge about HL7 would be able to solve the problem of modeling HL7-based health information systems. Reducing the learning curve when working in projects that need HL7 standards.

Wrinkled titanium nitride nanocomposite for robust bendable electrodes.

Electrical contacts and interconnections are critical components for all electronic devices. Bendable electrodes with enhanced electro-mechanical properties are highly desirable to develop innovative wearable electronic devices. Herein we report on a fabrication method for robust bendable coatings based on titanium nitride (TiN) thin films and silver nanowires (Ag NWs). TiN and TiN-AgNWs nanocomposites were deposited on polyethylene terephthalate (PET) substrates using a plasma enhanced pulsed laser deposition (PLD) technique. The resulting TiN coatings exhibit excellent adhesion to PET and their sheet resistance can be tuned using a dual frequency PLD process and further decreased by incorporating Ag NWs into the TiN layers. Sample sheet resistance was decreased down to values as low as [Formula: see text] corresponding to the formation of TiN-AgNWs nanocomposites. The electro-mechanical robustness of TiN based coatings were evaluated by four-probe resistance measurements in situ under cyclic bending tests. We show that the TiNAgNWs nanocomposites surpass both ITO and Ag NWs coatings in terms of mechanical robustness and electrical conductivity respectively. These nanocomposites withstand high strain fatigue loading up to ϵ = 2.6%, keeping R S below 5 Ω/□. The data demonstrates that the incorporation of Ag NWs in TiN coatings improve the mechanical robustness, limiting the crack growth and propagation, with low optical transmittance decrease (≈11%). These results indicate that Ag NWs based nanocomposites are attractive materials for flexible electronic devices.

Generalized pustular psoriasis triggered by Zika virus infection.

Zika virus is an emerging arbovirus, which is expanding in epidemic proportions through tropical and subtropical areas of the world. Although Zika is linked to a number of congenital and neurological complications, there is scarce knowledge on the impact of ZIKV infection in human skin. We report the case of a 68-year old woman who presented with generalized pustular psoriasis after a preceding and otherwise uneventful episode of ZIKV infection. Based on recent experimental data on the biology of ZIKV infection in the cutaneous environment, we speculate that ZIKV may have directly triggered the development of generalized pustular psoriasis by stimulation of keratinocyte-derived mediators of inflammation and a polyfunctional T-cell driven immune reaction in the cutaneous milieu.

Working with the HL7 metamodel in a Model Driven Engineering context.

HL7 (Health Level 7) International is an organization that defines health information standards. Most HL7 domain information models have been designed according to a proprietary graphic language whose domain models are based on the HL7 metamodel. Many researchers have considered using HL7 in the MDE (Model-Driven Engineering) context. A limitation has been identified: all MDE tools support UML (Unified Modeling Language), which is a standard model language, but most do not support the HL7 proprietary model language. We want to support software engineers without HL7 experience, thus real-world problems would be modeled by them by defining system requirements in UML that are compliant with HL7 domain models transparently. The objective of the present research is to connect HL7 with software analysis using a generic model-based approach. This paper introduces a first approach to an HL7 MDE solution that considers the MIF (Model Interchange Format) metamodel proposed by HL7 by making use of a plug-in developed in the EA (Enterprise Architect) tool.

A Strategic Study about Quality Characteristics in e-Health Systems Based on a Systematic Literature Review.

e-Health Systems quality management is an expensive and hard process that entails performing several tasks such as analysis, evaluation, and quality control. Furthermore, the development of an e-Health System involves great responsibility since people's health and quality of life depend on the system and services offered. The focus of the following study is to identify the gap in Quality Characteristics for e-Health Systems, by detecting not only which are the most studied, but also which are the most used Quality Characteristics these Systems include. A strategic study is driven in this paper by a Systematic Literature Review so as to identify Quality Characteristics in e-Health. Such study makes information and communication technology organizations reflect and act strategically to manage quality in e-Health Systems efficiently and effectively. As a result, this paper proposes the bases of a Quality Model and focuses on a set of Quality Characteristics to enable e-Health Systems quality management. Thus, we can conclude that this paper contributes to implementing knowledge with regard to the mission and view of e-Health (Systems) quality management and helps understand how current researches evaluate quality in e-Health Systems.

SunoCaps: A novel dataset of text-prompt based AI-generated music with emotion annotations.

The SunoCaps dataset aims to provide an innovative contribution to music data. Expert description of human-made musical pieces, from the widely used MusicCaps dataset, are used as prompts for generating complete songs for this dataset. This Automatic Music Generation is done with the state-of-the-art Suno generator of audio-based music. A subset of 64 pieces from MusicCaps is currently included, with a total of 256 generated entries. This total stems from generating four different variations for each human piece; two versions based on the original caption and two versions based on the original aspect description. As an AI-generated music dataset, SunoCaps also includes expert-based information on prompt alignment, with the main differences between prompt and final generation annotated. Furthermore, annotations describing the main discrete emotions induced by the piece. This dataset can have an array of implementations, such as creating and improving music generation validation tools, training systems for multi-layered architectures and the optimization of music emotion estimation systems.

The physiology of ex vitro pineapple (Ananas comosus L. Merr. var MD-2) as CAM or C3 is regulated by the environmental conditions: proteomic and transcriptomic profiles.

KEY MESSAGE: Proteomic and transcriptomic profiles of key enzymes were monitored in pineapple plants propagated under C3 and CAM-inducing metabolisms to obtain insight into the CAM-facultative metabolism and the relationship of CAM plants with oxidative stress. ABSTRACT: Pineapple is one of the most important tropical crops worldwide. The use of temporary immersion bioreactors for the first stages of pineapple propagation enables precise control of plant growth, increases the rate of plant multiplication, decreases space, energy and labor requirements for pineapple plants in commercial micropropagation. Once the plantlets are ready to be taken from the reactors, they are carefully acclimatized to natural environmental conditions, and a facultative C3/CAM metabolism in the first 2 months of growth is the characteristic of pineapple plants, depending on environmental conditions. We subjected two sets of micropropagated pineapple plants to C3 and CAM-inducing environmental conditions, determined by light intensity/relative humidity (respectively 40 µmol m−2 s−1/85 % and 260 µmol m−2 s−1/50 %). Leaves of pineapple plants grown under CAM-inducing conditions showed higher leaf thickness and more developed cuticles and hypodermic tissue. Proteomic profiles of several proteins, isoenzyme patterns and transcriptomic profiles were also measured. Five major spots were isolated and identified, two of them for the first time in Ananas comosus (OEE 1; OEE 2) and the other three corresponding to small fragments of the large subunit of Rubisco (LSU). PEPC and PEPCK were also detected by immunobloting of 2DE at the end of both ex vitro treatments (C3/CAM) during the dark period. Isoenzymes of SOD and CAT were identified by electrophoresis and the transcript levels of OEE 1 and CAT were associated with CAM metabolism in pineapple plants.

Comparison of round and knife-edge-like cathodes on gas-puff implosions.

Preionization is believed to play an important role on the implosion of gas-puff Z pinches. Some experiments have used an external preionization source, e.g., UV light or electron beam. In contrast, other experiments rely completely on over voltage breakdown by the own generator's voltage pulse. However, this approach lacks shot-to-shot reproducibility since self-breakdown is mainly a stochastic process. In this work, we performed a systematic study on self-breakdown using two different cathode geometries: (i) a smooth, round cathode to provide a homogeneous electric field, (ii) a sharp, knife-edge-like geometry to enhance the electric field locally and eventually electron emission. The experiments were carried out on the Llampudken current generator, which provides a current pulse of ∼400kA amplitude and 200 ns rise time (10%-90%). We implemented gated XUV imaging, filtered diodes and time-integrated x-ray imaging to obtain information about the implosion as well as the stagnation phase for the two cathode geometries. We found that erosion of the knife-edge cathode might be a serious problem, and we had to replace it every 15 shots. On the other hand, the round cathode lasted for the whole series of experiments. We also measured a more reproducible and larger peak current for the knife cathode. From the photo-conductive detectors we observed that even if the round cathode might present shots with higher x-ray yield compared to the knife cathode, dispersion is almost twice as large. Moreover, after a statistic analysis, it is demonstrated that the dispersion in the yield is due solely to differences imposed by the cathodes and not to variations in the driver, as no correlation was found between them. We found that in order to fit the experimental data with the snowplow model, only ∼60% of the total mass is compressed in the knife cathode while ∼20% for the round one, highlighting the importance of the cathode and preionization. Therefore, we conclude that the use of the knife cathode increases the reproducibility of the experiment in comparison with the round cathode.

Bayesian inference of plasma parameters from collective Thomson scattering technique on a gas-puff near stagnation.

The Collective Thomson scattering technique has been implemented to study the stagnation of a single liner gas-puff. The plasma parameters are determined by theoretically modelling the scattering form factor in combination with Bayesian inference to provide the set of the most probable parameters that describe the experimental data. Analysis of the data reveal that incoming flows are able to interpenetrate partially. Estimation of the mean free path shows a gradual transition from a weakly collisional to a collisional regime as the plasma gets to the axis. Furthermore, we find that the ion energy at [Formula: see text] is [Formula: see text] and is mostly kinetic in nature and represents [Formula: see text] of the total energy. This kinetic energy is far greater than the value on axis of [Formula: see text] which is [Formula: see text] of the total energy. Energy transfer to the electrons and radiation losses are found to be negligible by this time. A possible explanation for this energy imbalance is the presence of an azimuthal magnetic field larger than [Formula: see text] that deflect the ions vertically. The uncertainties quoted represent 68% credible intervals.

The physiology of ex vitro pineapple (Ananas comosus L. Merr. var MD-2) as CAM or C3 is regulated by the environmental conditions.

Many plant species grown under in vitro controlled conditions can be used as models for the study of physiological processes. Adult pineapple can display CAM physiology while in vitro it functions as a C3 plant. Ex vitro Ananas comosus has plastic morphology and physiology, both easy to modify from C3 to CAM by changing the environmental conditions. The yield of survival for a rentable propagation protocol of pineapple is closely related with the C3/CAM shift and the associated physiological characteristics. In the present work, ex vitro pineapple plants were divided in two sets and subjected to C3 and CAM-inducing environmental conditions, determined by light intensity and relative humidity, respectively, 40 µmol m(-2) s(-1)/85% and 260 µmol m(-2) s(-1)/50%. The results demonstrated that the stress imposed by the environmental conditions switched pineapple plants from C3 to CAM behavior. Comparing to CAM induced, C3-induced pineapple plants showed substandard growth parameters and morphological leaf characteristics but a better rooting process and a higher ABA production, a phenotype closer to adult plants, which are expected to produce fruits in a normal production cycle. We conclude that the upholding of these characteristics is conditioned by low light intensity plus high relative humidity, especially during the first 8 weeks of ex vitro growth. It is expected that the better understanding of pineapple acclimatization will contribute to the design of a protocol to apply as a rentable tool in the pineapple agronomic industry.

Diurnal biting periodicity of parous Simulium (Diptera: Simuliidae) vectors in the onchocerciasis Amazonian focus.

We describe the hourly patterns of parous biting activity of the three main simuliid vectors of human onchocerciasis in the Amazonian focus straddling between Venezuela and Brazil, namely, Simulium guianense s.l. Wise; S. incrustatum Lutz, and S. oyapockense s.l. Floch and Abonnenc. Time series of the hourly numbers of host-seeking parous flies caught in five Yanomami villages during dry, rainy, and their transition periods from 1995 to 2001 were investigated using harmonic analysis (assuming an underlying circadian rhythm) and periodic correlation (based on Spearman's r). Parous S guianense s.l. showed a bimodal activity pattern, with a minor peak in mid-morning and a major peak at 16:00 h. S. incrustatum exhibited mainly unimodal activity during either early morning or midday according to locality. S. oyapockense s.l. bit humans throughout the day mainly between 10:00 and 16:00 h but also showed bimodal periodicity in some localities. Superimposed on the endogenous, species-specific daily cycles, parous activity showed variation according to locality, season, air temperature and relative humidity, with biting being promoted by warmer and drier hours during wet seasons/periods and reduced during hotter times in dry seasons or transitions. The results are discussed in terms of their implications for blackfly biology and ecology as well as onchocerciasis epidemiology and control.

Role of the switch II region in the conformational transition of activation of Ha-ras-p21.

The role of the switch II region in the conformational transition of activation of Ha-ras-p21 has been investigated by mutating residues predicted to act as hinges for the conformational transition of this loop (Ala59, Gly60, and Gly75) (Díaz JF, Wroblowski B, Schlitter J, Engelborghs Y, 1997, Proteins 28:434-451), as well as mutating the catalytic residue Gln61. The proposed mutations of the hinge residues decrease the rate of the conformational transition of activation as measured by the binding of BeF3- to the GDP-p21 complex. Also, the thermodynamic parameters of the binding reaction are altered by a factor between three and five, depending on the temperature. (Due to changes in activation and reaction enthalpies, partially compensated by entropy changes.) The control mutation Q61H in which only the catalytic residue is changed has only a limited effect on the kinetic rate constants of the conformational transition and on the thermodynamic parameters of the reaction. The fact that mutations of the hinge residues of the switch II region affect both the binding of the phosphate analog and the conformational transition of activation indicates that the switch II is implicated both in the early and the late states of the transition.

Polymorphism in the type I collagen (COLIA1) gene and risk of fractures in postmenopausal women.

Twin and family studies have demonstrated that a large part of a population's variance in bone mineral density (BMD) is attributable to genetic factors. A polymorphism in the collagen type I alpha1 (COLIA1) gene has recently been associated with low bone mass and fracture incidence. We analyzed the relationship between COLIA1 gene polymorphism, lumbar spine and hip BMD, and fracture prevalence in a population of 319 postmenopausal women classified by WHO standards, including 98 nonosteoporotic women (NOPW) and 221 osteoporotic postmenopausal women (OPW), divided into 139 osteoporotic women without fracture (OPWnF) and 82 osteoporotic women with fracture (OPWwF). The COLIA1 genotype was assessed by polymerase chain reaction and BalI endonuclease digestion. Genotype frequencies for the total group were 49.2% GG homozygotes, 39.5% GT heterozygotes, and 11.3% TT homozygotes. We found significant differences in the percentage of homozygous TT between NOPW and OPW (6.1% and 13.6%, respectively). Significantly, the occurrence of genotype TT in OPWnF was 6.2%, and 28% in OPWwF. We observed no associations between the COLIA1 genotype and lumbar spine and hip BMD. The prevalence of fractures varied significantly by genotype: GG, 26.1%; GT, 15.9%; and TT, 58.3%. Logistic regression analysis of fracture prevalence showed that, for prevalent fractures, the women with the TT genotype had a 5.9-fold increased risk when compared with the other genotypes (GG + GT). When prevalence was adjusted for age, body mass index, and BMD, the fracture risk was 4.8 for the TT group vs. the genotype GG, whereas it was 0.6 for the GT genotype. In conclusion, we found the COLIA1 Sp1 TT genotype to be associated with an increased fracture risk in postmenopausal women. Interestingly, this genotype-dependent risk could not be explained completely by BMD differences.

Pólipos endometriales: Actualización en diagnóstico y tratamiento / Endometrial polyps: update on diagnosis and treatment

ANTECEDENTES: Los pólipos endometriales son protrusiones nodulares benignas de la superficie endometrial con características clínico-patológicas propias y de origen desconocido. Su prevalencia es alta, especialmente en pacientes con sangrado uterino anormal, se asocia a infertilidad y a cáncer de endometrio, lo que se traduce en que se trata de una patología muy importante en el quehacer ginecológico habitual. OBJETIVOS: Revisar la patogenia, actualizar y evaluar los métodos diagnósticos, y definir las mejores opciones terapéuticas de esta frecuente patología. MÉTODO: Revisión sistemática de la literatura publicada en el tema, mediante búsqueda en base de datos Pub Med. RESULTADOS: La patogenia es aun desconocida, es una patología muy heterogénea y no hay causa única, se han reportado varios hallazgos relacionados con alteraciones genéticas. La ultrasonografía de alta definición, la hidrosonografia y la histeroscopia son el estándar actual en el diagnóstico. Las opciones terapéuticas se extienden desde la observación y seguimiento con imágenes, hasta la histerectomía con biopsia contemporánea, siendo la histeroscopia quirúrgica el método más costo efectivo. CONCLUSIÓN: La patogenia de los pólipos endometriales se encuentra actualmente en revisión, no hay ninguna teoría que explique la génesis de todos los pólipos. La ultrasonografía con contraste y la histeroscopia constituyen el estándar en el diagnóstico. En el tratamiento, la indicación es la cirugía histeroscopica y en especial la resección electroquirúrgica, que permite una extracción completa del pólipo bajo visión directa, con enfoque diagnóstico y terapéutico, con riesgos bajos y recurrencia mínima.

BACKGROUND: Endometrial polyps are benign nodular protrusions of the endometrial surface with clinical and pathological features of unknown origin. Its prevalence is high, especially in patients with abnormal uterine bleeding, it is associated with infertility and endometrial cancer, what constitutes a common and important disease. AIMS: To review the pathogenesis, to update and evaluate diagnostic methods, and to define the best treatment options for this common condition. METHODS: A systematic review of the published literature on the subject by searching PubMed database. RESULTS: The pathogenesis is still unknown, it is a very heterogeneous disease and there is no single cause, there have been several findings related to genetic alterations. High definition ultrasonography, the hidrosonography and hysteroscopy are the current standard in diagnosis. Therapeutic options range from observation and follow up with images to the hysterectomy using contemporary biopsy, surgical hysteroscopy being the most cost effective method. CONCLUSION: The pathogenesis of endometrial polyps are currently under review, there is no theory to explain the genesis of all polyps. Contrast ultrasonography and hysteroscopy are standard in the diagnosis. In the treatment, the indication is histeroscopy surgery and especially electrosurgical resection, which allows complete removal of polyps, diagnostic and therapeutic approach, with low risk and low recurrence.

[Experience of the Birth Regulation Department]. / Experiencia del Departamento de Regulación de la Natalidad.

PIP: Since the establishment of the department at a hospital in Valparais o, Chile, the number of births has declined, as well as the number of abortions (monthly births, from 102 to 70, abortions from 24.7 to 13.8, that is, a decrease of 36.4% and 43.4%, respectively). IUDs, oral contraceptives and, in some cases, condoms have been prescribed. Complications due to IUDs generally concerned expulsion, metrorrhagia (both curable and requiring removal of IUD), infection and intrauterine perforation (few cases) and pelvic pain. The pregnancy rate per 100 years of observations was .80 with the Lippes IUD (more used) and 2.03 with the zipper type. Expulsions amounted to 5.4%. After repositioning, the final expulsion rate was only 1.25%. With respect to oral contraceptives, the findings coincide with those already widely published. The sequential treatment appears to be tolerated considerably better. Since 1970 all patients were subjected to cytological tests, irrespective of age and of apparent good health. This made possible to detect several cases of inflammation and suspected cancer; after treatment, most cases improved, leaving two highly probably cancer cases.^ieng

[Prognostic value of anti-RNP/Sm and anti-Ro/La antibodies in lupus nephropathy]. / Valor pronóstico de los anticuerpos anti-RNP/Sm y anti-Ro/La en la nefropatía lúpica.

With the aim to analyze the prognostic value of anti-RNP/Sm and anti-Ro/La antibodies (Ab) in lupus nephropathy, we have studied through Contraimmunoelectrophoresis (CIE) and Immunoblotting (IB) the serum of 63 patients diagnosed of systemic lupus erythematosus. Mean age was 36.5 years (15-71) and 90% were females. We have classified the patients into three subgroups: I, 25 patients without nephropathy; II, 26 patients with evidence of nephropathy (persistent proteinuria and/or microhematuria) and normal renal function; and III, 12 patients with renal failure (servu creatinine > 1.5 mg/dl). 21 patients had kidney biopsy. IB allows to identify a higher number of positive serum, specially in the case of anti-RNP (7.9% CIE vs 28.5% IB) and anti-Sm antibodies (6.3% vs 30.1%). Prevalence of anti-RNP Ab is lower in subgroup III (32% I vs 34% II vs 8% III) (p > 0.05). Anti-Sm Ab are more frequent in group II and are not associated with renal failure (16% vs 54% vs 8%) (p > 0.05). Anti-Ro Ab are related with the absence of nephropathy (52% vs 15% vs 0%) (p < 0.05). We conclude that IB is more sensitive than CIE in the detection of these Ab and its use in Systemic Lupus Erythematosus permits to identify patient subgroups with lesser risk to develop renal failure. Even though our data are preliminary, we suggest that the detection of anti-RNP/Sm and/or anti-Ro/La antibodies are a good prognostic factor in lupus nephropathy.

[Variability of measured energy expenditure in patients with acute pancreatitis: is it possible to obtain a reliable pathology factor for these cases?]. / Variabilidad del gasto calórico medido en pacientes con pancreatitis aguda: es posible obtener un factor de patologia confiable para estos casos?

Energy expenditure was measured in 55 patients with acute pancreatitis, during variable periods ranging from 1 to 5 weeks and it was compared with estimated energy expenditure according to Harris Benedict equations. Patients with severe pancreatitis had similar measured and measured/estimated energy expenditure rations, compared to those with mild pancreatitis (1678 +/- 349.6 kcal/day and 1.1 +/- 0.19 vs 1632 +/- 383 kcal/day and 1.06 +/- 0.19). There was a high dispersion of measured/estimated rations (0.67 - 1.7) that precluded the calculation of a reliable energy expenditure correction factor for this disease. It is concluded that energy expenditure must be measured and not estimated, when planning an adequate nutritional support in patients with acute pancreatitis.