Aquatic self-assembly of sixteen subunits into a 39-kDa dendrimer.

We have developed the 8-(m-acetylphenyl)-2'-deoxyguanosine (mAG) scaffold for the self-assembly of supramolecules in water and for the synthesis of self-assembled dendrimers (SADs) in organic media. Previously, reported mAG assemblies showed promising characteristics for the construction of SADs. Yet, none of these SADs had large enough dendrons to reach a fractal geometry characteristic of high-generation dendrimers. Here we present the synthesis as well as the molecular and supramolecular characterization of a fourth-generation hydrophilic self-assembled hexadecameric dendrimer [mAGD(4)(OH)(16)](16)·3KI (3(16)) with a size and shape akin to those of globular proteins. The diameter of 3(16) (5.0 nm) was measured by pulsed field gradient NMR and dynamic light scattering experiments, which enabled the construction of a computer-generated molecular model. This SAD represents an attractive platform for biomedical applications due to its water solubility, discreteness, well-defined structure, thermal stability (T(m) = 68 °C), and functional core.

Transobturator versus transabdominal mid urethral slings: a multi-institutional comparison of obstructive voiding complications.

PURPOSE: In the last year TO slings have become an increasingly popular alternative to TA slings for the surgical treatment of SUI. Proposed advantages of the transobturator approach include improved speed, safety and the reduction of obstructive complications. We assessed outcomes of TO and TA slings in a large series of women treated at several institutions to compare the rate of obstructive complications from these procedures. MATERIALS AND METHODS: We reviewed the charts of 504 consecutive women who had synthetic mid urethral sling procedures (154 TO or 350 TA) performed by 24 different urologists for SUI at 8 institutions from 2002 to 2004. Obstructive complications were defined as increased PVR (greater than 100 cc), or the need for CIC, prolonged Foley catheter drainage or urethrolysis. RESULTS: While TO and TA sling procedures appeared to be similarly efficacious in eliminating the need for incontinence pad use (TO 89%, TA 86%, p = 0.36), the transobturator approach was associated with fewer obstructive complications (TO 11.0%, TA 18.3%, p < 0.05). Urethrolysis was required in none of the 154 TO cases and 8 of 350 (2.3%) TA cases. Concomitant pelvic surgery did not significantly increase the likelihood of obstructive voiding complications in either group. CONCLUSIONS: Although TO and TA sling procedures had similar short-term results for decreasing pad use in patients with stress urinary incontinence, the transobturator approach is associated with fewer obstructive voiding complications.

Trastorno ficticio crónico en una adolescente / Chronic factitions disorder in an adolescent

Una niñez caótica e inconsistente, egos débiles y cargados de conflicto, relaciones objetales empobrecidas y preocupaciones hipocondríacas y sadomasoquistas, son rasgos del contexto en el que proliferan los trastornos ficticios. Este escrito presenta el caso de un trastorno ficticio crónico en una fémina adolescente. Se incluye un repaso de la literatura reciente con atención particular a la compleja interacción psico-socio-dinámica, los asuntos diagnósticos que merecen consideración especial y las técnicas terapéuticas a usarse en el manejo de este grupo de desórdenes potencialmente tratables

El uso y abuso de sustancias prohibidas en el deporte

Se han presentado y discutido las definiciones, clasificaciones y ejemplos específicos de sustancias prohibidas y no prohibidas en el deporte. Se discutió el problema de la detección de sustancias y el papel de los laboratorios y las metodologías usadas en la deteccón. Finalmente, se trató el asunto de la prevención, el tratamiento y la rehabilitación desde la perspectiva del modelo biopsicosocial de la medicina

Estudio basal de Prevalencia de Caries y Fluorosis Dental en Niños Escolarizados. Venezuela 1997: Informe Final / Basal Study of caries prevalence and dental fluorose in Scholastic Children: Venezuela 1997: Final Report

El objetivo del estudio fue determinar la prevalencia de la enfermedad cariosa y de fluorosis dental, necesarias para la implementación del Programa Nacional de Fluoración de la Sal de Consumo en Venezuela. Los hallazgos sobre Fluorosis dental a nivel nacional revelaron que el 15 por ciento de la muestra estudida tenía signos de alteración, correspondiendo apenas el 0.6 por ciento a las categorias moderada y severa; Las clasificaciones menos severas (dudosa a leve) representaron el 14.4 por ciento de los casos. La distribución de la prevalencia de fluorosis en los grupos etáreos osciló entre el 20 por ciento a los 8 años y 9.3 a los 15. Se destaca que los estractos de mayor edad estuvieron por debajo del porcentaje nacional.