Extracorporeal Membrane Oxygenation (ECMO) Training Program in A Pediatric Cardiac Intensive Care Unit: An 8-Year Single-Center Experience in Argentina

ABSTRACT Introduction: Extracorporeal membrane oxygenation (ECMO) for temporary cardiopulmonary support is one of the most intense and technologically complex therapies offered in medicine. It is a high-risk procedure that requires specific knowledge and technical skills to perform it with good results. Objective: The main goal of this study is to describe our extracorporeal membrane oxygenation (ECMO) training program based on the study of specialized nurses and physicians of a simulation teaching experience, conducted in a pediatric cardiac intensive care unit. The program was developed as a theoretical-practical course with final exam and annual maintenance training sessions, caring for ECMO patients, its implementation and results. Methods: A descriptive study for registered nurses, intensivists, and cardiac surgeons. A self-administered, anonymous, and voluntary survey was conducted to assess the long-term perception about the program. Demographic data to describe the population was required, and questions about satisfaction and confidence in acquired skills and competences were asked. A descriptive statistical analysis was performed; patient survival and complications were compared before and after ECMO program using chi-square test, and P<0.05 was considered statistically significant. Results: Twenty-four training courses were performed for 68 professionals. More than 88% of the professionals considered the course components to be adequate and complete; and 94% felt trained to manage the ECMO circuit. Most valued activities were workshops and clinical cases. Since the implementation of the training program, 88 patients were assisted, with a survival rate at discharge of 58%, higher than in the previous period (P=0.03). Conclusion: More than 80% of the professionals considered the workshops and simulations as the most useful components. Reliance on the circuit care was higher than in training problem scenarios. Since 2013 we assisted 88 patients on ECMO, with a survival rate at discharge of 58%, within international standards results.

Prevalence and factors associated with seroprotection after primary series of hepatitis b vaccination among children seen in the outpatient setting of Philippine Children’s Medical Center

BACKGROUND@#Hepatitis B is a vaccine-preventable condition that could develop into cirrhosis and hepatocellular carcinoma. Identifying patients at risk for Hepatitis B infection despite the universal implementation of Hepatitis B vaccination will help improve the immunization program.@*OBJECTIVE@#To determine the prevalence and factors associated with seroprotection among children 3 months to 18 years old primary Hepatitis B vaccination series.@*METHODOLOGY@#This is a cross-sectional study among children 3 months to 18years old with complete Hepatitis B immunization. Demographic, social and clinical data were correlated with response to HBsAg, Anti-HBs and Total Anti-HBc tests.@*RESULTS@#Among 110 subjects from different age groups, 52% had seroprotective anti-HBs levels (>10 mIU/ml). Seventy four percent seroprotection was seen in subjects with <5 years interval from vaccination, 26% in cases after 5-10 years, and 38% at 10 years after vaccination with significant difference. Other factors such as gender, geographic area, type of vaccine, schedule, age at first dose and place of vaccine were not associated with seroprotection.@*CONCLUSION@#Fifty two percent seroprotection from Hepatitis B infection among different age groups was demonstrated in our study. Interval year after vaccination was the only factor established to have significant association with seroprotection, with < 50% decline of anti-HBs level at 5 years or more after vaccination. @*RECOMMENDATIONS@#Community studies with larger population are needed. Anti-HBs detection 5 years or more post-vaccination may be considered to identify patients at risk for breakthrough infection. Repeat serologic testing among non-seroprotected subjects is recommended.

Efficacy of a public promotion program on children's oral health / Eficácia de um programa público de promoção de saúde bucal em crianças

Abstract Objective: To assess the efficacy of the Baby's Mouth early dental care prevention and promotion program in preventing oral diseases (caries, gingivitis, or malocclusions) in children attended since 2010. Methods: This was a cross-sectional and cohort study that assessed 252 children between 36 and 60 months of age in both sexes. The children were divided into three groups: G1: effective participants of the program from birth; G2: children who have stopped participating for more than 24 months, and G3: children who have never attended a prevention program. The evaluation was carried out in two stages: first, an interview with the mothers and, afterwards, a clinical children examination to assess the presence of caries, gingivitis, and malocclusion. The chi-squared test was used for statistical analysis between groups (p < 0.05). Results: The diseases assessed were: caries (G1: 5.9%, G2: 54.7%, G3: 70%), gingivitis (G1: 8.3%, G2: 17.9%, G3: 40.5%), and malocclusion (G1: 22.6%; G2: 28.6%; G3: 50%). For gingivitis, there was no significant difference when comparing G1 and G2 (p = 0.107), but it was significant between G1 and G3 (p < 0.001). Regarding malocclusion, a statistically significant relationship was observed (p = 0.004) among all groups. Conclusion: The prevention and promotion program in public oral health was effective in preventing caries disease, gingivitis, and malocclusion in children under 5 years of age.

Resumo Objetivo: Avaliar a eficácia do programa de prevenção e promoção de cuidados dentários precoce da boca do bebê, a fim de prevenir doenças bucais (cáries, gengivite ou má oclusões) em crianças atendidas desde 2010. Métodos: Estudo transversal e de coorte com avaliação de 252 crianças entre 36 e 60 meses de idade de ambos os sexos. As crianças foram divididas em dois grupos: G1: participantes efetivos do programa a partir do nascimento; G2: crianças que pararam de participar por mais de 24 meses do programa; e G3: crianças que nunca participaram de um programa de prevenção. A avaliação foi feita em dois estágios: entrevista com as mães e, depois, um exame clínico nas crianças para analisar cáries, gengivite e oclusão. Foi utilizado o teste qui-quadrado para análise estatística entre os grupos (p < 0,05). Resultados: As doenças analisadas foram: cáries (G1: 5,9%, G2: 54,7%, G3: 70%), gengivite (G1: 8,3%, G2: 17,9%, G3: 40,5%) e má oclusão (G1: 22,6%; G2: 28,6%; G3: 50%). Para gengivite, não houve diferença significativa ao comparar G1 e G2 (p = 0,107), porém a diferença foi extremamente significativa entre G1 e G3 (p < 0,001). Nas oclusões, houve uma relação estatisticamente significativa (p = 0,004) entre todos os grupos. Conclusão: O programa de prevenção e promoção de saúde bucal pública foi efetivo na prevenção de cáries, gengivite e má oclusão em crianças com menos de cinco anos de idade.

Lychee (Litchi chinensis Sonn) peel flour: effects on hepatoprotection and dyslipidemia induced by a hypercholesterolemic diet

ABSTRACT Dyslipidemias are associated with the incidence of cardiovascular diseases, obesity, diabetes, hypertension and hepatic steatosis, being the cause of morbidity and mortality. This study investigated the effects of lychee peel flour (PF) on serum levels of total cholesterol (TC), low-density lipoprotein (LDL-c), triacylglycerols (TAG) and various parameters related to obesity, in rats fed a hypercholesterolemic diet. Therefore, 20 male rats were used. In the first 21 days, the animals were fed a hypercholesterolemic diet, except for control group. In the following 21 days, their diets were modified, and they received a standard diet (Control); hypercholesterolemic (Hyper); hypercholesterolemic + 5% PF (PF5) and hypercholesterolemic + 10% PF (PF10). The results revealed that PF intake attenuated weight gain, reduced body mass index, glucose and the levels of TAG, TC, LDL-c, hepatic enzymes and leptin, besides the percentage of hepatic lipids, liver lipid peroxidation and frequency of severe steatosis. Histological studies of the aorta did not show the formation of the atheromatous plaque. These results reinforce its potential to reduce the risk of diseases associated with obesity.

Clinical profile and factors affecting outcome of children with Hepatic Abscess: 19 year study

Objectives@#To describe the clinical profile of children with hepatic abscess, determine their laboratory & imaging findings, medical and surgical treatments and study factors affecting its outcome.@*Methodology@#A retrospective cohort study done in December 2016 on children 0 to Demographic, clinical and diagnostic data were correlated with the outcome and presence of complications.@*Results@#Thirty cases were identified in 19 years but only 25 charts were available for review. Mean age in years was 5.27 +/- 4.80 SD with male predominance. Fever (96%) and abdominal pain (60%) were common symptoms.Only 9 patients had hepatic abscess culture with Staphylococcus aureus (56%) as the most frequent growth. Anemia (76%) and leukocytosis (96%), and solitary (76%), large abscess >5 cms (60%) involving the right lobe (72%), were the common diagnostic findings. Most were treated with antibiotics alone (60%).All patients improved with no mortality noted, while pleural effusion was seen in 8 out of 12 patients with complications. Only male gender was significantly associated with complications both on chi-square (p0.004) and logistic regression (p 0.008). @*Conclusion@#Hepatic abscess is a liver infection usually seen among young and male population, manifesting as fever with anemia and leucocytosis. Most were complicated by pleural effusion with no deaths reported. Male gender had significant association with complications.

A prospective cross-sectional study on the prevalence and factors associated with Seroprotection after primary series of Hepatitis B vaccination

Objectives@#To determine the prevalence and factors associated with seroprotection among children 3 months to 18 years old with primary Hepatitis B vaccination series@*Methodology@#This is a prospective cross-sectional study done among children 3 months to 18 years old with complete primary series of Hepatitis B vaccination. Demographic, social and clinical data were correlated with reactivity to antibody to Hepatitis B surface antigen (antiHBs) (>10 IU/L),total antibody to Hepatitis B core antigen (total anti-HBc) and Hepatitis B surface antigen (HBsAg) serologic tests.@*Results@#Among 110 subjects from different age groups,52% had seroprotective anti-HBs levels, with the highest noted among infants (3 months-2 years) at 82%, followed by 41% from the childhood group (3-9 years) and 26% from adolescent group (10-18 years). Seventy-four percent of subjects with <5 years interval from vaccination were seroprotected, 26% in subjects after 5-10 years, and 38% at more than 10 years after vaccination with significant difference on multi-logistic regression (p value 0.000/0.020). None of the other factors including gender, geographic area, age at first dose, vaccination schedule, type and place of vaccination were significantly associated with seroprotection.@*Conclusion@#Fifty-two percent of patients among different age groups were seroprotected. Seroprotection was significantly associated with the interval year after vaccination demonstrated at < 50% 5 years and beyond post-vaccination.

Clinical profile and factors associated with Non-Alcoholic Fatty Liver Disease (NAFLD) among overweight and obese children: A prospective study

@#<p style="text-align: justify;"><strong>INTRODUCTION:</strong> In the past decades, the prevalence of childhood overweight and obesity has increased worldwide. Childhood obesity has been associated with wide range of serious health complications and increased risk of premature adult illnesses. Non-alcoholic Fatty Liver Disease (NAFLD) was of concern because of limited data among children. The study aims to determine the prevalence and demographic /clinical factors associated with NAFLD among overweight and obese children.</p><p style="text-align: justify;"><strong>METHODOLOGY:</strong> The study was a cross-sectional study among overweight and obese participants aged 2-18 years old. A total of 96 subjects were included. Frequencies and percentages of clinical characteristics were determined. Chi-square, linear correlation and logistic regression analysis for different factors were performed.</p><p style="text-align: justify;"><strong>RESULTS:</strong> Among the 92 subjects, 26 (28%) were overweight while 66 (72%) were obese. The M:F ratio was 1.8:1 and majority belonged to 6-10 years old (44%). As to socioeconomic class, the rity (59%) were from the low-income group. The overall prevalence of NAFLD among overweight and obese subjects was 29.3%. None of the clinical factors (age, gender, socioeconomic status, BMI, waist circumference, actual caloric intake, and dietary fat consumption) were significantly associated with NAFLD. Analysis of biochemical factors revealed that alanine aminotransferase, aspartate aminotransferase, serum triglycerides and total cholesterol were found to be associated with NAFLD. Among which AST and ALT were identified predictors of NAFLD.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> There was high prevalence of NAFLD among overweight and obese children. Screening among the pediatric population may aid on early identification and prevent its progression. ALT, AST, serum triglycerides and total cholesterol were independently related wih NAFLD. AST and ALT were identified predictors of NAFLD.</p>

Vitamin D status of Filipino high school students in selected schools in Quezon City

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Vitamin D deficiency has been documented as a frequent problem in almost every region of the world even in the tropical countries and its health consequences are enormous. Infancy and adolescence are age groups particularly at risk of developing vitamin D deficiency. However, there are no data on the Vitamin D status of Filipino adolescents.</p><p style="text-align: justify;"><strong>OBJECTIVES:</strong> To determine the serum 25-hydroxyvitamin D levels in Filipino high school students in selected schools in Quezon City</p><p style="text-align: justify;"><strong>METHODS:</strong> A cross-sectional study of Filipino high school students was undertaken. A total of 97 boys and girls aged 11- 18 years old, attending selected private and public secondary schools in Quezon City participated in the study after parents' consent and students' assent were taken. Serum 25(OH)D levels were determined by electrochemiluminescence immunoassay (ECLIA) using Roche HITACHI Cobas e immunoassay analyzer.</p><p style="text-align: justify;"><strong>RESULTS:</strong> The total serum 25-hydroxyvitamin D levels of the students ranged from 19.92 nmol/L to 88.63 nmol/L with a mean of 52.43 nmol/L. Among the 97 high school students, there was a prevalence of hypovitaminosis D (serum 25 (OH)D <50nmol/L) of 41.2% with 20.6% having deficient (</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> Hypovitaminosis D is highly prevalent among Filipino adolescents in secondary school despite abundance of sunlight. Appropriate interventions are needed to address the problem of poor vitamin D status in schoolchildren.</p>

Generalized aggressive periodontitis: microbiological composition and clinical parameters in non-surgical therapy / Periodontitis agresiva generalizada: composición microbiológica y parámetros clínicos en la terapia no quirúrgica

The aim of this study was to determine the variations in periodontal parameters and microbiological composition in periodontal pockets at the baseline and 3 and 6 months posttreatment in patients with Generalized Aggressive Periodontitis (GAP) undergoing nonsurgical periodontal treatment combined with chlorhexidine and systemic antibiotics. Medical and dental history was taken from 10 subjects, average age 30.62.7 years, diagnosed with GAP. A nonsurgical periodontal treatment combined with 0.12% chlorhexidine, 875 mg amoxicillin and 500 mg metronidazole every 12 hours for ten days was conducted. At each visit, the following measurements were recorded: bacterial plaque (BP), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), hypermobility, and furcation lesions, and a sample of subgingival plaque was taken from the site of the deepest probing depth of each sextant to identify Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Prevotella intermedia and Aggregatibacter actinomycetemcomitans using molecular biology techniques. After 6 months, the Wilcoxon test showed an increase of 0.97 mm in CAL (p=0.0047) and 2.54 mm in PD (p=0.009). A healthy site was defined as having a PD <5 mm, negative BOP and no pathogenic bacteria detected at 6 months, indicating significant improvement (p=0.008), with OR (95% CI) =4.7 (1.102220.11). With the treatment protocol used in this study, 6 months after treatment, patients had an approximately 4fold higher possibility of presenting PD <5 mm and periodontal pockets without periodontal pathogenic bacteria.

En este trabajo, nos propusimos determinar las variaciones de los parámetros periodontales y la composición microbiológica de las bolsas periodontales al inicio, a los 3 y 6 meses después del tratamiento en pacientes con periodontitis agresiva generalizada (GAP), sometidos a tratamiento periodontal no quirúrgico combinado con clorhexidina y antibióticos sistémicos. Se elaboró historia médica y dental en 10 sujetos, con una edad media de 30,6 2,7 años, con diagnóstico de GAP. Se les practicó tratamiento periodontal no quirúrgico combinado con clorhexidina al 0,12%, 875 mg de amoxicilina y 500 mg de metronidazol. Los antibióticos se prescribieron cada 12 horas durante diez días. Se registraron: la placa bacteriana (BP), sangrado al sondaje (BOP), la profundidad de sondaje (PD), el nivel de inserción clínica (NIC), hipermovilidad y lesiones de furcación. En cada visita, se tomaron las mediciones, y se tomó una muestra de la placa subgingival en sitio de la mayor profundidad al sondaje en cada sextante para identificar mediante técnica de biología molecular: Porphyromonas gingivalis, Treponema denticola, forsythia Tannerella, Prevotella intermedia, y Aggregatibacter actinomycetemcomitans. Después de 6 meses, el análisis de la prueba de Wilcoxon mostró un aumento de 0,97 mm de CAL (p = 0,0047) y 2,54 mm en la PB (p = 0,009). Se definió sitio sano, cuando se determinó un PD <5 mm, BOP negativo, y no se detectaron bacterias patógenas a los 6 meses, lo que indicó una mejora significativa (p = 0,008), con (IC 95%) = 4,7 (1,1022 a 20,11). Con el protocolo de tratamiento presentado, es posible especular que a los 6 meses después del tratamiento, un paciente puede tener aproximadamente 4 veces más posibilidades de presentar una PD<5 mm y bolsillos periodontales sin bacterias patógenas.

Conhecimento e opinião de estudantes de medicina sobre doação e transplante de órgãos / Attitude and opinion of medical students about organ donation and transplantation

OBJETIVOS: Analisar o conhecimento e a opinião de estudantes de medicina sobre doação e transplante de órgãos. MÉTODOS: Trezentos e quarenta e sete estudantes responderam, voluntariamente, questionário com 17 perguntas sobre doação e transplante de órgãos. Eles foram avaliados globalmente, para verificar tendências gerais, e agrupados de acordo com o seu ano no curso médico (primeiro ao sexto), para avaliar diferenças entre os períodos. Alunos do quinto e sexto ano foram reunidos em um só grupo. Os resultados foram analisados pelo teste Qui quadrado. RESULTADOS: A intenção de ser doador post mortem foi de 89 por cento e intervivo de 90 por cento, contudo, apenas 62 por cento sabiam dos riscos da doação intervivo. Entre os 347 estudantes, 70 por cento admitiram conhecimento regular, ruim ou péssimo do assunto, 90,2 por cento consideraram importante o tema transplante para a graduação médica, 76,9 por cento consideraram o consentimento informado/expresso como o melhor critério de doação e 64,3 por cento optaram pela gravidade da doença do paciente como melhor forma de alocação. O entendimento sobre transplante aumentou conforme o avanço no curso de graduação. Estudantes do quarto, quinto e sexto ano adotaram atitude negativa, em comparação aos dos anos iniciais, quanto à doação de órgãos para pacientes alcoólatras, não doadores, usuários de drogas ilícitas, estrangeiros e criminosos. CONCLUSÃO: Este trabalho demonstrou grande interesse e atitude positiva dos estudantes de medicina sobre doação e transplante de órgãos, embora a maioria tenha declarado conhecimento deficiente sobre o tema. Observamos também atitude negativa dos estudantes do quarto, quinto e sexto ano médico em relação à doação para alcoólatras, não doadores, usuários de drogas ilícitas, estrangeiros e criminosos.

We analyzed the opinion and understanding of medical students about organ donation and transplantation. METHODS: 347 students voluntarily completed a questionnaire with 17 queries concerning organ donation and transplantation. They were analyzed to identify general tendencies and divided into five groups, according to their year of study (first through sixth year), to assess differences among the years. Students of the fifth and sixth years were placed in the same group. RESULTS:were analyzed by the Chi-square test. RESULTS: The intention to become a post mortem or living donor was of 89 percent and 90 percent respectively; however, only 62 percent were aware of living donation risks. 70 percent of the 347 students admitted regular or little knowledge of the subject, 90.2 percent considered organ transplantation an important issue for a medical graduation program, 76.9 percent considered informed/expressed consent the best organ donation criterion and 64.3 percent of them chose severity of patient disease as the best allocation condition. As students progressed in their studies their understanding about transplantation improved. Students of the fourth, fifth and sixth year manifested a negative attitude about organ donation to alcohol addicts, non donors, drug users, law offenders and foreigners. CONCLUSION: This data show the great interest and positive attitude of medical students toward organ donation and transplantation, despite the fact that most of them admitted having insufficient knowledge on the subject. A negative attitude by students of the fourth, fifth and sixth year on organ donation to alcohol addicts, non donors, drug users, law offenders and foreigners was also observed.

Hypertonic saline solution increases cerebral perfusion pressure during clinical orthotopic liver transplantation for fulminant hepatic failure: preliminary results

Neste estudo testamos a hipótese de que os efeitos benéficos decorrentes da administração da solução salina hipertônica (NaCl 7,5%, 4 mL/kg) sobre a hemodinâmica sistêmica e cerebral na hipertensão intracraniana e no choque hemorrágico, possam atenuar a diminuição da pressão de perfusão cerebral que freqüentemente acompanha o transplante do fígado para hepatite fulminante.MÉTODO: Foram estudados 10 pacientes com hepatite fulminante em encefalopatia grau IV e monitorização de pressão intracraniana submetidos ao transplante do fígado. A hemodinâmica sistêmica e cerebral de 3 pacientes que receberam solução salina hipertônica durante a fase anepática (Grupo SSH) foi analisada comparando com os dados obtidos de 7 pacientes transplantados anteriormente nas mesmas condições (Grupo Controle). Os valores de pressão intracraniana máxima e a correspondente pressão arterial média foram coletados em quatro tempos: (T1) nos últimos 10 min da fase de disseccão, (T2) nos primeiros 10 minutos da fase anepática, (T3) no final da fase anepática e (T4) nos primeiros 5 min da reperfusão.RESULTADO: Imediatamente após a infusão da solução salina hipertônica a pressão intracraniana diminuiu 50,4%. Nos primeiros 5 min da reperfusão a pressão intracraniana no Grupo SSH se manteve estável e todos os pacientes apresentavam pressão intracraniana menor que 20 mmHg enquanto no Grupo Controle a pressão intracraniana aumentou 46,5% (p<0,001). O Grupo SSH apresentou maior estabilidade hemodinâmica, nos primeiros 5 min da reperfusão hepática, a pressão arterial média no Grupo SSH aumentou 21,1% e no Grupo Controle diminuiu 11,1% (p<0,001). Nos primeiros 5 min da reperfusão a pressão de perfusão cerebral no Grupo SSH aumentou 28,3% e no Grupo Controle diminuiu 28,5% (p< 0,001). A natremia no final da fase anepáica e após 3 horas da reperfusão foi significativamente maior no Grupo SSH (153.00 ± 2.66 and 149.00 ± 1.73 mEq/L) que no Grupo Controle (143.71 ± 3.30 and 142.43 ± 1.72 mEq/L), p=0.003 e p< 0.001 respectivamente.CONCLUSÃO: Estes resultados sugerem que a solução salina hipertônica pode ser utilizada com sucesso como medida neuroprotetora no transplante de fígado para hepatite fulminante, promovendo diminuição efetiva da pressão intracraniana e estabilidade cardiocirculatória, proporcionando aumento sustentado da PPC durante a cirurgia.

Estudo quantitativo e qualitativo dos plexos de Auerbach e Meissner do esôfago de cäes inoculados com o Trypanosoma cruzi / A quantitative and qualitative study of the Auerbach and Meissner plexus in dogs inoculated with Trypanosoma cruzi

A quantitative and qualitative study was conducted on the Auerbach and Meissner plexuses of the esophagus of four chagasic dogs sacrificed during the acute phase of infection. Ganglionitis and periganglionitis of the Auerbach plexus ranged from mild to moderate and induced significant neuronal lesions, especially in two animals. The ganglions of the Meissner plexus were observed in small number which did not permit any analysis. Mild or moderate myositis was observed mainly in the lower third of the esophagus and was rarely associated with amastigote nests. Ganglion and neuron counts did not demonstrate denervation. Although the formation of megaesophagus was not induced in any dog, lesions of the Auerbach plexus and myocells of the esophagus were observed during the acute phase of chagasic infection. To our knowledge, this is the first systematic quantitative and qualitative study of the Auerbach and Meissner plexuses of the esophagus in experimental trypanosomiasis cruzi.

Cardiac plexus of dogs experimentally infected with Trypanosoma cruzi: inflammatory lesions and quantitative studies

Qualitative and quantitative aspects of the superficial and profound cardiac plexus of dogs experimentally infected with Be-62 and Be-78 strains of Trypanosoma cruzi were studied. Animals were autopsied in the acute phase ofinfection. The inflammatory process, lesions and number of parasites were more intense and frequent in animals infected with the Be-78 strain than in those infected with Be-62. espite this, no statistically significant differences could be found between the number of neuron bodies in the ganglia of infected and control dogs.

Determinacion en sangre arterial de las presiones parciales de 02 y del pH en muestras seleccionadas de la poblacion del mineral El Salvador, Chile (2.416 m. de altitud). / Arterial blood determinations of pH and partial pressures of oxygen and carbon dioxide in samples selected from inhabitants of the El Salvador mine (2,416 meters)

Se muestran los valores de los gases en sangre arterial, hematocrito y hemoglobina en 55 sujetos sanos, residentes en un campamento cuprifero a una altitud de 2.416 m. sobre el nivel del mar. Estos muestran una alcalosis respiratoria compensada con una menor reabsorcion de bicarbonato por el rinon, respecto de los sujetos que residen a nivel del mar. Se reproducen, por lo tanto, cambios similares a los observados en grandes alturas aunque de menor intensidad en los mecanismos reguladores de la ventilacion, acido base, hematocrito y hemoglobina. Los cambios en los mecanismos reguladores de la ventilacion se establecerian en un punto de equilibrio en un lapso superior a una semana