Nefrectomía laparoscópica de donante vivo: experiencia de 75 casos consecutivos / Live donor laparoscopic nephrectomy: experience in 75 cases

Background: Live Donor Laparoscopic Nephrectomy (LDLN) has substantial benefits when compared with open nephrectomy such as shorter hospital stay, prompt return to work, less post-operative pain, better cosmetic results, less blood loss and less surgical wound infections. It is the mode of choice for safely harvesting a kidney for organ transplantation. Aim: To describe the surgical results of LDLN in a pioneer renal transplant center in Chile. Material and Methods: Review of clinical records of 75 subjects aged 27 to 60 years (37 males) subjected to a LDLN in a public hospital between 1998 and 2013. Information about clinical and surgical data and perioperative complications was retrieved. Results: No subject died. All kidneys were satisfactorily implanted in their receptors. The mean operative time was 116 minutes. Mean hospital stay was 1.6 days, warm ischemia time was 6.8 minutes, and cold ischemia time was 31.5 minutes. Operative adverse events occurred in 8 percent. The conversion and reoperation rates were 4 and 1.3 percent, respectively. Among receptors, 1.5 percent evolved with Acute Tubular Necrosis and 2.2 percent required graft excision. Conclusions: LDLN is a safe and pioneering surgical technique in Chile. Its results are satisfactory and comparable to those obtained with classic lumbotomy.

Introducción: El trasplante renal es en la actualidad el tratamiento de elección de la Insuficiencia Renal Crónica Terminal. La Nefrectomía Laparoscópica del Donante Vivo (NLDV) tiene ventajas sustanciales en relación a la Nefrectomía Clásica. Entre estas se destacan una menor estancia hospitalaria, pronto regreso a la actividad laboral, disminución del dolor post-operatorio, mejores resultados cosméticos, menor pérdida de volumen sanguíneo y una disminución de infecciones de heridas operatorias, consolidándose como la primera prioridad como forma de obtener un órgano para trasplante renal. El presente trabajo tiene como objetivo mostrar la casuística y complicaciones en el Hospital Barros Luco-Trudeau (HBLT), como centro pionero en NLDV en nuestro país. Material y Método: Estudio retrospectivo de corte transversal. Se realiza una revisión de registros clínicos de 75 NLDV realizadas entre 1998-2013, seleccionando datos demográficos, clínicos y quirúrgicos de donantes y receptores, con un especial énfasis en relación a complicaciones peri-operatorias. Resultados: Sin mortalidad. Todos los riñones fueron implantados satisfactoriamente en sus respectivos receptores. Cirugía con duración promedio de 116 min, estadía hospitalaria promedio de 1,6 días, isquemia caliente promedio de 6,8 min e isquemia fría promedio de 31,5 min. Incidentes operatorios 8 por ciento y 4 por ciento conducentes a conversión. Tasa de reoperación de 1,3 por ciento. En cuanto a receptores, un 1,5 por ciento desarrolla Necrosis Tubular Aguda. 2,2 por ciento requiere transplantectomía. Discusión: La NLDV representa una técnica segura, que ha llegado a constituir el 100 por ciento de las nefrectomías de donantes vivos realizadas durante los últimos tres años. Los resultados son satisfactorios y plenamente comparables a los resultados obtenidos por lumbotomía clásica y de otros centros de alto volumen laparoscópico a nivel internacional.

¿Podría ser aceptable la eutanasia infantil? / Could infant euthanasia be ever acceptable?

The recent enactment of a law that allows infant euthanasia in Belgium raises questions with varied answers. To contribute to a better understanding of the topic, euthanasia and legislation concepts are described. After a bioethical analysis, we propose as conclusion that children euthanasia could only be acceptable in very exceptional situations in which palliative measures have failed. The answer should be that it is not acceptable in our setting, not until we have public policies, protocols and palliative care services for terminally ill children.

La reciente promulgación de una ley que permite la eutanasia infantil en Bélgica plantea interrogantes que admiten respuestas diversas. Para contribuir a una mejor comprensión del tema se describen los conceptos de eutanasia y la legislación pertinente. Después de hacer un análisis bioético, se plantea como conclusión que la eutanasia de niños podría ser aceptable sólo de manera muy excepcional ante situaciones en las cuales hubiesen fracasado las medidas de cuidado paliativo. Para nuestro medio la respuesta debería ser que no es aceptable, al menos mientras no existan políticas públicas, protocolos y servicios de cuidados paliativos para niños con enfermedades terminales.

An alternative method to isolate protease and phospholipase A2 toxins from snake venoms based on partitioning of aqueous two-phase systems

Snake venoms are rich sources of active proteins that have been employed in the diagnosis and treatment of health disorders and antivenom therapy. Developing countries demand fast economical downstream processes for the purification of this biomolecule type without requiring sophisticated equipment. We developed an alternative, simple and easy to scale-up method, able to purify simultaneously protease and phospholipase A2 toxins from Bothrops alternatus venom. It comprises a multiple-step partition procedure with polyethylene-glycol/phosphate aqueous two-phase systems followed by a gel filtration chromatographic step. Two single bands in SDS-polyacrylamide gel electrophoresis and increased proteolytic and phospholipase A2 specific activities evidence the homogeneity of the isolated proteins.

Cross-neutralization of the coagulant activity of Crotalus durissus terrificus venom from the northeast of Argentina by bivalent bothropic antivenom

Cross-neutralization of Crotalus durissus terrificus venom coagulant activity was tested using bivalent horse antivenom against Bothrops alternatus and Bothrops diporus venoms. Our in vitro and in vivo experiments showed that bothropic antivenom neutralizes the thrombin-like activity of crotalic snake venom and this cross-reaction was demonstrated by immunoassays either with whole venom or a purified thrombin-like enzyme. These results suggest common antigenic properties and, consequently, similar molecular structure among venom thrombin-like enzymes. Besides, they provide information that could be further used in the development of new antivenom formulations.

Relación entre motivación y hábitos de estudio en alumnos de la carrera de psicología de una universidad privada de Asunción / Relation between motivation and habits of study in students of the career of psychology of a private university of Asunción

La presente investigación es de tipo descriptivo correlacional, de corte transversal y el método utilizado es el cuantitativo. Tiene el objetivo de describir la relación existente entre Motivación y Hábitos de estudio en alumnos de la carrera de Psicología de una Universidad Privada de Asunción. La muestra está compuesta por 129 estudiantes seleccionados a través de un muestreo estratificado y de participación voluntaria. Los instrumentos aplicados son el Inventario de Métodos y Hábitos de Estudio de Álvarez de TEA Ediciones y un cuestionario prediseñado para el efecto. El análisis y procesamiento de los datos aplicó técnicas de estadística descriptiva e inferencial. Los principales hallazgos demuestran que hay poca relación entre Motivación y Hábitos de Estudio, sin embargo no por eso queda rechazada la hipótesis.

This is a descriptive correlational and cross-sectional study and the method used is the quantitative one. It aims to describe the relationship between motivation and study habits in Psychology students attending a private university in Asuncion. The sample consists of 129 students selected through a stratified sampling and voluntary participation. The instruments used are "Methods and habits Inventory Study" of TEA Edition Alvarez and a pre-designed questionnaire for this purpose. The analysis and data processing techniques applied descriptive and inferential statistics. The main findings from the study show that there is little relationship between motivation and study habits, but that does not mean that the hypothesis is rejected.

Epidemiología de la urgencia psiquiátrica en el Instituto Psiquiátrico Doctor José Horwitz: un nuevo estudio comparativo / Epidemiology of psychiatric emergency consultations psychiatric Institute Doctor José Horwitz: a new comparative study

Introducción: Una urgencia psiquiátrica es cualquier alteración del afecto, conducta o pensamiento que puede producir daños a terceros o al consultante. La consulta de urgencia ido en aumento en los últimos años. Objetivos: Determinar la prevalencia de las distintas patologías, describir su distribución según sexo, edad, sector de residencia, estado civil, ocupación, previsión y derivación en las consultas de urgencia psiquiátrica en el Hospital Psiquiátrico "Dr. JoséHorwitz" de Santiago y comparar estos resultados con publicaciones previas de estudios en el mismo centro. Material y Método: Muestra representativa de 1999 casos, escogidos aleatoriamente de las consultas realizadas entre el Iº de julio de 2005 y el 30 de junio de 2006. Se agruparon los diagnósticos de acuerdo a la nomenclatura CIE-10. Resultados: 48,7 por ciento de las consultas fueron realizadas por pacientes de sexo masculino. La media de edad fue 39 años. 76,7 por ciento de las consultas fueron realizadas en horario diurno. El 48,3 por ciento de los pacientes no tiene ocupación. 48 por ciento eran solteros. Abuso de sustancias y alcohol, trastornos esquizoides, afectivos y neuróticos congregan el 73,9 por ciento de las consultas. La más prevalente fue la de trastornos asociados al abuso de sustancias y alcohol con un 19,7 por ciento del total. Conductas autoagresivas (74 por ciento) y trastornos afectivos (74 por ciento) se asoció más a mujeres, en cambio el abuso de sustancias y alcohol más con hombres (76 por ciento). Discusión: Las consultas por trastornos esquizoides han disminuido a lo largo de los años. En cambio las consultas por el abuso de sustancias y alcohol y los trastornos afectivos han aumentado. Se hacen sugerencias para enfrentar el nuevo perfil epidemiológico.

Introduction: A psychiatric emergency is any alteration of affection, thought or behavior that may cause harm to others or to the same consultant. These consultations have increased over the last years. Objectives: Determine the prevalence of the various pathologies, describing their distribution according to sex, age, area of residence, marital status, occupation, health insurance, and referral in psychiatric emergency consultations at "Dr. José Horwitz" Hospital of Santiago, and to compare these results with previously published studies in the same center. Material and Method: We used a representative sample of 1999 cases, chosen randomly from consultations held between July 1,2005 and June 30,2006. Diagnoses were grouped according to the nomenclature of the ICD-10. Results: 48.7 percent of the consultations were carried out by male patients and. Average age of consultation was 39. 76.7 percent of consultations were carried out in daytime. The 48.3 percent of people who consulted didn't have any occupation. 48 percent were singles. Abuse of substances and alcohol, schizoid, afective and neurotic disorders congregate 73.9 percent of total consultations. The most prevalent were the disorders associated with abuse of substances and alcohols with a 19.7 percent overall. Autoagressive behaviors (74 percent) and affective disorders (74 percent) were associated with females, while abuse of substances and alcohol was associated with males (76 percent). Discussion: Schizoid disorders have proportionally declined in importance over the years. In contrast, abuse of substances and alcohol, and affective disorders have increased their frecuency. Suggestions are made to FACE the new epidemiological profile.

Cytotoxicity and morphological analysis of cell death induced by Bothrops venoms from the northeast of Argentina

Bothrops snake venoms have been proved toxic to a variety of cell types, in both in vivo and in vitro models. Studies on the pharmacological actions of Bothrops venoms from Argentina are relatively secarce and the direct action of the crude venoms has not been assessed using cell culture models. In this work, we investigated the cytotoxicity of crude venoms from B. alternatus and B. diporus in a skeletal muscle (C2C12) cell line, which is commonly used as a model for studying the myotoxic action of snake venom. Both venoms (1.25-50 miug/mL) induced an early and significant decrease in cell viability. The cytotoxic concentration 50 (CC50), determined three hours after exposure, revealed that B. diporus venom was significantly more cytotoxic (CC50: 2 miug/mL) than B. aftematus (CC50: 5.8 miug/mL). To investigate the cell death mechanism involved, myoblast cells were examined by phase contrast microscopy and after acridine orange and ethidium bromide fluorescence staining, respectively. Our data clearly demonstrated that an apoptotic mediated this cell line destruction. The current study aimed to provide new information on the citotoxicity meohanisms of Argentine Bothrops snake venoms on a skeletal muscle cell line

IgG antibodies against phospholipase A2 from Crotalus durissus terrificus: cross-reaction with venoms from Bothrops species from Argentina

We examined the ability of IgG anti-crotalic PLA2 to cross-react with Bothrops spp. venoms, from snakes found in the northeast of Argentina. Immunoblotting and ELISA tests showed that IgG anti-crotalic PLA2 recognize antigens of bothropic venoms. Indirect hemolytic activity tests showed that the quantity of antibodies that neutralized 50% of Crotalus durissus terrificus venom (ED50: 2.1 mg IgG anti-crotalic PLA2/100 µg of venom) were also able to neutralize venom from other snakes in the following proportion: 34% of B. alternatus, 18% of B. diporus and 12% of B. jararacussu. Likewise, direct PLA2 activity neutralization tests showed a similar cross-neutralization pattern including 56% of B. alternatus, 29% of B. diporus and 30% of B. jararacussu. In addition, in a myotoxic activity neutralization test, measured by plasma activity of creatine kinase, 35% of B. alternatus venom and 26% of B. diporus venom were neutralized, while no neutralization was detected with B. jararacussu venom. This study presents original data concerning cross-reactions between bothropic venoms from Argentina and IgG anti-crotalic PLA2. Our results suggest that anti-crotalic PLA2 antibodies should not be used to neutralize PLA2 activity of B. alternatus, B. diporus and especially B. jararacussu venoms; nor to enrich commercial antivenoms against these Bothrops species.(AU)

Endometriosis profunda del tabique rectovaginal con compromiso intestinal: manejo quirúrgico con resección segmentaria de rectosigmoides / Deep infiltrating endometriosis of the rectovaginal space with intestinal commitment: surgical treatment

Presentamos 3 casos de endometriosis profunda del tabique rectovaginal con compromiso intestinal, en los cuales se realizó resección segmentaria del rectosigmoides para lograr la remoción completa de la enfermedad. Se analiza el cuadro clínico, manejo quirúrgico, complicaciones y seguimiento posterior. Revisamos la literatura a fin de establecer algunas pautas de manejo de esta entidad.

We reported 3 cases of deep endometriosis affecting the rectovaginal space with intestinal disease in which a rectosigmoides resection was required to achieve a complete surgical removal of disease. The clinical course, surgical management, complications and follow-up are analyzed. We review the literature to define some guidelines in the management of this entity.

Isolation and biological characterization of a basic phospholipase A2 from Bothrops jararacussu snake venom

A phospholipase A2 has been isolated from Bothrops jararacussu venom from snakes that inhabit the northeast region of Argentina. The present study describes in vivo and in vitro biological activities of phospholipase A2 from B. jararacussu as well as isolation details of its. Venom was obtained by milking of adult snakes which were housing in wood reptile cages of varying dimensions in heated (20-30ºC) rooms. Snakes received a weekly diet of mice and water was available ad libitum for drinking and soaking. The enzyme was purified by gel filtration on a Sephadex G-75 column followed by ion exchange chromatography on a SP-Sephadex C25 column. The major peak belonging to proteins was retained in the cation exchanger and then eluted using a concentration gradient of KCl that exhibited phospholipase activity. This basic PLA2 consists of a single polypeptide chain with a molecular mass of 15.6 kDa. It had a high indirect hemolytic activity and produced a significant paw edema reaction in mice. The enzyme showed a low lethality (LD50 148.6 mg) when was administered i.p. but exhibited elevated myotoxic effects in vivo by increasing plasma CK activity of injected mice, corroborated results by the histological observations of samples of gastrocnemius muscle. Myonecrosis is the result of intense destruction of muscular fibers that involves local infiltration of inflammatory cells and leads to the highest peak of CK level just after 1 hour mice injection. Moreover, the isolated enzyme showed anticoagulant activity, evaluated on sheep platelet-poor plasma which recalcification time was prolonged after incubation with the isolated phospholipase A2. These findings showed that this phospholipase, isolated by only two simple chromatographic steps, possesses high edematogenic and myotoxic activities. However, despite the low lethal activity, this enzyme would contribute markedly to the pathophysiology of the bothropic envenomation.

Demanda espontánea de urgencias psiquiátricas al Hospital Asistencia Pública Dr. Alejandro del Río / Spontaneus demand on psychiatric emergency at Hospital Asistencia Pública Dr. Alejandro del Rio

Se estudió la demanda psiquiátrica en la Asistencia Pública de Santiago durante mayo de 2005. Se registraron las variables sociodemográficas y clínicas extraídas del formulario de atención. Los diagnósticos se organizaron de acuerdo al CIÉ 10. Se encontraron 562 consultas equivalentes al 5,1 por ciento de las atenciones realizadas. Destaca que: 52 por ciento eran mujeres; 48 por ciento eran menores de 35 años 54,6 por ciento provenían del Área Central y 60 por ciento tenía gratuidad. El 58 por ciento consultó de 8 a 20 hrs. En términos diagnósticos, destacaron los trastornos por alcohol y drogas (32,7 por ciento) y los trastornos neuróticos (51,1 por ciento). En los hombres predominaron los trastornos por alcohol y drogas (58,2 por ciento) y los trastornos neuróticos (31,9 por ciento) de los cuales los trastornos somatomorfos eran el 62,8 por ciento; mientras que en las mujeres fueron los trastornos neuróticos (68.7 por ciento), los trastornos por alcohol y drogas (9,3 por ciento) y las autolesiones intencionales (10 por ciento). Se indicó psicotrópicos al 15 por ciento de los consultantes e interconsulta a especialista sólo en un 2,5 por ciento. La frecuencia de trastornos es similar a la observada en estudios previos. Se constata escasa derivación a especialista o atención psicológica especializada en el establecimiento.

We studied the psychiatric demand in Hospital Asistencia Pública Dr. Alejandro del Rio, during May of2005. We registrated social, demographic and clinical variables, taken from the attention data. The diagnostic were organized following CIE10 classification. We founded 562 psychiatric attentions, which means 5.1 percent of all the attentions done in this institution. It's remarkable that 52 percent of the patients were women, 48 percent) younger than 35 years, 54.6 percent) were from metropolitans center area and 60 percent > had free attentions. A 58 percent> consulted at daytime (08:00 - 20:00hrs). In the whole sample we founded a high number of drugs and alcoholic disorders (32.7 percent >), and also a high incidence of neurotic disorders (51.1 percent >). In the men group predominated drugs and alcoholic disorders (58.2 percent >), followed by neurotic disorders (31.9 percent); in this last group a 62.8 percent correspond to somatomorphic disorders. Inside the women group the highest incidence was for neurotic disorders (68.7 percent), followed by self- aggressive disorders in 10 percent, and in third place the drugs and alcohol disorders (9.3 percent). They gave psychotropics drugs to a 15 percent of the patients and they sent to specialist consult only to a 2.5 percent. Conclusions: The disorders frequency founded now is similar to the frequency seen in others investigations. We noticed a very low derivation to psychiatric specialists.

Fluorescent serum and urinary advanced glycoxidation end-products in non- diabetic subjects

Introduction: Advanced glycoxidation end-products (AGEs) are involved in age-related conditions and diabetic complications. Diet intake contributes to their circulating concentrations. Aim: To measure serum and urinary AGEs in non-diabetic volunteers and relate their concentration to body composition, blood chemistry and dietary ingesti¢n. Methods: We studied 41 adult men (31 middle-aged adults and 10 elderly). A nutritional assessment including a dietary recall designed for detection of AGE ingesti¢n (specifically carboxymethyl-lysine(CML)), and anthropometric measurements were performed. Also serum lipoproteins, insulin, glucose, leptin and C reactive protein (CRP). AGEs were measured in serum and urine samples using size exclusion chromatography and flow injection assay (FIA); the technical procedures were first employed in 11 heterogeneous diabetics, as positive controls for this methodology. Results: Serum and urinary chromatograms indicated that areas under the curve were not different in younger compared with elderly adults. AGEs did not correlate with dietary intake, body composition, nor metabolic parameters, however they correlated significantly with renal function and CRP concentration. Discussion: In these non-diabetic volunteers, with low CML intake, serum and urinary concentration of AGEs were not related to dietary intake. AGEs were related to renal function and CRP, but not to body composition, lipoproteins, insulin and glucose.

Antibody response to pneumococcal capsular polysaccharide vaccine in Down syndrome patients

The majority of children with Down syndrome (DS) tend to have frequent bacterial infections including recurrent respiratory infections. Our objective was to evaluate the production of antibodies to pneumococcal polysaccharide antigens after active immunization in DS subjects. IgG antibodies to pneumococcal serotypes (1, 3, 6B, 9V, and 14) were measured before and 6 weeks after immunization with a 23-valent pneumococcal vaccine (Pneumo23®, Pasteur-Merrieux) in 6- to 13-year-old DS children (N = 17) and in aged-matched normal controls (N = 30). An adequate response was defined as a 4-fold increase over baseline or a post-immunization level of specific pneumococcal serotype antibody > or = 1.3 æg/mL. After immunization, all DS children had an increase in post-immunization levels against all serotypes analyzed. A 4-fold or more increase was observed in all DS children concerning serotypes 1 and 14, in 90 percent of subjects for serotypes 3 and 9V, and in 65 percent for serotype 6B. Regarding this increase, 8 of the 17 DS children had an adequate response to all serotypes analyzed, 8/17 patients to 4 serotypes and 1/17 to 3 serotypes. However, when we compared post-immunization levels between DS children and controls, we observed lower levels in the former group (P < 0.05) for all serotypes except serotype 3. We conclude that pneumococcal polysaccharide immunization could be beneficial for these DS children.

Mice plasma fibrinogen consumption by thrombin-like enzyme present in rattlesnake venom from the north-east region of Argentina

Due to variability of venom components from the same species of snakes that inhabit different regions, particular properties of the venom of Crotalus durissus terrificus that inhabits the North-East of Argentina were studied. Gyroxin, a thrombin-like enzyme, was isolated from this venom by gel filtration and affinity chromatography, it was found to be homogeneous according to SDS-PAGE, with a molecular weight of 33 kDa. [quot ]Gyroxin syndrome[quot ] in mice was tested and it showed changes in the animal behavior, confirming that the isolated thrombin-like enzyme is gyroxin. Effects of this enzyme and the crude venom on mice plasmatic fibrinogen levels were determined. The mice plasma fibrinogen decreased rapidly until incoagulability during the first hour after thrombin-like enzyme injection, then reaching its normal level 10 hours after injection; whereas crude venom resulted in a 60% decrease of the mice plasma fibrinogen, reaching its normal level after the same period of time. After 1 hour of gyroxin inoculation, intravascular coagulation was observed in histological cuttings of lung, cardiac muscle and liver. The isolated enzyme showed strong hydrolyzing activity on fibrinogen and fibrin in vitro, whereas the crude venom exhibited weak hydrolyzing activity on both substrates. It is probable that this very low activity is due to the low percentage of the enzyme in the crude venom. Decreasing of plasmatic fibrinogen levels may be due to either the coagulant or hydrolyzing actions of the enzyme.

Teniendo en cuenta la variabilidadde los componentes del veneno de serpientes de una misma especie que habitan regiones diferentes, se decidióestudiar las propiedades particulares del veneno de Crotalus durissus terrificus que habita el nordeste de Argentina, Giroxina, una enzima con actividad trombínica, fue aislada del veneno por cromatografía de filtración por gel y de afinidad; se comprobó su homogeneidad y se determinó su peso molecular, 33 kDa, por SDSPAGE. Se ensayó el síndrome giroxina en ratones, los que mostraron cambios en el comportamiento, confirmandoque la enzima tipo trombina aislada es giroxina. Se evaluó la acción de esta enzima sobre los niveles de fibrinógeno plasmático en ratones, comparándola con la del veneno crudo. Se comprobó que la enzima provoca una disminución de los niveles plasmáticos de fibrinógeno hasta la incoagulabilidad, durante la primer hora de inoculación, mientras que el veneno entero produjo una reducción del nivel plasmático en un 60%; sin embargo, en ambos casos, se evidenció una rápida reposición de fibrinógeno plasmático, alcanzando sus valores normales en un plazo de 10 horas. Se observó coagulación intravascular con la administración de giroxina una hora después de la inoculación, evidenciados en estudios histológicos de tejido pulmonar, cardíaco y hepático. En ensayos realizados in vitro, la enzima aislada mostró capacidad de degradar fibrinógeno como así también coágulos de fibrina, mientras que el veneno exhibió débil actividad hidrolítica sobre ambos sustratos. Es probable que esta baja actividad sea debida a la baja concentración de la enzima en el veneno. La disminución de los niveles de fibrinógeno plasmático observado en ratones se debería a la acción coagulante de la enzima, sin embargo no se descarta que también contribuya a este proceso una acción hidrolítica sobrefibrinógeno y fibrina por parte de la enzima.

Hernioplastía inguinal con malla / Inguinal hernioplasty with mesh

Se presenta la experiencia con hernioplastía con malla de polipropileno por vía preperitoneal en 177 pacientes; 77 con hernia inguinal recidivada (HIR) 43,5 por ciento; 87 con hernia inguinal bilateral (HIB) 49,2 por ciento y 13 con hernia inguinoescrotal gigante (HIEG) 7,3 por ciento. La morbilidad quirúrgica observada fue del 14 por ciento, todas menores, y la mortalidad del 0,56 por ciento, representada por un paciente fallecido de un infarto del miocardio. No se observó rechazo ni proceso inflamatorio atribuible al material protésico utilizado. Los pacientes fueron controlados entre 1 y 46 meses, con promedio de 21 meses, encontrándose 3 recidivas (1,69 por ciento) en el primer año

Mineralización ósea en niños chilenos determinadas por densitometría ósea bifotónica / Bone mineralization of Children determined by dual photon absortiometry

En 198 escolares, 108 hombres y 90 mujeres, cuyas edades fluctuaban entre los 6 y 13 años de edad, se detertmino la densidad y el contenido mineral óseo en cuerpo entero, Columna lumbar y cadera de lado no dominante, mediante densitometría isotópica de doble haz (Gd 153). Se encontró que la masa ósea total (MOT) y la densidad mineral ósea (DMO) de las tres zonas análizadas aumentan con la edad. A los 12 años las mujeres tuvieron valores significativamente mayores de MOT y DMO en cuerpo entero. En columna las mujeres tuvieron una densidad significativamente mayor que los varones entre los 11 y 13 años. Al conparar la DMO de columna y de cuello femoral de las escolares de 9 años de edad de este estudio, con la de mujeres adultas jivenes chilenas (masa ósea máxima), se observó que algún les falta adquirir un 36 por ciento de la mineralización en columna y 18 por ciento en la cadera. Se enfatiza sobre la importancia de contar con valores normales de mineralización ósea para un adecuado diagnóstico y tratamiento de los niños con problemas de mineralización ósea y para la evaluación de programas especificos destinados a corregir estas deficiencias

Errores diagnósticos en la enfermedad afectiva bipolar / Diagnostic mistakes in bipolar illness

Se presentan los resultados de una serie de trabajos colaborativos realizados entre el Hospital Psiquiátrico de Santiago y la Clínica Psiquiátrica de la Universidad de Chile, en 40 pacientes establemente diagnosticados como bipolares. Del análisis retrospectivo de las historias clínicas se desprende que los errores diagnósticos ocurren principalmente durante las fases de exaltación anímica, las que teniendo un perfil clínico muy similar a la manía clásica, presenta además una multiplicidad de síntomas diferentes habitualmente concebidos como pertenecientes a otras series psicopatológicas, especialmente a la esquizofrenia

Efectos del deficit de yodo durante la vida intrauterina y postnatal precoz en la sintesis de ADN en higado y encefalo de ratas. / Effects of iodine deficiency during intrauterine and early postnatal life on DNA synthesis in liver and brain of rats

El deficit de yodo durante la vida pre y postnatal temprana de la rata, produce un descenso transitorio en el contenido de ADN en cerebro y cerebelo. Este se recupera espontaneamente, sin que medie una terapia de reemplazo, debido a una prolongacion del periodo critico de multiplicacion celular. Los resultados del estudio revelaron un aumento transitorio de la captacion de timidina radiactiva al 21o dia en el higado, cerebro y cerebelo, indicativo de una mayor actividad de sintesis y desplazamiento del periodo critico. Estos hallazgos sugieren, por lo tanto, un dano del sistema nervioso por deficit precoz de yodo durante el embarazo