Sal y salud, el punto de vista del consumidor Argentino obtenido por la técnica de grupos focales / Salt and health, Argentine consumers' views via focus groups technique

La ingesta de altos niveles de sal (NaCl) se asocia a hipertensión arterial, enfermedades cardiovasculares y cerebrovasculares. Objetivo: explorar la comprensión de la ingesta diaria de sal, percepciones y conocimientos sobre sus implicancias para la salud y la opinión sobre acciones para su reducción. Se realizaron cuatro grupos focales (31 participantes): uno de jóvenes estudiantes universitarios, dos de adultos en edad económicamente activa y otro de mujeres de 52-73 anos. Algunos desconocian el contenido de sal de alimentos/preparaciones; otros la identificaban como: contenida en alimentos, agregada en cocción/plato, como conservante, relacionada al gusto y asociada a hipertensión arterial. La reducción del consumo de sal y/o alimentos/preparaciones que la contienen ocurrió predominantemente ante eventos de salud, no como conducta preventiva. Se observó tendencia a considerar el propio consumo como bajo/moderado y a detectar una ingesta alta en otros miembros convivientes, basándose sólo en la sal de mesa. Los 3 grupos de adultos manifestaron preocupación por esto último. Predominó la propuesta de cocinar sin sal y usar alimentos condimentos y especias como estrategias de reducción. Sugirieron campanas y medidas que involucren escuelas y medios de comunicación masivos. Los jóvenes propusieron involucrar a la industria alimentaria y elaboradores de comidas rápidas y alimentos de conveniencia.

The consumption of high levels of salt (NaCl) is associated with hypertension, and possible development of cardiovascular and cerebrovascular diseases. The aim of this study was to explore consumers' understanding of salt in their daily diet, their perceptions and knowledge about health implications and actions to reduce salt intake. Four focus groups were conducted (31 participants): one with university students, two with working adults and one older woman's group. Some participants were not aware of salt content of food whereas others demonstrated an awareness of salt in food, the role of salt as a preservative, affecting taste and health implications. Reducing consumption of salt tended to be a reactive event when personal/family health events took place rather than a proactive behaviour. Participants tended to consider their own consumption ofsalt as low/moderate but those who they lived with were perceived to have a high intake based only on table salt. The three adult focus groups expressed concerns about adding salt. Alternatives to salt such as seasonings/spices could be used as strategies to reduce its consumption. At the population level campaigns involving schools and mass media were suggested. Only university students raised the need to involve the food industry and food processors in reducing salt consumption.

Diagnóstico y manejo de la hernia paraduodenal / Diagnosis and management of paraduodenal hernia

Internal hernias cause 1 percent of intestinal obstructions with aproximately 50 percent of these hernias been paraduodenal hernias. Paraduodenal hernias are the product of a malrotation of the midgut during embryogenesis or a non-fusion of the peritoneal folds. These type of internal hernia are more cornmon in males and on the left side of the abdomen. The usual presentation age is in the 4th decade of life. The clinical presentation of these patients is non specific and varies, ranging from mild dyspepsia to intestinal perforation and septic shock. The radiographic studies of these patients show a dumping of the intestinal loops on the upper quadrant of the abdomen with an image of abdominal compartamentalization. The surgical management of these patients should follow three simple principles. The intestines should be reduced, their perfusion and viability must be verified and the hernia sack entrance should be repaired with interrupted non absorbable sutures.

Las hernias internas causan el 1 por ciento de las obstrucciones intestinales. De estas, aproximadamente la mitad son causadas por hernias paraduodenales. Las hernias paraduodenales son producto de una embriogénesis defectuosa, donde el intestino no rota o los pliegues mesentéricos no se fusionan adecuadamente. Estas hernias son más comunes en el género masculino, del lado izquierdo y por lo general se diagnostican en la cuarta década de la vida. La presentación clínica es inespecífica con manifestaciones que varían desde la dispepsia hasta la perforación intestinal y el choque séptico. Los estudios de imagen muestran el agrupamiento de las asas intestinales en el abdomen superior dando una imagen de compartamentalización de la cavidad abdominal. Para el manejo quirúrgico de estos pacientes se debe reducir el intestino herniado, verificar que este sea viable y posea una adecuada perfusión y reparar el orificio hemiario con material no absorbible.

Hidroxietilalmidón (Hextend®) en solución electrolítica balanceada en el choque hipovolémico hemorrágico / Use of hetastarch in a balanced electrolyte solution - Hextend®- in the resuscitation of the patient in hypovolemic hemmorrhagic shock: review of the international literature

Hextend® is a preparation of hetilstarch in a balanced electrolyte solution that contains 143 mEq/L of sodium, 124mEq/L of chloride, 5 mEq/L of calcium 3 mEq/L of potassium 0.9 mEq/L of magnesium, 0.99 g/L of glucose and 24 mEq/L of lactate. It has a volume of distribution similar to blood volume which enables it to stay in the intravascular compartment until it is renally cleared or absorbed by the reticuloendothelial system. It shows a bimodal pattern of clearance with a half life during the first 8 hrs of its infusion of 4.2 hrs and during the 7 days following of 38.2 hrs. Hextend® is currently one of the preferred resuscitation solutions in the hypovolemic patient showing a better profile of effects over hemostasis and acid base status and conferring a better survival over similar patients resuscitated with crystalloids or other synthetic colloids. Hextend® provides an adequate fluid that is effective in the resuscitation of the trauma patient in hypovolemic hemorrhagic shock and promises to become the fluid of choice in the routine management of these patients. There is a need of more randomized prospective studies in the field of trauma using Hextend ® and its combination with the inflammatory cascade modifiers such as ethyl pyruvate among others.

Hextend® es una combinación de hetilalmidón balanceada en una solución de electrolitos que contiene 143 mEq/L de sodio, 124 mEq/L de cloro, 5 mEq/L de calcio, 3 mEq/L de potasio, 0,9 mEq/L de magnesio, 0,99 g/L de glucosa y 24 mEq/L de lactato. Posee un volumen de distribución equivalente al volumen sanguíneo manteniéndose en el compartimento vascular hasta ser excretado vía renal o absorbido por el sistema retículo-endotelial. Estas características le confieren un patrón farmacocinético bimodal con una vida media de 4,2 horas durante las primeras 8 hrs de infusión y de 38,2 h durante los primeros 7 días. Hextend® es actualmente una de las soluciones de reanimación con mejor perfil de efectos sobre la hemostasia y el equilibrio ácido base del paciente en choque hipovolémico y confiere un aumento de la sobrevida, comparado con controles resucitados con cristaloides u otros coloides sintéticos. Esta combinación de hetilalmidón en una solución amortiguadora electrolítica posee mínimos efectos sobre la función hemostática y plaquetaria por lo que actualmente es preferido frente a soluciones cristaloides y otros coloides utilizados en el pasado en la reanimación de pacientes politraumatizados en estado de choque hipovolémico hemorrágico. A su vez, promete transformarse en el fluido de elección en el manejo rutinario de estos pacientes. En relación al uso de este producto es imperativo realizar un mayor número de estudios prospectivos randomizados. La literatura internacional augura un esplendoroso futuro al uso de Hextend®, como también a su posible combinación con modificadores de la cascada inflamatoria, entre otros con el etil piruvato.

Consumo de tabaco en la Facultad de Odontología de la Universidad Nacional de Asunción / Consumption of snuff at the Faculty of Dentistry, National University of Asuncion

El uso del tabaco es una de las mayores causas de enfermedades y muertes prematuras en el mundo. Según la Organización Mundial de la Salud (OMS) aproximadamente 5 millones de muertes al año pueden atribuirse al tabaco. El número de muertes excederá los 10 millones para el 2020. En el Paraguay mueren dos personas por día como consecuencia de enfermedades relacionadas al consumo del tabaco. Más de la mitad de las muertes son por cáncer del pulmón. Con el objetivo de determinar la frecuencia de consumidores de tabaco en estudiantes, docentes y funcionarios de la Facultad de Odontología se realizó un estudio observacional descriptivo de corte transverso, con empleo de cuestionario autoadministrado. (Test de Fagerstrõm modificado, para detectar la dependencia a la Nicotina).Se pudo constatar que en la Institución el 61% de los encuestados fuma, de ellos el 66% son estudiantes. 63% de las mujeres encuestadas fuma frente al 59% de los varones. El promedio de edad de inicio es similar en ambos sexos. La gran mayoría de los fumadores presentan bajo grado de dependencia a la Nicotina. Es necesario continuar los estudios sobre este tema y fomentar el aumento de campañas de concienciación de manera a que en nuestra institución, como lugar dedicado al servicio de la salud, en un futuro cercano podamos desarrollar nuestras actividades en un “ambiente saludable”

Extracellular proteases from the Antarctic marine Pseudoalteromonas sp. P96-47 strain / Proteasas extracelulares de la cepa marina antártica Pseudoalteromonas sp. P96-47

The extracellular protease-production capacity of 33 bacterial isolates taken from marine biotopes in King George Island, Antarctica, was evaluated in liquid cultures. The P96-47 isolate was selected due to its high production capacity and was identified as Pseudoalteromonas sp. The optimal growth temperature was 20 °C and the optimal for protease production was 15 °C. Proteases were purified from culture supernatants, developing a multiple-band profile in zymograms. They were classified as neutral metalloproteases and worked optimally at 45 °C with an Eact of 47 kJ/ mol. Their stability was higher at neutral pH, retaining more than 80% of activity at pH 6-10 after 3 h incubation at 4 °C. After 90 min incubation at 40 and 50 °C, the percentages of residual activities were 78% and 44%. These results contribute to the basic knowledge of Antarctic marine proteases and also help evaluate the probable industrial applications of P96-47 proteases.

La capacidad productora de proteasas extracelulares de 33 aislamientos bacterianos tomados de biotopos marinos en la Isla Rey Jorge, Antártida, fue evaluada en cultivo líquido. El aislamiento P96-47 fue seleccionado debido a su alta capacidad productora y fue identificado como Pseudoalteromonas sp. La temperatura óptima de crecimiento fue de 20 °C y la de producción de 15 °C. Las proteasas fueron purificadas a partir del sobrenadante de cultivo, y en los zimogramas desarrollaron un perfil de múltiples bandas. Estas proteasas fueron clasificadas como metaloproteasas neutras y se observó que trabajan óptimamente a 45 °C, con una Eact de 47 kJ/ mol. Su estabilidad fue superior a pH neutro y retuvieron más del 80% de su actividad a pH 6-10 después de 3 h de incubación a 4 °C. Luego de 90 min de incubación a 40 y 50 °C, las actividades residuales fueron 78% y 44%, respectivamente. Los resultados que se presentan en este trabajo contribuyen al conocimiento básico de las proteasas marinas antárticas y también a evaluar las probables aplicaciones industriales de las proteasas de P96-47.

Reduction of the impact produced by sea lions on the fisheries in Mexico.

Activities of fishermen in the Bay of La Paz, B. C. S. are focused to satisfy the local demand of fish and shellfish by using approximately 300 small outboard crafts equipped with gillnets.Sea lions in this Bay attack the fishes captured damaging both product and gear. We did experimental gillnet throws to determine the frequency and preferences of sea lions in fishing areas. 52 experimental gillnet throws with time averages of 2 hr were performed, rending an average of 30 kg of fish captured and less than 10% of damages to the net.. Traditional fishermen in this Bay usually left the net the whole night, (approximately 7.50 hr, obtaining an average of 50 kg of captured fish, but the damages to the nets is in average of 40%. The cost-benefit balance comparing our alternative fishing method, which includes the use of the gillnets during the afternoon, watching for sea lions and retiring the nets at their arrival, it is more sustainable and profitable than the traditional fishing method currently used by the local fishermen. This paper suggests how to minimize the harmful effects of the sea lions on the fishermen productivity and gear, maximizing the production and reducing the damage. Our alternative method is applicable to other regions where this harmful interaction is taking place. We conclude that the coexistence of sea lions-fisheries is feasible, by applying the simple measures that we propose.

Encefalomielitis aguda diseminada de presentación atípica: utilidad de la biopsia estereotáctica para su diagnóstico. Caso clínico / Diagnosis of acute disseminated encephalomyelitis using a stereotaxic biopsy: Report of one case

We report a 15 year-old female presenting with behavioral disturbances, headache, left hemiparesis and paresis of the vertical gaze. CAT scan and magnetic resonance showed an involvement of right thalamus, third ventricle and medial temporal lobe suggesting an encephalitis or lymphoma. 201Thalium SPECT suggested a lymphoma. A stereotaxic biopsy showed a subacute demyelinizing lesion, compatible with an acute disseminated encephalomyelitis. The patient was treated with Methylprednisolone with resolution of symptoms. She remains in good condition after one year of follow-up.

Lunar phase and catch success of the striped marlin (Tetrapturus audax) in sport fishing at Los Cabos, Baja California Sur, Mexico

The influence of the lunar phases on the catch-per-unit effort (CPUE) of the striped marlin (Tetrapturus audax) captured by the Cabo San Lucas, Baja California Sur, Mexico sport-fishing fleet from October 1987 to June 1989 was analyzed. The information is from 3,377 fishing trips by 13 vessels that represent about 10% of the fleet. The analysis of the CPUE showed a maximum in January 1988 and a minimum in February 1989. Taking into account the knowledge of the factors that had influence on the fishing success is important in the resource management. No significant difference during the full moon compared with results during other lunar phases was found.

Ictiofauna de la pesquería ribereña en Bahía de Navidad, Jalisco, México, asociada al evento El Niño 1997-1998 / Ichthyofauna fisheries in BahÝa de Navidad, Jalisco, Mexico, associated to the El Niño event 1997-1998

The ichthyofauna fished in BahÝa de Navidad, Jalisco, Mexico in the Central Pacific was surveyed during 1998. Six thousand nine hundred and fourty-four organisms of 130 species were caught which weighted 3,231 kg. Nearly 30 of the species belonged to Carangidae. Haemulidae and Sciaenidae. The most important species in number and biomass were Microlepidotus brevipinnins, Caranx caninus and C. caballus. Species number, abundance and biomass fluctuated during the year. The largest number of species was caught in June (61), the minimum in March (33). January had the maximum abundance (1,397 organisms), while the minimum was obtained during August (251). The maximum biomass values were from January (556.5 kg), and the lowest from August (114.7 kg). Eighteen species accumulated 87 of the total abundance, while 20 species represented 86.3 of the biomass. There were large in differences species number, abundance and biomass nets of different mesh size.

Factors influencing protease production by two Antarctic strains of Stenotrophomonas maltophilia

The influence of culture medium buffer capacity, the supplementation of culture medium with L-ala and the requirement of calcium for exoprotease production by Antarctic psychrotrophic Stenotrophomonas maltophilia strains ANT-1-1 and ANT-7-1 were examined. When increasing concentrations of calcium chloride (0 to 0.3 g l-1) were added to culture media, maximum protease production yields increased 70-75 (ANT-1-1) and 50 (ANT-7-1), while biomass levels showed little difference. Calcium was also necessary for optimal activity of proteases. L-ala had no effect on protease production. The reduction in buffer capacity, with the consequent change in external pH, had a positive effect, enhancing protease yields. Secretion of proteases into the medium started at the beginning of the stationary phase, corresponding with a rise in pH values up to pH 8.7 and was maximal at 36 h of culture. These results indicate that the regulation of calcium concentration and buffer capacity and also pH monitoring are factors to be considered when the design of an industrial culture medium and the optimisation of protease production processes using these Antarctic strains are concerned.

Utilidad de sangre almacenada en papel de filtro para estudios serologicos por ELISA de inhibicion / Utility of storaged blood in paper strips for serologic studies through ELISA of inhibition

Para evaluar la utilidad del metodo de recoleccion de muestras de sangre en papel de filtro para la deteccion de anticuerpos anti-dengue mediante un ELISA de Inhibicion recientemente desarrollado en nuestro laboratorio, se realizo una toma simultanea de muestras de sangre en papel de filtro y de suero, de donantes de Banco de Sangre. Ambas muestras fueron conservadas a -20 graus Celsius y probadas a los 15 dias, 3 y 6 meses respectivamente. A las muestras que resultaron positivos se les amplio el rango de dilucion para determinar titulo. Al realizar la comparacion entre ambas muestras, sangre en papel de filtro y suero, encontramos que no existian diferencias de deteccion significativas, tanto para los casos positivos como los negativos. No obstante se observo en ambas muestras y de forma general una disminucion del titulo de anticuerpos (una dilucion) al transcurrir el tiempo maximo establecido en nuestro estudio (6 meses).

Serological diagnosis of dengue by an Elisa inhibition method (EIM)

An ELISA Inhibition Method (EIM) was proposed for the serologic diagnosis of dengue, comparing its results with the Hemagglutination Inhibition (HI) and the IgM capture-ELISA (MAC-ELISA). Advantages and disadvantages of both methods are discussed according to sensitivity, specificity, performance and usefulness. As a conclusion we recommend the complementary inclusion of the EIM and MAC-ELISA substituting the HI for laboratories engaged in the diagnosis and surveillance of dengue

Fiebre hemorragica del dengue con sindrome de choque en ninos Cubanos / Clinical and serologic study of Cuban children with dengue hemorrhagic fever

During the 1981 epidemic of dengue type 2 in Cuba a study was done of 124 children from 0 to 14 years of age who had dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS), degress III and IV. Almost all these children (98 percent) had neutralizing antibodies against the dengue type 1 and 2 viruses, indicating that they had already been previously infected with the type 1 virus. Neither sex was predominant among the patients. The frequency of the serious form of the disease was significantly greater among white children (p0.01) than among black or mulatto. Subjects between the ages of 4 and 11 were most apt to suffer serious clinical manifestations of the disease. In most of the cases the shock occurred four or five days after the appearance of the signs and symptoms, often preceded by abdominal pain. The most frequent clinical manifestations were fever, vomiting, and hepatomegaly. In 68.5 percent of the children there were hemorrhagic manifestations, mainly petechia and hematemesis. It was noted that and unusually high percentage of the children in the study had a personal or family background of asthma. In general, the results confirm that infection with the dengue type 1 virus shortly before infection with the type 2 virus is closely related to the appearance of DHF/DSS. In addition, the high percentage of children with a background of asthma supports the theory that this and other forms

Acute effect of the gastrokinetics cisapride and metoclopramide on the gastric emptying function in patients with the early satiety syndrome

Diez pacientes con dispepsia postprandial crónica, 4 de ellos con retardo de la evacuación gástrica se incluyeron en un estudio simple-ciego, con evaluaciones realizadas por cámara Gamma con el objetivo de comparar los efectos del Cisapride y la metoclopramida sobre la evaluación gástrica. Ambas drogas se adminstraron secuencialmente con una semana de intervalo entre sí, a la dosis única de 10 mg., 15 minutos antes de la toma de la comida de prueba marcada. Aplicando un modelo matemático exponencial para los datos de cámara Gamma, se determinó el tiempo medio y el perfil de la curva de vaciamiento. El tiempo medio de vaciamiento (T 1/2) se redujo desde 81.5 minutos en condiciones basales a 62.5 minutos (- 23%) con Cisapride, a 74.5 (-9%) con metoclopramida. Comparado con los valors basales Cisapride reduce el porcentaje de retención a partir de los 45 minutos con una significancia de P <0,05 (Wilcoxon Test). La fase inicial (LAG FASE) fué más acelerada por acción del Cisapride que por la meto clopramida (P < 0,05). Cada una de estas drogas aceleraron la evacuación de la comida de prueba en los casos de retardo evacuatorio. Cisapride acortó particularmente la fase lag de vaciamiento inicial y fue superior a la metoclopramida en este punto