Exactitud y precisión de los métodos dentales para estimar la edad basados en la transparencia de la dentina radicular / Accuracy and Precision o Dental Methods to Estimate Age Based Transparenc o Root Dentin / Exatidão e precisão dos métodos odontológicos para estimar a idade com base na transparência da dentina radicular

Introducción: este trabajo buscó determinar la exactitud y precisión de los métodos dentales para estimar la edad, basados en la transparencia de la dentina radicular. Materiales y métodos: estudio transversal de tipo comparativo en el que se evaluaron 90 dientes unirradiculares de una muestra peruana de 90 cadáveres adultos masculinos. En cada diente se midió la altura de la periodontosis, altura radicular y longitud de la transparencia de la dentina radicular. Con estas medidas se hallaron las edades dentales de acuerdo con los métodos de Prince-Ubelaker, Ubelaker-Parra y Vilcapoma, y se compararon los resultados entre sí y con la edad cronológica (edad real). Debido a la normalidad de los datos y a su homocedasticidad, se utilizó la prueba de Pearson, el Anova de un factor para muestras relacionadas y la prueba de Tukey. La exactitud se evaluó mediante las diferencias entre las edades cronológicas y las estimadas por cada método, y la precisión se obtuvo del análisis de confiabilidad y repetibilidad, mediante diagramas de Bland-Altman. El nivel de significancia fue 0.05. Resultados: las exactitudes y precisiones fueron de 0.15-0.14, 2.18-2.07, 3.5-3.11 y 9.92-9.82 para los métodos de Vilcapoma, Ubelaker-Parra, Prince-Ubelaker para masculinos blancos y Prince-Ubelaker para para masculinos negros, respectivamente. Conclusiones: el método de Vilcapoma tuvo mayor exactitud y precisión para estimar la edad.

Objective: To determine the accuracy and precision of dental methods for age estimation based on transparency of root dentin. Materials and Methods: Transversal study of comparative type where 90 uniradicular teeth of a Peruvian sample of 90 male adult corpses were evaluated. In each tooth was mea-sured: height of periodontosis, root height and height of transparency of root dentin. With these mea-surements the dental ages were found according to the methods of Prince-Ubelaker, Ubelaker-Parra and Vilcapoma, comparing the results with each other and with the chronological age (real age). Due to the normality of the data and its homocedasticity, the Pearson test, the one-factor Anova for related samples and the Tukey test were used. Accuracy was evaluated by differences between chronological and esti-mated ages for each method and accuracy was obtained from reliability and repeatability analysis using Bland-Altman diagrams. The significance level was 0.05. Results: Accuracy and precision were 0.15-0.14, 2.18-2.07, 3.5-3.11 and 9.92-9.82 for the Vilcapoma, Ubelaker-Parra, Prince-Ubelaker for white males and Prince-Ubelaker for black males, respectively. Conclusions: The Vilcapoma method had greater accuracy and precision in estimating age.

Objetivo: determinar a precisão e a exatidão dos métodos odontológicos para a estimativa da idade com base na transparência da dentina radicular. Materiais e métodos: estudo transversal comparativo onde foram avaliados 90 dentes uniradiculares de uma amostra peruana de 90 cadáveres masculinos adultos. Cada dente foi medido para: altura da periodontose, altura da raiz e comprimento da transparência da dentina radicular. Com estas medidas foram encontradas as idades dentárias de acordo com os métodos de Prince-Ubelaker, Ubelaker-Parra e Vilcapoma, comparando os resultados entre si e com a idade cro-nológica (idade real). Devido à normalidade dos dados e sua homocedasticidade, foram utilizados o teste Pearson, a anova de um fator para amostras relacionadas e o teste Tukey. A exatidão foi avaliada pelas diferenças entre as idades cronológicas e as estimadas por cada método e a exatidão foi obtida a partir da análise de confiabilidade e repetibilidade usando diagramas de Bland-Altman. O nível de significância foi de 0,05. Resultados: precisão e exatidão foram 0,15-0,14, 2,18-2,07, 3,5-3,11 e 9,92-9,82 para os métodos Vilcapoma, Ubelaker-Parra, Prince-Ubelaker para os homens brancos e Prince-Ubelaker para os homens negros, respectivamente. Conclusões: o método Vilcapoma foi mais preciso e exato na estimativa da idade.

Conceptos básicos sobre el método de Lamendin en la estimación de edad / Basic concepts about Lamendin´s method in age estimation

Resumen La odontología forense representa una de las disciplinas más útilesen la identificación de seres humanos, los dientes también puedenbrindar entre otras características la edad aproximada de una persona. A lo largo de la historia se han desarrollado diferentes métodos de estimación de edad dentro de los cuáles el método de Lamendin(translucidez radicular) resulta sencillo y bastante precisosin la necesidad de equipo especializado para su realización. Como cualquier método diagnóstico presenta limitaciones, puede ser utilizado en adultos después de los 20 años en dientes unirradiculares sin caries, presentando mayor fiabilidad y precisión, cuando el rango de edad se mantiene entre 40 y 70 años. Sin embargo, el mismo no toma en consideración el sexo, ni la raza, por lo que esto puede representar una limitación considerable; aunado a lo anterior en Costa Rica hasta hoy no existen estudios que permitan corroborar la efectividad del método Lamendin en la población.

Abstract Forensic dentistry represents one of the most useful disciplines in the identification of human beings, teeth can also provide, among other characteristics, the approximate age of a person. Throughout history, different age estimation methods have been developed, among which the Lamendin method (root translucency) is simple and quite accurate without the need for specialized equipment to perform it.As any diagnostic method has limitations, it can be used in adults after the age of 20 in single-rooted teeth without caries, presenting greater reliability and precision, when the age range remains between 40 and 70 years. However, it does not take gender or race into consideration, so this can represent a considerable limitation; In addition to the above, in Costa Rica, to date, there are no studies that allow corroborating the effectiveness of the Lamendin method in the population.

Estimación de la edad dental con finalidad forense en una muestra poblacional argentina aplicando el método Cameriere / Estimation of dental age for forensic purposes in an Argentine population sample applying the Cameriere method

El desarrollo de los dientes representa el criterio más utilizado para estimar la edad en niños y adultos jóvenes. El método de Cameriere et al., aceptado y validado internacionalmente, evalúa radiográficamente la edad dental a través de mediciones de dientes con el ápice abierto y la aplicación de ecuaciones de regresión específicas. En el presente estudio se analizaron 7 dientes mandibulares (excepto los terceros molares) en 122 radiografías panorámicas digitales mediante el programa ImageJ, de una muestra de ciudadanos argentinos de 5 a 19 años (63 masculinos y 54 femeninas) con el objetivo de evaluar la precisión del método propuesto por Cameriere et al. Se registraron los datos de sexo y edad de las ortopantomografías en forma ciega de la base de datos. Se desarrollaron modelos de regresión lineal para la estimación de la edad. Los resultados demostraron que el sistema es confiable para la estimación de la edad en la población estudiada, con un error absoluto medio de 0.014 años entre edades cronológicas y estimadas (p=0,603). Hubo una ligera tendencia a sobreestimar las edades de 5 a 10 años y a subestimar las edades de 11 a 16 años. Se considera apropiado efectuar nuevas investigaciones para obtener mayores conclusiones y contribuir a la estandarización del método Cameriere con fines forenses en Argentina (AU)

Estimación de edad mediante la relación área pulpa/diente en caninos mandibulares: estudio en una muestra chilena utilizando el Método de Cameriere / Dental age estimation by pulp/tooth ratio in mandibular canines: study in a Chilean sample by Camerierer's Method

La estimación de edad compone un aspecto importante en investigaciones forenses. Diferentes métodos se han descrito en odontología forense basadas en la correlación entre la edad y estructuras dentales. Cameriere et al. proponen un método cuantitativo para estimación de edad en adultos, a partir de la evaluación de la relación del área pulpa/diente, en base a la aposición de dentina secundaria. El objetivo del estudio fue desarrollar modelos de regresión para la estimación de edad dental mediante la relación área pulpa/diente en caninos inferiores en una muestra Chilena. Se analizaron 212 radiografías periapicales digitales (RPD) (86 hombres y 126 mujeres) de caninos mandibulares mediante el programa Image J para establecer el área de la pulpa y el diente. Se registraron los datos de sexo y edad de las RPD seleccionadas en forma ciega. Fueron desarrollados modelos de regresión lineal simples para la estimación de edad. El coeficiente de determinación para R33 fue 27,8 % y de 29,6 % para R44, con un error absoluto medio de 11,02 años y 10,37 años respectivamente. El análisis de ANOVA no mostró diferencias estadísticamente significativas para las relaciones área pulpa/diente de caninos según sexo (p> 0,05). Según los resultados obtenidos, la metodología propuesta por Cameriere et al. es fiable para estimar la edad dental mediante la relación área pulpa/diente en adultos. Sin embargo, en los modelos de regresión desarrollados para la población Chilena, se puede afirmar que el ajuste indicado por los coeficientes de determinación muestran incerteza entre las variables área pulpa/diente y edad cronológica en caninos inferiores, por lo tanto se sugiere considerar otros métodos adicionales para estimar edad en esta población.

Age estimation is an important aspect In forensic investigations. Different methods in forensic odontology based on the correlation between age estimation in adults, from the analysis of the pulp/tooth area, based on the apposition of secondary dentine. The aim of the study was to develop regression models for the dental age estimation by the relation pulp/tooth area, in lower canines in a Chilean sample, using digital peri-apical radiographs (DPR) applying Cameriere's method. We analyzed 212 DPR (86 males and 126 females) mandibular canines through Image J program to measure the pulp/tooth area. Age and sex information was obtained of the DPR's blindly selected. We developed simple linear regression models for age estimation. The coefficient of determination to R33 was R2 age and dental structures have been described. Cameriere et al. proposed a quantitative method for 27.8 % and R2 29.6 % to R44, with a mean absolute error of 11.02 years, to R33 and 10.37 years to R44. ANOVA analysis showed no statistically significant differences for the pulp/tooth relation area of canines according to sex (p> 0.05). According to the results, the Cameriere's et al., method is reliable for dental age estimation according to pulp/tooth ratio in adults. However, in the regression models developed for Chilean population, it can be stated that the adjustment indicated by the coefficients of determination, show uncertainty between the pulp / tooth area and chronological age in lower canines, therefore it is suggested to use additional estimation methods for age in this population.

Relationship between cervical vertebral maturation and dental development in a sample of yemeni children and adolescents / Relación entre la maduración vertebral cervical y el desarrollo dental en una muestra de niños y adolescentes yemeníes

Objective: This study was conducted to investigate the relationship between dental development and cervical vertebral maturation stages in a group of Yemeni children and adolescents. Materials an Methods: The study included digital panoramic radiographs and lateral skull cephalograms obtained from 207 Yemeni subjects­122 females and 85 males aged between 8 to 18 years. Dental maturity was evaluated according to the method of Demirijian et al., calcification stages of the left mandibular canines, first and second premolars and second molars were assessed. Skeletal maturity was assessed by the cervical vertebral maturation (CVM) stages according to the method of Baccetti et al. Correlation between CVM and dental maturation was evaluated by Spearman rank-order correlation coefficient (SROCC). Results: CVM and dental calcification stages were highly correlated (p<0.001) in both genders, ranging from 0.686 to 0.873 for females and 0.787 to 0.871 for males. Calcification stages of the second molars showed the strongest correlation with CVM. Conclusion: Calcification stages of the second molar may be used as a reliable maturation indicator. Dental maturation may be applied to determine the skeletal maturity status of Yemeni children and adolescents.

Objetivo: Este estudio se realizó para investigar la relación entre el desarrollo dental y las etapas de maduración vertebral cervical en un grupo de niños y adolescentes yemeníes. Material y Métodos: El estudio incluyó radiografías panorámicas digitales y cefalogramas laterales del cráneo obtenidos de 207 sujetos yemeníes: 122 mujeres y 85 hombres de entre 8 y 18 años. La madurez dental se evaluó de acuerdo con el método de Demirijian et al. Se evaluaron las etapas de calcificación de los caninos mandibulares izquierdos, primer y segundo premolares y segundos molares. La madurez esquelética se evaluó mediante las etapas de maduración vertebral cervical (CVM) de acuerdo con el método de Baccetti et al. La correlación entre la CVM y la maduración dental se evaluó mediante el coeficiente de correlación de orden de rango de Spearman (SROCC). Resultado: Las etapas de CVM y calcificación dental estuvieron altamente correlacionadas (p<0.001) en ambos sexos, con un rango de 0.686 a 0.873 para las mujeres y 0.787 a 0.871 para los hombres. Las etapas de calcificación de los segundos molares mostraron la correlación más fuerte con CVM. Conclusión: las etapas de calcificación del segundo molar pueden usarse como un indicador de maduración confiable. La maduración dental puede aplicarse para determinar el estado de madurez esquelética de los niños y adolescentes yemeníes.

Evaluation of modified petroff’s method and manual MGIT culture system to facilitate detection of acid-fast bacilli in smear-negative presumptive cases of pulmonary tuberculosis

Background: Tuberculosis is a major public health problem in India. According to RNTCP guidelines, all efforts are to be made to diagnose tuberculosis on the basis of detection of AFB/ MTB in the clinical specimen; hence all those cases where AFB/ MTB have not been detected are presumptive cases of tuberculosis. In this background, the present study aims to detect AFB/ MTB in the sputum of clinico-radiologically presumptive cases of pulmonary tuberculosis using direct ZN microscopy, Modified Petroff’s method followed by ZN microscopy & MGIT liquid culture method. Materials and Methods: A total of 94 sputum samples which were negative for AFB by direct ZN microscopy at the DMC of the institute, were subjected to Modified Petroff’s method followed by microscopy & MGIT liquid culture test to find out any additional yield of bacteriologically confirmed disease. Result: Out of 94 specimens, 20 (21.28%) were positive for AFB on ZN microscopy post Modified Petroff’s method. Among all the specimens, 30 (31.91%) were found to be positive by MGIT liquid culture method with average time to detection growth (TTD) around 16.73 days (2-38 days). Conclusion: Modified Petroff’s method followed by ZN microscopy & MGIT test for mycobacterial culture can improve case detection.

Cembrane-type diterpenoids from the South China Sea soft coral

Eight cembrane-type diterpenoids, namely, (+)-(6)-6-hydroxyisosarcophytoxide (), (+)-(6)-6-acetoxyisosarcophytoxide (), (+)-17-hydroxyisosarcophytoxide (), sarcomililatins A-D (-), and sarcomililatol (), were isolated from the soft coral collected from Weizhou Island, Guangxi Autonomous Region, together with 2 known related analogues, (+)-isosarcophytoxide () and (+)-isosarcophine (). The structures of these compounds were elucidated by a combination of detailed spectroscopic analyses, chemical methods, and comparison with reported data. The absolute configuration of compound was established by the modified Mosher׳s method, while the absolute configurations of compounds and were assigned by electronic circular dichroism (ECD) spectroscopy and that of compound was established by time-dependent density functional theory electronic circular dichroism (TD-DFT ECD) calculation. In bioassays, compound displayed significant cytotoxicity against the human cancer cell lines human promyelocytic leukemia cells (HL-60) and human lung adenocarcinoma cells (A-549) with IC values of 0.78±0.21 and 1.26±0.80 μmol/L, respectively. Compounds and also showed moderate inhibitory effects on the TNF-induced Nuclear factor kappa B (NF-B, a therapeutical target in cancer) activation, showing IC values of 35.23±12.42 and 22.52±4.44 μmol/L, respectively.

An analysis on health life expectancy of adult residents in Zhejiang Province / 预防医学

Objective To analyze the health life expectancy (HALE) of the residents aged 15 years and above in Zhejiang Province and to evaluate the health level among adults. Methods The study was based the mortality data collected from Zhejiang Chronic Disease Surveillance Information and Management System, and the mortality rates were from the Under-Reporting Survey and the sample data in Zhejiang from the 5th National Health Service Survey in 2013. A Sullivan' s method was used to calculate the HALE. Results The life expectancy and self-evaluated HALE were 63.62 years, 55.80 years, respectively, and the difference was 7.82 years (61.49 years VS 55.13 years in males and 66.10 years VS 56.57 years in females) . The self-evaluated HALE 55.89 years in urban and 55.54 years in rural residents aged 15 years and above. The proportion of self-evaluated HALE in the total life expectancy was 87.70%, and it decreased with age, and the proportion has dropped to 67.31% in ≥65 age group. Life expectancy without chronic morbidity was 46.68 years (46.35 years in males and 47.01 years in females; 44.03 years in urban and 47.15 years in rural areas) among residents aged 15 years and above, and the proportion of self-evaluated HALE without chronic morbidity in the total life expectancy without chronic morbidity was 73.37%. Conclusion In general the proportion of self-evaluated HALE in the total life expectancy was small , and males had a greater proportion than female, and adults in rural areas had a greater proportion than that in urban areas. We should consider NCDS management for the elderly residents and to improve the life quality among the elderly residents.

Abordaje fisicoquímico del estado ácido-base en pacientes críticamente enfermos después de la infusión de siete diferentes tipos de soluciones balanceadas / A physicochemical approach to acid-base balance in critically ill patients after infusion of seven different types of balanced fluids / Enfoque físico-químico do estado ácido-básico em pacientes em estado crítico depois da infusão de sete diferentes tipos de soluções balanceadas

Resumen: Introducción: El método simplificado de Fencl-Stewart puede ser empleado a la cabecera del paciente y es más exacto para la evaluación del balance ácido-base. Omron desarrolló un modelo fisicoquímico del cambio en el exceso de base posterior a la infusión de cristaloides con diferencia de iones fuertes (DIF) diferente; sin embargo, fue un trabajo experimental bajo condiciones controladas. Objetivo: Describir el cambio en el estado ácido-base inicial y a las 24 horas en personas críticamente enfermas tras la infusión de siete diferentes tipos de soluciones balanceadas. Material y métodos: Se realizó un estudio retrospectivo, observacional y descriptivo en una terapia intensiva de tercer nivel. Se incluyeron individuos mayores de 18 años de enero de 2015 a julio de 2016. Se evaluaron los efectos en el estado ácido-base a través del modelo fisicoquímico de Fencl-Stewart modificado al inicio y a las 24 horas de la infusión de cristaloides balanceados con DIF de 27 a 154 mEq/L. Se analizaron los gases arteriales a través del gasómetro ABL800 Flex y GEM Premier 3500. El análisis de electrolitos séricos se realizó a través de Architec plus c16,000. El análisis estadístico fue descriptivo a través del programa SPSS v21.0. Resultados: Se incluyeron 198 sujetos. Las soluciones utilizadas con mayor frecuencia fueron Hartmann y H25, en 27.8 y 26.3%, respectivamente. En general, al analizar la totalidad de la población estudiada, todos los parámetros relacionados con acidosis metabólica tuvieron mejoría a las 24 horas. Conclusiones: El uso de soluciones con DIF > 24 mEq/L mejora el estado ácido-base, sin mayor incidencia de hipercloremia a las 24 horas.

Abstract: Introduction: Acid-base status in a body fluid is physically determined by several independent variables. These are: pCO2, the «strong ion difference¼ (SID), all the strong anions (among them is Cl-), and concentrations of nonvolatile weak acids (ATOT). Normal acid-base status is achieved when the independent variables have normal (empirically established) values. The simplified Fencl-Stewart's method can be used at the bedside of the patient and is more accurate in the assessment of acid-base balance. Omron developed a physicochemical model of the projected change in standard base excess (SBE) as a consequence of infused crystalloid solutions of common use (isotonic saline and balanced fluids); unfortunately this was a clinical simulation at standard physiological state. In addition, Kaplan evaluated acid-base balance after the administration of balanced fluids in trauma patients. Nevertheless, to our knowledge, there are no other clinical trials that evaluate the administration of other types of balanced fluids. Objective: To assess the acid-base status of critically ill patients after the infusion of seven different types of balanced solutions. Material and methods: This was a retrospective, observational and descriptive study conducted in an intensive care unit of a tertiary care hospital. We included all patients 18 years and older admitted to this department from January 2015 to July 2016. We evaluated the effects on acid-base balance after the infusion of seven different solutions: 1) Hartmann + 17.8 mEq/L sodium bicarbonate (NaHCO3) (SID 45.8), 2) Hartmann + 8.9 mEq/L NaHCO3 (SID 36.9), 3) Hartmann + 15 mEq/L NaHCO3 (SID 43), 4) Hartmann + 25 mEq/L NaHCO3 (SID 53), 5) Hartmann (SID 28), 6) normal saline 0.45% + 77 mEq/L NaHCO3 (SID 75), and 7) dextrose solution 5% + 154 mEq/L NaHCO3 (SID 154). Arterial blood gases, serum electrolytes, and proteins were measured in the same blood sample. Also SIDa, SEDe, SIG, ATOT, pCO2, change in standard base excess (SBE), pH, [HCO3], [Na]p and SOFA were calculated. pH, SBE and pCO2 were estimated with the ABL8000 FLEX blood gas analyzer. Data are mean ± SD or percents. We used the data analysis package SSPS. Results: One hundred ninety-eight patients were included. Of these, 54% were women and 45% men. The solutions most used were Hartmann (25%), Hartmann + 8.9 mEq/L NaHCO3 (21%), and Hartmann + 25 mEq/L NaHCO3 (18%). Before the infusion, SIDe was under 30 mEq/L in 30% of the patients and above in 23% of them. The effect on the SIDe was significant before the infusion of different solutions (p 0.01), SIDe > 30 ± 8 mEq/L. No metabolic alkalosis or greater decrease of SIDa/SIDe was observed. Conclusions: This study assesses additional varieties of fluids that have a different SID in the clinical setting. No major acid-base disturbances were observed.

Resumo: Introdução: O método simplificado de Fencl-Stewart pode ser usado no leito do paciente e é mais preciso para a avaliação do equilíbrio ácido-básico. Omron desenvolveu um modelo físico-químico da mudança do excesso de base após a infusão de cristalóide com DIF diferente; No entanto, foi um estudo experimental sob condições controladas. Objetivo: Descrever a mudança no estado ácido-básico inicial e às 24 horas em pacientes em estado crítico após a infusão de sete tipos diferentes de soluções equilibradas. Material e métodos: Realizou-se um estudo retrospectivo, observacional e descritivo em uma terapia intensiva. Incluiram-se pacientes maiores de 18 anos de janeiro de 2015 a julho de 2016. Avaliamos os efeitos no estado ácido-básico através do modelo físico-químico de Fencl-Stewart modificado no início e às 24 horas após a infusão de cristalóides equilibrados com DIF 27 a 154 mEq/L. Analizaram-se gases arteriais através do Gasômetro ABL800 Flex e GEM Premier 3500. A análise dos eletrólitos séricos foi feita através de Architec plus C16,000. A análise estatística foi descrita através do programa SPSS v21.0. Resultados: 198 pacientes. As soluções usadas com mais frecuência eram Hartmann e H25, com 27,8 e 26,3%, respectivamente. Em geral, ao analisar toda a população estudada, todos os parâmetros relacionados com acidose metabólica apresentou melhoria às 24 horas. Conclusão: O uso de soluções com DIF 24 mEq/L melhoraram o estado ácido-básico, sem maior incidência de hipercloremia em um intervalo de 24 horas.

Aplicación del método de Maloney en el cálculo del lente intraocular después de cirugía refractiva corneal / Use of the Maloney´s method in the intraocular lens calculation after the refractive corneal surgery

OBJETIVO: Determinar la efectividad del método de Maloney para el cálculo del lente intraocular en pacientes operados con cirugía refractiva corneal en el Instituto Cubano de Oftalmología «Ramón Pando Ferrer¼ durante el año 2007. MÉTODOS: El lente intraocular implantado se calculó con la queratometría que aportó el Método de Maloney usando la fórmula SRK/T. Tanto la queratometría como el poder del lente, aportados por el método convencional y por el de Maloney fueron comparados estadísticamente, así como los datos refractivos del preoperatorio con los del posoperatorio de catarata. RESULTADOS: Las queratometrías obtenidas por el método de Maloney fueron menores mientras el poder de los lentes resultaron ser mayores al compararlos con los del método convencional. Se obtuvo un equivalente esférico postoperatorio promedio de -0,44D. El componente esférico medio después de la cirugía de cataratas fue de 0,50D, se reportó el 43, 75 por ciento emétropes, mientras el 37,50 por ciento resultaron hipermétropes. CONCLUSIONES: El método de Maloney es una opción efectiva para calcular el poder del lente intraocular después de cirugía refractiva corneal.

OBJECTIVE: To determine the effectiveness of Maloney´s method for the calculation of the intraocular lens in patients operated from refractive corneal surgery at "Ramón Pando Ferrer" Cuban Institute of Ophthalmology in 2007. METHODS: The implanted intraocular lens was estimated through the keratometry included in Maloney´s method using the SRK/T formula. Both the keratometry and the lens power, contributed by the conventional method and Maloney´s method, were statistically compared and also the preoperative refractive data with respect to postoperative data in the cataract surgery. RESULTS: The keratometries from Maloney´s method were lower whereas the lens powers were higher than those of the conventional method. The average postoperative spherical equivalent was -0.44D. The mean spherical component after the cataract surgery was 0.50D; 43.75 percent of patients were reported to be emmetropes and 37.50 percent were hypermetropes. CONCLUSIONS: Maloney´s method is an effective alternative for the calculation of the intraocular lens power after the refractive corneal surgery.

Situación de salud, una herramienta para la gerencia en los posgrados / Health situation, a management tool for postgraduate courses

El Análisis de Situación de Salud es una herramienta que busca transformar la complejidad de los determinantes y condicionantes de la salud en sus múltiples dimensiones, para mejorar el estado de salud y calidad de vida de la población. Acorde con la iniciativa continental de la Organización Panamericana de la Salud del año 2000 "La salud pública en las Américas" y con las políticas del gobierno venezolano en los programas de Posgrados de Gestión en Salud Pública y de Epidemiología del Instituto de Altos Estudios en Salud Pública "Dr. Arnoldo Gabaldon", se desarrolló el módulo de aprendizaje sobre el Análisis de Situación de Salud. Se utilizó el método de Hanlón como parte fundamental donde se aborda la salud desde la óptica gerencial o epidemiológica y los Análisis son construidos por los participantes con criterio multidisciplinario, intersectorial e interinstitucional. Con esta metodología se identifican y priorizan las necesidades con los actores sociales comunitarios, de ahí que el Análisis, sea una herramienta para el equipo de salud y para las comunidades mismas, que deben participar activamente dando a conocer la verdadera situación de salud que presentan, elemento fundamental para lograr los cambios necesarios.

The Health Situation Analysis is a tool that is looking for changing the complexity of health determinants and conditions in their range of dimensions, in order to improve the health status and the quality of life of the population. According to the continental initiative by the Pan American Health Organization in 2000 known as "Public Health in the Americas" and the Venezuelan government policies with respect to postgraduate programs in Health Public Management and Epidemiology of "Dr Arnoldo Gabaldón" Higher Public Health Education, the learning module on Health Situation Analysis was given. For this end, Hanlón´s method was used as a key element in which health is addressed from a managerial or epidemiological perspective, and the Analysis are made by the participants using multidisciplinary, intersectoral and interinstitutional criteria. This methodology allows identifying and giving priority to the needs with the involvement of community's social actors, hence, the Analysis becomes a tool for both the health team and the communities which should actively participate in providing true information about their real health situation - a fundamental element to make the necessary changes.

Two fast screening methods (GC-MS and TLC-ChEI assay) for rapid evaluation of potential anticholinesterasic indole alkaloids in complex mixtures

The pharmacotherapyfor Alzheimer's disease (AD) includes the use of acetylcholinesterase inhibitors (AChEI). Recent investigations for novel AD therapeutic agents from plants suggested that Tabernaemontana genus is a promising source of novel anticholinesterasic indole alkaloids. In this work two fast screening techniques were combined in order to easily identify novel cholinesterase inhibitors (ChEI). Gas chromatography-mass spectrometry (GC-MS) of the less polar alkaloidic fractions obtained from the acid-base extraction of the stalk of T. laeta revealed thirteen monoindole alkaloids, four of them confirmed by co-injection with previously isolated alkaloids. The others were tentatively identified by mass fragmentation analysis. By gas chromatography with flame ionization detection (GC-FID) and using isatin as internal standard, affinisine and voachalotine were determined as major compounds. These fractions and fourteen previously isolated alkaloids, obtained from root bark of T. laeta and T. hystrix were investigated for acetyl (AChE) and butyrylcholinesterase (BuChE) inhibitory activities by the modified Ellman's method in thin layer chromatography(TLC-ChEI). Results showed selective inhibition of the alkaloids heyneanine and Nb-methylvoachalotine for BuChE, and 19-epi-isovoacristine for AChE, whereas olivacine, affinisine, ibogamine, affinine, conodurine and hystrixnineinhibited both enzymes. In addition to confirming that monoterpenoid indole alkaloids can be novel therapeutic agents for AD, this is the first report of the ChEI activity of olivacine, a pyridocarbazole alkaloid.

Dentre os tratamentos da doença de Alzheimer (DA) está o uso de inibidores da enzima acetilcolinesterase. Pesquisas recentes visando a descoberta de novos agentes terapêuticos naturais para esta doença sugerem que o gênero Tabernaemontana é uma fonte promissora de alcalóides indólicos anticolinesterásicos. Neste trabalho, duas técnicas de análise em mistura foram associadas de modo a identificar facilmente novos inibidores colinesterásicos. A cromatografia em fase gasosa acoplada a espectrometria de massas (CG-EM) das frações alcaloídicas apolares, obtidas da extração ácido-base do caule de T. laeta, revelou a presença de treze alcalóides monoindólicos, quatro deles confirmados por co-injeção com padrões previamente isolados. Os outros alcalóides foram tentativamente identificados pelo padrão de fragmentação de massas. Por cromatografia em fase gasosa com detecção por ionização de chama (CG-DIC) e utilizando isatina como padrão interno, affinisina e voachalotina foram identificadas como substâncias majoritárias. As frações alcaloídicas obtidas e os quatorze alcalóides previamente isolados das raízes de T. laeta e T. hystrix foram analisados quanto à atividade inibitória das enzimas acetil (AChE) e butirilcolinesterase (BuChE) pelo método de Ellman em cromatografia em camada delgada (CCD-ChEI). Os resultados revelaram uma inibição seletiva dos alcalóides heyneanina e Nb-metilvoachalotina para BuChE e de 19-epi-isovoacristina para AChE, enquanto que olivacina, affinisina, ibogamina, affinina, conodurina e hystrixnina inibiram ambas as enzimas. Além de confirmar que alcalóides indólicos monoterpênicos são agentes terapêuticos promissores para o tratamento da DA, este é o primeiro relato da atividade anticolinesterásica de olivacina, um alcalóide piridocarbazólico.