Malnutrition in all its forms and socioeconomic status in Bolivia.

OBJECTIVE: To estimate the prevalence of malnutrition (undernutrition and excess BMI) among children under the age of 5 years and women of reproductive age in Bolivia considering three socioeconomic indicators: wealth, education and ethnicity. DESIGN: We used the 2008 nationally representative Bolivian Demographic and Health Survey (DHS). Malnutrition's prevalence was estimated by wealth, ethnicity and educational level. Wealth index was measured based on the DHS methodology and nutritional status by using WHO standards and indicators. Education level (EL) was categorized by years of formal education. SETTING: Bolivia. PARTICIPANTS: In total, 5·903 children <5 years, 3·345 adolescent women (15-19 years) and 12·297 women (20-49 years) with available information on anthropometric measurements·. RESULTS: A disproportionate prevalence of malnutrition was observed among different wealth groups: lower wealth tertiles show the higher prevalence of stunting (>30 %) and anaemia (>40 %) in all ages· The prevalence of overweight and obesity tends to rise with age from childhood (10·02-11·60) to adolescence (27·9-31·03), reaching highest levels in women of reproductive age (56·02-57·76). According to wealth tertiles, higher prevalence of overweight and obesity was found in children of high tertile (12·23), adolescent women of low (32·56) and adult women of medium tertile (63·08). CONCLUSIONS: The present study shows that currently Bolivia is in a transitional stage, faces not only the problem of undernutrition but also those of overnutrition, showing strong inequalities according to socioeconomic and education status. This study calls for state-specific policies keeping in view of the nature of inequality in malnutrition in the country and its differential characteristics across wealth status.

A novel approach to systematically collect critical chloride contents in concrete in an open access data base.

A living data collection providing critical chloride contents for steel corrosion in concrete (Ccrit) is presented. The Ccrit values were measured on samples taken from engineering structures. This approach allows to overcome the well-known limitations of testing laboratory samples. The data are available in a public data repository. Currently, 46 Ccrit are reported (measured on four different structures). The database will continuously be updated. The database includes information about the structure, material properties, and local condition of the steel-concrete interface. For possible applications of this database and discussion refer to the related research article in Corrosion Science.

Chiral organocatalysts based on lipopeptide micelles for aldol reactions in water.

A comprehensive study of the self-assembly in water of a lipopeptide consisting of a sequence of l-proline, l-arginine and l-tryptophan with a hydrocarbon chain has been performed. Fluorescence assays were used to determine the critical aggregation concentration. In situ small-angle X-ray scattering (SAXS) and molecular dynamics simulations showed the presence of spherical micelles with diameters around 6 nm. In agreement with these results, cryo-TEM images showed globular aggregates with diameters ranging from ≈4 nm up to ≈9 nm. Furthermore, the lipopeptide catalytic activity has been tested for the direct aldol reaction between cyclohexanone and p-nitrobenzaldehyde, and we have observed that the self-association of the organocatalyst played a critical role in the enhanced activity. Water affects the selectivity, and poor results are obtained under neat reaction conditions. The location of the catalytic groups at the lipopetide/water solvent interface also endowed unusual selectivity in the catalyzed aldol reactions. Under optimized reaction conditions, high yields (up to >99%), good enantioselectivity (ee up to 85%) and high diastereoselectivity (ds up to 92 : 8) were obtained.

Registro de actividades de la Sociedad Española de Angiología y Cirugía Vascular, año 2008 / Activities register of the Spanish Society of Angiology and Vascular Surgery, year 2008

Objetivo. Describir la actividad asistencial, correspondiente al año 2008, de los Servicios/Unidades de Angiología y Cirugía Vascular en España. Pacientes y métodos. Estudio transversal. Se registraron los procedimientos quirúrgicos y endovasculares realizados en el año 2008 en 80 centros (correspondientes a 78 servicios/unidades de angiología y cirugía vascular) que aceptaron voluntariamente la participación en el registro. El instrumento de recogida de información fue un cuestionario específico, Registro Vascular (RV), utilizado por la Sociedad Española de Angiología y Cirugía Vascular (SEACV) en los últimos años (2000-2008). Se realizó un análisis descriptivo y se comparó el volumen de la actividad de los servicios acreditados para la docencia con el de los servicios no docentes. Resultados. El RV fue cumplimentado por 78 servicios/unidades, 34 de los cuales poseen acreditación para la docencia. Se produjeron un total de 51.177 ingresos hospitalarios, 18.161 (35,5%) urgentes y 33.016 (64,5%) programados con una estancia media global de 7,8 días. En la lista de espera, a fecha 31-12-2007, existía un predominio de pacientes con patología venosa (n = 10.514) frente a un menor número de casos con patología arterial (1.835). El detalle de la actividad quirúrgica en cirugía arterial directa comprende 2.168 procesos practicados en los troncos supraaórticos, 924 en miembros superiores, 138 en la aorta torácica/tóraco abdominal, 3.491 en el sector aortoilíaco anatómico (de los que 1.229 fueron realizados por AAA electivo y 466 por AAA urgente) y 1.281 vía extra-anatómica, 137 en los troncos viscerales digestivos, 54 en arterias renales, 2.656 en sector femoropoplíteo y 1.354 en sector femorodistal de los miembros inferiores(AU)

La cirugía venosa tuvo un alto predominio de varices con 22.868 procedimientos realizados. De los procedimientos endovasculares 774 correspondieron a TSA, 465 a MMSS, 1.226 a aneurismas de la aorta (torácica 162 y abdominal 1.064) y 4.925 a arterias de miembros inferiores. Los procedimientos endovasculares venosos, incluyendo embolizaciones de las venas pelvianas y fibrinólisis venosas, fueron 333. El número total de exploraciones del Laboratorio vascular ascendió a 259.753. El volumen de actuaciones, tanto quirúrgicas como endovasculares o del laboratorio vascular, es significativamente más elevado en los servicios docentes que en los no docentes. Conclusión. La participación de los servicios ha sido semejante a la de 2007 aunque ha bajado la participación de los servicios docentes. Según los datos obtenidos, en relación con 2007 se ha incrementado la actividad quirúrgica arterial y venosa, así como la endovascular, siendo la actividad de los servicios docentes superior a la de los no docentes. La lista de espera arterial y venosa también se ha incrementado(AU)

Objective. To describe the health care activities carried out by Angiology and Vascular Surgery Services/ Units in Spain during 2008. Patients and methods. Cross-sectional study. The surgical and endovascular procedures carried out in 2008 were recorded in the 80 hospitals (78 Angiology and Vascular Surgery Services/Units) that voluntarily agreed to participate in the register. The data collection tool was a specific questionnaire, the Vascular Register (RV), used by the Spanish Society of Angiology and Vascular Surgery (SEACV, in Spanish) in recent years (2000-2008). A descriptive analysis was made, and centres with teaching accreditation were compared with non-teaching centres as regards volume of activity. Results. The VR was completed by 78 Services/Units, 34 of which have teaching accreditation. There were a total of 51,177 hospital admissions, of which 18,161 (35.5%) were for emergencies and 33,016 (64.5%) were for programmed admissions, with an overall mean stay of 7.8 days. As of 31/12/2007, most of the patients on the waiting list had venous diseases (n=10,514) while a smaller number had arterial disease (1, 835). Direct arterial surgical activity consisted of 2,168 interventions in the supra-aortic trunk, 924 in upper limbs, 138 in the thoracic/thoraco-abdominal aorta, 3,491 in the anatomic aorto-iliac segment (of which 1,229 were for elective abdominal aortic aneurysms (AAA) and 466 for emergency AAA), and 1,281 interventions involving an extra-anatomic route, 137 in digestive tract arteries, 54 in renal arteries, 2,656 in the femoral-popliteal segment and 1,354 in the fem-oral-distal segment of the lower limbs(AU)

The most frequently performed intervention in venous surgery was for varicose veins, with 22,868 procedures. Of the endovascular procedures, 774 involved the supra-aortic trunk, 465 the upper limbs, 1,226 were for aortic aneurysms (162 thoracic and 1.064 abdominal), and 4,925 for lower limb arteries. A total of 333 venous endovascular procedures were performed, including pelvic vein embolization and venous fibrinolysis. In all, 259,753 examinations were carried out in the Vascular Laboratory. The volume of activity, including both surgical and endovascular interventions and non invasive vascular laboratory examinations, was significantly higher in teaching centres than in non-teaching centres. The waiting list for arterial and venous surgery has been increased in both, teaching and non teaching centres. Conclusions. The participation of centres has continued, although it remains insufficient. According to the data obtained, arterial and venous surgical activity and endovascular activity have increased compared to 2006, and teaching centres have a larger volume of activity than non-teaching centres. The waiting list for both, venous and arterial surgery, has increased(AU)

The gender composition of the medical profession in Mexico: implications for employment patterns and physician labor supply.

The gender composition of the medical profession is changing rapidly in many parts of the world, including Mexico. We analyze cross-sectional and longitudinal data on sex differences in physician employment from household employment surveys. The results suggest that Mexico is a particularly interesting example of the feminization of physician employment. Female enrollment in medical school increased from 11% in 1970 to about 50% in 1998. The increased participation of women in medicine seems to be accompanied by differences in employment patterns that could generate significant reductions in the total supply of physician hours of service. Women physicians are unemployed at a much higher rate than men and hence account for half of underused physician human capital. The results suggest that improved educational opportunities do not translate automatically into equal employment opportunities.

Intravenous BQ-123 and phosphoramidon reduce ventricular ectopic beats and myocardial infarct size in dogs submitted to coronary occlusion and reperfusion.

The aim of this work was to investigate the influence of endothelin on myocardial ischemia and reperfusion in anaesthetized dogs. Animals were submitted to left thoracotomy and 120 min of left anterior descending coronary occlusion, followed by 180 min of reperfusion. Arterial blood pressure and electrocardiogram (ECG) were recorded in order to analyze heart rate (HR)-pressure product and production of ectopic beats. Infarcted areas were identified by a macroscopic staining method and infarct size was expressed as percentage of risk zone. To inhibit the effects of endothelin in a group of animals, we administered intravenously an endothelin synthesis inhibitor (phosphoramidon) and in another group, an endothelin-1 A receptor blocker (BQ-123). Phosphoramidon decreased the HR-pressure product during reperfusion period, and both, phosphoramidon and BQ-123 decreased infarct size by 40% and the number of ventricular ectopic beats by 88% and 68%, respectively, as compared to the saline treated dogs. In conclusion, endothelin seems to play a deleterious role on the myocardium submitted to ischemia and reperfusion.