[Prevalence of asthma and associated risk factors in schoolchildren from an area of indigenous population]. / Prevalencia de asma y factores de riesgo asociados en escolares provenientes de una zona de pueblos indígenas.

INTRODUCTION: The prevalence of asthma in Chile ranges from 10.2 to 14.9%. In previous studies, the Araucanía Region has not been included. OBJECTIVE: To determine the prevalence of asthma in the school po pulation of the Araucanía Region. SUBJECTS AND METHOD: The ISAAC questionnaires were used for asthma symptoms in addition to a questionnaire for recording sociodemographic data, belonging to the Mapuche ethnicity, type of heating, exposure to indoor air pollution, and family history. The Binomial Regression Model was used to evaluate the effect of each of the different variables of inter est, adjusting by age groups (6-7 and 13-14 years). The model also evaluated the additive interaction between these variables and age. RESULTS: 823 surveys were applied, where the prevalence of asthma was 14.2% and 23.2% in the 6-7 year old group and the 13-14 year old group, respectively. 43.7% de clare to be Mapuche, 32.9% live in rural areas, and 81.4% use firewood as a heating method. Through binomial regression model analysis, where for the study group, living in the coastal commune was significantly associated with a lower prevalence of asthma (-13.2% [CI: -17.7 to -8.6]. The history of an asthmatic mother was significantly associated with a higher prevalence of asthma (17.9% [CI: 2.7 to 33.1]. Living in a rural area, to be Mapuche or the type of heating used, showed differences statistically significant (p 0.18, p 0.609 and p 0.480, respectively) Conclusion: 13-14 year-olds school children in the Araucanía Region presented a higher prevalence of asthma. There was an association with asthma in the mother where this increase is not associated with living in a rural area, to be Ma puche or type of heating.

Myths and realities about knowledge, attitudes and practices of household contacts of tuberculosis patients.

SETTING: Five Colombian cities: Villavicencio, Pereira, Cucuta, Bucaramanga and Bosa. OBJECTIVE: To describe the knowledge, attitudes and practices related to tuberculosis (TB) in household contacts (HHCs) of TB patients. METHODS: A cross-sectional study was conducted. The estimated sample size required was 855. The World Health Organization guide 'Advocacy, communication and social mobilization for TB control: a guide to developing knowledge, attitude and practice surveys' was translated into Spanish and adapted to the dialect of each city. HHCs were invited to participate in the study and included if they agreed. RESULTS: We interviewed 878 HHCs. Most of them knew that TB was transmitted by airborne droplets; however, 52.2% also said that TB could be transferred from one person to another by sharing plates or clothes or shaking hands. Fifty-five per cent of HHCs acquired TB-related information from health care workers, and 44% from family members and friends. Fear was the main reaction reported by HHCs when they were informed of a TB diagnosis (60%). Eighty-five per cent of HHCs answered that the community rejects or avoids TB cases. CONCLUSION: There are significant gaps in the knowledge about TB and the stigmatisation associated with it. Educational strategies should be designed together with the community to demystify many misconceptions about TB.

Factors associated with ever use of mammography in a limited resource setting. A mixed methods study.

OBJECTIVE: To evaluate facilitators and barriers influencing mammography screening participation among women. DESIGN: Mixed methods study. SETTING: Three hospital catchment areas in Hidalgo, Mexico. PARTICIPANTS: Four hundred and fifty-five women aged 40-69 years. INTERVENTION: Three hundred and eighty women completed a survey about knowledge, beliefs and perceptions about breast cancer screening, and 75 women participated in semi-structured, in-person interviews. Survey data were analyzed using logistic regression; semi-structured interviews were transcribed and analyzed using elements of the grounded theory method. MAIN OUTCOME MEASURE: Women were categorized as never having had mammography or having had at least one mammogram in the past. RESULTS: From survey data, having had a Pap in the past year was associated with ever having had breast screening (odds ratio = 2.15; 95% confidence interval 1.30-3.54). Compared with never-screened women, ever-screened women had better knowledge of Mexican recommendations for the frequency of mammography screening (49.5% vs 31.7% P < 0.001). A higher percentage of never-screened women perceived that a mammography was a painful procedure (44.5% vs 33.8%; P < 0.001) and feared receiving bad news (38.4% vs 22.2%; P < 0.001) compared with ever-screened women. Women who participated in semi-structured, in-person interviews expressed a lack of knowledge about Mexican standard mammographic screening recommendations for age for starting mammography and its recommended frequency. Women insured under the 'Opportunities' health insurance program said that they are referred to receive Pap tests and mammography. CONCLUSIONS: Local strategies to reduce mammogram-related pain and fear of bad news should work in tandem with national programs to increase access to screening.

Technovigilance and risk management as tools to improve patient safety in colombian health care institutions / La tecnovigilancia y la gestión de riesgos como herramientas para mejorar la seguridad de los pacientes en las instituciones de salud colombianas / A tecnovigilância e a gestão de riscos como ferramentas para melhorar a segurança dos pacientes nas instituições de saúde colombianas

This paper presents the results of a survey about technovigilance carried out in 21 clinical institutions from the southwest of Colombia. It also provides an analysis of how these programs take into account different risk management methodologies in order to create awareness of the importance of patient safety in all members of the staff and improve the quality of the health services provided.

Este trabajo presenta los resultados de una encuesta acerca de la vigilancia tecnológica llevada a cabo en 21 instituciones de salud del suroeste de Colombia. Adicionalmente proporciona un análisis de cómo estos programas consideran diferentes metodologías de manejo de riesgos para crear conciencia en todos los empleados de la importancia de la seguridad de los pacientes y así mejorar la calidad de los servicios de salud prestados.

Este trabalho apresenta os resultados de uma pesquisa a respeito da vigilância tecnológica levada a cabo em 21 instituições de saúde do sudoeste da Colômbia. Adicionalmente proporciona uma análise de como estes programas consideram diferentes metodologias do controle de riscos para criar consciência em todos os empregados da importância da segurança dos pacientes e assim melhorar a qualidade dos serviços de saúde emprestados.

VUV and soft x-ray ionization of a plant volatile: Vanillin (C8H8O3).

Plant volatiles are emitted by plants in response to several forms of stress, including interaction with energetic photons. In the present work, we discuss the interaction of extreme UV and soft X-ray photons with a plant volatile, vanillin. The single and double (multiple) ionization of the vanillin molecule have been studied for the first time using time-of-flight mass spectrometry and VUV and soft X-ray photons (synchrotron radiation, at 12.0 eV, 21.2 eV, 130 eV, 310 eV, 531 eV, and 550 eV). At 12.0 and 21.2 eV, only singly charged species are observed and the parent ion, C8H8O3 (+), is the dominant species. Energy differences for some selected fragments were calculated theoretically in this energy region. At 130 eV, direct double and triple ionization of the valence electrons may occur. The fragmentation increases and CHO(+) becomes one of the main cations in the mass spectrum. The molecular ion is still the dominant species, but other fragments, such as C6H5O(+), begin to present similar intensities. At 310 eV, C 1s electrons may be ionized and Auger processes give rise to dissociative doubly ionized cations. Ionization around the O 1s edge has been studied both at the 531 eV resonance and above the ionization edge. Resonant and normal Auger processes play a significant role in each case and a large fragmentation of the molecule is observed at both photon energies, with intense fragments such as CHO(+) and CH3 (+) being clearly observed. A near edge X-ray absorption fine structure spectrum of the vanillin molecule was obtained around the O 1s ionization threshold. In addition, the fragmentation of vanillin has also been studied using a fast beam of electrons (800 eV), for the sake of comparison.

Acerca del título para la revista Médica de la Facultad de Medicina de la Universidad de Antioquia / About the title for the medical journal of the Faculty of Medicine, University of Antioquia

Por graciosa insinuación del Profesor Federico Díaz G., he tratado de investigar en las fuentes griegas un nombre adecuado para una revista de las cualidades científicas y académicas como la que se nos propone. Al leer a Lucrecio en el cuarto libro de su obra De rerum natura cuando hace la defensa de su obra encontramos los siguientes versos que transcribió literalmente y que viene como anillo al dedo Avia Pieridum peragro loca nullius ant Trita solo, juvat integros accederé fonte Et haurire, juvatque novos decerpere flore Insingnemque meo capiti petere inde corona Unde prius nulli velarint tempora musae… Realmente es una invocación a las Piérides para que le permitan transitar lugares no hollados antes por pié humano, llegar a la fuente misma de las cosas y beber en ella, recoger flores y hacer una corona para ceñir su cabeza que nunca antes les había sido permitido a las Musas para ornar sus cienes.

[Development of a nested polymerase chain reaction test for the diagnosis of transmissible gastroenteritis of pigs]. / Desarrollo de una prueba de reacción en cadena de la polimerasa anidada para el diagnóstico de la gastroenteritis transmisible del cerdo.

The aim of this study was to develop a nested polymerase chain reaction (nested PCR) for the rapid detection of transmissible gastroenteritis virus (TGEV) of pigs. The primers were designed on the basis of highly conserved regions of several TGEV sequences included in the analysis. External primers were used to amplify a fragment of the expected size (441 bp) in all the samples evaluated using reverse transcriptase polymerase chain reaction (RT-PCR), but with very low intensity. In the second amplification (nested PCR), internal primers were used to amplify a fragment of the expected size (168 bp), with good concentration. The performance of the test based on virus isolates in tissue culture and in clinical samples was judged good for the virological diagnosis of transmissible gastroenteritis of pigs.

Caracterización epidemiológica de pacientes con sospecha de atopía, evaluados mediante Prick test: IX Región (2007-2009) / Epidemiological characterization of patients with suspicion of atopy, evaluated through Prick test: IX Region (2007-2009)

Las enfermedades alérgicas constituyen una importante causa de morbilidad en la población general. OBJETIVO: Describir la distribución de la sensibilización para AI y AA mediante Prick test (PT), en una población seleccionada de pacientes de la Región de la Araucanía con sospecha clínica de atopía, según sexo, edad, etnia y estación del año durante los años 2007 al 2009. PACIENTES Y MÉTODO: Estudio de corte transversal, en un muestreo no probabilístico por conveniencia de 3055 pacientes, derivados para estudio mediante PT, al Centro de Diagnóstico y Tratamiento de Enfermedades Respiratorias desde Enero 2007 a Diciembre 2009. El PT se realizó con técnica estandarizada para AI y/o AA. Los datos fueron ingresados en el programa Microsoft Excel y analizados con el programa Stata 10.0. RESULTADOS: De un total de 3055 pacientes, 53,9 por ciento son mujeres, 4,8 por ciento son de etnia mapuche. El promedio de edad 20,7+/-19,13 años con un rango de 1 a 93 años. Del total de pacientes, 45,2 por ciento presentaron sensibilización para AI, 2,3 por ciento para AA y un 21 por ciento para ambos. CONCLUSIONES: En la población estudiada, se observó mayor sensibilización al polvo de habitación. Destaca la sensibilización a Dermatofagoide pteronyssinus en la población masculina, presentando una diferencia estadísticamente significativa con respecto a la población femenina.

The allergic diseases constitute an important reason of morbidity in the general population. AIM: Describe the distribution of the sensitization for AI and AA through Prick test (PT), in a selected population of patients from the Araucanía Region with clinical suspicion of atopy, according to sex, age, ethnic group and season of the year, during the years 2007 to 2009. PATIENTS AND METHODS: Transversal cut study, in a non-probability sample of 3055 patients, derived for study through PT to the Center of Diagnosis and Treatment of Respiratory Diseases from January 2007 to December 2009. The PT was realized by standardized technique for AI and / or AA. The information was ingresed by the program Microsoft Excel and analyzed by the program Stata 10.0. RESULTS: Of a total of 3055 patients, 53,9 percent are women, 4,8 percent are Mapuche. The average of age 20,7 +/-19,13years with a range from 1 to 93 years. Of the total of patients, 45,2 percent presented sensitization for AI, 2,3 percent for AA and 21 percent for both. CONCLUSIONS: In the population studied, we observed increased sensitization to house dust. Stresses the Dermatophagoides pteronyssinus sensitization in the male population, showing a statistically significant difference compared to the female population.

Mutational analysis of BRCA1 and BRCA2 genes in Mexican breast cancer patients.

Germline mutations in the BRCA1 and BRCA2 genes predispose to breast and ovarian cancer. A variable incidence of mutations has been reported for these genes. The contribution of BRCA1 and BRCA2 mutations to Mexican women with breast and/or ovarian cancer is not known. Because of the increasing prevalence of breast cancer in this population, it is necessary to study the presence of mutations in both genes. We screened BRCA1 and BRCA2 genes in 40 patients: 29 patients with a history of breast and/or ovarian cancer, and 11 patients with early-onset breast cancer (< 40 years), through denaturing high performance liquid chromatography analyses. We found two frameshift mutations in BRCA1 and one missense mutation in each gene. Additionally we found several intronic variants as well as synonymous mutations. We found 5% of deleterious mutations in the BRCA genes. Larger studies are needed to establish the significance and prevalence of BRCA mutations among Mexican women.

Carotid artery restenosis in a Hispanic population.

BACKGROUND AND PURPOSE: Carotid endarterectomy is one of the main surgical procedures used for carotid stenosis and its recurrence. Besides the setting of a randomized controlled trial for asymptomatic and symptomatic carotid artery stenosis, there is little information about the rate of restenosis after carotid endarterectomy in Hispanics. The purpose of this study is to describe the results of carotid endarterectomy on the basis of restenosis in a Hispanic population. METHOD: A retrospective revision of 47 endarterectomies performed on 43 patients by a single surgeon at the VA Caribbean Health Care System and Pavia Hospital, during an eight year period (1990-1998), was conducted. Information about endarterectomies, restenosis and known risk factors for carotid stenosis were obtained from medical records. RESULTS: Of the 43 patients, 31 were male (72%) and 12 female (28%), with a mean age of 67.9 years. Re-operations for recurrent carotid stenosis were performed in 2 patients (4.7%). Restenosis cases were asymptomatic, hence diagnosed through followup ultrasound Duplex studies and confirmed by angiography after 3 and 4 years of the first surgical procedure. The degree of restenosis (70% to 99%) after the initial endarterectomy was 4.3%. The major risk factors found among patients were hypertension (58%), hypercholesterolemia (50%), smoking (46%), and alcohol (34%). CONCLUSIONS: Carotid endarterectomy with primary closure is safe and durable. Repeated surgery using patch grafts in this Hispanic population was also safe. The concordance of risk factors and incidence of carotid stenosis correlated well with other studies.

Prevalence of Candida albicans and Trichomonas vaginalis in Pregnant Women in Havana City by an Immunologic Latex Agglutination Test / s. t

We aimed to estimate the prevalence of Candida albicans and Trichomonas vaginalis in immunocompetent pregnant women living in Havana City, Cuba, with or without symptoms of vaginitis, using a sample of 640 women from 6 Gyneco-obstetrics hospitals, which represents 2,5 percent of total yearly pregnant women. Diagnosis was made using a new latex agglutination kit (Newvagin C-Kure, La Habana, Cuba)...(AU)

[A comparative study of intravenous immunoglobulin and plasmapheresis preoperatively in myasthenia]. / Estudio comparativo entre inmunoglobulina intravenosa y plasmaféresis en el perioperatorio de la miastenia gravis.

INTRODUCTION: Thymectomy is a well established procedure in myasthenia gravis (MG). To reduce its morbidity, treatments which are effective in the short term, such as plasmapheresis and intravenous immunoglobulin (IGI) have been used. OBJECTIVE: To evaluate the efficacy and tolerability of the IGI, compared with plasmapheresis, in the preparation of myasthenic patients before thymectomy. PATIENTS AND METHODS: We compared a group of 33 prospective myasthenic patients treated with IGI with 38 clinical histories taken as controls treated by plasmapheresis during the peri operative period of thymectomy. RESULTS: The patients treated with IGI were in the intensive care unit and neurology ward for less time. The endotracheal tube was also removed sooner. However, these differences were not significant. The commonest complications of IGI were fever, shivering and phlebitis. The most frequent adverse reaction to plasmapheresis were cutaneous eruptions. One patient developed Hepatitis C after plasmapheresis. CONCLUSION: IGI is comparable in efficacy to plasmapheresis in the peri operative period of MG, but has a better profile of adverse reactions.

[Cost evaluation of two induced labor methods]. / Evaluación de los costos en 2 métodos inductores del parto.

Two induced labor methods, the venoclysis with oxitocin and the self-stimulation of the nipples, were comparatively evaluated in 2 groups of pregnant women (80) admitted at the Eastern Gyneco-obstetric and Teaching Hospital in Santiago de Cuba during the first semester of 1993. The following variables were calculated: drugs intake, material expenses, length of stay, and quality. A questionnaire was used to collect them. Percent and chi square were applied to these data, which were represented by tables. The self-stimulation of the nipples proved to be the most economical as regards the saving os spendable material and drugs. Hospital stay and the perinatal results connected with the type of labor and the newborn status were similar with both methods.

[Myocardial infarct and rupture of the left ventricular free wall. Some considerations on incidence, morphological characteristics and risk factors]. / Infarto del miocardio y ruptura de la pared libre del ventrículo izquierdo. Algunas consideraciones sobre la frecuencia, características morfológicas y factores de riesgo.

Rupture of the left ventricle free wall is a sudden and unexpected event in myocardial infarction. It is considered the third most common cause of death, following cardiogenic shock and arrhythmias. The frequency of rupture varies because many patients may survive the initial insult of myocardial infarction. Conflicting reports regarding risk factors have been published by several authors. With these considerations in mind, the present investigation was undertaken to evaluate ventricular rupture in an autopsy population from the Instituto Nacional de Cardiología. We analyzed the salient morphologic features and the risk factors. Our results indicated an incidence rate of 17.7% of cardiac rupture in patients who died of acute myocardial infarction and were autopsied. Ruptures are more common in elderly female patient during their first infarct, they were localized preferentially in the anterior wall and occurred within the first four days after infarction. Chance of rupture was greater in hypertensive patients, whereas a history of previous infarct protected against this contingency.

Fibrosis quística del páncreas en la IX región / Cystic fibrosis in southern Chile

Entre mayo de 1989 y diciembre de 1990 se estudiaron 200 pacientes pediátricos por sospecha clínica de fibrosis quística y 25 niños sanos como grupo comparativo. En todos se determinaron electrolitos en el sudor según técnica de Gibson y Cooke y en los pacientes hospitalizados estudio de absorción intestinal por medio de carotinemia, grasas en deposiciones (Van de Kamer) y quimotripsina en heces por método colorimétrico. En 7 niños cuya edad promedio fue 4,8 años (2 m - 9 años) se confirmó el diagnóstico de fibrosis quística por valores de sodio y cloro elevados en el sudor (> 60 mEq/1). En el grupo control de estos valores fueron inferiores (p < 0,005). La presentación clínica común fue de tipo respiratorio y el componente de insuficiencia pancreática exocrina fue evidenciado por el laboratorio. En todos hubo compromiso nutricional. En base a esta experiencia se desarrolló un equipo profesional multidisciplinario para el diagnóstico y control de los pacientes con fibrosis quística de nuestra región y zona sur del país

Venezuelan haemorrhagic fever.

An outbreak of severe haemorrhagic illness began in the municipality of Guanarito, Portuguesa State, Venezuela, in September, 1989. Subsequent detailed study of 15 cases confirmed the presence of a new viral disease, designated Venezuelan haemorrhagic fever. Characteristic features are fever, toxicity, headache, arthralgia, diarrhoea, conjunctivitis, pharyngitis, leucopenia, thrombocytopenia, and haemorrhagic manifestations. Other features include facial oedema, cervical lymphadenopathy, nausea/vomiting, cough, chest or abdominal pain, and convulsions. The patients ranged in age from 6 to 54 years; all were residents of rural areas in central Venezuela, and 9 died. Infection with Guanarito virus, a newly recognised arenavirus, was shown by direct culture or by serological confirmation in all cases. Epidemiological studies suggest that the disease is endemic in some rural areas of central Venezuela and that it is rodent-borne. Venezuelan haemorrhagic fever has many similarities to Lassa fever and to the arenavirus haemorrhagic fevers that occur in Argentina and Bolivia.