Glycerol valorization using Colombian olivine as a catalyst.

The biodiesel industry currently generates large amounts of crude glycerol that are not marketed, thus accumulating, and causing environmental problems. This study evaluates the catalytic potential of Colombian olivine, using glycerol steam reforming to assess valorization alternatives for this by-product. The analyzed olivine was thermally treated at 1200 °C and reduced at 900 °C, then producing nanometer-sized Fe compounds. The catalyst was characterized by X-ray diffraction (XRD), Brunauer-Emmett-Teller (BET) surface area, scanning electron microscopy (SEM), temperature-programmed reduction (TPR), and transmission electron microscopy (TEM). Calcined olivine increased glycerol conversion at 600 °C from 43% (without catalyst) to 96% with the formation of liquid-phase products such as aldehydes and carboxylic acids. In addition, syngas with H2/CO ratios of 1.1 and 1.5 was generated at reaction temperatures of 700 °C and 800 °C, respectively, with low CH4 content. Finally, it was established that olivine from Medellín, under the conditions used for glycerol steam reforming, is a viable and interesting alternative to valorize glycerol into gas- or liquid-phase products.

Metabolomic Profile of Insulin Resistance Women with Systemic Lupus Erythematosus.

The aims of this study were in systemic lupus erythematosus (SLE) patients: 1) to compare the metabolomic profile of insulin resistance (IR) with controls and 2) to correlate the metabolomic profile with other IR surrogates and SLE disease variables and vitamin levels. In this cross-sectional study, serum samples were collected from women with SLE (n=64) and gender- and age-matched controls (n=71), which were not diabetic. Serum metabolomic profiling was performed using UPLC-MS-MS (Quantse score). HOMA and QUICKI were carried out. Serum 25(OH)D concentrations were measured by chemiluminescent immunoassay. In women with SLE, the metabolomic Quantose score significantly correlated with HOMA-IR, HOMA2-IR, and QUICKI. Although concentrations of IR metabolites were not different between SLE patients and controls, fasting plasma insulin levels were higher and insulin sensitivity lower in SLE women. Interestingly, the Quantose IR score was significantly correlated with complement C3 levels (r=0.7; p=0.001). 25 (OH)D did not correlate with any metabolite or the Quantose IR index. Quantose IR may be a useful tool for IR assessment. There was a possible correlation between the metabolomic profile and complement C3 levels. The implementation of this metabolic strategy may help develop biochemical insight into metabolic disorders in SLE.

Insulin Resistance and Diabetes Mellitus in Patients with Systemic Lupus Erythematosus.

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by damage to multiple systems and a higher risk of cardiovascular disease. In addition, several studies have found that insulin resistance (IR) is more prevalent in SLE patients than controls, increasing the risk of prediabetes, type 2 diabetes mellitus (T2DM) and morbidity. The objective of this review article was to summarize the most relevant evidence about the relationship among IR, T2DM and SLE, including the effects of proinflammatory states, acute-phase proteins, pro-inflammatory cytokines, and pharmacological SLE treatment. A better understanding of the mechanisms involved in these comorbidities will allow better treatment strategies.

RNA transcript response by an Acidithiobacillus spp. mixed culture reveals adaptations to growth on arsenopyrite.

Biooxidation of gold-bearing refractory mineral ores such as arsenopyrite (FeAsS) in stirred tanks produces solutions containing highly toxic arsenic concentrations. In this study, ferrous iron and inorganic sulfur-oxidizing Acidithiobacillus strain IBUN Ppt12 most similar to Acidithiobacillus ferrianus and inorganic sulfur compound oxidizing Acidithiobacillus sp. IBUNS3 were grown in co-culture during biooxidation of refractory FeAsS. Total RNA was extracted and sequenced from the planktonic cells to reveal genes with different transcript counts involved in the response to FeAsS containing medium. The co-culture's response to arsenic release during biooxidation included the ars operon genes that were independently regulated according to the arsenopyrite concentration. Additionally, increased mRNA transcript counts were identified for transmembrane ion transport proteins, stress response mechanisms, accumulation of inorganic polyphosphates, urea catabolic processes, and tryptophan biosynthesis. Acidithiobacillus spp. RNA transcripts also included those encoding the Rus and PetI proteins involved in ferrous iron oxidation and gene clusters annotated as encoding inorganic sulfur compound metabolism enzymes. Finally, mRNA counts of genes related to DNA methylation, management of oxidative stress, chemotaxis, and motility during biooxidation were decreased compared to cells growing without mineral. The results provide insights into the adaptation of Acidithiobacillus spp. to growth during biooxidation of arsenic-bearing sulfides.

Insulin resistance metabolomic profile in non-diabetic women with systemic lupus erythematosus.

INTRODUCTION: Patients with systemic lupus erythematosus (SLE) have a higher prevalence of insulin resistance (IR) and metabolic syndrome (MetS) than controls. OBJECTIVE: To evaluate IR in non-diabetic women with SLE by means of biomarkers using high-throughput metabolomic techniques. METHOD: Cross-sectional study in patients with SLE. A metabolomic approach was employed using ultra-high performance liquid chromatography coupled with high-resolution mass spectrometry. MetS was evaluated according to NCEP-ATP III criteria. RESULTS: Seventy patients with SLE were included, out of whom 45 (64.2%) and 27 (38.5%) had IR and MetS, respectively. Patients with IR had a higher body mass index and hypertension more often than those without IR. Chronic damage and disease activity were not related to IR. A Quantose-IR score ≥ 63 was more common in patients with MetS (81.5 vs. 53.5%; p = 0.02). Quantose-IR score was also correlated with the number of criteria for MetS (r: 0.35; p = 0.003). CONCLUSIONS: In non-diabetic women with SLE, the prevalence of IR based on Quantose-IR score was 64.2%.

INTRODUCCIÓN: En lupus eritematoso sistémico (LES) es más frecuente la prevalencia de resistencia a la insulina (RI) y síndrome metabólico (SMet) que en controles. OBJETIVO: Evaluar la RI en mujeres no diabéticas con LES mediante biomarcadores usando técnicas metabolómicas de alta resolución. MÉTODO: Estudio transversal en pacientes con LES. Se empleó un abordaje metabolómico usando cromatografía de líquidos de ultra-alta resolución con espectrometría de masa de alta resolución. El SMet fue evaluado de acuerdo con los criterios NCEP-ATP III. RESULTADOS: Se incluyeron 70 pacientes con LES. Tuvieron RI y SMet 45 (64.2%) y 27 (38.5%), respectivamente. Pacientes con RI tenían un mayor índice de masa corporal e hipertensión con mayor frecuencia que aquellas sin RI. El daño crónico y la actividad de la enfermedad no se relacionaron con RI. Un puntaje de Quantose RI ≥ 63 fue más elevado en pacientes con SMet (81.5 vs 53.5%; p = 0.02). El puntaje Quantose RI también se correlacionó con el número de criterios para SMet (r: 0.35; p = 0.003). CONCLUSIONES: En mujeres con LES no diabéticas, la prevalencia de RI basada en el puntaje de Quantose RI fue del 64.2%.

Quo vadis Pantanal? Expected precipitation extremes and drought dynamics from changing sea surface temperature.

Climate change poses a critical threat to the Pantanal, the largest wetland in the world. Models indicate an increase in the frequency of extreme precipitation events and extended periods of drought. These changes can amplify consequences for Pantanal's ecological functioning, which has already experienced intensive human modification of its hydrological system and environmental health. The present study analyzed the spatial and temporal dynamics of rainfall and resulting extremes in the Brazilian area of the Upper Paraguay River Basin (UPRB) along with a co-evaluation of the global Sea Surface Temperature data (SST). The predicted results indicate that wet extreme precipitation events will become more frequent in the highlands, while severe and prolonged droughts triggered by warming SSTs in the Northern Hemisphere (North Atlantic and North Pacific oceans) will affect the Pantanal. The linear relations between precipitation with SST of very specific oceanic regions and even from specific oceanic indexes obtained in the present study significantly improve the forecasting capacity, mainly from a resulting reduction to two months of the lead-time between SST warming to concomitant precipitation impacts, and by explaining 80% of Pantanal´s precipitation variation from major oceanic indexes (e.g., ENSO, PDO, NAO, ATL3). Current SST trends will result in inter- and intra-annual flooding dynamic alterations, drastically affecting the Pantanal ecosystem functioning, with consequences for wildlife diversity and distribution. Regarding the foreseeable global climate and land use change scenarios, the results from the present study provide solid evidence that can be used at different decision-making levels (from local to global) for identifying the most appropriate management practices and effectively achieving sustainability of the anthropic activity occurring in the Pantanal.

Benign recurrent subcutaneous emphysema of the upper limbs in a teenager / Enfisema subcutáneo benigno recurrente de las extremidades superiores en una adolescente

Background: The physiological properties of the interstitial subcutaneous tissue of the limbs could bring the abnormal distribution of air coming from superficial trauma of the skin. We present the case of a young woman who developed subcutaneous emphysema after a superficial trauma and discussed the differential diagnosis and treatment. Clinical case: A teenager woman 13 years old had subcutaneous emphysema in the left arm, following the scratch produced by her cat, of two months of evolution, without signs suggestive of local or systemic infection, it was resolved spontaneously during the period of observation. During this period she also presented subcutaneous emphysema in the right arm as a complication of a peripheral venous access performed for the administration of parenteral solutions, in the same way, it resolved spontaneously within a few days. Conclusion: Benign subcutaneous emphysema is a rare clinical condition which should be considered only after the exclusion of other pathologies that require a more aggressive early medical intervention, such as necrotizing fasciitis, which, if not detected in a timely manner, could endanger life.

Introducción: las propiedades fisiológicas del tejido celular subcutáneo de las extremidades pudieran favorecer la distribución anormal de aire proveniente de traumatismos superficiales de la piel. Presentamos el caso de una joven mujer quien desarrolló enfisema subcutáneo posterior a traumatismos superficiales y discutimos el diagnóstico diferencial y tratamiento. Caso clínico: mujer de 13 años, con signos de enfisema subcutáneo en el brazo izquierdo, posterior al rasguño producido por su gato, de dos meses de evolución, sin signos sugestivos de infección local o sistémica, el cual remitió en forma espontánea durante el periodo de observación. Durante este lapso también presentó enfisema subcutáneo en el brazo derecho, como complicación de un acceso venoso periférico realizado para la administración de soluciones parenterales, igualmente remitió espontáneamente a los pocos días. Conclusión: el enfisema subcutáneo benigno es una condición clínica rara, debe considerarse únicamente después de la exclusión de otras patologías que requieren de una intervención médica temprana más agresiva como en la fascitis necrotizante, la cual de no ser detectada oportunamente pudiera poner en peligro la vida.

Reduced first-phase insulin secretion increases postprandial lipidemia in subjects with impaired glucose tolerance.

OBJECTIVE: It is not clear which phase of insulin secretion is more important to regulate lipoprotein lipase (LPL) activity. After a meal, insulin is released and acts as a major regulator of LPL activity. Postprandial hyperlipidemia is a common comorbidity in subjects with insulin resistance (IR). Therefore this study aimed to evaluate the role of the first-phase insulin secretion (FPIS) on postprandial lipidemia in subjects with IR and impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS: This is a cross-sectional, observational and comparative study. We included male and female subjects between 40 and 60 years with a body mass index (BMI) between 23 and 30 kg/m2. Then, patients were divided into three groups. Group 1 consisted of control subjects with normal glucose tolerance and preserved FPIS. Group 2 included patients with IGT and a reduced FPIS. Group 3 consisted of subjects with IGT but normal FPIS. Both groups were paired by age and BMI with subjects in the control group. Subjects underwent an intravenous glucose tolerance test to classify each case, and then a load with a mixed meal load to measure postprandial lipidemia. RESULTS: A total of 32 subjects were evaluated: 10 were control subjects, 8 subjects with IGT with a reduced FPIS and 14 subjects with IGT and preserved FPIS. After administration of a standardized meal, group 2 showed a greater glucose area under the curve (AUC) at 30 and 120 min (p=0.001, for both). This group also showed a statistically significant increase (p<0.001) in triglyceride AUC. CONCLUSIONS: A reduced FPIS is significantly and independently associated with a larger postprandial hyperlipidemia in subjects with IGT.

Easy Handling of Sensors and Actuators over TCP/IP Networks by Open Source Hardware/Software.

There are several specific solutions for accessing sensors and actuators present in any process or system through a TCP/IP network, either local or a wide area type like the Internet. The usage of sensors and actuators of different nature and diverse interfaces (SPI, I2C, analogue, etc.) makes access to them from a network in a homogeneous and secure way more complex. A framework, including both software and hardware resources, is necessary to simplify and unify networked access to these devices. In this paper, a set of open-source software tools, specifically designed to cover the different issues concerning the access to sensors and actuators, and two proposed low-cost hardware architectures to operate with the abovementioned software tools are presented. They allow integrated and easy access to local or remote sensors and actuators. The software tools, integrated in the free authoring tool Easy Java and Javascript Simulations (EJS) solve the interaction issues between the subsystem that integrates sensors and actuators into the network, called convergence subsystem in this paper, and the Human Machine Interface (HMI)-this one designed using the intuitive graphical system of EJS-located on the user's computer. The proposed hardware architectures and software tools are described and experimental implementations with the proposed tools are presented.

[Serum levels of vitamin D in systemic lupus erythematosus patients (SLE) and their relationship with disease activity: longitudinal study]. / Niveles séricos de vitamina D en pacientes con lupus eritematoso sistémico (LES) y su asociación con la actividad de la enfermedad: estudio longitudinal.

OBJECTIVE: To determine changes over time of serum levels of 25-hydroxy vitamin D (25(OH)D) in Mexican patients with SLE and their relationship with disease activity. MATERIALS AND METHODS: Longitudinal and observational study. Women with SLE were included. Serum levels of 25(OH)D were measured at baseline and after two years; the disease activity was measured with MEX-SLEDAI. Patients with initial suboptimal levels of 25(OH)D received supplements or increased doses of calcitriol. RESULTS: 105 women with SLE were included, mean age 49.4 ± 11 years. Serum levels of 25(OH)D were higher at two years (baseline 20 ± 6.8 vs. follow-up 22.7 ± 7.7; p = < 0.001). There were no differences between disease activity scores at baseline and two years (baseline 1.7 ± 1.9 vs. follow-up 1.1 ± 1.7; p = 0.7). Serum levels of 25(OH)D did not correlate with disease activity during the follow up, p = 0.7. No correlation was found between changes in MEX-SLEDAI scores and serum levels of 25(OH)D, p = 0.87. CONCLUSION: Mexican women with SLE had increased serum levels of 25(OH)D. No correlation between serum levels of 25(OH)D and disease activity was found.

Biooxidación de concentrados de arsenopirita por Acidithiobacillus ferrooxidans en erlenmeyer agitados / Biooxidation of arsenopyrite concentrates by Acidithiobacillus ferrooxidans in shake flasks

Se evaluó el proceso de biooxidación de concentrados de arsenopirita por A. ferrooxidans ATCC 23270, previa adaptación de los microorganismos al mineral y dos tamaños de partícula, pasante malla Tyler 200 (~75μm) y 325 (~45μm). También, se determinó el grado de concentración del mineral mediante DRX y MOLPP/LR, bajo norma ASTM D 2799 de 2009. Los microorganismos fueron adaptados mediante disminución gradual, en etapas sucesivas, de sulfato ferroso y posterior aumento en el contenido de arsenopirita. Finalmente, se llevó a cabo el proceso de biooxidación del mineral sin adición de Fe2+. Después de treinta días de proceso, la disolución de arsénico para la malla Tyler 200 fue de 7550 mgL-1 (18,7%) y para la malla Tyler 325 fue de 2850 mgL-1 (7,1%). Por otra parte, la curva de crecimiento bacteriano mostró que entre los días 6 y 21 de proceso la población bacteriana promedio fue de 1,70x108 cel.mL-1 y de 8,00x107 cel.mL-1 para las mallas Tyler 200 y 325, respectivamente.Por lo tanto, el tamaño de partícula jugó un papel fundamental en la cinética de adaptación de los microorganismos, sugiriendo que a menor tamaño del sustrato empleado mayor dificultad se le presenta al microorganismo para oxidar el mineral.

Arsenopyrite biooxidation process was evaluated with A. ferrooxidans ATCC 23270. The microorganisms were previously adapted to mineral and two different Tyler mesh sizes, 200 (~75μm) and 325 (~45μm). Also, the mineral concentration was made by DRX and MOLPP/LR under ASTM D 2799. The microorganisms were adapted through gradual decreasing of ferrous sulphate in successive state and subsequent arsenopyrite concentration increase. Finally, biooxidation process was carried out without Fe2+. After thirty days of process, Arsenic bioleaching was 7550 mgL-1(18,7%) and 2850 mgL-1 (7,1%) for the 200 and 325 Tyler meshes, respectively.On the other hand, bacterial growth curve showed, between 6 and 21 days of process that the average bacterial population was 1,70x108 cel.mL-1 y de 8,00x107 cel.mL-1 for 200 and 325 Tyler mesh respectively. For this reason, the particle size played an important role in the adaption kinetics of microorganism. The results showed that the microorganism oxide the larger particle size of the mineral easier.

Primary amenorrhea in two sisters: description of a Mexican family with 17α hydroxylase-17 lyase deficiency caused by arginine - stop mutation.

A rare cause of congental adrenal hyperplasia is 17α-hydroxylase deficiency. It results in sexual infantilism, primary amenorrhea in females, pseudohermaphroditism in males, hypertension, and hypokalemia. We studied two female siblings from a rural community in Mexico. The cause of consultation was primary amenorrhea. The proband had low levels of estrogen, progesterone and cortisol. Deoxycorticosterone and corticosterone levels were elevated. The proband was homozygous for a transversion of cytosine to thymine at exon 4 (CGA→TGA), causing a premature stop codon at position 239 (R239X). Analysis of family members showed the presence of this heterozygous mutation in the mother, father and one healthy sibling. In summary, we describe a Mexican family with 17α-hydroxylase deficiency due to R239X mutation.

Adenoma adrenal como etiología de síndrome de Cushing: veinte años de experiencia en un centro mexicano de tercer nivel / Adrenal adenoma as a cause of Cushing's syndrome: twenty years’ experience in a referral center in Mexico

Introducción El síndrome de Cushing (SC) incluye una amplia gama de manifestaciones clínicas y de laboratorio resultado final de la exposición crónica a glucocorticoides. Los adenomas adrenales son una causa infrecuente de SC en adultos. Objetivo Describir las características y la evolución de los pacientes con SC causados por adenomas adrenales en un hospital de tercer nivel. Métodos Se trata de un estudio retrospectivo, transversal, observacional. Se estudiaron individuos con el diagnóstico de SC causado por adenomas adrenales, en 20 años. Se describió la experiencia clínica en el diagnóstico y tratamiento. Resultados Se encontró un total de 20 pacientes, 19 mujeres y un hombre. Edad promedio 25,9 años (14 a 52). Los datos clínicos que se documentaron con mayor frecuencia fueron hirsutismo y cara de luna llena. La concentración promedio de cortisol basal fue de 2,9±10,7mcg/dl; del cortisol por la tarde 24,4±8,5mcg/dl y de corticotropina (ACTH) 24±19,4pg/ml. Sólo 4 pacientes (20%) tenían concentraciones de ACTH por debajo de 5pg/ml. Los resultados en las pruebas dinámicas con dexametasona sugirieron adenoma adrenal en el 100% de los casos. El 70% de los adenomas se encontraron en la glándula izquierda. El tamaño promedio de las lesiones fue de 2,8±0,47cm.Conclusiones En las pruebas dinámicas los criterios de no supresión con dosis altas de dexametasona estuvieron presentes en prácticamente todos los pacientes. La medición de ACTH en nuestro centro no resulta confiable para discriminar como causa de hipercortisolismo a los adenomas adrenales (AU)

Introduction Cushing's syndrome (CS) includes a wide range of clinical and laboratory abnormalities and is the final outcome of chronic glucocorticoid exposure. Adrenal adenomas are an uncommon cause of adult CS. Objective To describe the characteristics and outcome of patients with CS caused by adrenal adenomas in a referral center. Methods We performed a retrospective cross-sectional observational study of patients with a diagnosis of CS caused by adrenal adenomas managed in our center over a 20-year period. Our clinical experience in the diagnosis and treatment of this entity was analyzed.Results There were a total of 20 patients, 19 women and one man. The mean age was 25.9 years (14 to 52). The most frequently recorded clinical data were hirsutism and moon face. The mean morning cortisol level was 26.9±10.7mcg/dl, the mean afternoon level was 24.4±8.5mcg/dl and the mean corticotropin (ACTH) concentration was 24±19.4pg/ml. Only four patients (20%) had ACTH levels below 5pg/ml. The results of dynamic testing with dexamethasone suggested adrenal adenoma in 100% of the patients. Seventy percent of adenomas were found in the left gland. The mean size of the lesion was 2.8±0.47cm.Conclusions In dynamic testing, the criteria of non-suppression with high doses of dexamethasone were evident in almost all patients. ACTH measurement in our center was not reliable in identifying adrenal adenoma as a cause of CS (AU)

[Adrenal adenoma as a cause of Cushing's syndrome: twenty years' experience in a referral center in Mexico]. / Adenoma adrenal como etiología de síndrome de Cushing: veinte años de experiencia en un centro mexicano de tercer nivel.

INTRODUCTION: Cushing's syndrome (CS) includes a wide range of clinical and laboratory abnormalities and is the final outcome of chronic glucocorticoid exposure. Adrenal adenomas are an uncommon cause of adult CS. OBJECTIVE: To describe the characteristics and outcome of patients with CS caused by adrenal adenomas in a referral center. METHODS: We performed a retrospective cross-sectional observational study of patients with a diagnosis of CS caused by adrenal adenomas managed in our center over a 20-year period. Our clinical experience in the diagnosis and treatment of this entity was analyzed. RESULTS: There were a total of 20 patients, 19 women and one man. The mean age was 25.9 years (14 to 52). The most frequently recorded clinical data were hirsutism and moon face. The mean morning cortisol level was 26.9±10.7 mcg/dl, the mean afternoon level was 24.4±8.5 mcg/dl and the mean corticotropin (ACTH) concentration was 24±19.4 pg/ml. Only four patients (20%) had ACTH levels below 5 pg/ml. The results of dynamic testing with dexamethasone suggested adrenal adenoma in 100% of the patients. Seventy percent of adenomas were found in the left gland. The mean size of the lesion was 2.8±0.47 cm. CONCLUSIONS: In dynamic testing, the criteria of non-suppression with high doses of dexamethasone were evident in almost all patients. ACTH measurement in our center was not reliable in identifying adrenal adenoma as a cause of CS.

Continuous high-solids corn liquefaction and fermentation with stripping of ethanol.

Removal of ethanol from the fermentor during fermentation can increase productivity and reduce the costs for dewatering the product and coproduct. One approach is to recycle the fermentor contents through a stripping column, where a non-condensable gas removes ethanol to a condenser. Previous research showed that this approach is feasible. Savings of $0.03 per gallon were predicted at 34% corn dry solids. Greater savings were predicted at higher concentration. Now the feasibility has been demonstrated at over 40% corn dry solids, using a continuous corn liquefaction system. A pilot plant, that continuously fed corn meal at more than one bushel (25 kg) per day, was operated for 60 consecutive days, continuously converting 95% of starch and producing 88% of the maximum theoretical yield of ethanol. A computer simulation was used to analyze the results. The fermentation and stripping systems were not significantly affected when the CO(2) stripping gas was partially replaced by nitrogen or air, potentially lowering costs associated with the gas recycle loop. It was concluded that previous estimates of potential cost savings are still valid.

Evaluación de oxidación bacteriana de sulfuros con Acidithiobacillus ferrooxidans mediante pruebas de / Evaluating Acidithiobacillus ferrooxidans bacterial oxidation of sulphur compounds using FTIR and X-ray diffraction assays

Una cepa bacteriana nativa con capacidad de oxidar hierro ferroso y compuestos del azufre fue aislada a partir de efluentes y material de la mina de oro La Maruja, en el municipio de Marmato (Caldas), la cual fue identificada bioquímicamente como Acidithiobacillus ferrooxidans. Esta cepa fue evaluada en su capacidad de oxidar concentrados de sulfuros metálicos a dos diferentes concentraciones de pulpa y dos tamaños de partícula. Después de 15 días de biooxidación de los sulfuros se observó que, efectivamente, la bacteria mostró acción catalizadora sobre el proce-so de disolución del mineral.

Operación radical versus conservadora en algunos quistes hidáticos hepáticos: conducta con la adventicia / Radical vs. conservative surgery in some hydatic hepatic cysts: management of the adventitia

La adventicia de los quistes hidáticos del hígado evolucionados adquiere caracteres físicos de engrosamiento escleroso y calcificación que la hacen proclive a la infección y gravan los procedimientos operatorios que la abandonan total o parcialmente (quistectomía parcial). Ello da lugar a la propuesta de recurrir en todos los casos a la quistectomía total que elimina ese riesgo y crea otros. Es preciso discriminar el tipo de quistes que por aquellas características de su adventicia -y teniendo en cuenta también su tamaño y topografía- se prestan a la discusión entre su tratamiento conservador o radical o ambos. La infección posoperatoria de la adventicia residual tiene como causas principales la retención cavitaria en los procedimientos cerrados y la bilirragia cuando existe una comunicación quisto biliar. Si se evitan estas causales se puede tener una evolución con tolerancia de los restos de adventicia hidática en las quistectomías parciales. Lo que es perfectamente factible tan pronto se logre: 1) mantener la cavidad abierta hacia el peritoneo; 2) realizar la desconexión quisto-biliar; 3) evitar la colocación de tubos intracavitarios, 4) administrar antibioticoterapia preventiva. En contrapartida se resaltan los riesgos inconvenientes de las quistectomías totales

Estudio epidemiológico de hidatidosis: detección precoz por ultrasonido en áreas de alto riesgo / Epidemiologic survey of hidatidosis: early detection by ultrasound in high risk areas

6027 personas de siete poblaciones de "alto riesgo" en hidatidosis, del medio rural uruguayo, fueron sometidas a una encuesta epidemiológica y a relevamientos ecográficos hepáticos. Las encuestas demostraron que las condiciones siguen dadas para el automantenimiento de la enfermedad. El seguimiento y confirmación quirúrgica de la hidatidosis hepática en las personas con imágenes quísticas positivas, lleva a establecer un índice promedio de prevalencia en las poblaciones examinadas de 13,9 por mil. En 3593 microrradiografías realizadas concomitantemente no se encontraron quistes pulmonares. El predominio de las imágenes hialinas hepáticas en todos los grupos etarios nos habilita a afirmar que la enfermedad continúa siendo adquirida a lo largo de toda la vida. La frecuencia y el riesgo relativo son tanto mayores en el sexo masculino y a medida que aumenta la edad. El ultrasonido es un método idóneo para lograr su diagnóstico precoz. La existencia de un alto número de imágenes hialinas pequeñas(<5cm.) intrahepáticas, no pasibles de tratamiento quirúrgico llevó a establecer una instancia de vigilancia clínica y ecográfica sobre ellas. Este estudio nos permite reflejar con mejores bases la real prevalencia de la hidatidosis en aquellas poblaciones expuestas, llegar al diagnóstico en la etapa más útil antes de que aparezcan complicaciones y establecer un plan proyectivo para englobar a toda la campaña de este programa de atención primara en salud