Tamaulipan thornscrub after fire: an analysis of the composition of species / Espinho de Tamaulipan após incêndio: uma análise da composição das espécies

Abstract Forest fires are a natural element in many terrestrial ecosystems, in Mexico one of the main causes of loss of vegetation coverage is related to them. Nevertheless, no research has been carried out in the Tamaulipan thornscrub communities regarding post-fire regenerative strategies of plant species, therefore, is important to generate knowledge about the ecological role of fire in them. The aim of this study is to characterize the arboreal and shrub vegetation of a Tamaulipan thornscrub community in the Northeast of Mexico after a fire. To determine the composition, diversity and structure of the floral community consisting of trees and shrubs, 6 square-shaped sampling sites of 1,600 m2 were established 3 years after the fire. Margalef (DMg), Shannon-Weiner (H') and Pretzsch (A) indices were calculated to determine the richness, diversity and vertical stratification of species, respectively.23 species, 21 genera and 14 families of vascular plants were registered. The most species were Fabaceae (6) and Rhamnaceae (3) and Cordia boissieri was the specie with greater ecological weight (IVI = 20.3%). The indexes of richness and true diversity (DMg = 3.16; D = 16.44) showed high values, which suggests that the post-fire area has a good regeneration and a high species diversity. With these results we can conclude that the fire is an important agent of change in successional stages of Tamaulipan thornscrub with high values of regeneration after a surface fire.

Resumo Os incêndios florestais são um elemento natural em muitos ecossistemas terrestres, no México uma das principais causas de perda de cobertura vegetal está relacionada a eles, no entanto, nenhuma pesquisa foi realizada nas comunidades de espinheiros de Tamaulipan sobre as estratégias regenerativas pós-fogo de espécies de plantas, portanto, é importante gerar conhecimento sobre o papel ecológico do fogo neles. O objetivo deste estudo é caracterizar a vegetação arbórea e arbustiva de uma comunidade de plantas espinhosas no Tamaulipas, nordeste do México após um incêndio. Para determinar a composição, diversidade e estrutura da comunidade vegetal constituída por árvores e arbustos, seis locais de amostragem em forma de quadrado de 1.600 m2 cada um, foram estabelecidos três anos após o incêndio. Índices de Margalef (DMg), Shannon-Weiner (H') e Pretzsch (A) foram calculados para determinar a riqueza, diversidade e estratificação vertical das espécies, respectivamente. Foram registradas 23 espécies, 21 gêneros e 14 famílias de plantas vasculares. As mais ricas foram Fabaceae (6) e Rhamnaceae (3), Cordia boissieri foi a espécie com maior peso ecológico (IVI = 20,3%). Os índices de riqueza e diversidade verdadeira (DMg = 3,16; D = 16,44) apresentaram valores elevados, o que sugere que a área pós-fogo apresenta boa regeneração e alta diversidade Vegetal. Com estes resultados podemos concluir que o fogo é um importante agente de mudança nos estágios sucessionais do espinho de Tamaulipan com altos valores de regeneração após um incêndio na superfície.

Tamaulipan thornscrub after fire: an analysis of the composition of species.

Forest fires are a natural element in many terrestrial ecosystems, in Mexico one of the main causes of loss of vegetation coverage is related to them. Nevertheless, no research has been carried out in the Tamaulipan thornscrub communities regarding post-fire regenerative strategies of plant species, therefore, is important to generate knowledge about the ecological role of fire in them. The aim of this study is to characterize the arboreal and shrub vegetation of a Tamaulipan thornscrub community in the Northeast of Mexico after a fire. To determine the composition, diversity and structure of the floral community consisting of trees and shrubs, 6 square-shaped sampling sites of 1,600 m2 were established 3 years after the fire. Margalef (DMg), Shannon-Weiner (H') and Pretzsch (A) indices were calculated to determine the richness, diversity and vertical stratification of species, respectively.23 species, 21 genera and 14 families of vascular plants were registered. The most species were Fabaceae (6) and Rhamnaceae (3) and Cordia boissieri was the specie with greater ecological weight (IVI = 20.3%). The indexes of richness and true diversity (DMg = 3.16; D = 16.44) showed high values, which suggests that the post-fire area has a good regeneration and a high species diversity. With these results we can conclude that the fire is an important agent of change in successional stages of Tamaulipan thornscrub with high values of regeneration after a surface fire.

Tamaulipan thornscrub after fire: an analysis of the composition of species

Abstract Forest fires are a natural element in many terrestrial ecosystems, in Mexico one of the main causes of loss of vegetation coverage is related to them. Nevertheless, no research has been carried out in the Tamaulipan thornscrub communities regarding post-fire regenerative strategies of plant species, therefore, is important to generate knowledge about the ecological role of fire in them. The aim of this study is to characterize the arboreal and shrub vegetation of a Tamaulipan thornscrub community in the Northeast of Mexico after a fire. To determine the composition, diversity and structure of the floral community consisting of trees and shrubs, 6 square-shaped sampling sites of 1,600 m2 were established 3 years after the fire. Margalef (DMg), Shannon-Weiner (H) and Pretzsch (A) indices were calculated to determine the richness, diversity and vertical stratification of species, respectively.23 species, 21 genera and 14 families of vascular plants were registered. The most species were Fabaceae (6) and Rhamnaceae (3) and Cordia boissieri was the specie with greater ecological weight (IVI = 20.3%). The indexes of richness and true diversity (DMg = 3.16; D = 16.44) showed high values, which suggests that the post-fire area has a good regeneration and a high species diversity. With these results we can conclude that the fire is an important agent of change in successional stages of Tamaulipan thornscrub with high values of regeneration after a surface fire.

Resumo Os incêndios florestais são um elemento natural em muitos ecossistemas terrestres, no México uma das principais causas de perda de cobertura vegetal está relacionada a eles, no entanto, nenhuma pesquisa foi realizada nas comunidades de espinheiros de Tamaulipan sobre as estratégias regenerativas pós-fogo de espécies de plantas, portanto, é importante gerar conhecimento sobre o papel ecológico do fogo neles. O objetivo deste estudo é caracterizar a vegetação arbórea e arbustiva de uma comunidade de plantas espinhosas no Tamaulipas, nordeste do México após um incêndio. Para determinar a composição, diversidade e estrutura da comunidade vegetal constituída por árvores e arbustos, seis locais de amostragem em forma de quadrado de 1.600 m2 cada um, foram estabelecidos três anos após o incêndio. Índices de Margalef (DMg), Shannon-Weiner (H) e Pretzsch (A) foram calculados para determinar a riqueza, diversidade e estratificação vertical das espécies, respectivamente. Foram registradas 23 espécies, 21 gêneros e 14 famílias de plantas vasculares. As mais ricas foram Fabaceae (6) e Rhamnaceae (3), Cordia boissieri foi a espécie com maior peso ecológico (IVI = 20,3%). Os índices de riqueza e diversidade verdadeira (DMg = 3,16; D = 16,44) apresentaram valores elevados, o que sugere que a área pós-fogo apresenta boa regeneração e alta diversidade Vegetal. Com estes resultados podemos concluir que o fogo é um importante agente de mudança nos estágios sucessionais do espinho de Tamaulipan com altos valores de regeneração após um incêndio na superfície.

[Celiac disease: descriptive study at the Anglo American clinic]. / Enfermedad celiaca: estudio descriptivo en la clínica Anglo Americana.

BACKGROUND: Celiac disease (CD) is a condition in which gluten intake develops an autoimmune response generating intestinal villous atrophy, causing malabsorption. Prevalence worldwide is approximately 1%, in our country it is not known. MATERIAL AND METHODS: Retrospective, descriptive, observational study in Anglo American Clinic between September 2004 and February 2012. We reviewed the medical charts, upper GI endoscopy reports and duodenal biopsy reports of all patients with positive anti TTG results, who were older than 18 years of age. RESULTS: We studied 39 cases, 26 (66.7%) women and 13 (33.3%) men. Mean age was 61.25 years. The symptoms were chronic diarrhea in 32 (82.1%), abdominal pain in 22 (56.4%), abdominal distention in 14 (35.9%), and others in lower frequency. Eight (20.5%) patients had anemia. Just 5 (12.8%) had upper endoscopy findings consistent with CD, and Marsh classification was: 0: 5 (12.7%), I: 1 (2.6%), II: 0 (0%), IIII A: 20 (51.3%), III B: 12 (30.8%) y III C: 1 (2.6%). CONCLUSIONS: CD should be considered as a differential diagnosis of patients with non-specific long-term gastrointestinal symptoms, extraintestinal symptoms should also be taken into account. Diagnosis should be made with anti TTG as the initial test and posteriorly with a duodenal biopsy for staging.

Enfermedad celiaca: estudio descriptivo en la Clínica Anglo Americana / Celiac disease: descriptive study in the Anglo American clinic

INTRODUCCIÓN: La enfermedad celiaca (EC) es una condición en la que la ingesta de gluten desencadena una respuesta de autoinmunidad que genera aplanamiento de las vellosidades intestinales causando malabsorción. La prevalencia mundial es de aproximadamente 1%. En nuestro país no es conocida MATERIALES Y MÉTODOS: Estudio retrospectivo, descriptivo y observacional realizado en la Clínica Angloamericana entre Septiembre del 2004 y Febrero 2012. Se revisaron las historias clínicas, reportes endoscópicos y reportes de biopsias duodenales de los pacientes con anti Transglutaminasa tisular (TTG) positiva, mayores de 18 años. Resultados: Se estudiaron 39 casos, siendo 26 (66.7%) mujeres y 13 (33.3%) varones. La edad media de diagnóstico fue 61.25 años. Los síntomas fueron diarrea crónica en 32 (82.1%), dolor abdominal en 22 (56.4%), distensión abdominal en 14 (35.9%) y otros en menor frecuencia. Ocho (20.5%) pacientes presentaron anemia. Solo 5 (12.8%) pacientes presentaron hallazgos endoscópicos compatibles con EC. La clasificación Marsh de las biopsias duodenales fueron 0: 5 (12.7%), I: 1 (2.6%), II: 0 (0%), III A: 20 (51.3%), III B: 12 (30.8%) y III C: 1 (2.6%). CONCLUSIONES: La EC debe ser considerada como diagnóstico diferencial de pacientes con síntomas gastrointestinales inespecíficos de larga data, teniendo en cuenta también sus manifestaciones extraintestinales. Para el diagnóstico debe utilizarse la anti TTG como prueba inicial y posteriormente realizar una biopsia duodenal para estadiaje.

BACKGROUND: Celiac disease (CD) is a condition in which gluten intake develops an autoimmune response genetaring intestinal villous atrophy, causing malabsorption. Prevalence worlwide is approximately 1%, in our country it is not known. MATERIAL AND METHODS: Retrospective, descriptive, observational study in Anglo American Clinic between September 2004 and February 2012. We reviewed the medical charts, upper Gl endoscopy reports and duodenal biopsy reports of all patients with positive anti TTG results, who were older than 18 years of age. RESULTS: We studied 39 cases, 26 (66.7%) women and 13 (33.3%) men. Mean age was 61.25 years. The symptoms were chronic diarrhea in 32 (82.1%), abdominal pain in 22 (56.4%), abdominal distention in 14 (35.9%), and others in lower frequency. Eight (20.5%) patients had anemia. Just 5 (12.8%) had upper endoscopy findings consistent with CD, and Marsh classification was: 0: 5 (12.7%), l: 1 (2.6%), ll: 0 (0%), llll A: 20 (51.3%), lll B: 12 (30.8%) y lll C: 1 (2.6%). CONCLUSIONS: CD should be considered as a differential diagnosis of patients with non-specific-long-term gastrointestinal symptoms, extraintestinal symptoms should also be taken into account. Diagnosis should be made with anti TTG as the initial test and posteriorly with a duodenal biopsy for staging.

Determination of metal impurities in advanced lead zirconate titanate ceramics by axial view mode inductively coupled plasma optical emission spectrometry.

An inductively coupled plasma optical emission spectrometry quantification method for the determination of Al, Ca, Cr Cu, Fe, Mn, Mg, Ni, Zn, Ba, K, In and Co in lead zirconate-titanate (PZT) ceramics, modified with strontium and chromium, was developed. Total digestion of ceramics was achieved with a HNO(3), H(2)O(2) and HF (ac) mixture by using a microwave furnace. The sensitivity of the net signal intensity respect to radiofrequency power (P) and nebulizer argon flow (F(N)) variations was strongly dependent of the total excitation energy of line (TEE). For lines with TEE near metastable atoms and ions of argon, an increment of the sensitivities to P and F(N) variation was observed. At robust plasma conditions the matrix effect was reduced for all matrices and analytes considered. The precision of analysis ranged from 3 to 13%, whereas the analytes recoveries in the spiked samples varied, mostly, from 90 to 110%. The detection limits of studied elements were from 0.004 to 10 mg kg(-1).

[Incidence and associated factors in ulcer bleeding recurrence post inyectotherapy with adrenaline]. / Incidencia y factores asociados en la recurrencia de sangrado ulceroso post inyectoterapia con adrenalina.

AIM: To determine the incidence and associated factors with upper gastrointestinal bleeding after injection therapy with adrenaline in a general hospital. STUDY DESIGN: longitudinal and analytic. Clinical records of patients with upper gastrointestinal bleeding who received injection therapy with adrenalin during 2005 and 2011 in Daniel Alcides Carrion Hospital, Peru were reviewed. Rebleeding and pre-endoscopic and endoscopic associated factors were sought. A bivariate (Chi Square, Fisher Exact test and RR) and multivariate analysis were performed. RESULTS: A total of 111 patients were included. Rebleeding rate was 20.7%. Multivariate analysis showed active bleeding (p=0.002) and anticoagulant drugs (p=0.035) were associated with rebleeding. CONCLUSION: Rebleeding rate was 20.7% and active bleeding as well as anticoagulant drugs use were associated factors.

Tratamiento de schwanomas vestibulares esporádicos mediante radiocirugía: estudio prospectivo de cohorte / Radiosurgical treatment of sporadic vestibular schwannomas: a prospective cohort study

Objetivo: Analizar los resultados iniciales de un estudio prospectivo en pacientes con schwanomas vestibulares tratados con radiocirugía en la Pontificia Universidad Católica de Chile. Material y método: Se presentan 17 pacientes portadores de schwanomas vestibularesesporádicos tratados con radiocirugía y seguidos entre 6 y 26 meses. El tratamiento fue realizado con acelerador lineal Varian clinac 21 EX, con equipamiento Varian-Zmed. La dosismarginal administrada al tumor fue de 12 a 12,5 Gray. El seguimiento a 6, 12 y 24 meses consta de resonancia magnética, audiometría y evaluación clínica. Resultados: La dosis marginal de irradiación usada fue entre 12 y 12,5 Gray normalizada a la isodosis 70% u 80%. En todos los pacientes se documentó disminución de la captación de contraste del tumor y en 16 (94%) se observaron áreas de necrosis centro tumoral. No hubo mortalidad, la preservación de audición útil fue 62,5% actuarial a 2 años. No ha existido deterioro de la función de los nervios facial ni trigémino. Todos los pacientes que previamente estaban trabajando retornaron a sus labores en promedio 11,5 días luego del tratamiento. Conclusiones: Los resultados iniciales de esta serie son comparables a los resultados publicados en la literatura y refuerzan el demostrado rol de la radiocirugía en el tratamiento de los schwanomas vestibulares.

Objective: To analyze the preliminary experience of radiosurgery for VestibularSchwannomas at the Pontificia Universidad Católica de Chile. Material and methods: The first 17 patients with sporadic Vestibular Schwannomas treated by radiosurgery at our institution are reported. The marginal dose used was 12 to 12.5 Gy. prescribed at the 70 or 80 isodose line. Patients were controlled at 6, 12 and24 months with magnetic resonance, audiometric study and clinical examination. Results: In all of the 17 patients treated a decrease tumor enhancement on MR was demonstrated. In 16 patients (94%) a pattern of central tumor necrosis was observedduring the firs year. Actuarial useful hearing was maintained in 62.5% at 2 year after treatment. Facial nerve function was maintained in all of the 15 patients with normal function at treatment (100%). Trigeminal function was maintained in all of the 14 patients (100%) with previous normal trigeminal function. The mean time to return to work or normal activities was 11.5 days after treatment Conclusions: These preliminary results are comparable with results published in theliterature and reinforce the demonstrate role of radiosurgery in the management of vestibular schwannomas.

[Autoimmune hepatitis with elevation of CA 19-9 and normalization with immunosuppressant [corrected]treatment: case report and review of the literature]. / Hepatitis autoinmune con elevacion de CA 19-9 y normalización con tratamiento inmunosupresor: reporte de caso y revisión de la literatura.

We describe the case of an 81 year old woman that presented with jaundice, bile duct dilation, hepatic liver tests abnormalities and elevated levels of CA-19-9 (741 UI). Intestinal and pancreatic neoplasia were ruled out. Hepatic biopsy revealed chronic inflammation, cirrhosis and findings consistent with autoimmune hepatitis. The patient was given a course of corticoids and the disease as well as levels of CA-19-9 returned to normal levels.

Hepatitis Autoinmune con elevacion de CA 19-9 y Normalización con tratamiento inmunosupresor: Reporte de Caso y Revisión de La Literatura / Autoimmune hepatitis with elevation of CA 19-9 and Normalization with immunosuppressive treatment: Case Report and Review of Literature

Describimos el caso de una mujer de 82 anos que se presento con ictericia, dilatación de colédoco, alteración de la bioquímica hepática y niveles elevados de CA-19.9 (741 UI). Se descartaron neoplasias pancreáticas e intestinales. La biopsia hepática mostróinflamación crónica, cirrosis y hallazgos consistentes con hepatitis autoinmune. La paciente recibió tratamiento con corticoides y tanto la enfermedad como los niveles de CA -19-9 regresaron a niveles normales.

We describe the case of an 81 year old woman that presented with jaundice, bile ductdilation, hepatic liver tests abnormalities and elevated levels of CA-19-9 (741 UI). Intestinaland pancreatic neoplasia were ruled out. Hepatic biopsy revealed chronic inflammation,cirrhosis and findings consistent with autoimmune hepatitis. The patient was given a courseof corticoids and the disease as well as levels of CA-19-9 returned to normal levels.

Multivariate analysis of Almendares River waters.

The Almendares River is the most important surface water body of the Cuban capital, Havana. In the present work, the environmental quality of waters was studied as a function of the following 14 variables: content of calcium, cadmium, iron, potassium, magnesium, manganese, sodium, nickel, zinc, chlorine, bicarbonate, and sulfate; pH; and electric conductivity parameters, which were reduced to three new variables by means of principal component analysis (PCA). The content of metal increased in waters sampled at stations located near garbage dumps and decreased inside the Ejercito Rebelde dam. The variation of the river water environmental quality with rainy and dry seasons and the differentiation of samples in three groups along the river course were obtained by PCA and corroborated by discriminant analysis. Applied statistical techniques showed their ability for environmental interpretation of limited experimental data.

¿Se está alcanzando el objetivo para las lipoproteínas de baja densidad en sujetos hipertensos con diabetes mellitus tipo 2, de acuerdo con las guías actuales? / Are we achieving the target low-density lipoprotein cholesterol level for patients with hypertension and type 2 diabetes according to American Diabetes Association criteria?

Objetivo: Evaluar el grado de control de los factores de riesgo para la enfermedad vascular (presión arterial [PA] y colesterol ligado a lipoproteínas de baja densidad [cLDL]) en adultos diagnosticados previamente de diabetes mellitus tipo 2 (DM2). Material y método: Analizamos los datos de una encuesta realizada durante el año 2005 en 129 sujetos diagnosticados previamente de DM2. Los participantes eran adultos de entre 20 y 80 años, que participaron tanto en la entrevista como en el examen. Los principales parámetros medidos fueron las concentraciones de cLDL y los valores de PA en referencia a los objetivos establecidos para personas con diabetes por la Asociación Americana de Diabetes (ADA). Se utilizó la media de un mínimo de 3 valores obtenidos a lo largo del año. Resultados: Sólo el 7,8% de los encuestados alcanzaron el objetivo de cLDL <100 mg/dL (un 9,8% en varones y un 6,4% en mujeres). El 45,7% de los participantes logró el objetivo de presión arterial sistólica (PAS) <130 mmHg y diastólica (PAD) <80 mmHg (un 51% en varones y un 42,3% en mujeres) y el 31,8% (un 31,4% en varones y un 32,1% en mujeres) tenía hipertensión (PAS ³140 o PAD ³80 mmHg). Sólo el 7,9% de los hipertensos adultos diagnosticados de DM2 logró el objetivo de cLDL <100 mg/dL. En total, sólo el 4,7% de los participantes cumplieron los objetivos recomendados para el cLDL y la PA. Todos los porcentajes son similares entre varones y mujeres. Conclusiones: Es necesario realizar esfuerzos más enérgicos en el campo de la salud pública para controlar los factores de riesgo de la enfermedad vascular en individuos diagnosticados de DM2

Objective: To evaluate the degree of control of risk factors for vascular disease in adults with previously diagnosed type 2 diabetes mellitus (DM2) undergoing regular ambulatory follow-up in an endocrinology department. Materials and method: We analyzed data from a survey conducted in 2005 in 129 adults with previously diagnosed DM2. Participants were adults aged 20 years old and older who participated in both the interview and examination. Main outcome measures: values of low-density lipoprotein cholesterol (LDL-C) and blood pressure with reference to the target goals for persons with diabetes established by the American Diabetes Association. The means of a minimum of three values obtained throughout the year were used. Results: Only 7.8% of the participants achieved the target LDL-C of less than 100 mg/dl (9.8% of the men and 6.4% of the women). Less than half of the participants (45.7%) achieved the target systolic blood pressure (SBP) of less than 130 mmHg and diastolic blood pressure (DBP) of less than 80 mmHg (51.0% of the men and 42.35% of the women), and 31.8% had hypertensive blood pressure values (SBP >140 mmHg or DBP >90 mmHg). Only 7.9% of hypertensive patients with type 2 diabetes achieved the target of LDL-C <100 mg/dL. Only 4.5% of adults with diabetes attained the recommended goals of LDL-C under 100 mg/dL and blood pressure below 130/80 mmHg. The values were similar in men and women. Conclusions: Further public health efforts are needed to control risk factors for vascular disease among individuals diagnosed as having DM2

Total and partial digestion of sediments for the evaluation of trace element environmental pollution.

Four different sample treatment methods for the determination of trace elements have been compared: a total digestion with HNO3-H2O2-HF using microwave, and three different standardized methods of fractionation: BCR three-steps sequential extraction, USEPA standard 3050B and ISO standard 11466. The four treatment methods were applied to the determination of Cu and Ni in four samples collected in different areas of Cienfuegos Bay (Cuba). The location of samples and the analytes were selected on the basis of results obtained by previous studies. Analyses following total digestion and BCR three-steps procedure were performed by inductively coupled plasma mass spectroscopy whereas analyses following EPA and ISO procedures were performed by flame atomic absorption spectroscopy. The results obtained have been compared with an estimated anthropic fraction evaluated in each sampling point as the difference between the total concentration and an estimated background concentration level. The BCR three-steps provided the best approximation of the estimated anthropic fraction and was therefore applied also in the determination of Pb and Cd for further consideration.

Utilidad del Homeostatic Model Assessment (HOMA-IR) como método para valorar la resistencia a la insulina en individuos que presentan al menos uno de los cinco criterios para síndrome metabólico definido por los criterios del NCEP-ATP-III / Utility of the Homeostatic Model Assessment (HOMA-IR) as method to value the insulin resistance in adults that present at least one of the five criteria for metabolic syndrome as defined by the NCEP-ATP-III

Objetivo: Establecer la utilidad del HOMA-IR como método matemático para valorar la resistencia a la insulina (RI) en individuos que presentan al menos uno de los cinco criterios para el diagnóstico del síndrome metabólico (SM) de acuerdo con el NCEP-ATPIII y correlacionarlo con métodos clínicos sencillos, como el índice de masa corporal (IMC) y el perímetro de cintura (PC). Material y métodos: Se analizan los datos de una encuesta realizada en el año 2004 en 125 individuos sin diabetes mellitus de entre 20 y 79 años que viven en Guayaquil (Ecuador), escogidos por presentar al menos uno de los cinco criterios del SM definido por el NCEP-ATP-III. A todos se les realizó un examen físico (IMC, PC y presión arterial [PA]) y determinaciones basales de laboratorio (glucosa, cHDL, triglicéridos e insulina) en búsqueda de los otros criterios. El HOMA-IR se calculó mediante la fórmula: Insulina plasmática en ayunas (mUI/L) 3 glucosa plasmática en ayunas (mmol/ L)/22,5. Se consideró RI cuando los valores HOMA-IR eran iguales o superiores a 2,8. Resultados: La prevalencia de RI fue del 57,6%. Los varones con obesidad central tuvieron un HOMA-IR más alto que aquéllos con obesidad no central (p <0,05). Las concentraciones plasmáticas en ayunas de triglicéridos (p <0,02), glucosa (p <0,02) e insulina (p <0,001) fueron más altas en las mujeres obesas con RI que en las mujeres obesas con sensibilidad normal a la insulina (SNI). Entre los varones, la concentración plasmática de insulina fue más alta en los obesos con RI que en aquellos con SNI (p <0,02). El IMC y las lipoproteínas de alta densidad (cHDL) no se diferenciaron estadísticamente en ninguno de los subgrupos. Conclusiones: La prevalencia de RI, medida a través del HOMA-IR, en individuos con alto riesgo de SM es alta. La utilización del HOMA-IR para evaluar a un paciente durante el diagnóstico constituye una herramienta muy útil por ser poco costosa, de fácil y rápida realización, poco invasiva y aportar información clínica de gran valor práctico. El PC puede servir como herramienta clínica sencilla para evaluar la obesidad central y es posible emplearlo para predecir qué individuos probablemente tienen SM, independientemente de la grasa corporal total calculada mediante el IMC

Objective: To establish the utility of HOMA-IR as a mathematical model to value the insulin resistance (IR) in adults having at least one of the 5 criteria of the metabolic syndrome (MS) as defined by the NCEP-ATP-III and to correlate it with simple clinical methods as the body mass index (BMI) and the waist circumference (WC). Material and methods: We analyzed data from a survey conducted in 2004 with 125 adults without diabetes mellitus aged >20 years living in the city of Guayaquil-Ecuador, chosen because they presented at least 1 of the 5 criteria of the MS defi ned by the NCEP-ATP-III. All of them were submitted to physical examination and measurement (BMI, WC, and blood pressure) and basal laboratory analyses (glucose, cHDL, triglycerides and insulin), in search of the other criteria. HOMAR-IR was calculated by means of the formula: plasmatic insuline before food intake (mUI/L) 3 plasmatic glucose before food intake (mmol/L)/22.5. It was considered IR when HOMA-IR values were equal or greates than 9.8. Results: The prevalence of IR was of 57.6%. Men with central obesity had an HOMA-IR higher than those with non central obesity (p <0.05). The plasmatic concentrations of triglycerides (p <0.02), glucose (p <0.02), and insulin (p <0.001) were higher in the obese women with IR than in obese women with normal insulin sensitivity (NIS). Among men the plasmatic concentration of insulin was higher in the obese ones with IR than in those with NIS (p <0.02). The BMI and the cHDL didn’t differ statistically in none of the subgroups. Conclusions: The prevalence of IR, measured through HOMA-IR, in adults with high risk of MS is high. The uses of HOMA-IR to evaluate a patient during the diagnosis constitutes a very useful tool because it is not very expensive, it is of easy and quick implementation, little invasive and it brings clinical information of great practical value. The WC can be a simple clinical tool to determine central obesity and it is possible to use it to predict which individuals would probably have the MS, independently of total body fat calculated by means of the BMI

Ultrasonido intraoperatorio en neurocirugía: aspectos técnicos / Intraoperative ultrasound in neurosurgery: technical aspects

Introducción. La ultrasonografía intraoperatoria en neurocirugía es una técnica útil, especialmente en la cirugía oncológica. Nuestro propósito es presentar los aspectos prácticos de su aplicación y a la vez describir nuestra experiencia inicial con su uso. Material y Métodos. Se empleó el ultrasonido TITAN™ de la empresa Sonosite Inc. Bothell, WA. USA con diferentes modelos de transductores. El estudio se realizó durante cuatro etapas de la cirugía: al realizar la craneotomía/laminotomía sobre la duramadre, al abrir duramadre sobre tejido neural, al resecar la lesión y posteriormente al cerrar la duramadre. Resultado. La identificación óptima de la lesión y de las estructuras anatómicas adyacentes se logró utilizando el transductor L38/5-10 Mhz. La adecuada visualización de las lesiones fue posible en todos los casos que se utilizó este transductor. No se logró una visualización adecuada en 2 casos en los cuales se utilizo el transductor C15/2-4 Mhz. Conclusión. La ultrasonografía intraoperatoria es útil en localizar lesiones e identificar estructuras anatómicas adyacentes. El transductor óptimo es uno que posea una cabeza de transductor pequeña plana (2.5cm x 1.5cm o menos) que emita frecuencias que oscilen entre 4-10 Mhz.

Concentraciones de hemoglobina glucosilada A1c, lipoproteínas de baja densidad y valores de presión arterial en adultos diagnosticados previamente de diabetes mellitus tipo 2 / Glycosylated hemoglobin A1c, low-density lipoproteins and blood pressure among adults with previously diagnosed diabetes

Objetivo: Evaluar el grado de control de los factores de riesgo para enfermedad vascular en adultos diagnosticados previamente de diabetes mellitus tipo 2 (DM2), que acuden de manera regular a la consulta ambulatoria de endocrinología. Material y método: Analizamos los datos de una encuesta conducida durante el año 2004 en 129 sujetos diagnosticados previamente de DM2. Los participantes eran adultos entre 20 y 80 años y participaron tanto en la entrevista como en el examen. Los principales parámetros medidos fueron las concentraciones de hemoglobina glucosilada A1c (HbA1c), el colesterol ligado a lipoproteínas de baja densidad (cLDL) y los valores de presión arterial (PA) en referencia a los objetivos establecidos para personas con diabetes por la Asociación Americana de Diabetes (ADA). Se utilizó el promedio de un mínimo de 3 valores obtenidos a lo largo del año. Resultados: El 20,2% de los participantes alcanzó el objetivo para HbA1c 8% (un 17,6% en varones y un 29,5% en mujeres), concentración por encima de los valores de HbA1c que recomiendan emprender acciones. Sólo el 7,8% de los participantes alcanzó concentraciones de cLDL = 140 o PAD >= 80 mmHg). Sólo el 1,6% de los adultos con DM consiguieron los 3 objetivos recomendados para HbA1c < 7%, PA < 130/80 mmHg y cLDL < 100 mg/dl. Conclusiones: Son necesarios esfuerzos más enérgicos en el campo de la salud pública para el control de los factores de riesgo para enfermedad vascular en individuos con DM diagnosticada

Objective: To evaluate the degree of control of risk factors for vascular disease in adults with previously diagnosed type 2 diabetes (DM2) undergoing regular ambulatory evaluation in an endocrinology department. Material and method: We analyzed data from a survey conducted in 2004 in 129 adults with previously diagnosed DM2. Participants were adults aged 20 years old and older who participated in both the interview and examination. Main outcome measures: values of glycosylated hemoglobin (HbA1c), low-density lipoprotein (cLDL) and blood pressure with reference to the target goals for persons with diabetes established by the American Diabetes Association. The means of a minimum of three values obtained throughout the year were used. Results: Only 20.2% of participants achieved the target goal of HbA1c level lower than 7.0% (19.6% in men and 20.5% in women) and 24.8% of participants were above the recommended "take action" HbA1c level of more than 8.0%. Only 7.8% of participants achieved the cLDL target of less than 100 mg/dl (9.8% in men and 6.4% in women). Less than half of the participants (45.7%) achieved the systolic blood pressure (SBP) target of less than 130 mmHg and diastolic blood pressure (DBP) target of less than 80 mmHg (51.0% in men and 42.3% in women), and 31.8% had hypertensive blood pressure values (SBP > 140 mmHg or DBP > 90 mmHg). Only 1.6% of adults with diabetes attained the recommended goals of HbA1c level lower than 7.0%, cLDL lower than 100 mg/dl, and blood pressure lower than 130/80 mmHg. Conclusions: Further public health efforts are needed to control risk factors for vascular disease among individuals with diagnosed diabetes

Metástasis cerebral y sobrevida / Survival of patients with brain metastases

Background: Brain metastases are the most common cerebral tumors, have a poor prognosis and their incidence is five times higher than primary brain tumors. Aim: To analyze the survival of patients with the diagnosis of brain metastases, operated in our institution. Patients and methods: We retrospectively reviewed all patients operated from January 1989 to December 2001, whose pathological diagnosis confirmed the presence of cerebral metastases. The death date of each patient was obtained from the analysis of death certificates, obtained from the computerized National Registry. Results: In 46 operated patients, the date of death was determined. In 23 of them, information about primary site of malignancy, type of surgery performed and adjunctive treatment with Holocerebral Radiotherapy (Rt) was obtained. The overall median survival time of the 46 patients was 29 weeks (range 4207). Thirty percent of patients were alive one year after surgery. Among those patients with complete clinical information, the median survival of 16 patients who received postoperative Rt was 41 weeks (range 12207), compared to a survival of 18 weeks (range 872), among those that did not receive Rt (p = 0.04). Conclusions: The median survival for patients operated for cerebral metastases in our institution is 29 weeks. Those who are operated and receive Rt, have a longer survival, than those who did not receive Rt.

Diagnosis of Chlamydia pneumoniae in community-acquired pneumonia in children in Chile.

UNLABELLED: The incidence of Chlamydia pneumoniae in community-acquired pneumonia in children was studied prospectively in 112 children aged 1 mo to 14 y. Diagnosis of C. pneumoniae was performed by polymerase chain reaction (PCR) on nasopharyngeal aspirates and serology by the microimmunofluorescence test on a single serum specimen. Three (2.7%) cases of pneumonia due to this agent were diagnosed by both PCR and serology. C. pneumoniae was not found in any of 62 children below 5 y of age. In the age group 5-8 y, only 1/30 (3%) was found positive, and in the age group 9-14 y, C. pneumoniae was diagnosed in 2/20 (10%) children. CONCLUSION: Although the number of enrolled patients is small, and the diagnostic techniques used may have some limitations, the results of this study suggest that C. pneumoniae.plays a minor role in the aetiology of pneumonia in children less than 9 y of age in our country. However, it should be considered as a potential agent in pneumonia in older children.

Osteopenia y osteoporosis en mujeres postmenopáusicas con diabetes mellitus tipo 2

El objetivo de este estudio fue evaluar la densidad mineral ósea (DMO) en mujeres postmenopáusicas con diabetes mellitus (DM) tipo 2 y compararla con la de mujeres postmenopáusicas sin esta patología (controles), de similar edad e índice de masa corporal (IMC) y reclutadas de la misma región geográfica.Formaron parte del estudio 69 mujeres menopáusicas sin terapia hormonal de reemplazo, que fueron clasificadas en dos grupos según tuvieran o no diagnóstico de DM tipo 2.Grupo I: 33 mujeres con DM tipo 2; edad: 65,3 ñ 8,3 años; IMC: 26,6 ñ 4,6 Kg/m2; edad de instalación de la menopausia: 41,5 ñ 10,3 años; años de postmenopausia: 22,4 ñ 10,7; duración de DM: 19,8 ñ 15,7 años.Grupo 11: n = 36; edad: 62,7ñ 9,7 años; IMC: 26,7 ñ 3,9 Kg/m2; edad de instalación de la menopausia: 43,9 ñ 10,0 años; años de postmenopausia: 17,4 ñ 11,6; sin DM conocida.Medimos la DMO por DEXA a nivel de columna lumbar (L2-L4) y cuello de fémur.Encontramos que en el grupo I la totalidad de las mujeres postmenopáusicas con DM tipo 2 tuvieron osteoporosis de columna lumbar (CL), el 30 por ciento osteoporosis de cuello femoral (CF) y el 70 por ciento osteopenia de CF. En el grupo II, el 92 por ciento de las mujeres postmenopáusicas sin DM tuvieron osteoporosis de CL, el 8 por ciento osteopenia de CL, el 44 por ciento osteoporosis de CF y el 56 por ciento osteopenia de CF (p = ns).Un mayor porcentaje de osteoporosis se evidenció, a nivel de CL comparado con el CF (p < 0,01). Por el contrario, a nivel de cuello femoral se observó un porcentaje mayor de osteopenia comparado con la CL (p < 0,001).En conclusión, este estudio demuestra que la pérdida de masa ósea es similar entre mujeres postmenopáusicas con DM tipo 2 y sus controles en ambas regiones analizadas (AU)