Effect of Moderate- Versus High-Intensity Interval Exercise Training on Heart Rate Variability Parameters in Inactive Latin-American Adults: A Randomized Clinical Trial.

Ramírez-Vélez, R, Tordecilla-Sanders, A, Téllez-T, LA, Camelo-Prieto, D, Hernández-Quiñonez, PA, Correa-Bautista, JE, Garcia-Hermoso, A, Ramírez-Campillo, R, and Izquierdo, M. Effect of moderate- versus high-intensity interval exercise training on heart rate variability parameters in inactive Latin-American adults: a randomized clinical trial. J Strength Cond Res 34(12): 3403-3415, 2020-We investigated the effect of moderate versus high-intensity interval exercise training on the heart rate variability (HRV) indices in physically inactive adults. Twenty inactive adults were randomly allocated to receive either moderate-intensity training (MCT group) or high-intensity interval training (HIT group). The MCT group performed aerobic training at an intensity of 55-75%, which consisted of walking on a treadmill at 60-80% of the maximum heart rate (HRmax) until the expenditure of 300 kcal. The HIT group ran on a treadmill for 4 minutes at 85-95% peak HRmax and had a recovery of 4 minutes at 65% peak HRmax until the expenditure of 300 kcal. Supine resting HRV indices (time domain: SDNN = SD of normal-to-normal intervals; rMSSD = root mean square successive difference of R-R intervals and frequency domain: HFLn = high-frequency spectral power; LF = low-frequency spectral power and HF/LF ratio) were measured at baseline and 12 weeks thereafter. The SDNN changes were 3.4 (8.9) milliseconds in the MCT group and 29.1 (7.6) milliseconds in the HIT group {difference between groups 32.6 (95% confidence interval, 24.9 to 40.4 [p = 0.01])}. The LF/HFLn ratio changes were 0.19 (0.03) milliseconds in the MCT group and 0.13 (0.01) milliseconds in the HIT group (p between groups = 0.016). No significant group differences were observed for the rMSSD, HF, and LF parameters. In inactive adults, this study showed that a 12-week HIT training program could increase short-term HRV, mostly in vagally mediated indices such as SDNN and HF/LFLn ratio power. Trial registration. ClinicalTrials.gov NCT02738385 https://clinicaltrials.gov/ct2/show/NCT01796275, registered on March 23, 2016.

Cambios en el modelo de atención de personas con multimorbilidad crónica: una revisión narrativa / Changes in the care model of people with chronic multimorbidity: a narrative review

Introducción: Muchos países deben enfrentarse al rápido aumento de personas viviendo con alguna condición crónica de salud. En Chile, según datos entregados por la última encuesta nacional de salud, se ha estimado que la población con alguna condición crónica es de 11 millones de personas, de las cuales un 81% presenta multimorbilidad. Este grupo tiene una menor calidad de vida, una mayor mortalidad ajustada por edad, mayor utilización de recursos del sistema de salud, así como un mayor riesgo de hospitalización y una estadía hospitalaria más prolongada. Metodología: revisión narrativa de la literatura para lograr identificar como se ha organizado el cuidado de los pacientes con multimorbilidad a lo largo del tiempo y como se han ido desarrollando estrategias que buscan un abor-daje distinto. Resultados: los sistemas de salud se han organizado con un enfoque centrado en la enfermedad, lo que genera que los pacientes reciban un cuidado fragmentado, ineficiente e inefectivo, sin lograr dimensionar la complejidad de la persona y su contexto biopsicosocial. Los sistemas de salud, principalmente en Europa han desarrollado diversas iniciativas que buscan cambiar la perspectiva desde el cuidado centrado en la enfermedad al cuidado centrado en la persona Conclusiones: se puede concluir que la multimorbilidad es un problema que afecta a millones de personas en el mundo y que los servicios y sistemas de salud necesitan hacer un cambio hacia un modelo centrado en la persona de forma de dar respuestas a las necesidades de este grupo de pacientes.

Acute Effects of High Intensity, Resistance, or Combined Protocol on the Increase of Level of Neurotrophic Factors in Physically Inactive Overweight Adults: The BrainFit Study.

The purpose of this study was to compare the neurotrophic factor response following one session of high-intensity exercise, resistance training or both in a cohort of physically inactive overweight adults aged 18-30 years old. A randomized, parallel-group clinical trial of 51 men (23.6 ± 3.5 years; 83.5 ± 7.8 kg; 28.0 ± 1.9 kg/m2) who are physically inactive (i.e., < 150 min of moderate-intensity exercise per week or IPAQ score of <600 MET min/week for >6 months) and are either abdominally obese (waist circumference ≥90 cm) or have a body mass index, BMI ≥25 and ≤ 30 kg/m2 were randomized to the following four exercise protocols: high-intensity exercise (4 × 4 min intervals at 85-95% maximum heart rate [HRmax] interspersed with 4 min of recovery at 75-85% HRmax) (n = 14), resistance training (12-15 repetitions per set, at 50-70% of one repetition maximum with 60 s of recovery) (n = 12), combined high-intensity and resistance exercise (n = 13), or non-exercising control (n = 12). The plasma levels of neurotrophin-3 (NT-3), neurotrophin-4 (also known as neurotrophin 4/5; NT-4 or NT-4/5), and brain-derived neurotrophic factor (BDNF) were determined before (pre-exercise) and 1-min post-exercise for each protocol session. Resistance training induced significant increases in NT-3 (+39.6 ng/mL [95% CI, 2.5-76.6; p = 0.004], and NT-4/5 (+1.3 ng/mL [95% CI, 0.3-2.3; p = 0.014]), respectively. Additionally, combined training results in favorable effects on BDNF (+22.0, 95% CI, 2.6-41.5; p = 0.029) and NT-3 (+32.9 ng/mL [95% CI, 12.3-53.4; p = 0.004]), respectively. The regression analysis revealed a significant positive relationship between changes in BDNF levels and changes in NT-4/5 levels from baseline to immediate post-exercise in the combined training group (R2 = 0.345, p = 0.034) but not the other intervention groups. The findings indicate that acute resistance training and combined exercise increase neurotrophic factors in physically inactive overweight adults. Further studies are required to determine the biological importance of changes in neurotrophic responses in overweight men and chronic effects of these exercise protocols. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02915913 (Date: September 22, 2016).

Función endotelial y lipemia postprandial en adultos con presencia de criterios asociados a síndrome metabólico: efecto del estado nutricional / Endothelial function and postprandial lipemia in adults presenting criteria associated to metabolic syndrome: effect of nutritional state

Resumen Introducción : La lipemia postprandial se caracteriza por un aumento de las lipoproteínas ricas en triglicéridos y varios trabajos lo describen como un factor que determina la salud metabólica de un individuo. El objetivo del estudio fue cuantificar la contribución del sobrepeso en la magnitud de la lipemia postprandial en 33 sujetos con criterios asociados al síndrome metabólico (n = 20, sobrepeso y n = 13 eutróficos, 66% hombres, edad media 31,2 ± 7,6 años). Métodos: Estudio descriptivo y transversal. Se midió la vasodilatación mediada por el flujo, la velocidad de onda del pulso, el perfil lipídico, el cociente Log triglicéridos/lipoproteínas de alta densidad, la glucosa y la presión arterial tras una ingesta estándar alta en lípidos (79% Kcal/grasa). Se calculó el Z-score de riesgo cardiovascular a partir de la suma de los residuos tipificados (Z) de las variables bioquímicas. El estado de lipemia se midió en ayuno (0 min.) y a los (60, 120, 180, y 240 minutos) postprandiales. Resultados: El valor basal de la vasodilatación mediada por el flujo y la velocidad de onda del pulso fue de 6,9 ± 5,9% y 7,0 ± 0,8 m/s, respectivamente. Se identificó que la lipemia postprandial reducía la vasodilatación mediada por el flujo en 19,2% a los 60 minutos (5,9 ± 1,5%) y a los 240 minutos (3,7 ± 1,2%) (p = 0,04), respectivamente. Este hallazgo se acompañó con un aumento en la velocidad de onda del pulso (p < 0,05). Al dividir los sujetos en dos grupos según el índice de masa corporal, los participantes en sobrepeso muestran cifras más elevadas en el Zscore de riesgo cardiovascular, la velocidad de onda del pulso, el Log triglicéridos/lipoproteínas de alta densidad y el Δ-velocidad de onda del pulso, (p < 0,001). Conclusión: Este estudio demuestra que los sujetos clasificados en sobrepeso y que presentan criterios asociados al síndrome metabólico, muestran un perfil cardiometabólico asociado con un mayor riesgo cardiovascular, tras una ingesta alta en grasas.

Abstract Introduction: Postprandial lipemia is characterised by an increase in triglyceride-rich lipoproteins and several studies describe it as a factor that determines metabolic health of an individual. The motivation of the study was to quantify the contribution to overweight in the magnitude of the postprandial lipemia in 33 persons with criteria associated to metabolic syndrome (n = 20 being overweight and n = 13 eutrophic, 66% male, average age 31.2 ± 7.6 years). Methods: Cross-sectional descriptive study. Flow-mediated vasodilation, pulse wave velocity, lipid profile, log of the triglyceride/protein ratio, glucose and blood pressure were measured after high standard intake of lipids (79% Kcal/fat). Z-score for cardiovascular risk was calculated using the sum of typified residues (Z) of biochemical variables. Lipemia state was measured at fasting (0 min) and after 60, 120, 180 and 240 postprandial minutes. Results: Baseline flow-mediated vasodilation and pulse wave velocity values were 6.9 ± 5.9% and 7.0 ± 0.8 m/s, respectively. It was identified that postprandial lipemia reduced flowmediated vasodilation by 19.2% after 60 minutes (5.9 ± 1.5%) and after 240 minutes (3.7 ± 1.2%) (p = 0.04), respectively. This finding was paired with an increase in pulse wave velocity (p < 0.05). When dividing subjects into two groups according to their body mass index, overweight participants show higher Z-score cardiovascular risk values, pulse wave velocity, log of the triglyceride/protein ratio and the Δ pulse wave velocity (p > 0.001). Conclusion: This study reveals that overweight individuals showing criteria associated to metabolic syndrome have a cardiometabolic profile linked to a higher cardiovascular risk, after high intake of lipids.

Similar cardiometabolic effects of high- and moderate-intensity training among apparently healthy inactive adults: a randomized clinical trial.

BACKGROUND: Metabolic syndrome (MetS) increases the risk of morbidity and mortality from cardiovascular disease, and exercise training is an important factor in the treatment and prevention of the clinical components of MetS. OBJECTIVE: The aim was to compare the effects of high-intensity interval training and steady-state moderate-intensity training on clinical components of MetS in healthy physically inactive adults. METHODS: Twenty adults were randomly allocated to receive either moderate-intensity continuous training [MCT group; 60-80% heart rate reserve (HRR)] or high-intensity interval training (HIT group; 4 × 4 min at 85-95% peak HRR interspersed with 4 min of active rest at 65% peak HRR). We used the revised International Diabetes Federation criteria for MetS. A MetS Z-score was calculated for each individual and each component of the MetS. RESULTS: In intent-to-treat analyses, the changes in MetS Z-score were 1.546 (1.575) in the MCT group and -1.249 (1.629) in the HIT group (between-groups difference, P =  0.001). The average number of cardiometabolic risk factors changed in the MCT group (-0.133, P = 0.040) but not in the HIT group (0.018, P = 0.294), with no difference between groups (P = 0.277). CONCLUSION: Among apparently healthy physically inactive adults, HIT and MCT offer similar cardiometabolic protection against single MetS risk factors but differ in their effect on average risk factors per subject. Trial registration ClinicalTrials.gov NCT02738385 registered on March 23, 2016.

The Role of Clusterin in Carcinogenesis and its Potential Utility as Therapeutic Target.

Clusterin is a glycoprotein that has been implicated in many processes, including apoptosis, cell cycle regulation and DNA repair. Since clusterin expression has also been associated with tumorigenesis and the progression of various malignancies including prevalent tumors like prostate, colon, bladder and breast, this protein has been proposed as a good candidate for future treatments. There have been numerous studies conducted in cell lines and xenograft models with successful results that, in general, justify the use of clusterin as a therapeutic target. However, it is still necessary to continue with these studies in order to achieve a better understanding of the role of this protein in carcinogenesis and to determine those specific situations in which its therapeutic use may be more favorable. In this review, we will make a brief description of clusterin structure and genetics, its implication in tumorigenesis and cancer progression and its prognosis utility. Finally, we will analyze the effects of clusterin inhibition in different types of cancer.

Tripanosomátidos aislados de mamíferos silvestres en tres departamentos de Bolivia (Cochabamba, Potosí y Santa Cruz de la Sierra) / Trypanosomatidae isolated from wild mammals in three departments of Bolivia (Cochabamba, Potosi and Santa Cruz de la Sierra)

Objetivos: el objetivo de la investigación fue aislar protozoarios kinetoplástidos a partir de mamíferos silvestres en tres departamentos de Bolivia, con la finalidad de identificar reservorios de tripanosomátidos que podrían causar infección en diferentes reservorios y enfermedades en el humano. Métodos: Los mamíferos silvestres fueron capturados en el Chaco, valles interandinos y la zona tropical de Bolivia, utilizando trampas Sherman, Havahard y Tomahawk. Los animales capturados fueron anestesiados para realizar el xenodiagnóstico y la extracción de sangre por punción cardiaca; el aislamiento de tripanosomátidos se realizó por hemocultivo utilizando medios de cultivo NNN y su respectiva identificación por las técnicas de PCR-RFLP en el laboratorio de Biología molecular IIBISMED. Resultados: fueron capturados 236 mamíferos silvestres pertenecientes a 30 especies, de las cuales 7 especies presentaron infección por hemoflagelados. Trypanosoma cruzi fue aislado de Didelphis marsupialis, D. albiventris, Galea musteloides, Graomys domorum y Andalgalomis pearsoni; T.c marinkellei y T. dionisii fueron aislados de Carolia perspicillata (murciélagos) y otros kinetoplástidos no identificados por herramientas moleculares disponibles fueron aislados de mamíferos del género Graomys y Andalgalomys, capturados en las provincias Campero de Cochabamba y Cordillera del departamento de Santa Cruz. Conclusiones: El T. cruzi, T.c. marinkellei, T. dionisii y otros tripanosomátidos se encuentran infectando a marsupiales (Didelphis), roedores (Graomys y Andalgalomys) y cobayos silvestres (Galea) los cuales se encuentran en su ciclo silvestre en las zonas estudiadas.

Objectives: The aim of this research was isolate kinetoplastid protozoan from wild mammals in three departments of Bolivia, to identify Trypanosomatids reservoirs that could cause infection in different reservoirs and disease in humans. Methods: The wild mammals were caught in the Chaco, valleys and the tropical zone of Bolivia, using Sherman, Havahard and Tomahawk traps. Captured animals were anesthetized and xenodiagnosis and blood cardiac puncture was performed; trypanosomatides isolation using blood culture was done in NNN culture media and the respective identification was performed by PCR-RFLP techniques in the molecular biology laboratory of IIBISMED. Results: 236 wild mammals belonging to 30 species were captured, of which 7 species showed infection by hemoflagellates. Trypanosoma cruzi was isolated from Didelphis marsupialis, D. albiventris, Galea musteloides, Graomys domorum and Andalgalomis pearsoni; T.c. marinkellei and T. dionisii were isolated from Carolia perspicillata (bats) and other kinetoplastid not identified by available molecular tools were also isolated from Andalgalomys and Graomys mammals genus, from Campero and Cordillera provinces of Cochabamba and Santa Cruz. Conclusions: The T. cruzi, T.c. marinkellei, T. dionisii and other trypanosomatids are infecting marsupials (Didelphis), rodents (Graomys and Andalgalomys) and wild guinea pigs (Galea) which are found in a sylvatic cycle in the studied areas.

Influence of physico-chemical parameters of the aquatic medium on germination of Eichhornia crassipes seeds.

The germination of seeds of Eichhornia crassipes in locations distant from the foci of infestation may be a means of dispersal of this invasive plant. Nonetheless, no modern studies have examined the influence of single components on germination, although the influence of temperature, oxygen and redox potential was examined in earlier studies. The effects of pH, conductivity, nitrate, phosphate, potassium, calcium, iron and boron on germination of E. crassipes were determined in seed germination tests. The results showed that external input of nutrients influences germination, since neither pH nor conductivity alone had any effect, but there was a significant increase in germination in growth media containing phosphorus at 3.95 mg·l(-1) (P/L; 95.5%) and boron at 10 mg·l(-1) (B/L; 97.5%); at higher concentrations, the latter was toxic. These findings contribute to knowledge of factors controlling the germination of E. crassipes seeds. Consequently, E. crassipes seeds would find very good conditions for germination in water classified as hypereutrophic, which may play a decisive role in expansion of this plant.

[Results of a private primary health system based on a family health care model in Chile]. / Resultados de un sistema de atención privado basado en un modelo de salud familiar en Chile.

BACKGROUND: The health care network of a University in Chile started a family based primary health care system using pre paid model as financing. AIM: To describe the results of this family Health Care Center. MATERIAL AND METHODS: Between 1999 and 2006, the Pontificia Universidad Catolica-Health Network offered a family care plan characterized by a preferential access to a Family Care Center (CSF), that coordinated and solved all health care needs. Several indicators and perception of satisfaction were used to assess the results of this plan, in 2003 and 2004. RESULTS: During the study period, 5,402 people were attended. Seventy three percent of these were aged between 15-44 years. The waiting lapse was less than 48 hours for medical appointments and less than 30 days for programmed surgical procedures. The coverage of preventive actions varied from 26% of mammographies among women between 25 to 69 years old to 100% for healthy child care among newborns. Thirty one percent of diabetics achieved a glycosilated hemoglobin of less than 7% and 19% of hypertensive subjects achieved blood pressure values below 135/85 mmHg. Family physicians had 2.3 appointments per person per year and solved 85% of the medical problems that motivated the consultation. In average, 88% of interviewed subjects evaluated the attention received as very good or excellent. CONCLUSIONS: The application of this model in the private sector achieves measurable health care results with a good degree of client satisfaction.

Resultados de un sistema de atención privado basado en un modelo de salud familiar en Chile / Results of a private primary health system based on a family health care model in Chile

Background: The health care network of a University in Chile started a family based primary health care system using pre paid model as financing. Aim: To describe the results of this family Health Care Center. Material and Methods: Between 1999 and 2006, the Pontificia Universidad Catolica-Health Network offered a family care plan characterized by a preferential access to a Family Care Center (CSF), that coordinated and solved all health care needs. Several indicators and perception of satisfaction were used to assess the results of this plan, in 2003 and 2004. Results: During the study períod, 5,402 people were attended. Seventy three percent of these were aged between 15-44 years. The waiting lapse was less than 48 hours for medical appointments and less than 30 days for programmed surgical procedures. The coverage of preventive actions varied from 26 percent of mammographies among women between 25 to 69 years old to 100 percent for healthy child care among newborns. Thirty one percent of diabetics achieved a glycosilated hemoglobin of less than 7 percent and 19 percent of hypertensive subjects achieved blood pressure values below 135/85 mmHg. Family physicians had 2.3 appointments per person per year and solved 85 percent of the medicalproblems that motivated the consultation. In average, 88 percent of interviewed subjects evaluated the attention received as very good or excellent. Conclusions: The application of this model in the private sector achieves measurable health care results with a good degree ofclient satisfaction.

[Critical appraisal: combined T3 and T4 replacement therapy is not better than replacement with T4 alone]. / Análisis crítico de un artículo:La terapia de reemplazo con la combinación de T3 con T4 no sería mejor que T4 sola en pacientes hipotiroideos.

Conflicting results have recently been published about the benefits of combined thyroxine (T4) and triiodothyronine (T3) in treating hypothyroid patients. However these studies may have been underpowered to detect differences in psychological well-being specifically related to thyroxine replacement. We conducted a large, double-blind, randomized controlled trial of partial substitution of 50 microg of T4 by 10 microg of T3 (T3) vs placebo (T4 alone - 50 microg of T4 replaced) in 697 hypothyroid patients. Thyroid function showed a rise in the TSH (132%), a fall in Free T4 (35%, P <0.001) and unchanged basal Free T3 levels (P=0.92). At 3 months there was a large (39%) <> improvement in <> defined by the General Health Questionnaire 12 score (GHQ 12) in the control group compared with baseline and this was sustained at 12 months. Differences vs the intervention (T3) group were more modest with improvements in GHQ caseness (OR - 0.61; 95% CI: 0.42, 0.90; P=0.01) and HADS anxiety scores at 3 months (P <0.03) but not GHQ Likert scores, HADS depression, thyroid symptoms or visual analog scales of mood and the initial differences were lost at 12 months. These results may be consistent with a subgroup of patients showing transient improvement following partial substitution with T3 but do not provide conclusive evidence of specific benefit from partial substitution of T4 by T3 in patients on thyroxine replacement. They also emphasize the large and sustained <> that can follow changes in thyroid hormone administration.

Análisis crítico de un artículo: La terapia de reemplazo con la combinación de T3 con T4 no sería mejor que T4 sola en pacientes hipotiroideos / Critical appraisal: Combined T3 and T4 replacement therapy is not better than replacement with T4 alone

Conflicting results have recently been published about the benefits of combined thyroxine (T4) and triiodothyronine (T3) in treating hypothyroid patients. However these studies may have been underpowered to detect differences in psychological well-being specifically related to thyroxine replacement. We conducted a large, double-blind, randomized controlled trial of partial substitution of 50 microg of T4 by 10 microg of T3 (T3) vs placebo (T4 alone - 50 microg of T4 replaced) in 697 hypothyroid patients. Thyroid function showed a rise in the TSH (132%), a fall in Free T4 (35%, P <0.001) and unchanged basal Free T3 levels (P=0.92). At 3 months there was a large (39%) ®placebo effect¼ improvement in ®psychiatric caseness¼ defined by the General Health Questionnaire 12 score (GHQ 12) in the control group compared with baseline and this was sustained at 12 months. Differences vs the intervention (T3) group were more modest with improvements in GHQ caseness (OR - 0.61; 95% CI: 0.42, 0.90; P=0.01) and HADS anxiety scores at 3 months (P <0.03) but not GHQ Likert scores, HADS depression, thyroid symptoms or visual analog scales of mood and the initial differences were lost at 12 months. These results may be consistent with a subgroup of patients showing transient improvement following partial substitution with T3 but do not provide conclusive evidence of specific benefit from partial substitution of T4 by T3 in patients on thyroxine replacement. They also emphasize the large and sustained ®placebo effect¼ that can follow changes in thyroid hormone administration.

Overexpression of clusterin in human breast carcinoma.

Clusterin has been implicated in numerous processes including active cell death, immune regulation, cell adhesion and morphological transformation. The purpose of this study was to examine clusterin expression in a large series of breast carcinomas by immunohistochemistry and in situ hybridization. The study included 40 samples of non-neoplastic glandular epithelia, 42 benign lesions, 15 atypical intraductal hyperplasias, 35 carcinomas in situ, 114 invasive carcinomas, and lymph node metastases from 40 patients. Epithelial normal cells were always negative for clusterin expression and only 19% of the benign lesions presented positive staining. In contrast to the benign lesions, however, the frequency of clusterin positive samples increased in atypical hyperplasias (47%, P = 0.08), intraductal carcinomas (49%, P = 0.01) and invasive carcinomas (53%, P < 0.001). Positive staining presented a cytoplasmic pattern, except in 3 cases of invasive carcinomas which had nuclear staining. Clusterin mRNA by in situ hybridization confirmed the specific cellular pattern of clusterin expression by immunohistochemistry. Clusterin expression was associated with large tumor size (P = 0.04), estrogen and progesterone receptor negative status (P = 0.02 and P = 0.001, respectively) and with the progression from primary carcinoma to metastatic carcinoma in lymph nodes (80% metastatic nodes had positive expression) (P = 0.004). Ten of 15 (67%) primary carcinomas without clusterin expression became positive in lymph node metastases, while most (22 of 25, 88%) of the clusterin-positive primary carcinomas were also immunoreactive in metastases. In survival analysis, clusterin expression did not represent a prognostic indicator by uni- or multivariate analysis. The increased clusterin expression in breast carcinomas tended to correlate inversely with the apoptotic index (P = 0.09) which indicates that clusterin gene expression is not a prerequisite to cellular death by apoptosis. From these results, we suggest that clusterin may have a role in tumorigenesis and progression of human breast carcinomas.

Función tiroidea en una población con aporte extra de yodo / Thyroid function in a population with an extra iodine intake

Background: After 20 years of iodine salt fortification, the prevalence of goiter has decreased significantly in the rural area of Pirque, central Chile. In this location, equipment has been installed that efficiently and economically adds 0.5 mg of elemental iodine per liter of water to render it potable. Aim: To study thyroid function and urinary iodine excretion in scbool age cbildren of this zone, after two years of extra iodine intake. Material and methods: One hundred thirty four children aged 6 to 12 years old were examined. In 56 randomly chosen children a morning urine sample was obtained to measure iodine excretion. In 45 children without goiter, a blood sample was obtained to measure TSH and thyroxin. Results: In nine cbildren (7 percent) a diffuse goiter was found. Median urinary iodine excretion was 158 ug/dl. Thyroxin and TSH levels were within normal limits (8.4Ý1.1 ug/dl and 2.2Ý1.5 uU/ml respectively). During the period of iodine water supplementation there were 47 births in the zone. All newborns had normal TSH values and none had goiter. Conclusions: When present results are compared with the period before water iodination (when the prevalence of goiter was 9.6 percent and mean urinary iodine excretion was 57.6 ug/dl), it can be concluded that extra iodine intake in this rural population has not caused additional thyroid problems

Prevalencia de bocio en escolares de la zona de Pirque: efecto de la yodación de la sal / Prevalence of goiter in school children at Pirque: effects of salt iodination

Twenty years ago, Pirque was a zone with a goiter prevalence of 39 percent, to assess the effects of salt iodination on the prevalence of goiter, school age children from 4 public schools of Pirque, were examined, following WHO criteria for the diagnosis of goiter. Urinary iodine excretion was also measured. Five hundred ninety one males and 298 females aged 12.1ñ2.5 years were examined. Fifty seven children (9.6 percent) had goiter. In 53, the goiter was grade I and in 4, grade II. No sex differences were observed. Minimal and median urinary iodine excretion values were 12.6 and 57.6 ug/dll respectively. In conclusion, goiter prevalence dropped from 39 to 10 percent. The fact that iodine intake is over minimal recommendations, underscores the effectiveness of salt iodination

Infiltración adiposa difusa de la glándula tiroides asociada a amiloidosis en un paciente con insuficiencia renal crónica / Diffuse fatty infiltration of the thyroid gland associated to amyloidosis in a patient with chronic renal failure

We report a 26 years old male with secondary amyloidosis and chronic renal failure who consulted due to rapidly growing goiter associated with coarseness and dysphagia. Serum levels of thyroid hormones and TSH were normal and a neck CT scan showed a big mass in the anterior lateral regions, thet compressed neighboring structures. The patient was subjected to a total thyroidectomy and the pathological study revealed a diffuse fatty and amyloid infiltration of the thyroid gland. There was no evidence of malignancy

Evaluación clínica del vello corporal en mujeres sanas / Clinical assessment of body hair in healthy women

To study tha amount and distribution of terminal body hair in non-hirsute women consulting in a public outpatient clinic. Two hundred thirty six premenopausical women consulting in a birth control clinic or consulting for acute non-endocrinological diseases were studied. Body hair was assessed with a semi-quantitative clinical method described by Ferriman and Gallwey. Ninetyfive percent of women had a score equal or less than 5. No correlations were found between the score and body mass index or age. Partial scores over 1 were found specially in the lower abdomen, chest, superior lip and thighs. This sample of women, coming from middle and low socioeconomic levels, appears more hairlee than European or North American Women. Thus, hirsutism must be suspected with scores over 5. These results cannot be extrapolated to all Chilean women, due to differences in ethnical backgrounds

[Veno-occlusive liver disease due to intake of Senecio vulgaris tea]. / Enfermedad venooclusiva hepática por ingestión de infusiones de Senecio vulgaris.

Veno-occlusive liver disease (VOLD) is a cause of portal hypertension by non thrombotic obstruction of hepatic venous drainage attributed to multiple etiologies (toxic, irradiation, antineoplastic, conditioning for bone marrow transplantation). One case of VOLD in a senile patient due to continuous two year consumption of Senecio vulgaris tea is reported. This compound, which has a high pyrrolizidine alkaloid content induced a subacute course of portal hypertension and death. The clinicopathologic features of VOLD and the etiopathogenesis in relation to the pyrrolizidine alkaloids present in Senecio vulgaris are discussed. The need for considering the history of medicinal plant ingestion in patients under portal hypertension studies are strongly recommended as is the advice regarding the possible dangers involved in the inappropriate use of remedies provided by herbalists.