An Indicator to Prioritize the Mechanical Ventilators Replacement in a Secondary Care Hospital in Mexico.

This paper presents a practical application of health technology assessment for 21 mechanical ventilators, located at a secondary care Hospital in the State of Mexico, Mexico. A global indicator is obtained, by using a mathematical tool, which involves 14 variables grouped into three partial indicators: technical, clinical and economic. The final aim of this approach is to provide evidence for decision-making, in order to prioritize the replacement of medical equipment, taking into consideration its performance features, the needs of demand for care, and the economic implications for the Hospital.Clinical Relevance-Invasive Mechanical Ventilation (IMV), is a clinical procedure which implies a total or partial replacement of lung function. Given the life support implications, it is important to assure security and reliability in medical equipment intended for this therapy. Therefore, in order to keep updated the IMV devices, in addition to requiring preventive maintenance programs, medical technology replacement programs are necessary.

Performance Evaluation of a Magnetic Resonance Imager with Evidence-Based Decision Making Tools.

Evidence-based decision-making tools were used to evaluate the performance of a 16-year-old 1.5T Magnetic Resonance Imager (MRI) that has been fully dedicated to clinical service in a public hospital in Mexico. The MRI age highlights the importance of regular performance evaluations to ensure that the equipment is still functioning optimally, even when the system went through an important software and hardware updated. The use of Multiple-Criteria Decision-Making is an effective method to evaluate the performance of complex systems like MR imagers. A technical global indicator was set, revealing that only 50% of available time has been used is interesting and could be further investigated to determine if there are any factors limiting the usage of the system. The good performance indicators in terms of productivity, availability, and technical aspects are encouraging and suggest that the updated software and hardware have had a positive impact on the overall performance of the system.Finally, the use of evidence-based decision-making tools to evaluate the performance of the MR imager was a successful approach and can serve as a model for other healthcare facilities to follow.Clinical Relevance- MRI is a non-invasive diagnostic test that uses a magnetic field and radiofrequency waves to obtain detailed images of internal structures of the body. Unlike X-rays and CT scans, which use ionizing radiation, MRI does not expose patients to harmful radiation, making it a safe option for diagnostic imaging. The use of MRI a valuable tool for characterizing lesions, detecting abnormalities, and monitoring disease progression and it is widely used in several medical fields, including neurology, oncology, and orthopedics, among others. Therefore, ensuring that the MRI system is working optimally is crucial for providing reliable and accurate results, which can lead to timely and appropriate treatment for patients.

Urothelial cell carcinoma of the bladder in pediatric patients: a systematic review and data analysis of the world literature.

BACKGROUND: Urothelial cell carcinoma (UCC) of the bladder is exceedingly rare in pediatric patients. Limited data are available to guide management in this population. METHODS: The authors systematically searched MEDLINE, Cochrane Library, and Google Scholar (through February 2019) for case reports and series to summarize data regarding presentation, evaluation, management, and follow-up for patients ≤ 18 years diagnosed with UCC of the bladder. Patient-level data were abstracted, and adjusted logistic regression was used to identify factors associated with a combined outcome of recurrence or death. RESULTS: One hundred two articles describing 243 patients from 26 countries met criteria. Average age was 12.5 years, 32.6% were female, 15.3% had medical comorbidities, and 13.2% had known risk factors for bladder cancer. Initial management was transurethral resection in 95.5% of patients, whereas 6.2% required secondary intervention. Tumor stage was TaN0M0 in 86.4% and low grade in 93.4%. Recurrence and death occurred in 8.6% and 3.7%, respectively. Mean time to recurrence or death was 8.6 months (standard deviation [SD] 7.6) for 10.7%. Mean disease free follow-up without recurrence or death was 56.9 months (SD 54.2) for 89.3%. Patients with comorbidities, risk factors, or family history (odds ratio [OR]: 2.4, 95% confidence interval [CI]: 1.02-5.6); ≥TaN0M0 disease (OR: 6.2, 95% CI: 2.5-15.6); and larger tumors at diagnosis (OR: 1.7, 95% CI: 1.2-2.4) had significantly greater adjusted odds of recurrence or death after initial treatment. CONCLUSION: Based on pooled results, disease recurrence or death occurred in 10.7% of pediatric patients and within 9 months for most and within 32 months for all patients. This may suggest that low-grade and stage UCC of the bladder in pediatric patients can be systematically monitored for at least 3 years. However, prospective evaluation of this clinical strategy is warranted.

Supraspinal modulation of neuronal synchronization by nociceptive stimulation induces an enduring reorganization of dorsal horn neuronal connectivity.

KEY POINTS: The state of central sensitization induced by the intradermic injection of capsaicin leads to structured (non-random) changes in functional connectivity between dorsal horn neuronal populations distributed along the spinal lumbar segments in anaesthetized cats. The capsaicin-induced changes in neuronal connectivity and the concurrent increase in secondary hyperalgesia are transiently reversed by the systemic administration of small doses of lidocaine, a clinically effective procedure to treat neuropathic pain. The effects of both capsaicin and lidocaine are greatly attenuated in spinalized preparations, showing that supraspinal influences play a significant role in the shaping of nociceptive-induced changes in dorsal horn functional neuronal connectivity. We conclude that changes in functional connectivity between segmental populations of dorsal horn neurones induced by capsaicin and lidocaine result from a cooperative adaptive interaction between supraspinal and spinal neuronal networks, a process that may have a relevant role in the pathogenesis of chronic pain and analgesia. ABSTRACT: Despite a profusion of information on the molecular and cellular mechanisms involved in the central sensitization produced by intense nociceptive stimulation, the changes in the patterns of functional connectivity between spinal neurones associated with the development of secondary hyperalgesia and allodynia remain largely unknown. Here we show that the state of central sensitization produced by the intradermal injection of capsaicin is associated with structured transformations in neuronal synchronization that lead to an enduring reorganization of the functional connectivity within a segmentally distributed ensemble of dorsal horn neurones. These changes are transiently reversed by the systemic administration of small doses of lidocaine, a clinically effective procedure to treat neuropathic pain. Lidocaine also reduces the capsaicin-induced facilitation of the spinal responses evoked by weak mechanical stimulation of the skin in the region of secondary but not primary hyperalgesia. The effects of both intradermic capsaicin and systemic lidocaine on the segmental correlation and coherence between ongoing cord dorsum potentials and on the responses evoked by tactile stimulation in the region of secondary hyperalgesia are greatly attenuated in spinalized preparations, showing that supraspinal influences are involved in the reorganization of the nociceptive-induced structured patterns of dorsal horn neuronal connectivity. We conclude that the structured reorganization of the functional connectivity between the dorsal horn neurones induced by capsaicin nociceptive stimulation results from cooperative interactions between supraspinal and spinal networks, a process that may have a relevant role in the shaping of the spinal state in the pathogenesis of chronic pain and analgesia.

Satisfacción de los pacientes con enfermedad de La Peyronie tras cirugía de placa e injerto de pericardio bovino / Satisfaction of patients with Peyronie's disease after plaque surgery and bovine pericardium graft

Introducción: La cirugía de placa e injerto de pericardio bovino es una herramienta útil en el tratamiento de la enfermedad de La Peyronie. Objetivo: Determinar la satisfacción de los pacientes tras la realización de esta cirugía. Materiales y métodos: Estudio retrospectivo, observacional y descriptivo. Se recabaron los datos de las historias clínicas de los pacientes operados entre 2004 y 2015, y fueron evaluados mediante un cuestionario de satisfacción postoperatoria. Resultados: Se realizaron 28 cirugías. La corrección de la curva se logró en 26 pacientes (95,3%). Un paciente (3,57%) requirió corrección de la curva residual mediante técnica de Yachia, y un paciente (3,57%) presentó una complicación grave consistente en infección protésica y fístula uretrocutánea. Veintiún pacientes (75%) se mostraron satisfechos con la cirugía. Conclusiones: Nuestros resultados muestran un aceptable nivel de satisfacción de nuestros pacientes con un bajo número de complicaciones, aunque se necesitan más trabajos, prospectivos, controlados y aleatorizados

Introduction: Plaque and bovine pericardium graft surgery is a useful tool for treating Peyronie's disease. Objective: To determine patient satisfaction following this operation. Materials and methods: This was a retrospective, observational and descriptive study. We collected data from the medical records of patients who underwent surgery between 2004 and 2015 and were evaluated through a postoperative satisfaction questionnaire. Results: Twenty-eight operations were performed. Curve correction was achieved in 26 patients (95.3%). One patient (3.57%) required residual curve correction using Yachia's technique, and 1 patient (3.57%) had a severe complication consisting of prosthetic infection and urethrocutaneous fistulae. Twenty-one patients (75%) expressed satisfaction with the surgery. Conclusions: Our results show an acceptable level of satisfaction among our patients, with a low number of complications. However, further prospective, controlled and randomised studies are needed

Satisfaction of patients with Peyronie's disease after plaque surgery and bovine pericardium graft. / Satisfacción de los pacientes con enfermedad de La Peyronie tras cirugía de placa e injerto de pericardio bovino.

INTRODUCTION: Plaque and bovine pericardium graft surgery is a useful tool for treating Peyronie's disease. OBJECTIVE: To determine patient satisfaction following this operation. MATERIALS AND METHODS: This was a retrospective, observational and descriptive study. We collected data from the medical records of patients who underwent surgery between 2004 and 2015 and were evaluated through a postoperative satisfaction questionnaire. RESULTS: Twenty-eight operations were performed. Curve correction was achieved in 26 patients (95.3%). One patient (3.57%) required residual curve correction using Yachia's technique, and 1 patient (3.57%) had a severe complication consisting of prosthetic infection and urethrocutaneous fistulae. Twenty-one patients (75%) expressed satisfaction with the surgery. CONCLUSIONS: Our results show an acceptable level of satisfaction among our patients, with a low number of complications. However, further prospective, controlled and randomised studies are needed.

Sun protection policies of Australian primary schools in a region of high sun exposure.

Queensland, Australia has the highest rates of skin cancer globally. Predetermined criteria were used to score the comprehensiveness of sun protection policies (SPP) of primary schools across Queensland. SPP were sought for schools in 10 regions (latitude range 16.3°S-28.1°S) from 2011 to 2014. Of the 723 schools sampled, 90.9% had a written SPP available publicly. Total SPP scores were low {mean 3.6 [95% CI: 3.4-3.9]; median 2 [interquartile range (IQR) 2, 4]}, with only 3.2% of schools achieving the maximum score of 12. Median SPP scores were higher in Northern and Central Queensland [both 2 (IQR 2, 6) and (IQR 2, 5), respectively] than in Southern Queensland [2 (IQR 2, 3); P = 0.004]. Clothing and hat-wearing were addressed in most policies (96% and 89%) while few schools used their SPP to plan outdoor events (5.2%) or reschedule activities to minimize sun exposure (11.7%). The SunSmart Schools program has been operating in Queensland for 17 years, and while most primary schools now have a written SPP, most are not comprehensive. Incentive-based approaches (5-star-rating award scheme and grants) may assist in addressing this issue, to reduce sun exposure of students and teachers. These data provide a baseline from which improvements in the comprehensiveness of school SPPs can be evaluated.

Photoactive High Explosives: Substituents Effects on Tetrazine Photochemistry and Photophysics.

High explosives that are photoactive, i.e., can be initiated with light, offer significant advantages in reduced potential for accidental electrical initiation. We examined a series of structurally related tetrazine based photoactive high explosive materials to detail their photochemical and photophysical properties. Using photobleaching infrared absorption, we determined quantum yields of photochemistry for nanosecond pulsed excitation at 355 and 532 nm. Changes in mass spectrometry during laser irradiation in vacuum measured the evolution of gaseous products. Fluorescence spectra, quantum yields, and lifetimes were measured to observe radiative channels of energy decay that compete with photochemistry. For the 6 materials studied, quantum yields of photochemistry ranged from <10(-5) to 0.03 and quantum yield of fluorescence ranged from <10(-3) to 0.33. In all cases, the photoexcitation nonradiatively relaxed primarily to heat, appropriate for supporting photothermal initiation processes. The photochemistry observed was dominated by ring scission of the tetrazine, but there was evidence of more extensive multistep reactions as well.

Ascariasis as cause of intestinal occlusion and concurrent appendicitis.

Intestinal occlusion by ascariasis is a commonly seen socio-economic status low, is associated with poor sanitary hygiene. It is rare to see a case with both intestinal occlusion and appendicitis at the same time, as described in this report.

Biotransformation of Endocrine-Disrupting Compounds in Groundwater: Bisphenol A, Nonylphenol, Ethynylestradiol and Triclosan by a Laccase Cocktail from Pycnoporus sanguineus CS43.

The biodegradation of organic compounds present in water at trace concentration has become a critical environmental problem. In particular, enzymatic oxidation by fungal laccases offers a promising alternative for efficient and sustainable removal of organic pollutants in water. In this work, the biocatalytic ability of laccases from the Pycnoporus sanguineus CS43 fungus was evaluated. A filtered culture supernatant (laccase cocktail) evidenced an enhanced biotransformation capability to remove common endocrine-disruptor compounds (EDCs), such as bisphenol A, 4-nonylphenol, 17-α-ethynylestradiol and triclosan. A biodegradation of around 89-100 % was achieved for all EDCs using synthetic samples (10 mg L-1) and after the enzymatic treatment with 100 U L-1 (50.3 U mg -1). The biodegradation rates obtained were fitted to a first order reaction. Furthermore, enzymatic biocatalytic activity was also evaluated in groundwater samples coming from northwestern Mexico, reaching biotransformation percentages between 55 and 93 % for all tested compounds. As far as we know this is the first study on real groundwater samples in which the enzymatic degradation of target EDCs by a laccase cocktail from any strain of Pycnoporus sanguineus was evaluated. In comparison with purified laccases, the use of cocktail offers operational advantages since additional purification steps can be avoided.

Agentes etiológicos y su sensibilidad antimicrobiana en urocultivos confirmatorios de infección urinaria en un servicio de urgencia de pediatría / Etiological agents and its antimicrobial sensitivity in confirmatory urine cultures in a pediatric emergency service

La infección del tracto urinario (ITU) es una patología frecuente en pediatría. Su diagnóstico ytratamiento precoz son fundamentales. Para un adecuado tratamiento, es importante conocer la sensibilidadantimicrobiana local. Objetivo: Identificar los agentes etiológicos más frecuentes y su sensibilidad antimicrobiana en urocultivos confirmatorios de ITU, solicitados en Servicio de Urgencia de Pediatría (SUP) del Hospital San Martin de Quillota (HSMQ). Materiales y métodos: Se analizaron todos los urocultivos solicitados desde el SUP del HSMQ entre enero 2013 – julio 2014. Se efectuó análisis por sexo y grupos etarios. La etiología y susceptibilidad microbiana se analizó con la técnica de difusión en agar. Resultados: Se analizaron 298 urocultivos, de los cuales el 80,5 por ciento correspondieron a mujeres. La bacteria encontrada más frecuente, en un 87,4 por ciento fue la Escherichia coli. La sensibilidad antibiótica de E.coli para ampicilina, cefalotina, cefixime, ciprofloxacino, ceftriaxona, gentamicina, nitrofurantoina y cotrimoxazol, correspondieron a un 23,3 por ciento; 32,8 por ciento; 96,6 por ciento; 92,7 por ciento; 97,7 por ciento; 94,5 por ciento; 99,6 por ciento; y 71,9 por ciento, respectivamente. Conclusión: El agente etiológico más frecuente en urocultivos confirmatorios solicitados en el SUP del HSMQ fue E. coli. Respecto a su sensibilidad antimicrobiana demostró una alta resistencia y sensibilidad intermedia a cefalosporinas de primera generación y una alta sensibilidad a cefalosporinas de tercera generación, nitrofurantoína, gentamicina y fluoroquinolonas...

Urinary tract infection (UTI) is a common pediatric disease. Early diagnosis and treatment are essential. For proper treatment, it is important to know the local antimicrobial susceptibility. Objective: Identify the most common etiologic agents and their antimicrobial susceptibility in urine cultures in Pediatrics Emergency Service (PES) of San Martin Hospital, Quillota. Summary of work: All the urine cultures requested from the PES between January 2013 and July 2014 were analyzed by sex and age groups. The etiology and microbial susceptibility was analyzed with the agar diffusion technique. Summary of Results: 298 urine cultures were analyzed, 80.5 percent were women. The most common bacteria found was Escherichia coli with 87.4 percent.The antimicrobial susceptibility of E.coli to ampicillin, cephalothin, cefixime, ciprofloxacin, ceftriaxone, gentamicin, cotrimoxazole and nitrofurantoin were 23.3 percent; 32.8 percent; 96.6 percent; 92.7 percent; 97.7 percent; 94.5 percent; 99.6 percent; and 71.9 percent, respectively. Conclusion: The most common etiologic agent in urine cultures requested in PES was E. coli. The antimicrobial susceptibility showed a high resistance and intermediate susceptibility to first generation cephalosporins and high susceptibility to thirdgeneration cephalosporins, nitrofurantoin, gentamicin andfluoroquinolones...

Dynamic synchronization of ongoing neuronal activity across spinal segments regulates sensory information flow.

Previous studies on the correlation between spontaneous cord dorsum potentials recorded in the lumbar spinal segments of anaesthetized cats suggested the operation of a population of dorsal horn neurones that modulates, in a differential manner, transmission along pathways mediating Ib non-reciprocal postsynaptic inhibition and pathways mediating primary afferent depolarization and presynaptic inhibition. In order to gain further insight into the possible neuronal mechanisms that underlie this process, we have measured changes in the correlation between the spontaneous activity of individual dorsal horn neurones and the cord dorsum potentials associated with intermittent activation of these inhibitory pathways. We found that high levels of neuronal synchronization within the dorsal horn are associated with states of incremented activity along the pathways mediating presynaptic inhibition relative to pathways mediating Ib postsynaptic inhibition. It is suggested that ongoing changes in the patterns of functional connectivity within a distributed ensemble of dorsal horn neurones play a relevant role in the state-dependent modulation of impulse transmission along inhibitory pathways, among them those involved in the central control of sensory information. This feature would allow the same neuronal network to be involved in different functional tasks.

Differential presynaptic control of the synaptic effectiveness of cutaneous afferents evidenced by effects produced by acute nerve section.

In the anaesthetized cat, the acute section of the saphenous (Saph) and/or the superficial peroneal (SP) nerves was found to produce a long-lasting increase of the field potentials generated in the dorsal horn by stimulation of the medial branch of the sural (mSU) nerve. This facilitation was associated with changes in the level of the tonic primary afferent depolarization (PAD) of the mSU intraspinal terminals. The mSU afferent fibres projecting into Rexed's laminae III-IV were subjected to a tonic PAD that was reduced by the acute section of the SP and/or the Saph nerves. The mSU afferents projecting deeper into the dorsal horn (Rexed's laminae V-VI) were instead subjected to a tonic PAD that was increased after Saph and SP acute nerve section. A differential control of the synaptic effectiveness of the low-threshold cutaneous afferents according to their sites of termination within the dorsal horn is envisaged as a mechanism that allows selective processing of sensory information in response to tactile and nociceptive stimulation or during the execution of different motor tasks.

Changes in correlation between spontaneous activity of dorsal horn neurones lead to differential recruitment of inhibitory pathways in the cat spinal cord.

Simultaneous recordings of cord dorsum potentials along the lumbo-sacral spinal cord of the anaesthetized cat revealed the occurrence of spontaneous synchronous negative (n) and negative-positive (np) cord dorsum potentials (CDPs). The npCDPs, unlike the nCDPs, appeared preferentially associated with spontaneous negative dorsal root potentials (DRPs) resulting from primary afferent depolarization. Spontaneous npCDPs recorded in preparations with intact neuroaxis or after spinalization often showed a higher correlation than the nCDPs recorded from the same pair of segments. The acute section of the sural and superficial peroneal nerves further increased the correlation between paired sets of npCDPs and reduced the correlation between the nCDPs recorded from the same pair of segments. It is concluded that the spontaneous nCDPs and npCDPs are produced by the activation of interconnected sets of dorsal horn neurones located in Rexed's laminae III­IV and bilaterally distributed along the lumbo-sacral spinal cord. Under conditions of low synchronization in the activity of this network of neurones there would be a preferential activation of the intermediate nucleus interneurones mediating Ib non-reciprocal postsynaptic inhibition. Increased synchronization in the spontaneous activity of this ensemble of dorsal horn neurones would recruit the interneurones mediating primary afferent depolarization and presynaptic inhibition and, at the same time, reduce the activation of pathways mediating Ib postsynaptic inhibition. Central control of the synchronization in the spontaneous activity of dorsal horn neurones and its modulation by cutaneous inputs is envisaged as an effective mechanism for the selection of alternative inhibitory pathways during the execution of specific motor or sensory tasks.

La enfermería en salud pública: el caso de la Influenza / The public health nursing: the case of influenza

Ante un brote de una enfermedad infecto-contagiosa, el estudio de contactos limita la transmisión de esta. El objetivo de este trabajo fue identificar a los contactos de los posibles casos de influenza en trabajadores de la UNAM para establecer una comunicación y proporcionar educación para la salud sobre medidas higiénicas. Material y métodos: Se elaboró un cuestionario, se estableció contacto con los casos por vía telefónica y se llevó a cabo una visita domiciliaria. Se llevó a cabo un análisis descriptivo de los datos y una descripción de las experiencias y percepciones durante las visitas. Resultados: Se identificó que la mayoría de los contactos eran familiares directos de los casos, que no contaban con un esquema de vacunación completo, ni contra la influenza y la frecuencia de síntomas varió de 1 hasta 4. Comentarios finales: Ante una situación de este tipo (la Pandemia del Virus de la Influenza Humana A (H1N1)) el papel de la enfermera en salud pública es de suma importancia no solo en la búsqueda de los casos y sus contactos, sino también en la orientación y educación de la población en relación a las medidas preventivas.

In the view of an infectious and contagious disease epidemic, the identification of the contacts limits its transmission. The objective of this work was to identify the contacts of the possible cases of UNAM workers in order to establish communication and provide health education about hygiene measures. Material and methods: A questionnaire was prepared, telephone contact was established with the cases, and a home visit was arranged. A descriptive analysis of the data was carried out, as well as, a description of the experiences and perception during the home visit. Results: Most identified contacts were relatives of the cases, which did not have a complete vaccine scheme, no even against influenza, and the frequency of symptoms varied between 1 a 4. Final comments: In a situation like this (A(H1N1) human influenza virus pandemic) the public health nurse roll is of great importance, not just in the identification of the cases and its contacts, but also in the orientation and education of the population in relation to preventive measures.

Evaluation of early embrionic development after natural mating using ultrasonography in bos indicus cows in the humid tropics of Costa Rica.

Fifty-eight nursing Zebu cows averaging 5922 days postpartum were used to evaluate the early embryonic development by ultrasound under a natural mating system (bulls A to F). Three consecutive mating periods of 21 days were established. Sixty two percent of the animals were diagnosed as pregnant (36/58). During the first period (AB) 76% (27/36) of the animals become pregnant, 17% (6/36) during the second (CD) and 9% (3/36) in the last mating period (EF). Sixty two percent of the animals were true positives (animals found pregnant diagnosed by ultrasound (US), and conforming with the embryonic scale proposed by Rosiles et al. (2006); 12% (n = 7) of false negatives (pregnant cows by US but not conforming with the scale); 2% (n = 1) of false positives (pregnant cows, evaluated with US and conforming with the embryonic scale but not pregnant at the end of the study); and a 26% (n = 15) of true negatives (not pregnancy evaluated with US). The sensitivity of the test was 97%, with a specificity of 68% with a positive predictive value of 83% and a negative predictive value of 6%. Relation between the measuring scale of embryo development and the results obtained by ultrasonography was k = 0.69. No significant correlation were observed between body condition score (BCS) evaluation and body fat (BF) measurement at any of the three evaluations performed after mating, however, measurements of BCS and BF among time showed a positive correlation (0.48 P < 0.05, 0.29, P < 0.07, respectively) from the beginning of the evaluation period to the end of the trial. Ultrasonography to monitor embryonic development to determine the early establishment of pregnancy in natural mating reproductive programs can be a valuable technique to monitor reproductive efficiency.

Menopausal symptoms and associated risk factors among postmenopausal women screened for the metabolic syndrome.

BACKGROUND: Although the frequency of menopausal symptoms may vary according to the studied population, in general severe intensity has been related to lower quality of life. OBJECTIVE: To assess the frequency of menopausal symptoms and involved risk factors in an Ecuadorian postmenopausal population. METHODS: Postmenopausal women that participated in a metabolic syndrome screening program were interviewed with the Menopause-specific quality of life questionnaire (MENQOL) in order to determine the most frequently presenting menopausal symptoms and correlate these symptoms with socio-demographic data and the main results of the screening program. RESULTS: Three hundred and twenty-five postmenopausal women (n = 325) were surveyed with the MENQOL. Mean age of participants was 55.9 +/- 8.1 years (median: 54 years). The most frequently presenting symptoms were: hot flushes (53.3%), sweating (49.2%), poor memory (80.6%), feeling depressed (67.4%), aching in muscles and joints (84%), drying of their skin (85.5%), avoiding intimacy (76.2%) and change in their sexual desire (76.5%). Multivariate analysis determined that abdominal obesity was a significant risk factor for presenting hot flushes, depression and muscle and joint pain. High triglyceride levels were associated to higher rates of sweating and depression. While women with basal hyperglycemia were associated to dry skin and changes in sexual desire in a higher proportion, those who were older and with more years of menopause onset were related less frequently to vasomotor symptoms. Older age was also significantly associated in a higher rate to dry skin. CONCLUSION: In this postmenopausal Ecuadorian population, the frequency of menopausal symptoms, as assessed with the MENQOL, was found to be relatively similar to other Latin and non-Latin American populations and associated to age, hormonal status and related metabolic conditions.

Ultralow-density nanostructured metal foams: combustion synthesis, morphology, and composition.

The synthesis of low-density, nanoporous materials has been an active area of study in chemistry and materials science dating back to the initial synthesis of aerogels. These materials, however, are most often limited to metal oxides, e.g., silica and alumina, and organic aerogels, e.g., resorcinol/formaldehyde, or carbon aerogels, produced from the pyrolysis of organic aerogels. The ability to form monolithic metallic nanocellular porous materials is difficult and sometimes elusive using conventional methodology. Here we report a relatively simple method to access unprecedented ultralow-density, nanostructured, monolithic, transition-metal foams, utilizing self-propagating combustion synthesis of novel transition-metal complexes containing high nitrogen energetic ligands. During the investigation of the decomposition behavior of the high-nitrogen transition metal complexes, it was discovered that nanostructured metal monolithic foams were formed in a post flame-front dynamic assembly having remarkably low densities down to 0.011 g cm(-3) and extremely high surface areas as high as 270 m(2) g(-1). We have produced monolithic nanoporous metal foams via this method of iron, cobalt, copper, and silver metals. We expect to be able to apply this to many other metals and to be able to tailor the resulting structure significantly.

Effects of spinal and peripheral nerve lesions on the intersegmental synchronization of the spontaneous activity of dorsal horn neurons in the cat lumbosacral spinal cord.

In the anesthetized and paralyzed cat, spontaneous negative cord dorsum potentials (nCDPs) appeared synchronously in the L3 to S1 segments, both ipsi- and contralaterally. The acute section of both the intact sural and the superficial peroneal nerve increased the variability of the spontaneous nCDPs without affecting their intersegmental coupling. On the other hand, the synchronization between the spontaneous nCDPs recorded in segments L5-L6 was strongly reduced following an interposed lesion of the left (ipsilateral) dorsolateral spinal quadrant and it was almost completely abolished by an additional lesion of the contralateral dorsolateral quadrant at the same level. Our observations support the existence of a system of spontaneously active dorsal horn neurons that is bilaterally distributed along the lumbosacral segments and affects, in a synchronized and organized manner, impulse transmission along many reflex pathways, including those mediating presynaptic inhibition.

Method for analysis of polymer-supported organic compounds using mass spectrometry direct insertion.

A new approach on the use of mass spectrometry direct-insertion and a quadrupole detector for analysis of organic compounds supported in solid phase has been developed. This is a simple and efficient method based on cleavage due to the thermal-instability of the benzylic group of most commercial resins. The cleavage of supported compounds takes place in the spectrometer as a consequence of the high temperature in the instrument's chamber. These compounds are detected using a similar fragmentation pattern and a molecular ion corresponding to the same compound obtained by traditional synthesis. Polymer degradation fragments do not interfere with the spectrum interpretation, because only a few peaks and low intensities are detected. We report here the identification of different types of compounds supported in Merrifield resin, such as bis-o-aminobenzamides and simple aromatic and aliphatic compounds, using this new approach.