Cigarette smoke is associated with up-regulation of inducible NOS and COX-2 protein expression and activity in granulosa cells of women undergoing in vitro fertilization.

Cigarette smoke exposure represents a well-established ovotoxic exogenous stress, but the molecular mechanisms underlying of this effect are still unclear. Cigarette smoke upregulates inflammatory genes in the female reproductive organs, therefore an abnormal inflammation response may contribute to the impairment of female fertility. In this study we investigated for the first time the effect of cigarette smoke exposure on NOS and COX expression and activity and on their transcription factors (CREB and NF-kB) in human GCs and on the release of NO and PGE2 in the FF in smoking and non-smoking patients undergoing IVF treatment. In addition, correlation analysis between AMH serum levels, an index of ovarian reserve, and smoking exposure or iNOS and COX-2 protein expression levels were performed using a Pearson correlation method. Cigarette smoke exposure resulted in a significant increase of iNOS and COX-2 protein expression together with an increase of iNOS activity and PGE2 levels. pNF-kB and pCREB protein expression were upregulated in the GCs of smokers compared to non-smokers. The habit of smoking was negatively correlated with serum AMH levels, and positively correlated with iNOS and COX-2 protein expression levels. The data presented in the current study revealed a novel molecular mechanism underlying the toxic effects of cigarette smoke on fertility. Additional pathways mediating the effects of cigarette smoke exposure in human GCs cannot be excluded and should be investigated in future studies.

Variabilidad en el diagnóstico nutricional de infantes menores de 12 meses realizados por profesionales nutricionistas

RESUMEN Antecedentes: La malnutrición por exceso (sobrepeso y obesidad) es una condición de alta prevalencia en Chile, para el diagnóstico de esta condición se deben utilizar diversas normativas nacionales, que en su aplicación son afectas a interpretaciones. Objetivo: Evaluar la concordancia en los diagnósticos nutricionales en niños menores de 12 meses entre profesionales nutricionistas. Métodos: Estudio observacional descriptivo de corte transversal con un muestreo no probabilístico por conveniencia. Se masificó un instrumento on-line con 5 casos para realizar el Diagnóstico del Estado Nutricional en grupos de profesionales nutricionistas en redes sociales. Se estableció el grado de concordancia en porcentaje y coeficientes Kappa de Fleiss. Resultados: 104 profesionales completaron el instrumento (3 hombres), la experiencia laboral promedio fue de 4,8 ± 4,7 años, el porcentaje de concordancia varió desde 8% a 81% con valores de Kappa de Fleiss de κ= 0,468 a κ= 0,847. Conclusión: A pesar de existir diversas normativas que regulan la determinación del Diagnóstico Nutricional existe alta variabilidad lo que demuestra la necesidad de crear consensos profesionales.

ABSTRACT Background: Overweight is a highly prevalent condition in Chile. For diagnosis of this condition, various national regulations must be used, but, their application are subject to interpretations, particularly in infants. Aim: To assess the agreement in infant nutritional diagnoses made by nutritionist. Methods: Observational descriptive cross-sectional study with non-probability sampling for convenience. An online instrument with 5 cases was used to carry out Nutritional Status Diagnosis among groups of nutritionists contacted via social networks. Degree of concordance was determined by percentage and Fleiss Kappa coefficients. Results: 104 professionals completed the instrument (3 men), average work experience was 4.8 ± 4.7 years, the percentage of agreement ranged from 8% to 81% with Fleiss Kappa values of κ= 0.468 to κ= 0.847. Conclusion: Although various national guidelines exist on nutritional diagnosis, there is high variability, which demonstrates the need to create professional consensus.

¿Cómo realizar el seguimiento de los pacientes con fibrosis pulmonar idiopática? / How to monitor patients with idiopathic pulmonary fibrosis?

La fibrosis pulmonar idiopática (FPI) se ha clasificado en enfermedad leve o temprana-moderada-severa o Avanzada, sin puntos de corte en parámetros clínicos, funcionales o imagenológicos. No existe aún consenso en cual es el principal parámetro que se debe medir. Si bien las variables funcionales como la capacidad vital forzada (CVF), capacidad de difusión de monóxido de carbono (DLCO) y test de caminata de 6 minutos se han utilizado de forma rutinaria en la practica clínica y en los principales estudios clínicos de tratamiento muchas veces no son representativos de la evolución clínica. Por lo anterior se han desarrollado, índices o puntajes compuestos como la escala GAP (Gender-Age-Physiology) que podrían ser útiles en el seguimiento de los pacientes.

Idiopathic pulmonary fibrosis (IPF) has been classified as mild or early - moderate - severe or advanced disease, with no cut-off points in clinical, functional or imaging parameters. There is no consensus yet on which is the main parameter to be measured although the functional variables such as forced vital capacity (FVC), carbon monoxide diffusion capacity (DLCO) and 6-minute walk test, have been routinely used in clinical practice and in the main clinical studies of treatment, are often not representative of the clinical evolution. Therefore, composite indices or scores such as the GAP (Gender-Age-Physiology) scale have been developed that could be useful in the follow-up of patients.

Identification and quantification of dimethyl acetals from plasmalogenic lipids in lamb intramuscular fat under different derivatization procedures.

Meat lipids are mostly comprised by triacylglycerols, but small amounts of plasmalogens are also present in intramuscular fat. The purpose of this study was to evaluate the effect of lipid derivatization on the presence of dimethyl acetal (DMA) molecules from plasmalogenic lipids in intramuscular fat samples. Three different methods of methylation were assayed. Acid-catalyzed methanolysis using HCl, the traditional procedure to derivatize meat lipids, was compared to two base-catalyzed methanolysis based on the ISO International standard procedure using either KOH and/or NaOCH3 which, apparently, are only able to methylate fatty acids from triacylglycerols. DMA compounds were isolated by thin layer chromatography and then identified by gas chromatography-mass spectrometry. The most prominent DMA molecules detected were 16:0 and 18:0, but also minor amounts of monounsaturated and branched-chain DMA were quantified. Acid methylation yielded the highest amounts of DMA. However, the present article demonstrates that ISO standard based methylation procedures could also generate DMA derivatives in considerable quantities, which is not usually considered and may interfere with the determination of fatty acid methyl esters (FAME) from triacylglycerides. The current research warns scientist about possible FAME misidentifying and overestimations in intramuscular fat analysis using basic methylation and the need to consider the presence of DMA in samples that contain plasmalogens.

Optimization of milk odd and branched-chain fatty acids analysis by gas chromatography using an extremely polar stationary phase.

Odd and branched-chain fatty acids (OBCFA) are of interest, since they have bioactive properties and could be regarded biomarkers of ruminant fat intake. An accurate analysis of the individual OBCFA in milk by gas chromatography (GC) is not easy due to milk fat complexity. The availability of ionic liquid stationary phases as SLB-IL111 can be a useful tool to discriminate OBCFA from other milk FA eluting in the same chromatographic regions. The elution behavior of OBCFA on SLB-IL111 was evaluated based on different GC oven temperature programs. All programs assayed discriminated 11:0, iso 13:0, anteiso 13:0, iso 15:0, anteiso 15:0, 15:0 and iso 17:0. Using an initial temperature of 150°C for 1h, 13:0 and iso 16:0 were separated from trans-12:1 and 13-14:1, respectively, whereas iso 18:0 was discriminated from cis-16:1 isomers. 17:0 and 21:0 were well resolved only when an initial GC temperature of 160°C was applied.

Sepsis grave en paciente con elephantiasis verrucosa nostra colonizada / No disponible

No disponible

Factores que inciden en la duración de la lactancia materna exclusiva en una comunidad rural de Chile / Factors affecting the duration of exclusiv breastfeeding in a rural community of Chile

Introducción. Según las directrices del Ministerio de Salud de Chile, la lactancia materna exclusiva (LME) se debe suministrar como único alimento hasta los 6 meses de vida del lactante; sin embargo, las cifras de destete precoz han aumentado, influyendo en este aspecto motivos de índole social, familiar y personal de salud. Objetivo. Determinar los factores que inciden en la duración de la lactancia materna exclusiva hasta los seis meses en un centro de salud rural. Métodos. Estudio no experimental, descriptivo y de cohorte retrospectivo; se incluyeron en este estudio a 81 madres de hijos/as en edades entre 6 y 11 meses de edad, y se aplicó un instrumento formado por 11 preguntas cerradas y semiestructuradas. Resultados. Se encontró un 56,8% de destete precoz, siendo las razones más relevantes: hipogalactia (45,7%), indicación médica y enfermedad de la madre (15,2%), y motivos laborales (13%). La edad de las madres se correlacionó con el destete precoz (p=0,046). Conclusiones. Las madres menores de 26 años proporcionaron por menos tiempo lactancia materna exclusiva a sus hijos, siendo el foco de atención para las actividades educativas de fomento de LME.

Background: Exclusive breastfeeding (EBF) must be provided as the only food until 6 months of life, according to the guidelines of the Ministry of Health of Chile. However the prevalence of early weaning has increased, influencing social, family and health aspects. Objective: To determine the factors that could affect the duration of exclusive breastfeeding until six months in a rural health center. Methods: A non-experimental descriptive and retrospective study cohort that included 81 mothers and their offspring aged 6 to 11 months old, applying an ad-hoc instrument consisting of 11 questions closed and semi-structured. Results: 56.7% of mothers had an early weaning, the most important reasons being hypogalactia (45.6%), health staffindication, ands mother's illness (15.2%), and work reasons (13%). Age of mother correlated with early weaning (p 0.046). Conclusions: Mothers under 26 years of age showed reduced time giving exclusive breastfeeding.

Determination of 10-hydroxystearic, 10-ketostearic, 8-hydroxypalmitic, and 8-ketopalmitic acids in milk fat by solid-phase extraction plus gas chromatography-mass spectrometry.

Fatty acids (FA) bearing oxygenated functions and present in esterified form in triacylglycerols are widespread in nature but very little is known about their occurrence in dairy products. A method based on gas chromatography (with flame ionization detector and mass spectrometry detectors), including the previous isolation of polar FA methyl esters by solid-phase extraction, was applied to quantify oxygenated FA in milk fat. Samples obtained from ewes and goats fed with a variety of oil sources were studied. Fatty acids identified were 8-ketopalmitic, 8-hydroxypalmitic, 10-ketostearic, and mainly 10-hydroxystearic acids. The highest levels of 10-ketostearic acid were obtained in milk from animals fed olive oil (up to 1.5%) and from those fed long-chain n-3 FA-enriched diets (0.5-1.0%). In all samples, 10-hydroxystearic acid, not reported so far in milk, was the second most abundant oxygenated FA (up to 0.8%). The high correlation obtained between contents of 10-ketostearic and 10-hydroxystearic acids would confirm the existence of a common pathway of formation in the rumen, whereas the presence of 8-ketopalmitate and 8-hydroxypalmitate could be putatively attributed to mechanisms of ß-oxidation in the tissues. The influence of cis-9 C18:1 and trans-10 C18:1 as precursors of these compounds in milk and the metabolic pathways involved in their formation are discussed.

Relación entre la dinamometría de mano y la circunferencia de pantorrilla con el índice de masa corporal en ancianos autovalentes / Relation beween body mass index with calf circunference and dynamometry in self-maintaining elderly

Background: The control of the birthrate and the decrease of the mortality have unleashed a demographic aging. Nutritional status indicators are useless and in some cases it is not possible to determine the exact height or weight, making these indicators useless. Aim: To correlate the BMI with calf perimeter and muscle strength (dynamo-metry dominant and non-dominant). Methods: We studied 60 adults over 60 years old, with self-maintenance functional capacity. The subjects belonged to the "Circle of Retired Chilean Police" of Chillan city in Chile. The anthropometric measurements and dynamometry were obtained according to WHO specifications. We used correlation coefficients and ANOVA to determine the association between variables. Results: There was a weak negative relationship between dynamometry with BMI, r= -0.19 dynamometry dominant (p=0.332) and r= -0.11 dynamometry non-dominant (p=0.806), but a positive correlation was found between the calf perimeter and BMI, r= 0,64 (p<0.001). Conclusions: The data show the utility of calf perimeter as an indicator of nutritional status in the study of subjects, which was not observed with dynamometry.

Introducción: El control de la natalidad y el descenso de la mortalidad han desencadenado un envejecimiento demográfico, por lo que en algunos casos no es posible determinar con exactitud la estatura o el peso, careciendo de utilidad los indicadores nutricionales. Objetivo: Relacionar el índice de masa corporal (IMC) con el perímetro de pantorrilla y la fuerza muscular medida por la dinamometría de mano dominante y no-dominante. Métodos: Se estudiaron 60 adultos mayores de 60 años, con capacidad funcional de autovalencia, los adultos pertenecían al círculo de Carabineros de Chile en retiro de la ciudad de Chillan en la VII Región. Los datos antropométricos y la dinamometría se determinaron de acuerdo a las técnicas establecidas por la OMS. Se utilizó el coeficiente de correlación y Anova para determinar la asociación entre las variables. Resultados: Se observó una relación negativa débil entre ambas dinamometrías con el IMC; r = -0.19, dominante (p 0.332) y no dominante r = -0.11 (p 0.806), pero se encontró una correlación positiva de carácter mediana, entre el perímetro de pantorrilla y el IMC, r = 0.64 (p<0.001). Conclusiones: Los datos aportados evidencian la utilidad del perímetro de pantorrilla como indicador del estado nutricional en los sujetos de estudio, no así la dinamometría de mano.

Construcción y validación de un cuestionario para medir conductas y hábitos alimentarios en usuarios de la atención primaria de salud / Construction and validation of a questionnaire to measure behaviors and dietary habits in users of primary health care

To identify behaviors and habits of the population is critical to establish appropriate strategies and tools to promote changes inappropriate practices. The aim of this study was to develop a reliable tool to quantify and determine eating habits both in individuals and in the population. Based on the survey validated by Pardo in 2004, a group of students of 3rd year of Nutrition and Dietetics took a survey of 44 items, which was applied to a sample of 402 subjects (220 women and 180 males) whose average age was 30.2 ± 24.7years. The questionnaire showed acceptable reliability (α=0.792), establishing 11 dimensions with 38 questions. Females showed a significantly higher average total score compared to males (p<0.001). In conclusion, implementation and validation of the questionnaire allows us to contribute a low-cost tool to know the intimate aspects of the behavior ofpeople attending public health centers.

Identificar las conductas y hábitos de la población es fundamental para establecer las estrategias y herramientas pertinentes para promover el cambio de las prácticas inadecuadas. El objetivo de este estudio es elaborar una herramienta confiable que permita cuantificar y determinar los hábitos alimentarios tanto individuales como poblacionales. En base a la encuesta validada por Pardo (2004), un grupo de estudiantes de 3° año de Nutrición y Dietética elaboró una encuesta de 48 ítems, la cual se aplicó a una muestra de 402 personas de todos los grupos etarios (220 mujeres y 180 varones), cuya edad promedio fue de 30,24 +/- 24,75 años. El cuestionario revela una confiabilidad aceptable (α=0,792), estableciéndose 11 dimensiones con 38 preguntas. Las mujeres presentaron un puntaje total promedio significativamente superior en comparación a los varones (p<0,001). En conclusión, la aplicación y validación del cuestionario nos permite contribuir con una herramienta de bajo costo que permita conocer aspectos más íntimos de las conductas alimentarias que forman parte de los hábitos de personas que asisten a centros de salud públicos.

Conocimientos alimentario-nutricionales y estado nutricionalde estudiantes de cuarto año básico según establecimientos particulares y subvencionados de la ciudad de Talca / Knowledge of food nutrition status of students of 4th grade in private and semi-private schools of city of Talca

The malnutrition by excess of school age children is problem that may also be treated at school, because Children spend most of their time at school. It was studied knowledge about food of students from year four in primary school of private and semi-private schools of Talca city. An instrument was created and was applied to measure the knowledge of eating habits in children in sample of 273 students. The average percentage of knowledge that students have, was 61,4 +/- 14;75 percent. Students from private schools had a better domain in the knowledge of eating habits (p<0.005). Insufficient knowledge can affect the nutritional status of children. This research must be confronted from a multifactorial perspective, even though, only knowledge does not indicate enough success in the nutritional recovery of the children.

La malnutrición por exceso en la etapa escolar es un problema que también se puede abordar en el aula, dado que los niños pasan gran parte del tiempo en el establecimiento educacional. Se estudiaron los conocimientos de alimentación de alumnos de cuarto año básico de colegios particulares y particulares subvencionados de la ciudad de Talca. Se creó y aplicó un instrumento para medir los conocimientos de hábitos en alimentación para niños en una muestra de 273 escolares. En promedio, el porcentaje de conocimientos que poseen los estudiantes fue de 61,4 +/- 14,75 por ciento. Los alumnos de colegios particulares tuvieron un mejor dominio en conocimientos sobre alimentación (p<0.05). El conocimiento insuficiente podría repercutir en el estado nutricional de los niños. Este tema se debe afrontar desde una perspectiva multifactorial, ya que sólo los conocimientos no son indicador de éxito suficiente en la recuperación nutricional de los niños.

Percepción de la imagen corporal: del estado nutricional y de la composición corporal de estudiantes de nutrición y dietética de la Universidad del Mar, Talca, Chile / Body image, nutritional status and body composition perception of nutrition and dietetics students in University del Mar, Talca, Chile

The increase in the prevalence of malnutrition by excess, specifically obesity, has led to the search of new factors, which influence the development of this pathology like the perception of body weight and nutritional condition. The study was performed in students of the Nutrition and Dietetics Career of the University del Mar, with the aim to relate the perception of their corporal image with their nutritional status and fat and lean cellular compartments. Anatomical figures, proposed by Montero were used. Weight height, brachial circumference and triceps skin fold were used to determine IMC, CHM, AHM and AGB. A trend was observed to the overestimation of the nutritional condition to the fat compartment (pp<0,001).

El aumento de la malnutrición por exceso, específicamente obesidad, ha llevado a la búsqueda de nuevos factores que intervienen en el desarrollo de esta patología siendo uno de estos la percepción del peso y estado nutricional. El estudio se efectuó en estudiantes de la carrera de Nutrición y Dietética de la Universidad del Mar Sede Centro Sur Campus Talca con el objetivo de relacionar la percepción de la imagen corporal de estos con el estado nutricional real y compartimentos celulares graso y magro. Se utilizaron figuras anatómicas propuestas por Montero y luego se procedió a medir, peso, talla, circunferencia braquial y pliegue tricipital, con los cuales se determinó IMC, CHM, AMH y AGB. Se observó una tendencia a la sobreestimación del estado nutricional (IMC) (p<0,01) relacionándose esta percepción con el compartimiento graso (p<0,001).

Estudio comparativo de las curvas de crecimiento NCHS/OMS: evaluación del estado nutricional e implicancias en un centro de salud familiar / Comparative study of NCHS/WHO growth curves: nutritional status evaluation and implications in a public family health center

Chile changed from the CDCINCHS to the new WHO standards in 2007 to evaluate growth in children less than 5 years of age. Our proposal was to determine the impact of this change on nutritional indicators. We studied 982 children aged less than 5 years in a public family health center in Chillan Viejo. Length height-for-age, weight-for-length height, and weight-for-age indicators were compared for both growth curves with the WHO Anthro program. Results showed significant differences in means for all anthropometric indicators (p<0.0001), increased proportion of undernourished, overweight, and obese children, as well as a significant decrease of those with normal nutritional status. Consultation hours increased 27.7 percent and 41.1 percent for nutritionists and doctors, respectively. We concluded that the WHO standard represents more adequately optimum child growth, increases the proportion of children with nutritional excess and deficit leading lo enhanced nutritional attention by health professionals.

El año 2007 Chile cambió la referencia NCHS por los nuevos estándares OMS, para evaluar el crecimiento de los menores de 5 años. Por ello, nos propusimos determinar el impacto del cambio en los indicadores nutricionales. Se estudiaron 982 menores de 5 años del Centro de Salud Familiar de Chillan Viejo, por los indicadores Talla/Edad, Peso/Talla y Peso/Edad, comparados por ambas curvas, en el programa WHO Anthro. Los resultados mostraron diferencias significativas en las medias de todos los indicadores antropométricos (p<0.0001), aumentó la proporción de niños desnutridos, sobrepeso y obesos, y disminuyeron significativamente los niños con estado nutricional normal. Las horas de consulta nutricional para nutricionistas y médicos aumentaron un 27.7 por ciento y 41.1 por ciento respectivamente. Concluimos que el estándar OMS representa mejor el crecimiento infantil óptimo, aumenta la proporción de niños con exceso y con déficit nutricional, lo que lleva a mayor atención nutricional de los profesionales.

Utilización de polialcamida en cirugía reconstructiva y estética facial / Use of polyalkylimide in facial reconstructive and cosmetic surgery

Objetivos. Presentar nuestra experiencia en el manejo y aplicaciónde biomateriales no reabsorbibles (poliaquilamida) en pacientes condefectos faciales de diversa etiología.Material y métodos. Empleamos poliaquilamida (Bio-Alcamid®) en un totalde catorce pacientes. Cuatro pacientes presentaban distintos grados delipodistrofia facial secundaria a tratamientos antiretrovirales. Otros cuatro,consultaron porque deseaban mejorar el aspecto de su perfil labial. Trespacientes habían sido sometidos con anterioridad a exéresis oncológicas,y otros dos mostraban defectos faciales derivados de traumatismos. Finalmente,un paciente presentaba un defecto nasal, secuela de una rinoplastiaprevia.Resultados. Todos los pacientes mostraron un índice muy elevado de satisfacción.No se registraron complicaciones graves. Queremos señalar la estabilidady durabilidad del implante.Conclusiones. La seguridad y sencillez de esta técnica asociada al alto gradode satisfacción manifestado por los pacientes, animan al empleo de estassustancias en la corrección de defectos faciales de diversa etiología(AU)

Objectives. To report our experience with the managementand application of nonresorbible biomaterials (polyalkylimide) inpatients with facial defects of diverse origin.Material and methods. Polyalkylimide (Bio-Alcamid®) was used infourteen patients. Four patients had different grades of faciallipodystrophy secondary to antiretroviral treatment. Four patientssought to improve their labial profile. Three patients had previouslyundergone oncological excision and two had traumatic facial defects.Finally, one patient had a nasal defect due to rhinoplasty.Results. All patients were very satisfied. No serious complicationsoccurred. Implants were stable and durable.Conclusions. The safety and simplicity of this technique, and thehigh degree of patient satisfaction, encourage the use of thesesubstances to correct facial defects of diverse etiology(AU)

Leptospirosis: Presentación de una infección fulminante y revisión de la literatura / Leptospirosis: Report of a fulminant fatal case and review

Entre las nuevas y re-emergentes enfermedades infecciosas que amenazan a la humanidad, y como resultado de este caso clínico, se hace una revisión bibliográfica acerca de leptospirosis insistiendo en la necesidad de tenerla in mente en el diagnóstico diferencial de un cuadro febril con ictericia.

Neutropenia inducida por propiltiouracilo en paciente con síndrome de Down e hipertiroidismo / Neutropenia induced by propylthiouracil in patient with down syndrome and hyperthyroidism

Se presenta el caso de un paciente de sexo masculino de 10 años de edad, con antecedente de síndrome de Down, que consulta por cuadro de hipertiroidismo compatible con enfermedad de Base-dow-Graves. Recibe tratamiento con propiltiouracilo en dosis de 5 mg/kg/día. Veinte días después de iniciado el tratamiento, desarrolla agranulocitosis secundaria al uso de PTU. Se realiza una revisión sobre el hipertiroidismo en pacientes con síndrome de Down, el tratamiento de esta patología, y las reacciones adversas más frecuentes descritas en relación al uso de PTU.

Resultado de la cirugía del hiperparatiroidismo: 12 años de experiencia / Hyperparathyroidism surgery: 12 years of experience

Presentamos un estudio retrospectivo de 103 paratiroidectomías realizadas sobre un total de 105 pacientes remitidos con diagnóstico de hiperparatiroidismo, entre los años 1990 y 2001, y candidatos a cirugía. 80 pacientes eran mujeres frente a 25 varones, con una edad media de 54 años. Procedemos a revisar las manifestaciones clínicas principales que presentaban los enfermos, tipo de hiperparatiroidismo, pruebas de imagen o complementarias solicitadas y tipo de intervención quirúrgica realizada. Analizamos las principales complicaciones obtenidas; hasta octubre del 2001 sólo hemos tenido un caso de paresia recurrencial, con un 23,8 por ciento de hipocalcemias transitorias y un 1,9 por ciento de definitivas. La evolución de los pacientes fue bastante positiva en general si exceptuamos cuatro casos de pacientes intervenidos en los que persistió la hipercalcemia. Por último defendemos la utilización del llamado test de la Paratohormona intacta rápida (rapid PTHi test), para evitar una exploración bilateral en los hiperparatiroidismos primarios

Determination of polycyclic aromatic hydrocarbons in seawater by high-performance liquid chromatography with fluorescence detection following micelle-mediated preconcentration.

In this work, the nonionic surfactant polyoxyethylene-10-lauryl ether has been used for the extraction and preconcentration of 14 polycyclic aromatic hydrocarbons, classified as priority pollutants by the US Environmental Protection Agency, from seawater samples. The cloud-point preconcentration previous separation by HPLC and quantification using fluorimetric detection and wavelength programming allow to determine these pollutants with detection limits ranging from 1.0 to 1.5 x 10(2) ng/l with RSDs better than 10.4%. The methodology is evaluated using well-established extraction and preconcentration methods and GC-MS.

Síndrome de Ramsay-Hunt. Nuestra experiencia y revisión de la literatura / Ramsay-Hunt’s syndrome. Our experience and a bibliographic review

El Síndrome de Ramsay-Hunt o parálisis facial asociada al herpes zóster ótico representa un 7 per cent de todas las parálisis faciales periféricas. Presentamos nuestra experiencia desde 1992 hasta el 2001; en este período ingresaron en nuestro Servicio de ORL 12 pacientes (9 mujeres y 3 hombres) con este diagnóstico. Analizamos distintas variables: Edad, manifestaciones clínicas, pruebas complementarias utilizadas, tratamiento administrado, complicaciones, estancia media y evolución de los pacientes. Nuestros resultados muestran sólo 2 pacientes (16,67 per cent) con recuperación total tras un seguimiento medio de 6 meses, permaneciendo el resto con secuelas. Realizamos una revisión de la literatura comparando nuestros resultados con otras series publicadas para intentar establecer la mejor pauta de tratamiento para esta patología. (AU)

Factores predictores de riesgo de morbimortalidad en hipertensos esenciales seguidos 25 años / Risk factors for morbidity and mortality in subjects with essential hypertension, followed for 25 years

Background: Among hypertensive patients, other risk factors for mortality and morbidity, besides blood pressure, must be considered when therapeutic decisions are done. Aim: To assess the incidence and relevance of cardiovascular risk factors in a cohort of patients with essential hypertension. Material and methods: A cohort of 1.072 treated patients with essential hypertension was followed for a period up to 25 years. Four hundred eighty six were men and 586 were women, age ranged from 31 to 70 years. At entry, 56 percent of subjects did not have any organic complications associated to hypertension (stage I WHO criteria), 30 percent had mild alterations (Stage II) and 14 percent had major complications (myocardial infarction, stroke, heart failure or renal failure). Likewise, 43.8 percent had mild, 14.5 percent, moderate and 41.7 percent, severe hypertension. Patients were treated with monotherapy or combined therapy based on diuretics, beta blockers, calcium antagonists and angiotensin converting enzyme inhibitors. Goal of therapy was 140/90 mm Hg. Risk factors associated diseases and complications were registered carefully. Causes of death were obtained from hospital records and death certificates. Mortality was analyzed using life tables (intention to treat method included). Results: Blood pressure dropped significantly during follow up from a mean of 182/110 to 154/92 mm Hg. During follow up, 143 patients died and 429 complications (lethal or non lethal) were recorded. Twenty four percent of patients smoked, 24 percent reported alcohol intake, 56 percent had hypercholesterolemia, 11 percent were obese, 13 percent had diabetes and 3 percent had gout. The proportional hazard model showed that the existence of previous complications, the presence of more than 3 risk factors, and age over 60 and mean systolic and diastolic pressure during therapy, were independent and significant risk factors for mortality. Conclusions: The incidence of risk factors among our hypertensive patients is very similar to that of other national or international cohorts