Dose-escalated SBRT for borderline and locally advanced pancreatic cancer. Feasibility, safety and preliminary clinical results of a multicenter study.

Background: Pancreatic Stereotactic Body Radiotherapy (SBRT) allows for the administration of a higher biologically effective doses (BED), that would be essential to achieve durable tumor control. Escalating treatment doses need a very accurate tumor positioning and motion control during radiotherapy.The aim of this study to assess the feasibility and safety of a Simultaneous Integrated Boost (SIB) dose-escalated protocol at 45 Gy, 50 Gy and 55 Gy in 5 consecutive daily fractions, in Border Line Resectable Pancreatic Cancer (BRCP) /Locally Advanced Pancreatic Cancer (LAPC) by means of a standard LINAC platform. Methods: Patients diagnosed of BRPC/LAPC, candidates for neoadjuvant chemotherapy and SBRT, in four university hospitals of the province of Las Palmas (Canary Islands, Spain) were included in this prospective study. Radiotherapy was administered using standard technology (LINACS) with advanced positioning (Lipiodol® and metallic stent used as fiducial markers) and tumor motion control (4D, DBH, Calypso®). There were 3 planned dose-escalated SIB groups, 45 Gy/5f (9 patients) 50 Gy/5f (9 + 9 patients) and 55 Gy/5f (9 patients). The defined primary end points of the study were the safety and feasibility of the proposed treatment protocol. Secondary endpoints included radiological tumor response after SBRT, local control and survival. Results: From June 2017 to December 2022, sixty-two patients were initially assessed for eligibility in the study in the four participating centers, and 49 were candidates for chemotherapy (CHT). Forty-one were referred to radiotherapy after CHT and 33 finally were treated by escalated-dose SIB, 45 Gy (9 patients) 50 Gy (16 patients), 55 Gy(8 patients). All patients completed the scheduled treatment and no acute or late severe (≥grade3) gastrointestinal toxicity was observed.Local response was analyzed by CT/MRI two months after the end of SBRT. Ten patients (31,25 %) achieved objective response (2/9:45 Gy, 5/15:50 Gy, 3/8:55 Gy). Follow-up was closed as July 2023. Freedom from local progression at 1-2y were 89,3% (95 %CI:83,4-95,2%) and 66 % (95 %CI:54,6-77,4%) respectively. The 1-2y survival rates were 95,7% (95 %CI:91,4-100 % and 48,6% (95 %CI:37,7-59,5%) respectively. Conclusion: These promising results should be confirmed by further studies with larger sample size and extended follow-up period.

Prospective Pilot study of Quality of Life in patients with severe late-radiation-toxicity treated by Low hyperbaric-oxigen-therapy.

Background/purpose: The aim of this study is to assess for the first time the immediate and long term impact on quality-of-life of HBO treatments(HBOT) at 1.45 ATA (Absolute Atmospheric Pressure) Medical Hyperbaric chamber. Methods: Patients over 18 years-old, suffering of grade 3 Common Terminology Criteria for Adverse Events (CTCAE) 4.0 radiation induced late toxicity and progressing to standard support therapy were included in this prospective study. HBOT was given daily, sixty minutes per session by a Medical Hyperbaric Chamber Biobarica System at 1.45 ATA at 100% O2. Forty sessions were prescribed for all patients given in 8 weeks. Patients reported outcomes (PROs) was assessed by the QLQ-C30 questionnaire, before starting, in the last week of the treatment, as well as during follow up. Results: Between February-2018/June-2021, 48 patients fulfilled the inclusion criteria. A total of 37 patients (77%) completed the treatment prescribed HBOT sessions. Patients with anal fibrosis (9/37) and brain necrosis (7/37) were the most frequently treated. The most common symptoms were pain (65%) and bleeding (54%). In addition, thirty out of the 37 patients who completed the pre- and post-treatment Patients Reported Outcomes (PROs) assessment also completed the follow up European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire C30 (EORTC-QLQ-C30), and were evaluated in the present study. Mean follow up was 22,10 (6-39) months.The Median score of the EORTC-QLQ-C30, at the end of HBOT and during follow-up, was improved in all assessed domains, except in the cognitive aspect (p = 0.106). Conclusions: HBOT at 1.45 ATA is a feasible and well tolerated treatment, improving long term quality of life in terms of physical function, daily activities and general health subjective state of patients suffering severe late radiation-induced toxicity.

Emergency Laparotomy Follow-Up Study (ELFUS): prospective feasibility investigation into postoperative complications and quality of life using patient-reported outcome measures up to a year after emergency laparotomy.

BACKGROUND: Emergency laparotomy carries a significant risk profile around the time of surgery. This research aimed to establish the feasibility of recruitment to a study using validated scoring tools to assess complications after surgery; and patient-reported outcome measures (PROMs) to assess quality of life and quality of recovery up to a year following emergency laparotomy (EL). METHODS: We used our local National Emergency Laparotomy Audit (NELA) register to identify potential participants at a single NHS centre in England. Complications were assessed at 5, 10 and 30 days after EL. Patient-reported outcome measures were collected at 1, 3, 6 and 12 months after surgery using EQ5D and WHODAS 2.0 questionnaires. RESULTS: Seventy of 129 consecutive patients (54%) agreed to take part in the study. Post-operative morbidity survey data was recorded from 63 and 37 patients at postoperative day 5 and day 10. Accordion Complication Severity Grading data was obtained from 70 patients. Patient-reported outcome measures were obtained from patients at baseline and 1, 3, 6 and 12 months after surgery from 70, 59, 51, 48, to 42 patients (100%, 87%, 77%, 75% and 69% of survivors), respectively. CONCLUSIONS: This study affirms the feasibility of collecting PROMs and morbidity data successfully at various time points following emergency laparotomy, and is the first longitudinal study to describe quality of life up to a year after surgery. This finding is important in the design of a larger observational study into quality of life and recovery after EL.

Causas de ingresos no deseados tras la realización de procedimientos quirúrgicos de cirugía ortopédica y traumatología en cirugía mayor ambulatoria / Causes of unplanned admission after orthopedic procedures in ambulatory surgery

OBJETIVO: Los procedimientos de cirugía ortopédica y traumatología realizados en unidades de cirugía mayor ambulatoria ofrecen importantes ventajas que desaparecen cuando la recuperación postoperatoria no es la esperada y los pacientes precisan ingresar. El objetivo de este estudio es analizar las causas de ingresos no deseados tras intervenciones quirúrgicas de cirugía ortopédica y traumatología en una unidad de cirugía mayor ambulatoria en relación con variables como edad, riesgo anestésico, tipo de anestesia, procedimiento o duración. MÉTODOS: Estudio de cohorte ambispectivo sobre 5.085 pacientes intervenidos desde 1995 a 2017. Se analizaron 39 variables proporcionadas por la base de datos de la unidad que se abre al ingreso en la misma y se cierra el día 30 postoperatorio. RESULTADOS: El 98,2% de los pacientes fueron dados de alta de la unidad. Precisaron ingresar 74 (1,5%). Este porcentaje demostró diferencias significativas en relación con el tipo de procedimiento, el tipo de anestesia y la duración, que condicionaron el ingreso inmediato por mal control del dolor agudo postoperatorio, náuseas o alteraciones de la herida. Diecisiete pacientes (0,3%) precisaron un ingreso diferido por complicaciones surgidas en el domicilio, siendo la más frecuente la infección de la herida. CONCLUSIONES: Los ingresos no deseados se relacionan con mayor frecuencia con el empleo de anestesia general, con operaciones de mayor duración y con procedimientos como la cirugía artroscópica, las correcciones de hallux valgus o las retiradas de material de osteosíntesis, siendo las causas de ingreso más importantes el mal control del dolor agudo postoperatorio en los inmediatos y la infección de la herida en los diferidos

OBJECTIVE: Orthopaedic procedures performed in Day Surgery Units provide important advantages which disappear when patients require admission when postoperative recovery is not as expected. The aim of this study was to analyse the reasons for unplanned hospital admissions after orthopaedic procedures in a Day Surgery Unit and their relationship between variables such as patient age, anaesthetic risk and technique, procedure or duration. METHODS: Ambispective cohort study of 5,085 patients who underwent surgical orthopaedic procedures between 1995 and 2017. Thirty-nine variables provided by the Unit's database were analysed. The database was opened on the day of admission and closed the 30th postoperative day. RESULTS: Of the patients, 98.2% were discharged from the Unit. Seventy-four (1.5%) required overnight admission. This percentage showed significant differences in relation to the type of procedure, type of anaesthesia and duration, which conditioned overnight admission due to inadequate postoperative pain management, nausea or wound complications. Seventeen patients (0.3%) required readmission after discharge due to complications that arose at home, such as wound infection, which was the most common. CONCLUSIONS: Unplanned admissions are more frequently related to general anaesthesia, lengthy surgeries and procedures such as arthroscopy, hallux valgus corrections or removal of osteosynthesis material. The major reasons for unplanned admissions were inadequate postoperative pain management for overnight admissions and wound infection for admissions after discharge

Causes of unplanned admission after orthopedic procedures in ambulatory surgery. / Causas de ingresos no deseados tras la realización de procedimientos quirúrgicos de cirugía ortopédica y traumatología en cirugía mayor ambulatoria.

OBJECTIVE: Orthopaedic procedures performed in Day Surgery Units provide important advantages which disappear when patients require admission when postoperative recovery is not as expected. The aim of this study was to analyse the reasons for unplanned hospital admissions after orthopaedic procedures in a Day Surgery Unit and their relationship between variables such as patient age, anaesthetic risk and technique, procedure or duration. METHODS: Ambispective cohort study of 5,085 patients who underwent surgical orthopaedic procedures between 1995 and 2017. Thirty-nine variables provided by the Unit's database were analysed. The database was opened on the day of admission and closed the 30th postoperative day. RESULTS: Of the patients, 98.2% were discharged from the Unit. Seventy-four (1.5%) required overnight admission. This percentage showed significant differences in relation to the type of procedure, type of anaesthesia and duration, which conditioned overnight admission due to inadequate postoperative pain management, nausea or wound complications. Seventeen patients (0.3%) required readmission after discharge due to complications that arose at home, such as wound infection, which was the most common. CONCLUSIONS: Unplanned admissions are more frequently related to general anaesthesia, lengthy surgeries and procedures such as arthroscopy, hallux valgus corrections or removal of osteosynthesis material. The major reasons for unplanned admissions were inadequate postoperative pain management for overnight admissions and wound infection for admissions after discharge.

Hypofractionation vs. conventional radiotherapy fractionation in the conservative treatment of T1 glottic cancer: a prospective cohort study.

BACKGROUND: Definitive radiotherapy is an effective single-modality in T1 glottic cancer. Hypofractionated schemes could offer excellent results in a shorter treatment period. We aimed to evaluate the clinical outcomes and toxicity comparing conventional vs. hypofractionated radiotherapy treatment in T1N0M0-glottic cancer. PATIENTS AND METHODS: Between Jan-1st, 2005 and August-1st, 2017, in a prospective cohort study, with 10-year follow-up, 138 patients were treated with conventional schedule 2 Gy/day, total dose 70 Gy/7 weeks (N = 71) or hypofractionated schedule 2, 2-2, 25 Gy/day, total dose 63, 8-63 Gy/5, 5 weeks (N = 67). Endpoints were clinical-response rate, local relapse-free survival (LRFS), laryngectomy-free survival (LFS), toxicity rates, relapse-free survival (RFS), metastasis-free survival (MFS), second tumour-free survival (2TFS), and overall survival (OS). RESULTS: All patients showed a complete clinical response. No differences were found for LRFS (p = 0.869), LFS (p = 0.975), RFS (p = 0.767), MFS (p = 0.601), 2TFS (p = 0.293), or OS (p = 0.685). Acute toxicity for skin and mucosae was similar (p = 0.550 and p = 0.698). Acute laryngeal toxicity was higher in the hypofractionation group (p = 0.004), due to an increase in slight moderate grade. No differences in late laryngeal edema were found (p = 0.989). CONCLUSION: Radiotherapy offers high rate survival, local control, and larynx preservation after 5-10-year follow-up. A hypofractionation could be preferable, since it offers the same results as conventional with fewer treatment sessions.

Conciliación de la vida laboral y familiar en profesionales que trabajan con menores de riesgo social en la Comunidad de Madrid / Balance of family and work life in professionals working with minors having social risk in the Community of Madrid

El término ‘conciliación de la vida laboral y familiar’ hace referencia a un conjunto de medidas tendentes a paliar las dificultades que, la dicotomía entre la vida laboral, y la vida personal presentan. En otras palabras que los espacios: laboral y familiar no entren en conflicto y por lo tanto, que ninguno de los dos perjudique el desarrollo del otro. La investigación se desarrolla con el personal activo mujeres y hombres que ejercen funciones de dirección, de educadores sociales, profesores, psicólogos, sanitarios y personal de apoyo logístico, que trabajan en Residencias de Menores que pertenecen a la Red de Protección del Instituto Madrileño de la Familia y el Menor. El objetivo que se persigue es conocer el resultado de las propiedades psicométricas de la versión española del Cuestionario de Interacción Trabajo-Familia (SWING) en un ámbito diferente, así como los resultados que se originen de la aplicación del cuestionario de usos del tiempo (AU)

The expression ‘work-life balance’ refers to a set of measures designed to palliate the difficulties that issue from the necessity to reconcile our working life with our private life. In other words, the aim is to prevent conflicts between the working environment and the private sphere so that neither of them affects the development of the other. The investigation has been carried out among the men and women (directors, social educators, teachers, psychologists, medical personnel and logistical support staff) who work in Residences for Minors belonging to the Protection Network and assigned to the Madrid Institute for Minors and the Family. Its objective is to gain knowledge of the result of the psychometric properties of the Spanish version of the Survey Work-Home Interaction Nijmegen (SWING) in a different sphere and draw reasonable conclusions from the application of the Time Management Test (AU)

Estudio transversal de las complicaciones postoperatorias detectadas mediante contacto telefónico en pacientes intervenidos en una Unidad de Cirugía Mayor Ambulatoria / Transversal study of postoperative complications through phone contact with patients operated on day surgery

Introducción: Algunas publicaciones establecen el control ineficaz del dolor agudo postoperatorio como uno de los principales problemas en las unidades de Cirugía Mayor Ambulatoria. El objetivo principal del estudio ha sido conocer las complicaciones postoperatorias más frecuentes en la unidad y las intervenciones que más frecuentemente las producen. Metodología: Estudio observacional, descriptivo, transversal, realizado a través del análisis de 12.850 llamadas telefónicas, desde marzo de 1999 hasta marzo de 2015. Como instrumento de medida se empleó un cuestionario no validado, diseñado específicamente para ese propósito. Para el análisis de los datos se utilizó el programa Stat View 5.0.1. El nivel de confianza del estudio se estableció en p < 0,05. Resultados: Como complicaciones más destacadas, el 10,56 % de los pacientes manifestó dolor, el 8,54 % detectó el apósito manchado y el 2,63 % sintió náuseas. Los pacientes intervenidos sobre patología ósea fueron los que más dolor expresaron (40,06 %); los operados de otorrinolaringología (excepto oído), los que más manifestaron haber manchado el apósito (33,71 %) y los pacientes intervenidos de cirugía general, los que más náuseas refirieron (14,10 %), todos ellos con una diferencia estadísticamente significativa (p < 0,0001). Conclusiones: El mal control del dolor agudo postoperatorio se constituye como la incidencia postoperatoria más relevante en el domicilio, muy especialmente tras las intervenciones sobre patología ósea (AU)

Background: Inefficient control of Acute Postoperative Pain has been stablished as one of the main problems in Day Surgery Units in recent published works. The primary endpoint of this study was to identify the most frequent postoperative complaints in the Day Surgery Unit and its relationship with different surgical procedures. Methods: Between March 1999 and March 2015, 12,850 phone calls were enrolled in an observational, descriptive transversal trial. A non-validated questionnaire, specifically designed, was used as a measurement tool. Data were analysed by Stat View 5.0.1 software. P values less than 0.05 were considered statistically significant. Results: Among the most important complications, 10.56 % of patients reported bad postoperative pain control, 8.54 % detected stained dressing and 2.63 % suffered nausea. With a statistically significant difference (p < 0,0001), patients operated on bone pathology (mainly hallux valgus correction) were those who expressed more pain (40.06 %), patients operated on ENT procedures (excluding ear) were those who reported more stained dressing (33.71 %) and patients operated on General Surgery procedures were those who suffered more postoperative nausea (14.10 %). Conclusions: Bad postoperative acute pain control becomes the most relevant complaint at home, mainly after bone pathology correction (AU)

El cuidado de enfermería: una visión integradora en tiempos de crisis / Nursing care: an integrating vision in times of crisis

Existen diversas organizaciones y movimientos humanitarios a nivel mundial que tratan de luchar contra las expresiones de deshumanización, sin embargo, continúa la presencia de situaciones que son causas de dolor en el mundo, por lo que debemos constituir una sociedad para que el mundo sea civilizado, vivir por la calidad de vida y no por acumular cifras estadísticas. El cuidado es una característica común de todos los seres vivos. Por consiguiente, el cuidado humano se reconoce como un concepto universal, inherente a la humanidad. Heidegger, el filósofo por excelencia del cuidado, reconoce que éste es "una constitución ontológica, siempre subyacente a todo lo que el ser humano emprende, proyecta y hace". Enfermería como profesión de naturaleza social intenta que su personal, bajo una óptica humanista, ayude a la persona solicitante del cuidado a reforzar potencialidades y/o minimizar desequilibrios en su estado de salud, por ello reconoce al ser humano como un ser complejo, misterioso, estructurado por diversas dimensiones que van de lo orgánico a lo espiritual, de lo tangible a lo intangible; con inclusión del aspecto social e histórico, que lo define como un ser de interrelaciones permanentes consigo mismo y el mundo. Bajo esta perspectiva, en enfermería, se procura reconocer que la persona cuidada es una entidad única, poseedora de atributos: conciencia, intelecto, dignidad, emociones, sentimientos y saberes, por lo tanto, el cuidado en enfermería asume una dimensión humanista y comprensiva del ser, cuya subjetividad está estructurada por sus vivencias y significados, sentimientos, emociones, intuiciones, razonamientos (AU)

Nowadays, there exist several organizations of humanitarian movements all over the world which try to fight against the dehumanization expressions; however there still exists the presence of situations which are the reasons of pain in the world. That is why we must construct a better and civilized world in which people worries about the quality of life instead of accumulating statistical numbers .Care is a common feature of all human beings. Therefore, human care is recognized as a universal concept, inherent in humanity. Heidegger, the philosopher for excellence of care, recognizes that this is "an ontological constitution that is always underlying to all what the human beings begin, project and make." Nursing as a profession of social nature tries that its staff , under an humanistic perspective , helps the person interested in care to reinforce his /her abilities and /or to minimize imbalances in her /his state of health .That is why it recognizes the human beings as a complex , mysterious and structured in several dimensions being that range from the organic to the spiritual, from the tangible to the intangible , including the social and historical aspect , which defines it as a being of permanent relationships with himself and the world. Under this point of view, nursing tries to recognize that the cared person is a unique entity which has attributes such as: awareness, intellect, dignity, emotions, feelings and knowledge. Therefore, the nursing care assumes a comprehensive and humanistic dimension of the human being whose subjectivity is structured by his experiences ,meanings , feelings , emotions , intuitions ,and reasoning (AU)

Brain Donation by Proxy: Are There Predictors in Neurodegenerative Dementia?

OBJECTIVES: To describe the frequency and predictors of brain donation by relatives in patients with neurodegenerative dementia. DESIGN: Database review and quantitative analysis. SETTING: The Alzheimer Center Reina Sofia Foundation (ACRSF), a center devoted to the care and research of patients with neurodegenerative dementia. PARTICIPANTS: Patients with signed consent for participation in the ACRSF research program. MEASUREMENTS: A set of 38 demographic, clinical, and social variables related to patient and closest relative, which were collected by the ACRSF multidisciplinary team upon patient admission. RESULTS: Admission data were available for 198 patients who entered the ACRSF research program; 85 of them (42.9%) died during follow-up. Mean age (SD) at admission was 82.3 (6.8) years and 80.8% of the patients were female. Family link between patient and closest relative was spouse or partner (12.0%), son or daughter (74.9%), or other link (13.1%). Brain was obtained from 56 patients (65.9%). Consent by legal representative and patient's depressive symptoms were more frequent in the donors (p<0.05, corrected) and trend was observed for more aberrant motor symptoms in the donors (p<0.05, uncorrected). CONCLUSION: A high rate of brain donation was achieved, probably due to the unique characteristics of the ACRSF and consent for research policy. Wish of alleviating suffering, as well as general interest in dementia research, possibly exerted an influence in brain donation. More research is needed to ascertain the values, motivations, and circumstances that may lead to brain donation by proxy in neurodegenerative dementia.

Embarazo ectópico ovárico: experiencia en 10 años del Hospital Universitario La Paz, Madrid, España / Ovarian ectopic pregnancy: 10-year experience at Hospital Universitario La Paz, Madrid, Spain

La gestación ectópica ovárica es muy infrecuente, presentando una incidencia de 1/2100-7000 gestaciones (0,5-3% de todos los ectópicos). Su diagnóstico es difícil y dada la poca experiencia, no está claro el tratamiento más adecuado. Se presentan seis casos clínicos, recogidos en nuestro hospital desde 2001 hasta 2011, destacando el difícil diagnóstico prequirúrgico así como el tratamiento realizado.

Ectopic ovarian pregnancy is very infrequent, with an incidence of 1/2100-7000 pregnancies (0.5-3% of all ectopic pregnancies). Diagnosis is difficult and due to few cases presented in the literature there is no consensus on the appropriate treatment. Here we review six clinical cases of ovarian ectopic pregnancy that presented to our hospital between 2001 and 2011, highlighting the difficult presurgical diagnosis and appropriate course of treatment.

Psychometric properties of the Spanish QoL-AD with institutionalized dementia patients and their family caregivers in Spain.

OBJECTIVES: To evaluate the psychometric attributes of the Spanish version of the Quality of Life-Alzheimer's Disease Scale (QoL-AD) in institutionalized patients and family caregivers in Spain. METHOD: 101 patients (88.1% women; mean age, 83.2 ± 6.3) with Alzheimer's disease (AD) (n = 82) and mixed dementia (n = 19) and their closest family caregivers. Patient-related variables included severity of dementia, cognitive status, perceived general health, quality of life, behavior, apathy, depression, and functional status. QoL-AD acceptability, reliability, and construct validity were analyzed. RESULTS: The mean Mini-Mental State Examination (MMSE) score was 7.2 ± 6.1 and Global Deterioration Scale was: stage four (4%); five (21.2%); six (34.3%); and seven (40.4%). Both, QoL-AD patient version (QoL-ADp) (n = 40; MMSE = 12.0 ± 4.5) and QoL-AD caregiver version (QoL-ADc) (n = 101) lacked significant floor and ceiling effects and the Cronbach α index was 0.90 and 0.86, respectively. The corrected item-total correlation was 0.11-0.68 (QoL-ADc) and 0.28-0.84 (QoL-ADp). Stability was satisfactory for QoL-ADp (intraclass correlation coefficient [ICC]=0.83) but low for QoL-ADc (ICC = 0.51); the standard error of measurement was 2.72 and 4.69. Construct validity was moderate/high for QoL-ADc (QUALID=-0.43; EQ-5D = 0.65), but lower for QoL-ADp. No significant correlations were observed between QoL-ADp and patient variables or QoL-ADc. A low to high association (r = 0.18-0.55) was obtained between QoL-ADc and patient-related measures of neuropsychiatric, function, and cognitive status. CONCLUSION: Differences in their psychometric attributes, and discrepancy between them, were found for QoL-ADp and QoL-ADc. In patients with AD and advanced dementia, the QoL perceived by the patient could be based on a construct that is different from the traditional QoL construct.

Estudio descriptivo, comparativo y correlacional del estado nutricional y condición cardiorrespiratoria en estudiantes universitarios de Chile / Descriptive, comparative and correlational study of nutritional and cardio-respiratory condition of Chilean universitary students

The aim of this research was to establish the nutritional and cardio-respiratory condition of university students from two important universities of Chile: Pontificia Universidad Católica de Valparaíso (PUCV) and Universidad de Concepción (UdeC). The nutritional and cardio-respiratory condition were evaluated through body mass index (BMI) and the Vo2max in the 2000 meter walk (UKK) test, respectively. The BMI results of the PUCV showed 78 J percent of students classified as normal (18,5- 24$ kg/mt), and the Vo2max showed that 28 percent of females were in the regular category (25- 30 ml.kg-1.min-1). A 34,1 percent of males were in the normal category (43- 52 m1.kg-1.min-1). In the U de C the female and male normal level was 79,2 percent. The Vo2max index for male and females responders was in the acceptable category of 44,3 percent and40,0 percent (31-37 and 34- 42 ml.kg-1.min-1), respectively. The correlation between the nutritional and cardio-respiratory condition established that there is a negative lineal relationship with base R- Pearson -0,263 (PUCV) and -0,386 (UdeC), which indicates that as BMI increases the Vo2max increases.

El siguiente estudio descriptivo correlacional fue realizado con el objeto de determinar el estado nutricional y el nivel cardiorrespiratorio de los alumnos de las universidades Pontificia Universidad Católica de Valparaíso (PUCV) y la Universidad de Concepción (UdeC). El estado nutricional se evaluó por el índice de Masa Corporal (IMC) y la condición cardiorrespiratoria por el consumo máximo de oxígeno (Vo2máx), mediante el test de la caminata de 2.000 metros (UKK). En la PUCV, los resultados del IMC presentan 78,1 por ciento clasificado como normal (18,5- 24,9 kg/ mt²), mientras que el 28 por ciento de las mujeres mostró una mayor frecuencia en la clasificación de regular en el Vo2máx. (25- 30 ml.kg-1. min-1). El 34,1 por ciento de los varones se encontró en la categoría normal (43- 52 ml.kg-1.min-1). Por su parte, en la UEDC, el IMC, tanto de mujeres como de varones se ubicaron en la categoría normal (79,2 por ciento). El Vo2máx de mujeres como varones presentó su mayor concentración en la categoría aceptable (44,3 por ciento y 40,0 por ciento) (31- 37 y 34- 42 ml.kg-1.min-1) respectivamente. La correlación entre estado nutricional y condición cardiorrespiratoria estableció una relación lineal negativa en base R de Pearson -0,263 (PUCV) y -0,386 (UdeC), que significa que a mayor IMC menor Vo2máx.

Valor de la secuencia de difusión en el estudio de cáncer de próstata en pacientes con antígeno prostático específico elevado / Value of diffusion-weighted sequences in the study of prostate cancer in patients with increased prostate specific antigen levels

En el carcinoma prostático la arquitectura glandular es reemplazada por células cancerosas, produciendo barreras al movimiento del agua, que pueden ser estudiadas con resonancia magnética potenciada en difusión. Para evaluar el aporte de estas secuencias en el estudio de la próstata, realizamos estudio descriptivo e inferencia!, utilizando difusión en 26 pacientes con tacto rectal anormal y antígeno prostático elevado. Se analizó sensibilidad, especificidad y curvas ROC basadas en coeficiente aparente de difusión (CAD). Se realizó biopsia prostática en 14 pacientes; 7 resultaron positivos. Con CAD <1000 um2/s, se encontraron altas sensibilidades con bajas especificidades y valores predictivos moderados. Incorporando T2 mejoraron: certeza diagnóstica, especificidad y valores predictivos. Al comparar los valores CAD en zonas con y sin cáncer, obtuvimos diferencias para CAD promedio y mínimo. Las curvas ROC mostraron áreas elevadas y significativas, sugiriéndose valores de corte de 1059 um2/s y 969 um2/s entre "normales" y con cáncer; LR(+) para valores de corte: 6,97 y 5,23 respectivamente. Nuestros resultados permiten proponer que se obtiene mayor ganancia diagnóstica en la interpretación conjunta de imágenes T2 y secuencias de difusión y que CAD permite diferenciar entre tejido normal y cáncer, por lo que se debiera incorporar en el estudio prostático.

In prostatic carcinoma, the glandular architecture is replaced by cancer cells producing barriers to water motion, anomaly that can be studied through diffusion-enhanced MRI technique. To assess the contribution of these sequences in the prostate cancer exploration, we conducted a descriptive and inferential study using diffusion-enhanced MRI technique in 26 patients with abnormal digital rectal examination (DRE) and increased prostate specific antigen (PSA) values. We analyzed sensitivity, specificity and ROC curves based on apparent diffusion coefficient (ADC). Seven out of 14 biopsies were positive in patients undergoing prostate biopsy. When applying ADC <1000 _m2/se, high sensitivity with low specificity levels, as well as moderate predictive values were obtained. By incorporating T2-weighted images, improved diagnostic accuracy, specificity and predictive values were achieved. When comparing ADC values in tissues with and without cancer, average and minimum ADC appeared to exhibit different values. ROC curves depicted increased and significant values, suggesting cutoff values of 1059 um2/s and 969/um2/s for healthy and malignant tissues, respectively; LR (+) for cut-off value: 6.97 and 5.23, respectively. Our results enable us to propose that improved diagnostic outcomes are attained through combined interpretation of T2-weighted images and diffusion-weighted sequences and that the ADC permits discrimination between normal and malignant tissues. Therefore, we strongly support that these criteria should be taken into account when performing prostate explorations.

Detection and characterization of hepatitis A virus and Norovirus in estuarine water samples using ultrafiltration--RT-PCR integrated methods.

AIMS: Waterborne outbreaks of hepatitis A and Norovirus disease have been reported and associated with contaminated water supply in various countries. However, in Mexico, there are no studies that report HAV and NV presence in water. This study reports the application of ultrafiltration and RT-nested PCR methods to concentrate and identify these viruses. METHODS AND RESULTS: Forty estuarine water samples were collected from the Huizache Caimanero Lagunary Complex. Samples were concentrated by ultrafiltration system (UFS) and RT-nested PCR was performed for HAV and NV identification. These viruses were found in 80% and 70% of the samples collected respectively and both were present in 57.5%. The DNA sequences analysis showed that 21 estuarine water samples were associated with HAV and 13 with NV. Faecal coliforms were isolated in 48.57% of the samples, while Escherichia coli were found in 34.28%. CONCLUSIONS: DNA sequencing showed that the genotype IB for HAV and GII for NV were predominant in México. No significant relationships were detected between indicators and viruses (P < 0.05). SIGNIFICANCE AND IMPACT OF THE STUDY: This study shows that the UFS is adequate for viral concentration. This is the first study analysing the genetic sequence of HAV and NV isolated from Mexican estuarine water.

Limitaciones de la PAAF en el diagnóstico del pilomatrixoma / FNA limitations in the diagnosis of pilomatrixoma

El pilomatrixoma es un tumor benigno de la piel que procede de la matriz celular del folículo piloso. Se localiza preferentemente en la cara y cuello. Clínicamente se presenta como un nódulo subcutáneo solitario y firme, no doloroso y de lento crecimiento. El tratamiento de elección es la resección quirúrgica.La PAAF (Punción Aspiración con Aguja Fina), como prueba diagnóstica prequirúrgica, puede hacer confundir el pilomatrixoma con un tumor maligno por la alta concentración de células, junto a la presencia de célulasaisladas con una tasa aumentada de la relación núcleo/citoplasma. Presentamos un caso clínico de pilomatrixoma cuyo diagnóstico inicial, trasla PAAF, fue tumor epitelial maligno de bajo grado. Asimismo, realizamos una revisión de la literatura

Pilomatrixoma is a benign skin neoplasm that arises fromhair follicle matrix cells. The most common anatomical location is the head and neck region. Clinically, it manifests as a firm, solitary, slow-growing, painless nodule of the dermis. Complete surgical excisionis the treatment of choice.With FNAB (Fine Needle Aspiration Biopsy) as a presurgical diagnostic test, the highly cellular smear with isolated cells showing a high nuclear/cytoplasmic ratio can be mistaken for a malignant tumor. We report a case of pilomatrixoma with an initial diagnosis,after the FNAB, of low-grade malignant epithelial tumor. Also, a review of the literature is made (AU)

Sensitivity of North American Isolates of Phytophthora erythroseptica and Pythium ultimum to Mefenoxam (Metalaxyl).

A 4-year study (1997 to 2000) was conducted to determine the sensitivities of the potato tuber rot pathogens, Phytophthora erythroseptica and Pythium ultimum, to mefenoxam (metalaxyl). A total of 2,277 tubers showing symptoms of "water rot" were collected from 16 states and 2 Canadian provinces. From these, 849 isolates of P. erythroseptica and 213 isolates of P. ultimum were obtained, and 805 and 190 isolates, respectively, were tested for their ability to grow on V8 medium amended at 0.01 to 100 µg/ml with fungicide. Isolates ranged widely in their responses to mefenoxam. The presence of resistant isolates (EC50 > 100 µg ml-1) of P. erythroseptica in the potato producing areas of Maine was confirmed. The presence of P. erythroseptica isolates in Idaho and Minnesota resistant to mefenoxam is reported for the first time. The proportion of P. erythroseptica isolates resistant to mefenoxam varied from 2.9 to 36.2% between 1997 and 2000. The proportion of resistant P. ultimum isolates represented only a small proportion of the isolates tested (3.7%). A single resistant P. ultimum isolate was recovered from Washington, whereas most of the resistant isolates obtained (5 of 7) were collected in Minnesota during the final year of the study. This is the first report of resistance in P. ultimum pathogenic to potato tubers. These observations suggest that pink rot and leak could become significant problems in the future, particularly in those areas where resistance has been detected. Our results have implications for the effective management of water rot. Monitoring the sensitivity of the pathogen population to mefenoxam in all production areas should be considered and integrated as a part of the overall disease management strategy.

Impact of pesticides use on human health in Mexico: a review.

Pesticides having a high adverse effect on the health and environment of inhabitants of the Mexican Republic were studied to establish the main parameters to bear in mind for their use and application. The investigation showed that Mexico is the agricultural zone with the highest health damage to its population from pesticides. The valid regulation norms for the use and application of these agrochemicals were analyzed. Case histories recorded by the public health sector in Mexico were reviewed. In this way, a strong relation was found between the health problems and the pesticides applied. Finally, the study concludes that the various Mexican States appear as a risk zone because of contamination by pesticides that are permitted by the regulation norms and by others whose use is prohibited in other countries and in Mexico. This situation causes a serious effect on the health deterioration of people who are exposed to these agro-chemicals and, in some cases, leads to death.

The Effect of Wounding, Temperature, and Inoculum on the Development of Pink Rot of Potatoes Caused by Phytophthora erythroseptica.

The effect of wounding, temperature, and inoculum on the development of pink rot caused by Phytophthora erythroseptica, was studied for its potential impact on postharvest infection. Tissue plugs cut from pink rot infected tubers and plugs of similar size from laboratory cultures of the pathogen were highly effective inoculum sources on wounded tubers. Severe wounding, temperatures of 15 to 25°C, and high inoculum density affected the infection risk. Regardless of source or amount of inoculum, any degree of wounding greatly increased incidence of infection of tubers by P. erythroseptica. Infections in unwounded tubers started at 15°C, whereas in wounded tubers infection started at 10°C. Incidence of pink rot was high when two or three of the factors (severe wounding, high temperature, high inoculum level) were favorable. Incidence of pink rot was intermediate when only one factor was favorable. Incidence of pink rot was low or absent without a favorable factor (no wounding, low temperature, and low inoculum), Since infected tuber tissue may serve as potential inoculum source for postharvest infection of tubers by P. erythroseptica, the removal of pink rot infected tubers at harvest is desirable. Avoidance of wounding and rapid cooling of storage bins to 10°C may also help control pink rot.

Desert ecosystems: similarities, characteristics, and health benefits.

Salty bodies of water in desert zones are known worldwide. The Salton Sea in California, USA, and the Dead Sea between Israel and Jordan are located in arid areas at approximately the same latitude, which might explain some similarities. Both the Salton and Dead Seas have ecosystems consisting of a singular saline sea/hot desert interface. The Salton Sea, the largest inland body of water in California, is a saline lake in the Coachella and Imperial Valleys. The Imperial Valley is one of the 10 top agricultural areas in the United States. Several thermoelectric plants exploiting geothermal wells operate around the Salton Sea, and some areas comprise a National Wildlife Refuge. The Dead Sea (Sea of Salt in Hebrew), the lowest saline lake on earth, contains high concentrations of salts and is a reservoir of minerals with a unique evaporation regime. The Dead Sea salts are the raw materials for the production of several chemical and health products. Magnesium salts and sulfur-containing mud are used for treating human skin disorders, allergies, arthritis, and respiratory diseases. After visiting both zones, we recorded, analyzed, and compared the similarities and differences between the areas. Some differences were found in the geographic, orographic, hydraulic, and climatic properties, but the main difference is in the economic-industrial aspect. The characteristics and health aspects are described in this report.