Determinación de la calidad de imágenes clínicas de proyecciones postero anterior y lateral de tórax / Determination of clinical image quality of posteroanterior and lateral chest images

RESUMEN Los estudios radiológicos son fundamentales en el diagnóstico y tratamiento de diversas patologías. Su calidad depende de múltiples variables, entre las que destacan, los parámetros de adquisición, interpretación, entre otros. Se propone una metodología estandarizada, sencilla, de fácil interpretación, permitiendo la evaluación regular de la calidad de las imágenes, dando indicios de la propiedad del trabajo en el centro de salud y poder realizar comparaciones entre centros y autores, a partir de los criterios anatómicos establecidos por la Unión Europea, definiendo el parámetro de calidad de la imagen (CI), representadas en una escala de Likert para el análisis de frecuencia, demostrando que puede ser una herramienta de utilidad para la evaluación reiterada de los centros de radiología. Evaluando 140 proyecciones postero anterior y 85 laterales de tórax, con una muestra de 225 estudios, realizados en un centro de salud, ubicado en la ciudad de Mérida, República Bolivariana de Venezuela, escogiendo estas proyecciones, ya que, representan el 32% de los estudios de radiología convencional. Permitiendo la comparación entre proyecciones y autores, obteniéndose para la proyección postero anterior un CI de 5,07 ± 1,53 criterios de los ocho establecidos, normalizado un CI de 0,62 ± 0,19; las imágenes excelentes solo representan el 22,78%. Comparado con un CI de 4,91 ± 1,17 criterios de los seis establecidos, normalizado un CI de 0,82 ± 0,19, e imágenes excelentes en un 64,71% para la proyección lateral. Se observa las notorias diferencias entre la calidad de las imágenes clínicas en hombres y mujeres para ambas proyecciones

ABSTRACT Radiological studies are essential in the diagnosis and treatment of various pathologies. Their quality depends on multiple variables, among which the acquisition and interpretation parameters, among others, stand out. A standardized methodology is proposed, simple, of easy interpretation, allowing the regular evaluation of the quality of the images, giving indications of the property of the work in the health center and being able to make comparisons between centers and authors, from the anatomical criteria established by the European Union, defining the parameter of image quality (IQ), represented on a Likert scale for frequency analysis, demonstrating that it can be a useful tool for the repeated evaluation of radiology centers. Evaluating 140 postero anterior and 85 lateral projections of the thorax, with a sample of 225 studies, performed in a health center, located in the city of Merida, Bolivarian Republic of Venezuela, taking these projections, since they represent 32% of the conventional radiology studies. Allowing the comparison between projections and authors, obtaining for the postero anterior projection an IQ of 5.07 ± 1.53 criteria of the eight established, normalized an IQ of 0.62 ± 0.19; the excellent images only represent 22.78%. Compared with an IQ of 4.91 ± 1.17 criteria of the six established, normalized IQ of 0.82 ± 0.19, and excellent images in 64.71% for the lateral projection. It is observed the notorious differences between the quality of clinical images in men and women for both projections

Técnicas de necropsia y toma de muestras en animales de experimentación: Una revisión bibliográfica y actualización / Necropsy and sampling techniques in experimental animals: A bibliographic review and update

Se plantea como objetivo describir las técnicas de necropsia en animales de experimentación, una revisión bibliográfica y actualización. Se describieron las técnicas de necropsia en cobayos (Cavia porcellus), conejos (Oryctolaguscuniculus), ratones (Mus musculus), la rata (Rattusnorvegicus (variedad albina), incluyendo peces. La necropsia sistemática incluye una revisión de la historia clínica, y/o datos del experimento realizado. El siguiente paso corresponde al examen externo, donde se describen lesiones sobre el tejido tegumentario, sistema locomotor, mucosas, cavidades naturales y cambios post-mortem. Posteriormente se realiza el desollado, de manera simultánea la apertura de cavidades, con la evaluación de órganos, mediante un exhaustivo examen macroscópico. Este procedimiento continua con la extracción de órganos y toma de muestras. Por último se debe elaborar un informe de necropsia donde el patólogo veterinario emitirá las conclusiones o diagnósticos comentarios, recomendaciones y las apreciaciones enmarcados en la epicrisis del caso. El proceso de necropsia junto con la recolección y envío de muestras apropiadas para la realización de pruebas de laboratorio es trascendental en el proceso de emisión de un diagnóstico, de la práctica de la toma de muestra y envío al laboratorio depende el diagnostico morfológico y etiológico. En conclusión se describieron las técnicas de necropsia y toma de muestras en animales de experimentación con énfasis en cobayos (Cavia porcellus), conejos (Oryctolaguscuniculus), ratones (Mus musculus), la rata (Rattusnorvegicus, variedad albina), incluyendo peces, como una herramienta básica para el diagnostico de patologías en animales de experimentación así como se mencionaron las condiciones de envío de muestras a los distintos laborator

The aim of this study was to describe the necropsy techniques in experimental animals, a literature review and update. Necropsy techniques were described in guinea pigs (Cavia porcellus), rabbits (Oryctolagus cuniculus), mice (Mus musculus), rat (Rattus norvegicus (albino variety), including fish, systematic necropsy includes a review of clinical history, and/or data of the experiment performed. The next step corresponds to the external examination, where lesions are described on the integumentary tissue, locomotor system, mucous membranes, natural cavities and post-mortem changes, followed by flaying, simultaneously opening cavities, with the evaluation of organs, through an exhaustive macroscopic examination. This procedure continues with the extraction of organs and sampling. Finally, a necropsy report must be prepared where the veterinary pathologist will issue the conclusions or diagnoses comments, recommendations and assessments framed in the epicrisis of the case, the necropsy process together with the collection and shipment of appropriate samples for the performance of laboratory tests is crucial in the process of issuing a diagnosis, the practice of sampling and sending to the laboratory depends on the morphological and etiological diagnosis. In conclusion, necropsy and sampling techniques were described in experimental animals with emphasis on guinea pigs (Cavia porcellus), rabbits (Oryctolagus cuniculus), mice (Mus musculus), rat (Rattus norvegicus albino variety), including fish, as a basic tool for the diagnosis of pathologies in experimental animals, as well as the conditions for sending samples to different laboratories.

[Articular fractures of the distal femur. Comparative analysis of three surgical treatments]. / Fracturas articulares de fémur distal. Análisis comparativo de tres tratamientos quirúrgicos.

INTRODUCTION: The distal articular femur fracture is a serious injury that for years has been a problem in traumatology. It is often believed that produced varying degrees of permanent disability in the knee and that the fate of the joint was determined by the injury rather than treatment. OBJECTIVES: Present the results of surgical treatment of articular distal femur fractures type C2 with three treatment modalities: dynamic condylar screw (TDC), condylar buttress plate (PSC) and periarticular plate (PPA). MATERIAL AND METHODS: We conducted a comparative study of three therapeutic series designed to compare the effectiveness of dynamic condylar screw, the condylar buttress plate and periarticular plate in treating complete articular fractures of distal femur type C2. Patients of both genders, aged between 16 and 60 years, treated in the IAHULA, with a minimum follow up of 24 months. RESULTS: We included 42 patients divided into three groups. Males predominated with 73.8%, the most affected age group was 21-30 years with 28.57%. The most common type of fracture was the 33C2.3 with 42.86%. The 71.43% of patients experienced complications, highlighting joint stiffness, angular deviation in recurvatum, chronic pain and post traumatic osteoarthritis. CONCLUSION: TDC and the PPA are valid options for the treatment of distal femur fractures AO 33C2, as offered better functional results than PSC.

INTRODUCCIÓN: La fractura articular de fémur distal es una lesión grave que durante años ha representado un problema en la traumatología que con frecuencia ocasiona distintos grados de incapacidad permanente en la rodilla. El destino de la articulación estaba determinado por la lesión más que por su tratamiento. OBJETIVOS: Presentar los resultados del tratamiento quirúrgico de las fracturas articulares de fémur distal tipo C2 con tres modalidades de tratamiento: tornillo dinámico condíleo (TDC), placa de sostén condíleo (PSC) y placa periarticular (PPA). MATERIAL Y MÉTODOS: Estudio comparativo de tres series terapéuticas, diseñado para comparar la efectividad del TDC, la PSC y la PPA en el tratamiento de fracturas articulares completas de fémur distal tipo C2. Se incluyeron 42 pacientes de ambos géneros, con edades entre 16 y 60 años, tratados en el IAHULA, con un seguimiento mínimo de 24 meses. RESULTADOS: Predominó el sexo masculino con 73.8%, el grupo etario más afectado fue de 21-30 años con 28.57%. El tipo de fractura más frecuente fue la 33C2.3 con 42.86%. La PPA mostró mejores resultados que los otros implantes fundamentalmente en la escala funcional de la Knee Society. Setenta y uno punto cuarenta y tres por ciento de los pacientes presentó alguna complicación, resaltando la rigidez articular, la desviación angular en recurvatum, el dolor crónico y la artrosis postraumática. CONCLUSIÓN: El TDC y la PPA son opciones válidas para el tratamiento de las fracturas de fémur distal AO 33C2, puesto que ofrecieron mejores resultados funcionales que la PSC.

Fracturas articulares de fémur distal. Análisis comparativo de tres tratamientos quirúrgicos / Articular fractures of the distal femur. Comparative analysis of three surgical treatments

Resumen: Introducción: La fractura articular de fémur distal es una lesión grave que durante años ha representado un problema en la traumatología que con frecuencia ocasiona distintos grados de incapacidad permanente en la rodilla. El destino de la articulación estaba determinado por la lesión más que por su tratamiento. Objetivos: Presentar los resultados del tratamiento quirúrgico de las fracturas articulares de fémur distal tipo C2 con tres modalidades de tratamiento: tornillo dinámico condíleo (TDC), placa de sostén condíleo (PSC) y placa periarticular (PPA). Material y métodos: Estudio comparativo de tres series terapéuticas, diseñado para comparar la efectividad del TDC, la PSC y la PPA en el tratamiento de fracturas articulares completas de fémur distal tipo C2. Se incluyeron 42 pacientes de ambos géneros, con edades entre 16 y 60 años, tratados en el IAHULA, con un seguimiento mínimo de 24 meses. Resultados: Predominó el sexo masculino con 73.8%, el grupo etario más afectado fue de 21-30 años con 28.57%. El tipo de fractura más frecuente fue la 33C2.3 con 42.86%. La PPA mostró mejores resultados que los otros implantes fundamentalmente en la escala funcional de la Knee Society. Setenta y uno punto cuarenta y tres por ciento de los pacientes presentó alguna complicación, resaltando la rigidez articular, la desviación angular en recurvatum, el dolor crónico y la artrosis postraumática. Conclusión: El TDC y la PPA son opciones válidas para el tratamiento de las fracturas de fémur distal AO 33C2, puesto que ofrecieron mejores resultados funcionales que la PSC

Abstract: Introduction: The distal articular femur fracture is a serious injury that for years has been a problem in traumatology. It is often believed that produced varying degrees of permanent disability in the knee and that the fate of the joint was determined by the injury rather than treatment. Objectives: Present the results of surgical treatment of articular distal femur fractures type C2 with three treatment modalities: dynamic condylar screw (TDC), condylar buttress plate (PSC) and periarticular plate (PPA). Material and methods: We conducted a comparative study of three therapeutic series designed to compare the effectiveness of dynamic condylar screw, the condylar buttress plate and periarticular plate in treating complete articular fractures of distal femur type C2. Patients of both genders, aged between 16 and 60 years, treated in the IAHULA, with a minimum follow up of 24 months. Results: We included 42 patients divided into three groups. Males predominated with 73.8%, the most affected age group was 21-30 years with 28.57%. The most common type of fracture was the 33C2.3 with 42.86%. The 71.43% of patients experienced complications, highlighting joint stiffness, angular deviation in recurvatum, chronic pain and post traumatic osteoarthritis. Conclusion: TDC and the PPA are valid options for the treatment of distal femur fractures AO 33C2, as offered better functional results than PSC.

Actividad antioxidante y marcha fitoquímica de los capítulos de Tagetes filifolia Lag. "pacha anís" / Antioxidant activity and phytochemical screening of capitula of Tagetes filifolia Lag. or "pacha anís"

Objetivo: Estudiar la actividad antioxidante y marcha fitoquímica de los capítulos de Tagetes filifolia Lag. "pacha anís".Materiales y métodos: Estudio de tipo experimental en el cual se empleó 5 kg de los capítulos de la planta medicinal Tagetes filifolia lag., provenientes de Junín. Se usó el método de cribado fitoquímico de Olga Lock para la marcha fitoquímica y el método DPPH para la determinación de la actividad antioxidante. Se dividió la muestra en 3 grupos: etéreo, alcohol etílico y agua destilada a concentraciones de 100, 50 y 5 µg/ml.Resultados: Se encontró fenoles en cantidades abundantes tanto en el extracto en agua destilada como en el extracto en alcohol etílico, además este último tuvo cantidades moderadas de quinonas. Por otro lado, el extracto en alcohol etílico fue el que presentó el mayor porcentaje de captación de radicales libres (91.26%) a una concentración de 100 µg/ml, similares resultados se encontró con el extracto etéreo (88.94%) y el extracto en agua destilada (75.58%).Conclusiones: Los principales componentes químicos fueron fenoles y quinonas. El mayor efecto antioxidante se obtuvo del extracto etanólico de la planta Tagetes filifolia a una concentración de 100 µg/ml.

Acceptability of Global Positioning System technology to survey injecting drug users' movements and social interactions: a pilot study from San Francisco, USA.

BACKGROUND: Despite potential applications for improving health services using GPS technology, little is known about ethical concerns, acceptability, and logistical barriers for their use, particularly among marginalized groups. OBJECTIVES: We garnered the insights of people who inject drug (PWID) in San Francisco on these topics. METHODS: PWID were enrolled through street-outreach (n=20) and an ongoing study (n=4) for 4 focus group discussions. Participants also completed a self-administered questionnaire on demographic characteristics and their numbers and types of interactions with other PWID. RESULTS: Median age was 30.5 years, majorities were male (83.3%) and white (68.2%). Most interacted with other PWID for eating meals and purchasing drugs over the last week; fewer reported interactions such as sexual contact, drug treatment, or work. Participants identified several concerns about carrying GPS devices, including what authorities might do with the data, that other PWID and dealers may suspect them as informants, and adherence to carrying and use. Most felt concerns were surmountable with detailed informed consent on the purpose of the study and practical ways to carry, charge, and hide devices. CONCLUSIONS: PWID felt data collection on their movements and social interactions with other PWID using GPS can be acceptable with addressing specific concerns. The technology is now in hand to greatly expand the ability to monitor health conditions with respect to the environment and improve the location of prevention, care, and treatment facilities to serve hard to reach, mobile, and hidden populations.

Estrés postraumático en escolares a 8 meses del 27F / Post-traumatic stress disorder in children eight months after february 27, 2010

Introduction: there are several epidemiological studies regarding the incidence of post-traumatic stress disorder (PTSD) in children exposed to natural disasters. Objective: to describe the prevalence of PTSD in a school-age population in a coastal town from the Maule Region, 8 months after the earthquake/tsunami in february 2010, and to compare differences among PTSD groups of symptom (re-experiencing, avoidance and activation) according to demographic variables such as age, grade, gender and family type. Methodology: the Child PTSD Symptom Scale (CPSS), validated in Chile in 2009, was used in 89 children between 3rd and 6th grade, corresponding to 94.7 percent of the children enrolled in the local school in such classes. Data are analyzed by gender, age, grade and type of family. 89 surveys were applied, 59.6 percent were male and 40.4 percent female aged 8-13. Results: 40.4 percent of children had symptoms consistent with PTSD, with higher incidence in women and younger children; the most significant association among women was age. Both groups (women and young children) presented the highest scores on all group of symptoms. There were no differences by type of family. Conclusions: the incidence of PTSD measured by CPSS scale in the study population was 40.4 percent, considered to be among the highest percentages reported in the international literature.

Introducción: existen diversos datos epidemiológicos respecto a la incidencia de Trastorno por Estrés Pos-traumático (TEPT) en niños expuestos a desastres naturales. Objetivo: describir la prevalencia de TEPT en una población infantil escolarizada de una localidad costera de la Región del Maule después de 8 meses de ocurrido el terremoto/maremoto de febrero/2010, y comparar las diferencias entre grupos de síntomas del TEPT (reexperimentación, evitación y activación) según variables demográficas, como edad, curso, sexo y tipo de familia. Metodología: se aplicó la escala Child PTSD Symptom Scale (CPSS) validada en Chile el año 2009, a 89 niños de 3° a 6° básico lo que corresponde al 94,7 por ciento de los niños matriculados en la escuela de la localidad en dichos cursos. Se analizan los datos según sexo, edad, curso y tipo de familia. Se aplicaron 89 encuestas, 59,6 por ciento eran varones y 40,4 por ciento mujeres de 8 a 13 años de edad. Resultados: el 40,4 por ciento del total de niños tuvo una evaluación compatible con TEPT, con mayor incidencia en mujeres y niños de menor edad, siendo la edad un factor de asociación significativa en las mujeres. Ambos grupos (mujeres y niños más pequeños) presentaron mayores puntajes en todos los grupos sintomáticos. No se encontraron diferencias según el tipo de familia. Conclusiones: la incidencia de TEPT medida a través de la escala CPSS en la población estudiada fue de 40.4 por ciento, encontrándose entre las más altas reportadas en la bibliografía internacional.

Intervención de salud mental en niños expuestos a desastre natural / Mental health intervention in children exposed to natural disasters

Introduction: this study is part of the mental health intervention, conducted by a child psychiatry team for children exposed to the february 2010 earthquake/tsunami in a community of the VII Region that was strongly affected by the natural disaster. Objective: to describe the intervention and evaluate the effectiveness of the strategies implemented for both children and teachers. Methodology: interventions are described and classified in three categories. (1) Case report and child care consulting, referred by their teacher. (2) Psychoeducational workshops for teachers of the intervened school. (3) Self-Care day aimed at professionals of the same school. The evaluation is done through an anonymous survey designed to measure the effectiveness of the intervention. Results: 33 children were evaluated and treated, the most common diagnoses were adaptive disorders (8/33) and ADHD (11/33), and only 3 patients met the criteria for post-traumatic stress disorder (PTSD). Intervention implementation included psychoeducation for parents (100 percent), coordination with schools and local health network (100 percent), counseling (70 percent) and drug prescription (45 percent). Only 45 percent of the cases evaluated had symptoms triggered or exacerbated by the earthquake/tsunami. Regarding teacher evaluation (N: 11), 100 percent described the intervention as "very good". 90 percent considered it appropriate to the needs at the moment and as a contribution to their educational work. Conclusions: after events of this nature, many interventions take place to support the affected population. It is important to have more scientific information about the effectiveness of such interventions to prevent the development of post-traumatic psychopathology.

Introducción: este trabajo forma parte de la intervención de salud mental, realizada por un equipo de psiquiatría infantil para niños expuestos al terremoto/maremoto de febrero de 2010, en una comunidad de la VII Región fuertemente afectada por el desastre natural. Objetivos: describir la intervención realizada y evaluar la efectividad de las estrategias implementadas tanto a niños como a profesores. Metodología: se describe las intervenciones realizadas, clasificadas en 3 categorías: 1) Consultoria de casos clínicos y atención de niños derivados por sus profesores. 2) Talleres psicoeducativos a profesores de la escuela intervenida. 3) Jornada de autocuidado, dirigida a los profesionales de la misma escuela. La evaluación se realiza a través de encuesta anónima a los profesores diseñada para cuantificar la efectividad de la intervención. Resultados: se evaluaron y trataron 33 niños, los diagnósticos más frecuentes fueron Trastornos adaptativos (8/33) y Déficit atencional (11/33); sólo 3 casos cumplían criterios de Trastorno por Estrés Postraumático(TEPT). Las intervenciones utilizadas incluyeron psicoeducación a padres (100 por ciento), coordinación con colegios y red de salud municipal (100 por ciento), apoyo psicológico (70 por ciento) y farmacológico (45 por ciento). Sólo en el 45 por ciento de los casos evaluados la sintomatología se había desencadenado o agravado con el terremoto/maremoto. En relación a la evaluación de profesores (n: 11), 100 por ciento consideró la intervención como "muy buena". Un 90 por ciento la consideró adecuada a las necesidades y constituyó un aporte a su quehacer educativo. Conclusiones: tras eventos como éste, se realizan variadas intervenciones de apoyo a la población afectada. Es importante contar con mayor información científica acerca de la efectividad de dichas intervenciones para prevenir el desarrollo de psicopatología postraumática.

Comportamiento epidemiológico de la rabia humana en el estado Zulia Venezuela: durante el período de vigilancia enero 1993 junio 2009 / Epidemiological Behavior of human rabies in the state of Zulia Venezuela: during the surveillance period january 1993 june 2009

La rabia representa un importante problema de salud pública en el estado Zulia, constituyendo en Venezuela la entidad con mayor incidencia de casos en animales y humanos, registrándose 25 muertes humanas por rabia durante el período enero 1993 - junio 2009. Describir su comportamiento epidemiológico durante este período constituye nuestro objetivo. Estudio epidemiológico realizado: observacional, descriptivo. La muestra incluyó todos los casos confirmados como rabia humana en la entidad durante este lapso (n = 25), con edades entre 2-57 años, de ambos sexos y procedentes de 7 municipios con incidencia. Datos tomados de los informes de casos de rabia de la Dirección Regional de Epidemiología. Los resultados están expresados en porcentajes, promedios, intervalos de confianza, tasa de letalidad y distribuciones según edad, sexo y municipio de ocurrencia. La mayor incidencia ocurrió en varones (68%). El grupo entre 2-10 años resultó mayormente afectado (60%). El 80% casos no efectuó consulta post exposición no recibiendo inmunoprofilaxia oportuna. La Inmunofluorescencia directa fue utilizada para confirmación diagnóstica. El conocimiento sobre las formas de transmisión de rabia es crucial para prevenirla; el tiempo entre la inoculación viral y la invasión neural es quizá el único período para una inmunoprofilaxia efectiva

Rabies represents a major public health problem in the State of Zulia, constituting the entitywith the highest incidence of animal and human cases in Venezuela, registering 25 human deathsby rabies from January, 1993 – June, 2009. The objective of this study is to describe its epidemiologicalbehavior during this period; the epidemiological study was observational and descriptive.The sample included all cases confirmed as human rabies in the entity during this period (n = 25);they were between 2 and 57 years of age, from both sexes and 7 municipalities. Data was takenfrom the reports of rabies cases in the Regional Epidemiology Direction. The results are expressedin percentages, means, confidence intervals, mortality rate and distributions according to age, sexand municipality of occurrence. The highest incidence was in males (68%).The group between2-10 years was principally affected (60%). Eighty per cent of the cases did not seek post-exposureconsultation and did not receive timely prophylaxis. The direct fluorescent antibody test was usedfor diagnostic confirmation. Knowledge about forms of rabies transmission is crucial for its prevention;the time between viral inoculation and neural invasion is perhaps the only period for aneffective prophylaxis

Utilidad de la tizanidina. Seguimiento de un año en el tratamiento de la espasticidad en la parálisis cerebral infantil / The usefulness of tizanidine. A one-year follow-up of the treatment of spasticity in infantile cerebral palsy

Introducción. La parálisis cerebral infantil ocupa el primerlugar de discapacidad (tipo espástico, 88%). La tizanidina es unimidazólico de acción central y agonista que actúa como α2-adrenérgico.Objetivo. Demostrar clínicamente la efectividad de la tizanidinaen la disminución de la espasticidad. Pacientes y métodos.Por asignación aleatoria en estudio doble ciego, se trataron durante6 meses 10 niños con tizanidina (0,05 mg/kg/día) y 30 con placebo,los cuales posteriormente se unificaron en el grupo de la tizanidina.Las variables dependientes fueron la espasticidad, la escalade Ashworth, la escala del tono postural, los reflejos y las pruebasde funcionamiento hepático. Resultados. La espasticidad y los reflejosfueron sistemáticamente menores en el grupo de la tizanidina, demanera que la espasticidad se redujo en un 78,85% frente al 7,64 %con el placebo (p = 0,0001); en el seguimiento de seis meses de los35 pacientes se redujo un 78,2% (p = 0,0001). La duración de laefectividad de la tizanidina en cuatro pacientes fue de dos meses yéstos nunca regresaron a su valoración basal. No se observaron efectosadversos ni la elevación de enzimas hepáticas. Conclusiones. Latizanidina produce una reducción significativa de la espasticidad enniños, sin efectos adversos y con un alto porcentaje de aceptaciónen las dosis prescritas

Introduction. The cerebral palsy has the first place of physical handicap in children (type spastic, 88%). Tizanidineimidazole derivative is centrally acting as a α2-adrenergic agonist. Aim. To demonstrate clinically the effectiveness oftizanidine in the decrease of the spasticity. Patients and methods. We assigned randomly in a double blind study 10 childrentreated with tizanidine (0.05 mg/kg/day) and 30 with placebo for a 6-month period, after which they were unified in the groupof tizanidine. The dependent variables were spasticity, Ashworth scale, posture tone scale, reflex scale and liver function test.Results. The spasticity and the reflex decreased in the group of tizanidine an 78.85% in comparison with a 7.64% in the groupof placebo (p = 0.0001); in the monitoring of 6 months 35 patients reduced this to 78.2% (p= 0.0001). The duration ofeffectiveness of tizanidine in four patients was two months and they never returned to their appraisal basal. Without reportedadverse effects, the liver function test remains normal. Conclusion. Tizanidine produces a significant reduction of thespasticity in children without adverse effects, having a high percentage of acceptance to the prescribe dose

[The usefulness of tizanidine. A one-year follow-up of the treatment of spasticity in infantile cerebral palsy]. / Utilidad de la tizanidina. Seguimiento de un ano en el tratamiento de la espasticidad en la paralisis cerebral infantil.

INTRODUCTION: The cerebral palsy has the first place of physical handicap in children (type spastic, 88%). Tizanidine imidazole derivative is centrally acting as a a2-adrenergic agonist. AIM: To demonstrate clinically the effectiveness of tizanidine in the decrease of the spasticity. PATIENTS AND METHODS: We assigned randomly in a double blind study 10 children treated with tizanidine (0.05 mg/kg/day) and 30 with placebo for a 6-month period, after which they were unified in the group of tizanidine. The dependent variables were spasticity, Ashworth scale, posture tone scale, reflex scale and liver function test. RESULTS: The spasticity and the reflex decreased in the group of tizanidine an 78.85% in comparison with a 7.64% in the group of placebo (p = 0.0001); in the monitoring of 6 months 35 patients reduced this to 78.2% (p= 0.0001). The duration of effectiveness of tizanidine in four patients was two months and they never returned to their appraisal basal. Without reported adverse effects, the liver function test remains normal. CONCLUSION: Tizanidine produces a significant reduction of the spasticity in children without adverse effects, having a high percentage of acceptance to the prescribe dose.

Epidemiology of American tegumentary leishmaniasis in domestic dogs in an endemic zone of western Venezuela.

Domestic dogs are not only reservoir hosts of the American zoonotic visceral leishmaniasis (ZVL) but of the American zoonotic tegumentary leishmaniasis (ATL) as well, for different reasons. However it is still controversial to state that dogs are incriminated as ATL reservoir hosts as there is evidence that humans and dogs are likely to be exposed in the same way to sandfly vector. In Venezuela this issue has not been completely addressed, for this reason we selected a location inside Trujillo city to study eco-epidemiological conditions as well as to survey a significant sample of dogs by Montenegro Skin Test (MST). Antigen was prepared according to standard procedure using Leishmania (V) braziliensis promastigotes (80 microg/ml); response was read 48 hours post-inoculation with an induration size > 5 mm being considered as positive. The study place is an endemic mountainous semi-urban area located at 850-950 masl with an average rainfall of 150 mm/year. We evaluated 61 dogs in 46 houses with 168 human beings. Among the human population 27 cases of ATL were reported (16.1%). With the MST we found 19 positive-reaction dogs (31%) (mean MST size of 9.58 mm, 95% CI: 8.41-10.75) in 13 houses (28%). Multivariate analysis did not reveal significant association between domestic MST positive-dog ownership and human ATL cases (RR = 1.48, p = 0.28). Although some studies have indicated that dog ownership and dog infection rates are associated with an increased risk of human disease in different evaluated places, this question has not been completely answered in Venezuelan studied zones, further research is necessary.

Tumor de húmero proximal como manifestación primaria de carcinoma hepatocelular. Presentación de dos casos / Metastatic hepatocellular carcinoma of the proximal humerus. Two cases report

En los países occidentales el cáncer de hígado no es común y son menos las metástasis al húmero proximal. Se presentan dos casos en varones de 37 y 76 años, sin enfermedad hepática previa, que consultaron en emergencias por dolor agudo del hombro. El estudio radiológico evidenció lesión lítica en el húmero proximal y la biopsia reveló una metástasis ósea de cáncer de hígado. Ambos pacientes sobreviven un año con quimioterapia sistémica y radioterapia local (AU)

[Viability and activity of the lactic bacteria (Streptococcus salivarius ssp thermophilus y Lactobacillus delbrueckii ssp bulgaricus) del yogurt en Venezuela]. / Viabilidad y actividad de la flora láctica (Streptococcus salivarius ssp thermophilus y Lactobacillus delbrueckii ssp bulgaricus) del yogurt en Venezuela.

National and international legislations have agreed that the population of lactic bacteria in yogurt must be viable and not less than 10(6) ufc/g. In Venezuela, during last years, observations indicate that the number of viable cells in some commercial samples show high variations, as low levels. This research attempted to find the origin of this problem in the local industry. For this purpose 105 commercial samples were analyzed during their shelf life and 32 samples of yogurt prepared in the laboratory following the flow diagram of the local industry. The different conditions of freeze dried lactic culture, were also analyzed. These samples were evaluated for viable cell count of lactic bacteria and possible variations of pH and acidity. The absence or low number of lactic bacteria detected in some commercial samples is due to the use of inadequate working cultures that show imbalanced proportions of the two microorganisms, besides a low count below 106 ufc/g. The succesive propagation and storage time of mother culture, and the overacidification of the product, produce subletal injury to the microbial cells of the yogurt starter culture. The data indicate that manufacturing practices significantly affect the survival of the lactic flora.

Geographic differences in bone mineral density of Mexican women.

The aim of this study was to generate standard curves for normal spinal and femoral neck bone mineral density (BMD) in Mexican women using dual-energy X-ray absorptiometry (DXA), to analyze geographic differences and to compare these with 'Hispanic' reference data to determine its applicability. This was a cross-sectional study of 4460 urban, clinically normal, Mexican women, aged 20-90 years, from 10 different cities in Mexico (5 in the north, 4 in the center and 1 in the southeast) with densitometry centers. Women with suspected medical conditions or who had used drugs affecting bone metabolism, were excluded. Lumbar spine BMD was significantly higher (1.089 +/- 0.18 g/cm2) in women from the northern part of Mexico, with intermediate values in the center (1.065 +/- 0.17 g/cm2) and lower values (1.013 +/- 0.19 g/cm2) in the southeast (p < 0.0001). Similarly, femoral neck BMD was significantly higher in women from the north (0.895 +/- 0.14 g/cm2), intermediate in the center (0.864 +/- 0.14 g/cm2) and lower (0.844 +/- 0.14 g/cm ) in the southeast part of Mexico (p < 0.0001). Northern Mexican women tend to be taller and heavier than women from the center and, even more, than those from the southeast of Mexico (p < 0.0001). However, these differences in BMD remained significant after adjustment for weight (p < 0.0001). A significant loss (p < 0.0001) in BMD was observed from 40 to 69 years of age at the lumbar spine and up to the eighth decade at the femoral neck. Higher and lower lumbar spine values, as compared with the 'Hispanic' population, were observed in Mexican mestizo women from the northern and southeastern regions, respectively. In conclusion, there are geographic differences in weight and height of Mexican women, and in BMD despite adjustment for weight.

Determination of nickel in saliva by electrothermal atomic absorption spectrometry using various chemical modifiers with Zeeman-effect background correction.

The profile of nickel signal using electrothermal atomic absorption spectrometry with deuterium and Zeeman-effect background correction is presented. The Zeeman effect system of background correction offered definitive advantages and therefore was used for the determination of nickel in saliva in the presence of various isomorphous metals. The highest nickel absorbance values corresponded at 200, 300, 300, 300, 600, and 200 ng of Tb, Mg, Sm, Lu, Tm, and Pd, respectively. On the other hand, the addition of Eu, Er, and Ho decreased the nickel signal. The presence on each modifier alone does not eliminate the matrix interference. However, the use of 200 ng of Pd in conjuction with 300 ng of Lu has a higher sensitivity, offers an advantage against interference from the background of saliva matrix and produces good recoveries (98 to 102% from unspiked and spiked saliva samples). The limit of detection was 0.11 micrograms/L for a characteristic mass of 16.6 pg of nickel using Pd-Lu as modifier. The within-batch precision varied between 0.8 and 1.5% relative standard deviations. The analysis of thirty samples of whole saliva gave an average of 0.81 +/- 0.30 of micrograms/L of Ni (range from 0.5 to 2.0 micrograms/L of Ni). The agreement between the observed and certified values obtained from a Seronorm Blood Serum Standard Reference Material was good.

Sex differences in occupational performance.

We tested the assumption that labor organizations possess structural arrangements that may favor specific individual abilities based on neurophysiological characteristics. As some basic abilities vary between sexes, so will the occupational performance of individuals, according to the labor organization they work for. We assumed that: (1) Females possess a higher perceptual sensibility (perceptual speed and accuracy), which allows them to discriminate rapid apparition events and fine changes in the environment, in contrast to males who have a greater ability to manage spatial relationships. (2) Organizations with a functional structure require more fine perceptual abilities and these requirements are stronger at higher levels of the hierarchy. (3) Occupational performance is related to basic abilities required for a specific task, leading women to have higher occupational performance than men in labor organizations with a functional structure. By studying the technical and administrative staff of the Universidad Simón Bolivar (Venezuela), we present evidence that women have a greater capacity for perceptual discrimination; that this capacity relates to occupational performance in a labor organization with a functional structure; and that this relation is stronger at higher levels in the hierarchy. However, the extremely small sample size available for this study limits the possible generalizations of these results to other populations.

[Comparison of methods for the detection and enumeration of lactic acid bacteria in yogurt]. / Comparación de metodologías para la detección y enumeración de bacterias ácido lácticas en el yogurt.

It is generally agreed that the population of lactic acid bacteria in yogurt must be not less than 10(6) ufc/g. Viability of the lactic flora until the end of shelf-life is affected for many factors, which has incidence in the recuperability of this microflora. MRS and LEE agar were selected for the total count of lactic bacteria, the M17 was used for the S salivarius ssp thermophilus and the RCA for L. delbrueckii ssp bulgaricus. Different methodologies were used for detection and enumeration of this bacteria: direct plate count; thermal treatment and recuperation of the injured cells in Soy Tripticase broth. The enumeration was done at time zero and 3 hours after the start of the fermentative process and during storage at 4, 12 and 21 days. The results shown an excellent recuperability of the lactic flora in the selected media and methods that were used: however the enumeration was significatively lower in the RCA agar. The counts in the LEE agar shown a better recuperability. The thermal treatment affected negatively the counts of lactic flora and the repair method shown better results in the yogurt sample during storage. pH and acidity were determined at the beginning and during the storage period. It was observed a pH decrease because of the lactic acid production at the end of shelf-life.

The role of oxalate and calcium oxalate activity and formation product ratio in patients with renal stones before and during treatment.

The participation of oxalate in nephrolithiasis was evaluated in 202 stone patients. The activity product and formation product ratios of calcium oxalate were substantially altered in the stone population. Treatment with thiazide derivatives and/or allopurinol was able to decrease urine oxalate and normalize the activity product and formation product ratios. Stone activity decreased in the stone population after treatment. Our data suggest that oxalate may have a critical role in nephrolithiasis activity.

Prevalent patterns of serotype-specific seroconversion in Mexican children infected with rotavirus.

The level of neutralizing antibodies to rotaviruses belonging to serotypes 1, 3, and 4 was determined in acute- and convalescent-phase sera from 36 Mexican children with rotaviral diarrhea. Most of the infants who seroconverted fell into one of the following three patterns: single seroconversion to serotype 1; seroconversion to serotypes 1 and 4; or seroconversion to all three serotypes tested. The heterotypic neutralizing antibody responses to rotavirus infections are discussed.