Limited drought tolerance in the neotropical seasonally dry forest plants impairs future species richness.

Neotropical seasonal dry forest (NSDF) is one of the most threatened ecosystems according to global climate change predictions. Nonetheless, few studies have evaluated the global climate change impacts on diversity patterns of NSDF plants. The lack of whole biome-scale approaches restricts our understanding of global climate change consequences in the high beta-diverse NSDF. We analysed the impact of global climate change on species distribution ranges, species richness, and assemblage composition (beta diversity) for 1,178 NSDF species. We used five representative plant families (in terms of abundance, dominance, and endemism) within the NSDF: Cactaceae, Capparaceae, Fabaceae, Malvaceae, and Zygophyllaceae. We reconstructed potential species distributions in the present and future (2040-2080), considering an intermediate Shared Socioeconomic Pathway and two dispersal ability assumptions on the taxa. Using a resource use scores index, we related climate-induced range contractions with species' water stress tolerance. Even under a favourable dispersal scenario, species distribution and richness showed future significant declines across those sites where mean temperature and precipitation seasonality are expected to increase. Further, changes in species range distribution in the future correlated positively with potential use of resources in Fabaceae. Results suggest that biotic heterogenization will likely be the short-term outcome at biome scale under dispersal limitations. Nonetheless, by 2080, the prevailing effect under both dispersal assumptions will be homogenization, even within floristic nuclei. This information is critical for further defining new areas worth protecting and future planning of mitigation actions for both species and the whole biome.

Calcificaciones pulmonares metastásicas, 3 casos clínicos / Metastatic pulmonary calcifications: three clinical cases

Las calcificaciones pulmonares metastásicas, hacen referencia a una enfermedad metabólica, caracterizada por depósitos de calcio en tejido pulmonar sano. La etiología es amplia e incluye enfermedades malignas y benignas, siendo la falla renal la causa más frecuente. Es una condición, que, a pesar de ser frecuente, suele ser subdiagnosticada, por presentar pocos o ningún síntoma. Presentamos tres casos clínicos asociados a enfermedad renal crónica, pre y post trasplante.

Metastatic pulmonary calcifications refer to a metabolic disease, characterized by calcium deposits in healthy lung tissue. The etiology is broad and includes malignant and benign diseases, the kidney failure being the most frequent cause. It is a condition, which, despite being frequent, is usually underdiagnosed, because it presents few or no symptoms. We present three clinical cases associated with pre- and post-transplant kidney disease.

Consciousness as a global property of brain dynamic activity.

We seek general principles of the structure of the cellular collective activity associated with conscious awareness. Can we obtain evidence for features of the optimal brain organization that allows for adequate processing of stimuli and that may guide the emergence of cognition and consciousness? Analyzing brain recordings in conscious and unconscious states, we followed initially the classic approach in physics when it comes to understanding collective behaviours of systems composed of a myriad of units: the assessment of the number of possible configurations (microstates) that the system can adopt, for which we use a global entropic measure associated with the number of connected brain regions. Having found maximal entropy in conscious states, we then inspected the microscopic nature of the configurations of connections using an adequate complexity measure and found higher complexity in states characterized not only by conscious awareness but also by subconscious cognitive processing, such as sleep stages. Our observations indicate that conscious awareness is associated with maximal global (macroscopic) entropy and with the short time scale (microscopic) complexity of the configurations of connected brain networks in pathological unconscious states (seizures and coma), but the microscopic view captures the high complexity in physiological unconscious states (sleep) where there is information processing. As such, our results support the global nature of conscious awareness, as advocated by several theories of cognition. We thus hope that our studies represent preliminary steps to reveal aspects of the structure of cognition that leads to conscious awareness.

Apróximación teórica al constructo resiliencia / Theoretical approach to the resilience construct

This essay aims to carry out a theoretical approach to the resilience construct through some reflections. Every day humans get on in various levels, achieving various roles and facing constant challenges of all kinds. The period lived as a student during the individual life cycle does not constitute an exception to these facts; and, it requires the appropriate use of all competences which he has. However, the occasions in which the student reflects that it does not have the necessary tools to have a triumphant result cannot be ruled out or be weakened, taking into account that the conditions for the achievement of goals are not always the best, and there are various obstacles that go beyond the individual, either personally or interpersonal, coupled with the system and own current context in which this develops; and, it must be survived by the Venezuelan citizen. That is why, the ability of people to develop psychologically well, despite of living in contexts of risk, refers both to individuals as to groups that are able to minimize and overcome the damaging effects of adversities and disadvantaged contexts.

El presente ensayo tiene como propósito llevar a cabo una aproximación teórica al constructo de la resiliencia a través de algunas reflexiones. Diariamente los seres humanos se desenvuelven en diferentes niveles, cumpliendo variados roles y afrontando constantes retos de toda índole, el período que se vive como estudiante durante el ciclo vital individual no constituye una excepción a estos hechos y el mismo exige el uso adecuado de todas las competencias con las cuales se cuenta. Sin embargo, no se pueden descartar las ocasiones en que el estudiante refleja que no posee las herramientas necesarias para tener un resultado triunfante o se encuentran debilitadas, teniendo en cuenta que las condiciones para la consecución de las metas no siempre son las mejores y existen diferentes obstáculos que superan al individuo, ya sea en lo personal, lo interpersonal, aunado al sistema y contexto actual propio en el que se desarrolla y debe subsistir el ciudadano venezolano. Es por esto que la capacidad que tienen las personas para desarrollarse psicológicamente con normalidad, a pesar de vivir en contextos de riesgo, se refiere tanto a los individuos en particular como a los grupos que son capaces de minimizar y sobreponerse a los efectos nocivos de las adversidades y los contextos desfavorecidos.

Tenosinovitis estenosante digital en pacientes de un Hospital Universitario / Digital stenosing tenosynovitis in patients of a University Hospital

La tenosinovitis es el engrosamiento del recubrimiento alrededor de los tendones de los dedos que resulta en una condición estenosante o dedo en resorte/gatillo (DR).Objetivo: Analizar la tenosinovitis estenosante en los pacientes que acudieron a la consulta de reumatología del hospital "Dr. Adolfo Prince Lara". Materiales y Métodos: Investigación cuantitativa, correlacional, transversal. Población integrada por 285 pacientes, muestra 105 pacientes con diagnóstico clínico de tenosinovitis estenosante. Resultados: Edad promedio de 55,32 años. Siendo 80% del sexo femenino. Ocupación predominante oficios del hogar 71,43%. Patologías médicas asociadas: Diabetes Mellitus 61,19%, Hipertensión Arterial 49,225% y Reumatológi cas: Osteoartrosis 48,49%, Tendinitis de D´Quervain 46,77%. Localización anatómica más frecuente el dedo anular (45,71%) seguida por el dedo pulgar (23,81%; 25 casos). Diagnóstico clínico en el 100% de los casos. Tratamiento más utilizado Aines con infiltración 75,24% remisión en 80% de los pacientes. Conclusión: La tenosinovitis estenosante representa más de un terc io de los pacientes que acuden a la consulta de reumatología, afecta principalmente a los adultos contemporáneos, de sexo femenino, diabéticos, de ocupación oficios del hogar u obreros, siendo el digito más afectado el anular, con 80% de remisión posterior a infiltración local y AINES administrado por via oral.

Tenosynovitis is the thickening of the lining around the tendons of fingers resulting in a condition stricturing, or spring/ trigger (ST) finger. Objective: Analyze the tenosynovitis in patients who come to the Rheumatology consult of the "Dr. Adolfo Prince Lara" hospital. Materials and methods: Quantitative, correlational and cross-sectional research. Population composed of 285 patients, sample of 105 patients with clinical diagnosis of tenosynovitis. Results: Average age of 5 5.32. 80% were female. Predominant occupation was home offices with 71.43%. Medical conditions associated: Diabetes Mellitus 61.19%, hypertension 49.22% and rheumatologic: 48.49% osteoarthritis, D´Quervain Tendinitis 46.77%. Anatomic location more frequent the ring finger (45.71%) followed by the thumb finger (23.81%; 25 cases). Clinical diagnosis in 100% of cases . Treatment most used nonsteroidal anti-inflammatory drugs (NSAIDs) with infiltration 75.24%, remission in 80% of patients. Conclusion: Tenosynovitis represents more than one third of the patients who come to the rehumatology consultation, mainly affects adult contemporary, female sex, diabetic, occupation offices of home or workers, being the ring finger the most affected, with 80% of remission after local infiltration and NSAIDs.

Conocimiento sobre el Virus del Papiloma Humano en estudiantes de Citotecnología de una Universidad Nacional / Knowledge on the human papilloma virus in students of Cytotechnology of a National University

Las infecciones de transmisión sexual incluyendo el Virus de Papiloma Humano (VPH) son muy comunes a nivel mundial. Objetivo. Determinar el conocimiento sobre el VPH en estudiantes de Citotecnología. Métodos. Investigación descriptiva. Se aplicó un cuestionario a 73 alumnos que incluyó edad, procedencia, ejercicio de función sexual, parejas sexuales, etiología del VPH, modo de transmisión, clínica y prevención. Resultados. La mediana de la edad fue 20 ± 0,5 años. Predominó significativamente el sexo femenino (Z = 8,28; p < 0,001) y los estudiantes que refirieron no tener más de una pareja sexual (42 de 73, 57,5%), con Z = 3,34; p < 0,001. Al existir 95,9% con un conocimiento muy bueno o excelente y significativamente mayor que quienes lo presentaron como bueno, (4,11%), no hubo diferencias estadísticamente significativas entre la medianas de puntajes de sexo. Conclusión: El conocimiento se puede asociar a un ejercicio responsable de la sexualidad en ambos géneros. Se recomienda reforzar las campañas de información y formación a los adolescentes respecto al VPH.

The sexual transmission infections including the Human Papilloma Virus (HPV) infection are very common in the world. Objective. To determine the knowledge on HPV in students of Cytotechnology. Methods. Descriptive investigation. A questionnaire was applied in 73 students, was included age, origin, exercise of sexual function, sex partners, etiology of HPV, transmission way, clinic and prevention. Results. The median of age was 20 ± 0.5 years. There was a significant predominance of female gender (Z = 8.28; p <0.001) and the students which refer to have more than a sexual partner (42 de 73, 57.5 %), with Z = 3.34; p < 0.001. There was a 95.9% a very good or excellent knowledge and significantly higher than whom had a good one (4.11%), whithout statistically significant differences between the medians of scores according sex, it is concluded that this knowledge could be associated to a responsible excercise of sexuality in both genders. It is recommended reinforce the information and tuition to the adolescents in respect of HPV.

Richness and Abundance of Ichneumonidae in a Fragmented Tropical Rain Forest.

Because of the magnitude of land use currently occurring in tropical regions, the local loss of animal species due to habitat fragmentation has been widely studied, particularly in the case of vertebrates. Many invertebrate groups and the ichneumonid wasps in particular, however, have been poorly studied in this context, despite the fact that they are one of the most species-rich groups and play an important role as regulators of other insect populations. Here, we recorded the taxonomic composition of ichneumonid parasitoids and assessed their species richness, abundance, similarity, and dominance in the Los Tuxtlas tropical rain forest, Mexico. We compared two forest types: a continuous forest (640 ha) and a forest fragment (19 ha). We sampled ichneumonids using four malaise traps in both forest types during the dry (September-October) and rainy (March-April) seasons. A total of 104 individuals of Ichneumonidae belonging to 11 subfamilies, 18 genera, and 42 species were collected in the continuous forest and 11 subfamilies, 15 genera, and 24 species were collected in the forest fragment. Species richness, abundance, and diversity of ichneumonids were greater in the continuous forest than in the forest fragment. We did not detect differences between seasons. Species rank/abundance curves showed that the ichneumonid community between the forest types was different. Species similarity between forest types was low. The most dominant species in continuous forest was Neotheronia sp., whereas in the forest fragment, it was Orthocentrus sp. Changes in the ichneumonid wasp community may compromise important tropical ecosystem processes.

Trastornos temporomandibulares: Perfil clínico, comorbilidad, asociaciones etiológicas y orientaciones terapéuticas / Temporomandibular disorders: clinical profile, comorbility, etiological associations and therapeutical guidelines

Objetivo: El propósito de la presente investigación fue dilucidar factores etiológicos y determinar la comorbilidad en enfermos con trastornos temporomandibulares (TTM) y dolor orofacial (DOF), con el objetivo de definir orientaciones terapéuticas. Materiales y métodos: Se realizó un estudio clínico-anamnésico entre abril de 2004 y abril de 2008, en pacientes que concurrieron en forma espontánea a la clínica universitaria de la especialidad. Resultados: Se examinaron 263 pacientes, de los cuales 80,22% fueron mujeres. El motivo de consulta más prevalente fue dolor cráneo-cérvico facial (84%). El 49,43% de los pacientes no reconoció la causa de inicio del problema, siendo “estrés/depresión” (24,71%) la más referida. Los TTM representaron una condición eminentemente crónica: el 34,55% de los pacientes relataron un tiempo de evolución entre 1-5 años, solo un 17,58%tuvo una evolución menor de 6 meses. La frecuencia relativa de diagnósticos, no excluyentes, fue: dolor muscular local, 81,37%; capsulitis/sinovitis, 74,52%; y desórdenes psicosociales, 61,98%. Se observó alta comorbilidad con cefaleas, 55,89%; alteraciones psicosociales, 52,47%; disturbios del sueño, 39,54%, y alteraciones cervicales, 28,9%Discusión: Las características sociodemográficas y clínicas de los pacientes evaluados, se corresponden con los reportes de la literatura actual. Se encontraron asociaciones significativas entre: bruxismo y dolor muscular local (p=0,014); bruxismo y capsulitis/sinovitis (p=0,025), y depresión severa/moderada con dolor muscular local (p=0,006). Se concluye que para el tratamiento de pacientes con TTM es necesaria la autorregulación física, el control de para funciones y la colaboración interdisciplinaria (AU)

Purpose: The aim of this study was to elucidate the etiologic factors and assess comorbidity in patients with temporomandibular disorders (TMD) and orofacial pain (OFP), to define therapeutic guidelines. Materials and methods: A clinical-anamnestic study was done between April 2004 and April 2008 in patients who spontaneously attended the university clinic of the specialty. Results: 263 patients were examined, of whom 80.22% were women. The most common complaint was craniofacial pain (84%). A 49.43% of the patients did not recognize the cause of onset of the problem. ”Stress /depression” (24.71%) was the most mentioned. TMD eminently represented a chronic condition: the 34.55% of patients reported a duration time between 1-5 years, only 17.58% had the pathology less than 6 months. The relative frequency of diagnoses, non exclusive, was local muscle pain, 81.37%; capsulitis / synovitis, 74.52%,and psychosocial disorders, 61.98%. High comorbidity of TMD was observed with headache, 55.89%;psychosocial disorders, 52.47%; sleep disturbances, 39.54%; and cervical abnormalities, 28.9%.Discussion: The sociodemographic and clinical features of patients that were evaluated match reports of the current literature. We found significant associations between bruxism and local muscle pain (p=0,014); bruxismand capsulitis / synovitis (p=0,025), and depression / moderate and local muscle pain (p=0,006). We conclude that physical self regulation, parafunction control and interdisciplinary collaboration are needed as treatment for patients with TMD (AU)

Visual neurophysiological dysfunction in infants exposed to hydroxychloroquine in utero.

AIM: Hydroxychloroquine therapy during pregnancy is thought to be safe for foetuses. Normal visual function has been showed on clinical grounds in infants exposed in utero to hydroxychloroquine, but there are few visual neurophysiological data. Our study was designed to assess retina and visual pathways using electroretinogram and visual evoked potentials in a series of infants born to mothers treated by hydroxychloroquine for connective tissue diseases. METHODS: Twenty-one infants (3-7 months of age) were consecutively examined between June 2002 and May 2007. Full-field electroretinogram was recorded by contact lens electrodes and visual evoked potentials were recorded by occipital surface electrodes using flash stimulation in mesopic condition. Analysis was focused on the amplitudes and latencies of the a- and b-waves of electroretinogram and the latency of the P(100) component of visual evoked potentials. RESULTS: Electroretinogram abnormalities were detected in six infants, associated with delayed visual evoked potentials in four of them. CONCLUSION: Early electroretinogram and visual evoked potentials testing evidenced neurophysiological visual disturbances in a subset of infants born to mothers treated by hydroxychloroquine. Systematic clinical and neurophysiological vision testing during childhood is needed to detect possible consequences of antenatal exposure to hydroxychloroquine.

Características epidemiológicas de pacientes atendidas en la consulta de endometriosis de un hospital universitario / Epidemiological characteristics of patients attended at the outpatient clinic of endometriosis in universitary hospital

Establecer las características epidemiológicas de pacientes con endometriosis. Es un trabajo descriptivo y transversal. La población fue de 54 pacientes. La recolección de la información mediante la revisión documental en una ficha. Consulta de endometriosis del Hospital Universitario Dr. Angel Larralde de Valencia. Edad promedio 30 ± 5,8 años. Motivos de consulta: dismenorrea (70,7 por ciento), dolor pélvico (58,5 por ciento) y dispareunia (36,6 por ciento). Edad promedio de menarquía 12 años. El 29 por ciento reportó algún tipo de trastorno menstrual, el más frecuente la metrorragia (17 por ciento). El 41,5 por ciento refirió uso previo de anticonceptivos orales. El 34 por ciento de las pacientes no habían estado embarazadas, 26,88 por ciento primigesta. Entre los antecedentes quirúrgicos gineco-obstétricos, 39 por ciento reportó cesáreas, 26,88 por ciento ooforectomía y 19,55 por ciento legrado uterino. Las endometriosis más frecuentes fueron la ovárica (56,09 por ciento) y en cicatriz abdominal postcesárea (24,39 por ciento). La endometriosis es una patología típica de la mujer en edad reproductiva, que puede darse inclusive en la adolescencia.

Hospitales públicos y Responsablidad Social Corporativa / Public hospitals and Social Corporate Responsibility

Todos los centros hospitalarios del Sistema Nacional de Salud, son en la práctica epresas de servicios de alta calificacion científico y tecnológica, pero prestadores de uns ervicio; para optimizar y gesionar mejor todos sus recursos el Hospital General Universiario “Reina Soía” de Murcia tiene un Proyecto Institucional de Ética y Responsabilidad Social Corporativo basado en una serie de iniiativas puestas ya en fuencionamiento y en otras qu se irán agregando paulatinamente, con una clara orientación hacia los pacientes y profesionales del centro (AU)

All the hospitable centers of the national System of Health, are in the practice companies, but lending of services, of high scientific and technological qualification of a service; to optimize and to manage better all his resources the Hospital General Universitari “Reina Sofia” of Murcia has an Institutional Project of Ethics and Social Corporate Responsibility based on a series of initiatives us already in functioning and in others who will be joing gradually, with a clear orientation towards the patients and professionals of the center (AU)

Gender-dependent differences in serum profiles of insulin and leptin in caloric restricted rats.

In the present study, we have investigated whether differences between male and female rats described in response to 40% caloric restriction (CR) were influenced by circulating level variations of sex hormones and/or insulin and leptin. Body weights (BW), organ weights, and adipose depot weights (ADW) were also measured. The most affected tissues by CR were the fat depots. Metabolically active organs were the least affected, especially more in females than in males (male weight lost: 24.3% vs. female: 17.3%). Testosterone and estradiol circulating levels did not show changes by CR. Insulin levels were decreased by CR in both genders, but was more evident in female rats than males. Leptin serum levels were higher in male rats than in females, and CR caused a circulating leptin level reduction only in males. In conclusion, our results indicate that leptin and insulin could be one of the keys of the different hormonal control of energy homeostasis in response to CR between female and male rats. In this sense, leptin serum levels correlated statistically with BW and with individual ADW only in male rats, whereas insulin serum levels correlated statistically with BW and with any of the ADW studied only in females.

Controlling viscoelastic flow by tuning frequency during occlusions.

We study the flow of a viscoelastic fluid flowing in an occluded tube due to either central or peripheral obstructions. We show that, by driving the fluid with a dynamic pressure gradient at the frequency that maximizes the dynamic permeability of the obstructed system, the magnitude of the flow can partially be recovered without the removal of the obstruction. We compare the results obtained for the two types of occlusions studied and find that flow recovering is larger in the case of central occlusions.

Sexual dimorphism in liver mitochondrial oxidative capacity is conserved under caloric restriction conditions.

Caloric restriction (CR) without malnutrition has been shown to increase maximal life span and delay the rate of aging in a wide range of species. It has been proposed that reduction in energy expenditure and oxidative damage may explain the life-extending effect of CR. Sex-related differences also have been shown to influence longevity and energy expenditure in many mammalian species. The aim of the present study was to determine the sex-related differences in rat liver mitochondrial machinery, bioenergetics, and oxidative balance in response to short-term CR. Mitochondria were isolated from 6-mo-old male and female Wistar rats fed ad libitum or subjected to 40% CR for 3 mo. Mitochondrial O(2) consumption, activities of the oxidative phosphorylation system (complexes I, III, IV, and V), antioxidative activities [MnSOD, glutathione peroxidase (GPx)], mitochondrial DNA and protein content, mitochondrial H(2)O(2) production, and markers of oxidative damage, as well as cytochrome C oxidase and mitochondrial transcription factor A levels, were measured. Female rats showed a higher oxidative capacity and GPx activity than males. This sexual dimorphism was not modified by CR. Restricted rats showed slightly increased oxygen consumption, complex III activity, and GPx antioxidant activity together with lower levels of oxidative damage. In conclusion, the sexual dimorphism in liver mitochondrial oxidative capacity was unaffected by CR, with females showing higher mitochondrial functionality and ROS protection than males.

M@TIC. Medicine Assisted by Information and Communication Technology: conflicts, responsibility and liability.

The term M@TIC, is that which encompasses all Medicine Assisted by Technology on Information and Communication. The development of these techniques brings up many ethical and legal conflicts, mainly because medical science has developed much faster than the law. Justice cannot be properly served if we do not have the regulations to help mankind to avoid aberrant behavior by medical practitioners in this field. M@TIC is still regarded as an experimental research procedure. Not all that is technically feasible is ethically acceptable. There are many potential risks associated with M@TIC and it is largely considered, and so it is understood by doctors, that any damage to the patient would be the fault of the system, never the responsibility of the doctor. It frightens one to think that this fact may be used, in the future, as a shield to protect negligent medical doctors from malpractice suits.

Kinetic analysis of a general model of activation of aspartic proteinase zymogens.

Starting from a simple general reaction mechanism of activation of aspartic proteinase zymogens involving an uni- and a bimolecular simultaneous route, the time course equation of the concentration of the zymogen and of the activated enzyme have been derived. From these equations, an analysis quantifying the relative contribution to the global process of the two routes has been carried out for the first time. This analysis suggests a way to predict the time course of the relative contribution as well as the effect of the initial zymogen and activating enzyme concentrations, on the relative weight. An experimental design and kinetic data analysis is suggested to estimate the kinetic parameters involved in the reaction mechanism proposed. Finally, we apply some of our results to experimental data obtained by other authors in experimental studies of the activation of some aspartic proteinase zymogens.

Frecuencia de aspergiloma en pacientes con antecedente de tuberculosis, hemoptisis, radiografía anormal y baciloscopía negativa / Frequency of aspergilloma in patients with history of tuberculosis, hemoptysis, abnormal chest x-ray films and negative sputum smears

Objetivo: Determinar la frecuencia de aspergilomas en pacientes con antecedentes de tuberculosis pulmonar curada,hemoptisis, radiografía de tórax anormal y BK negativo. Materiales y métodos: Se enroló 28 pacientes entre diciembrede 2002 y septiembre de 2004 en el Hospital Nacional Hipólito Unanue de Lima y Hospital Belén de Trujillo. A los pacientesevaluados en el Hospital Belén se les solicitó tres muestras de esputo, seriadas y consecutivas, mientras que lospacientes evaluados en el Hospital Nacional Hipólito Unanue y que fueron sometidos a cirugía de tórax, se les colectóuna porción de la pieza quirúrgica tisular pulmonar. Ambas muestras biológicas fueron cultivadas en agar sabourauddextrosa - cloramfenicol 0,05 por ciento e incubados a temperatura ambiente y 37 °C por 15 días. A todos los pacientes se lesextrajo 5 mL de sangre total para realizar la prueba de inmunodifusión contra Aspergillus sp. Resultados: La frecuenciade aspergiloma fue de 43 por ciento (12/28). Se identificó por cultivo Aspergillus fumigatus en cinco casos, Aspergillus sp endos, A. niger en uno, A. flavus en uno y en dos casos positivos por serología no se logró aislar el hongo. En los dospacientes donde se identificó A. niger, no se detectó presencia de anticuerpos contra Aspergillus sp. En el HospitalBelén la frecuencia de aspergiloma fue 39 por ciento (7/18) y en el Hospital Hipólito Unanue 50 por ciento (5/10). Conclusiones: Lafrecuencia de aspergiloma en los 28 pacientes investigados en ambos hospitales fue de 43 por ciento y el principal agenteetiológico fue A. fumigatus.

Objective: To determine the frequency of aspergilloma in patients with history of cured pulmonary tuberculosis, hemoptysis, abnormal chest X-ray films, and negative sputum smears for acid-fast bacilli. Materials and methods: 28 patients were enrolled between December 2002 and September 2004 in Hipolito Unanue National Hospital in Lima and Belen Hospital in Trujillo. Patients from Belen Hospital had three serial and consecutive sputum samples taken, while those patients from Hipolito Unanue Hospital who underwent thoracic surgery had a portion of the surgical specimen collected. Both biological samples were cultured in Sabouraud dextrose agar – 0,05% chloramphenicol, and they were incubated at room temperature and at 37° C for 15 days. All patients had a 5-mL blood sample taken in order to perform immunodifusion tests for Aspergillus sp. Results: The frequency of aspergilloma was 43%) (12/28). Aspergillus fumigatus was identified in cultures in five cases, Aspergillus sp. was identified in two cases, A. niger in one, A. flavus in one, and in two cases reported as positive for serological tests the fungus could not be isolated. In the two patients in whom A. niger was identified, no presence of antibodies against Aspergillus sp. was detected. In Belen Hospital the frequency of aspergilloma was 39% (7/18), and in Hipolito Unanue Hospital it was 50% (5/10). Conclusions: Aspergilloma frequency in 28 patients studied in both hospitals was 43%, and the main etiological agent was A. fumigatus.

Concentraciones sanguíneas de zinc en embarazadas con partos prematuros / Embarrassed sanguineous zinc concentrations in with premature childbirths

con el objetivo de evaluar la relación entre el comportamiento del zinc durante el embarazo y algunas variables estudiadas en embarazadas que tuvieron partos prematuros, se hizo un estudio de corte trasversal en 60 gestantes cuyos hijos nacieron entre las semanas 27 y 36, en la ciudad de Medellín, Colombia. La concentración media del metal y su error estándar fueron 7,33 ± 0,23 mg/L; no se observó una correlación entre los valores encontrados y la edad gestacional. Las gestantes sanas tuvieron una concentración media de zinc de 7,20 ± 0,25 mg/L, la cual fue significativamente menor que la de quienes tuvieron niños con crecimiento restringido, p = 0,03, pero similar a la de las que sufrieron hipertensión inducida, embarazos múltiples, fetos malformados o recibieron esteroides para la maduración pulmonar fetal. El percentil 75 de la curva de valores del zinc se estableció en 8,6 mg/L, y quienes se ubicaron por encima del mismo tuvieron un número significativamente mayor de fetos de sexo femenino, p = 0,011, y una tendencia no significativa a tener más fetos con restricción del crecimiento, p = 0,07. Las ubicadas por debajo del percentil 25, o sea de 6,2 mg/L, mostraron también tendencias no significativas a un número mayor de embarazos gemelares, p = 0,05 y de fetos malformados, p = 0,08. Los hallazgos de la muestra estudiada sugieren que puede existir asociación entre las concentraciones de zinc y efectos fetales importantes que se deben verificar en estudios posteriores que incluyan poblaciones mayores. Es llamativa la relación entre un zinc materno alto y el sexo femenino del feto, la cual podría estar indicando el efecto de factores hormonales específicos.Palabras claves: zinc, embarazo, parto prematuro.

Servicios Hospitalarios en Medicina Legal / Legal Medicine hospital services

Este artículo revisa los servicios hospitalarios de Medicina Legal, señalando que estos servicios son costo-eficientes para el Sistema Sanitario, que el profesional idóneo es el especialista en Medicina Legal con experiencia clínica y formando Bioética, haciendo énfasis en que es imprescindible la incorporación de los valores a los objetos del hospital (AU)

This article reviews the Legal Medicine hospital services, indicating that these services are cost-efficient for the Health System, that the ideal professional is the specialist in Legal Medicine with clinical experience and Bioethical training, and emphasising that it is essential to incorporate the values into the objective of the hospital (AU)