Epidemiología de las fisuras labiales y palatinas durante los años 1990–2004 en Asturias / The epidemiology of cleft lip and palate over the period 1990–2004 in Asturias

Introducción: Las fisuras labiales y palatinas son los defectos congénitos faciales más frecuentes. Objetivo: Conocer la frecuencia de estos defectos en Asturias y realizar una descripción clinicoepidemiológica de sus anomalías asociadas. Metodología: Análisis de los datos del Registro de Defectos Congénitos de Asturias de los años 1990–2004 sobre una población de 103.452 nacidos y comparación con el European Concerted Action on Congenital Anomalies and Twins y otros registros españoles. Resultados: De los 145 casos registrados, el 26,9% eran fisuras labiales, el 28,3% eran fisuras labiopalatinas y el 44,8% eran fisuras palatinas. La prevalencia total de las fisuras labiales o palatinas fue de 14,4 por 10.000 nacidos. Un 18,6% tenía otros defectos asociados, y fueron más frecuentes las anomalías esqueléticas, las cardiovasculares y las del sistema nervioso central. Un 22,1% de las fisuras labiales y palatinas pertenecía a un síndrome o secuencia reconocida. El diagnóstico prenatal fue del 12,4%, principalmente en los casos polimalformados y síndromes. Conclusiones: La prevalencia total de las fisuras labiales y palatinas en Asturias durante este período fue similar a la de otros registros europeos. Debido a la elevada asociación a otras anomalías, debe realizarse una búsqueda minuciosa de ellas, tanto en la ecografía prenatal como en la exploración del recién nacido (AU)

Introduction: Cleft lip and palate (oral clefts) are the most common congenital facial defects. Objective: To assess the prevalence of oral clefts and to describe the associated malformations in a geographically defined population. Method: Data from the Asturias Registry of Congenital Defects were used to investigate the epidemiology of congenital facial clefts over the period 1990–2004 among the 103,452 births in the region. The results were also compared with data from EUROCAT and other Spanish registries. Results: Out of 145 oral clefts recorded, cleft lip was 26.9%, cleft lip and palate 28.3% and cleft palate 44.8%. Total prevalence of oral clefts was 14.4 per 10,000 births. Other associated defects were found in 18.6% of the total cases, with skeletal, cardiovascular and central nervous systems being the most common anomalies. Syndromes or sequences were found in 22% of clefts. A prenatal diagnosis was made in 12.4%. Conclusion: The prevalence of oral clefts in Asturias over this period fell within the range reported for other European registries. An exhaustive prenatal ultrasound and examination of the affected newborns to look for other malformations should be considered in infants with clefts, due to the high association with them (AU)

Frecuencia y presentación clínica de los defectos oculares congénitos en Asturias (1990–2004) / Frequency and clinical presentation of congenital ocular anomalies in Asturias 1990–2004

Introducción: Los defectos oculares congénitos (DOC) pueden originar importante discapacidad. Objetivo: El objetivo de este estudio fue conocer la prevalencia total de los DOC en Asturias, su tendencia y realizar una descripción de su forma de presentación. Metodología: Análisis de los datos del Registro de Defectos Congénitos de Asturias (RDCA) de los años 1990–2004. La población estudiada fueron los 103.452 nacidos de madres residentes en Asturias en este periodo. Se calcularon las tasas de prevalencia total. Resultados: De los 3.035 casos con defectos congénitos registrados durante los 15 años estudiados, 70 tenían un DOC. La prevalencia total media fue de 6,8 por 10.000 nacidos, con una tendencia estable. Los más frecuentes fueron: las cataratas congénitas (2,0 por 10.000 nacidos vivos), la anoftalmia/microftalmia (1,4 por 10.000 nacidos vivos) y los colobomas (1,3 por 10.000 nacidos vivos). El 40 % de los DOC se presentaron de forma aislada, 37% pertenecían a un síndrome y 23% se asociaban a otras anomalías congénitas no sindrómicas. Conclusiones: La prevalencia total de los DOC durante este periodo en Asturias fue estable siendo las cataratas congénitas el DOC más frecuente. Más de la mitad de los DOC, en especial la anoftalmia/microftalmia se asociaron a otras malformaciones congénitas (AU)

Introduction: Congenital ocular anomalies (COAs) can produce serious disability. Objective: The purpose of this investigation was to assess the prevalence of COAs, their trends and to describe the associated malformations and syndromes in a geographically defined population. Method: Data from the Asturias Registry of Congenital Defects were used. The period studied was from 1990 to 2004 and the study population the 103,452 births of mothers living in the region. Total prevalence was calculated. Results: A total of 3035 cases with congenital defects were recorded, of these 70 had COAs. The total prevalence was 6.8 per 10000 births, with a stable trend during this period. The most common COAs were: congenital cataract (2.0 per 10000 births), anophthalmos/microphthalmos (1.4 per 10000 births) and coloboma (1.3 per 10000 births). 40% of COAs occurred as isolated defects, 37% were syndromes and 23% were associated with other congenital defects. Conclusions: The prevalence of COAs in Asturias over this period had a stable trend and the congenital cataract was the commonest COAs. COAs, particularly the anophthalmos/microphthalmos were associated with other congenital anomalies (AU)

[Frequency and clinical presentation of congenital ocular anomalies in Asturias 1990-2004]. / Frecuencia y presentación clínica de los defectos oculares congénitos en Asturias (1990-2004).

INTRODUCTION: Congenital ocular anomalies (COAs) can produce serious disability. OBJECTIVE: The purpose of this investigation was to assess the prevalence of COAs, their trends and to describe the associated malformations and syndromes in a geographically defined population. METHOD: Data from the Asturias Registry of Congenital Defects were used. The period studied was from 1990 to 2004 and the study population the 103,452 births of mothers living in the region. Total prevalence was calculated. RESULTS: A total of 3035 cases with congenital defects were recorded, of these 70 had COAs. The total prevalence was 6.8 per 10000 births, with a stable trend during this period. The most common COAs were: congenital cataract (2.0 per 10000 births), anophthalmos/microphthalmos (1.4 per 10000 births) and coloboma (1.3 per 10000 births). 40% of COAs occurred as isolated defects, 37% were syndromes and 23% were associated with other congenital defects. CONCLUSIONS: The prevalence of COAs in Asturias over this period had a stable trend and the congenital cataract was the commonest COAs. COAs, particularly the anophthalmos/microphthalmos were associated with other congenital anomalies.

[The epidemiology of cleft lip and palate over the period 1990-2004 in Asturias]. / Epidemiología de las fisuras labiales y palatinas durante los años 1990-2004 en Asturias.

INTRODUCTION: Cleft lip and palate (oral clefts) are the most common congenital facial defects. OBJECTIVE: To assess the prevalence of oral clefts and to describe the associated malformations in a geographically defined population. METHOD: Data from the Asturias Registry of Congenital Defects were used to investigate the epidemiology of congenital facial clefts over the period 1990-2004 among the 103,452 births in the region. The results were also compared with data from EUROCAT and other Spanish registries. RESULTS: Out of 145 oral clefts recorded, cleft lip was 26.9%, cleft lip and palate 28.3% and cleft palate 44.8%. Total prevalence of oral clefts was 14.4 per 10,000 births. Other associated defects were found in 18.6% of the total cases, with skeletal, cardiovascular and central nervous systems being the the most common anomalies. Syndromes or sequences were found in 22% of clefts. A prenatal diagnosis was made in 12.4%. CONCLUSION: The prevalence of oral clefts in Asturias over this period fell within the range reported for other European registries. An exhaustive prenatal ultrasound and examination of the affected newborns to look for other malformations should be considered in infants with clefts, due to the high association with them.

Epidemiología de las cardiopatías congénitas en Asturias durante el período 1990–2004 / The epidemiology of congenital heart disease in Asturias (Spain) during the period 1990–2004

Introducción: Las cardiopatías congénitas (CC) son los defectos congénitos (DC) más comunes. Objetivo: Conocer la prevalencia total de las CC en Asturias y su tendencia y realizar una descripción de las anomalías asociadas y los síndromes o las secuencias. Material y métodos: Análisis de los datos del Registro de DC de Asturias de los años 1990–2004. La población estudio fueron los 103.452 nacidos de madres residentes en Asturias en ese período. Se calcularon las tasas de prevalencia total y al nacimiento. Resultados: De los 3.035 casos con DC registrados durante los 15 años estudiados, 778 tenían una CC. La prevalencia total media fue de 75,2 por 10.000 nacidos, con una tendencia ascendente. Las más frecuentes fueron la comunicación interventricular (28,8 por cada 10.000 nacidos vivos), los defectos del septo auricular (10,3 por cada 10.000 nacidos vivos) y la persistencia del ductus arterioso (6,0 por cada 10.000 nacidos vivos). El 73,6% de las CC se presentó de forma aislada, el 12,5% asociadas a otras anomalías congénitas y el 14% pertenecía a un síndrome o a una secuencia. El diagnóstico prenatal fue del 7,3% (del 3,8% en los casos aislados). Conclusiones: La prevalencia total de las CC en Asturias durante este período fue similar a la de otros registros europeos. El aparente incremento de la prevalencia se debió a un mayor diagnóstico de los defectos menores, mientras que las CC más graves mantuvieron una frecuencia estable. El diagnóstico prenatal de las CC en Asturias fue inferior al de otros registros europeos (AU)

Introduction: Congenital heart diseases (CHDs) are the most common type of birth defect. Objective: The purpose of this investigation was to assess the prevalence and trends of CHDs, and to describe the associated malformations and syndromes or sequences in a geographically defined population. Material and methods: Data wers collected from the Asturias Registry of Congenital Defects. The period studied was from 1990 to 2004, and the study population was the 103,452 births of mothers living in the region. Total prevalence and birth prevalence were calculated. Results: A total of 3035 cases with congenital defects were recorded, of these 778 had CHDs. The total prevalence was 75.2 per 10000 births, with an upward trend during this period. The most common CHDs were: ventricular septal defects (28.8 per 10000 births), atrial septal defects (10.3 per 10000 births) and patent ductus arteriosus (6.0 per 10000 births). A total of 73.6% of CHDs occurred as isolated defects, 12.5% with other congenital defects and 14% were syndromes or sequences. Prenatal diagnosis was effective in only 7.3% (3.8% in isolated cases). Conclusions: The prevalence of CHDs in Asturias over this period falls within the range reported for other European registries. The apparent increase in prevalence of CHD results mainly from improved diagnosis of minor defects, but there has been no change over time in birth prevalence of more serious defects (AU)

[The epidemiology of congenital heart disease in Asturias (Spain) during the period 1990-2004]. / Epidemiología de las cardiopatías congénitas en Asturias durante el período 1990-2004.

INTRODUCTION: Congenital heart diseases (CHDs) are the most common type of birth defect. OBJECTIVE: The purpose of this investigation was to assess the prevalence and trends of CHDs, and to describe the associated malformations and syndromes or sequences in a geographically defined population. MATERIAL AND METHODS: Data were collected from the Asturias Registry of Congenital Defects. The period studied was from 1990 to 2004, and the study population was the 103,452 births of mothers living in the region. Total prevalence and birth prevalence were calculated. RESULTS: A total of 3035 cases with congenital defects were recorded, of these 778 had CHDs. The total prevalence was 75.2 per 10,000 births, with an upward trend during this period. The most common CHDs were: ventricular septal defects (28.8 per 10,000 births), atrial septal defects (10.3 per 10,000 births) and patent ductus arteriosus (6.0 per 10,000 births). A total of 73.6% of CHDs occurred as isolated defects, 12.5% with other congenital defects and 14% were syndromes or sequences. Prenatal diagnosis was effective in only 7.3% (3.8% in isolated cases). CONCLUSIONS: The prevalence of CHDs in Asturias over this period falls within the range reported for other European registries. The apparent increase in prevalence of CHD results mainly from improved diagnosis of minor defects, but there has been no change over time in birth prevalence of more serious defects.

Evolución del diagnóstico prenatal delas anomalías cromosómicas en Asturias(España). Período 1990-2004 / Prenatal diagnosis trend for chromosomal abnormalities in Asturias (Spain). Period 1990-2004

Fundamento. Evaluar el impacto del diagnóstico prenatal(DP) en las anomalías cromosómicas (AC).Métodos. Durante 15 años (1990-2004) el Registro deDefectos Congénitos de Asturias (RDCA) recogió informaciónsobre AC. El RDCA es un registro de base poblacionalque incluye todos los diagnósticos ya sean abortos, mortinatos,o nacidos vivos hasta los 5 años de edad. Se analizaronlos datos de las AC, particularmente del síndrome deDown, síndrome de Turner, y trisomía 18, y la evolución delDP.Resultados. Se diagnosticaron 356 AC, aumentando elDP con el paso de los años, más en el grupo correspondientea mujeres de 35 años y más (30 % en menores de 35 años entre1990 y 1993, frente a 50 % entre 2002 y 2004; 48 % enmujeres de 35 años y más en el primer período frente a 83%en el segundo). En el síndrome de Down en las mujeres menoresde 35 años entre 2002 y 2004 el DP apenas alcanzó el30 %. En la trisomía 18 y en el síndrome de Turner, el porcentajede DP fue alto, debido principalmente a hallazgosecográficos.Conclusiones. El DP de las AC ha mejorado sus resultadosa lo largo de los 15 años, con una mejoría significativaen el diagnóstico ecográfico, excepto en el síndrome deDown en el grupo de menores de 35 años (AU)

Methods. Over 15 years (1990-2004) the Registro deDefectos Congénitos de Asturias (RDCA) collected informationon CA. The RDCA is a population-based registrythat includes all diagnosed cases whether abortions, stillbirths,or live birth until the age of five. The data obtainedwere analyzed for the CA, particularly for Downsyndrome, Turner syndrome and trisomy 18, and the evolutionof PD.Results. 356 chromosomal abnormalities were diagnosed,the PD increased over the years, especially in womenaged 35 and over (30% under the age of 35 between 1990and 1993, compared with 50% between 2002 and 2004;48% in women aged 35 and over in the first period comparedto 83% in the second). In Down syndrome data in thegroup of women under 35 years in 2002-2004 PD barelyreached 30%. In trisomy 18 and Turner syndrome, the averageof PD was high, mainly due to ultrasound findings.Conclusions. PD on CA has improved its results over15 years, with a significant improvement in the ultrasounddiagnosis, except for Down syndrome in the groupof women under 35 years (AU)

Evolución del diagnóstico prenatal de los defectos congénitos estructurales en Asturias. Período 1990-2004 / Prenatal diagnosis trend for structural birth defects in Asturias (Spain). Period 1990-2004

Fundamento. Evaluar el impacto del diagnóstico prenatal(DP) en los defectos congénitos estructurales (DCE).Métodos. Durante 15 años (1990-2004) el Registro deDefectos Congénitos de Asturias (RDCA) recogió informaciónsobre defectos congénitos (DC). El RDCA es un registrode base poblacional que incluye todos los diagnósticos yasean abortos, mortinatos, o nacidos vivos hasta los cincoaños de edad. Se analizaron datos obtenidos de los defectosde cierre del tubo neural (DTN), hernia diafragmática (HD),onfalocele, gastrosquisis, y cardiopatías congénitas, y la evolucióndel DP de estos defectos.Resultados. Se diagnosticaron un total de 3.035 DC(2,9 % sobre el total de nacimientos), siendo 560 los diagnósticosprenatales (18,5 %). Se registraron 126 casos deDTN con un porcentaje de DP igual o superior al 90 % en losperíodos estudiados, principalmente a expensas del diagnósticoecográfico. Hubo 45 casos de HD, con un incrementosustancial en el DP (68 % en los últimos años). En elcaso del onfalocele y la gastrosquisis, también se produjouna mejoría en la frecuencia del DP, especialmente en elcaso de las gastrosquisis, siendo diagnosticadas el 90%prenatalmente. El 10,6 % de las cardiopatías congénitas sediagnosticaron antes de nacer, y analizando las ocho másseveras y estructuralmente más complejas el DP apenas llegaal 20 % (AU)

Objective. To asses the impact of prenatal diagnosis(PD) on structural birth defects.Methods. Over 15 years (1990-2004) the Registro deDefectos Congénitos de Asturias (RDCA) collected informationon birth defects (BD). The RDCA is a populationbasedregistry that includes all diagnosed cases whetherabortions, stillbirths, or live birth until the age of five.Data obtained were analyzed for the defects of the neuraltube closure (DNT), diaphragmatic hernia (DH), omphalocele,gastroschisis, and congenital heart disease, and theevolution of PD in these defects.Results. 3,035 BD were diagnosed (2.9% of totalbirths), of which 560 were prenatally (18.5%). They wererecorded 126 cases of DNT with an average of PD equalto or exceeds 90% in the periods studied, mainly due toultrasound diagnosis. There were 45 cases of DH, with asubstantial increase in the PD (68% the last years). Omphaloceleand gastroschisis, also show an increase in thefrequency of PD, especially in gastroschisis, being diagnosedthe 90% of them prenatally. 10.6% of congenitalheart diseases were diagnosed prenatally, and the eightvalues harsher and more structurally complex PD barelyreaches 20% (AU)

Trabajo en turnos en el sector de la salud chileno: una comparación entre el sector público y privado / Shiftwork in chilean health sector: a comparison between public and private sectors

En el sector de la salud chileno, un esquema de turnos tradicional es el denominado “cuarto turno”. Si bien este sistema es preferido por una proporción significativa de enfermeras y técnicos paramédicos, habitualmente se presume que el sector público presentaría alteraciones significativamente superiores a las que presenta el personal que se desempeña en el sector privado. La necesidad de respaldo científico al respecto, motivó esta investigación. En esta investigación, se aplicaron metodologías publicadas en la literatura científica (BESIAK, Standart Shiftwork Index y escala de hipersomnia de Epworth). Se encuestó una muestra de 44 trabajadores pertenecientes a un hospital privado y 43 trabajadores de un hospital público, ambos localizados en Santiago de Chile. La evaluación de la arquitectura de este sistema de turnos permite concluir que no representa riesgo significativo para las personas en los ámbitos de la salud, bienestar, vida social, adaptación y rendimiento. No existen diferencias significativas en la percepción de fatiga física, alteraciones sociales y presencia de trastornos del sueño entre el personal del sector privado y público. Las principales debilidades del sistema de cuarto turno son su alta irregularidad. Sus principales fortalezas son el alto número de días libres por semana, moderado impacto sobre el ritmo sueño-vigilia y moderada desvinculación social y familiar.

[Limb reduction defects in Asturias (1986-1997): prevalence and clinical presentation]. / Defectos de reducción de extremidades en Asturias, 1986-1997: prevalencia y presentación clínica.

AIM: To determine the prevalence and clinical presentation of limb reduction defects in Asturias (Spain). PATIENTS AND METHODS: Among the 92300 newborns, stillbirths and induced abortions for congenital defects surveyed by the Registry of Congenital Defects in Asturias (population-based registry) during 1986-1997, we studied the children with limb reduction defects. Frequency is expressed as total prevalence per 10000 births. RESULTS: Seventy-three children with limb reduction defects were identified, with a total prevalence of 8 per 10000 births (CI 6.2-9.8): upper limbs were affected in 65.7%, lower limbs in 23.3% and both upper and lower limbs were affected in 11%. Transverse terminal defects were present in 49.3%, and were intercalary in 16.4%, preaxial longitudinal in 8.2%, postaxial longitudinal in 9.6%, split hand/foot in 9.6% and multiple in 6.8%. Limb deficiencies were found in 52%; of these, 48% were associated with other congenital defects. Four had chromosomal anomalies and 20 were syndromes. 31% had low birth weight for their gestational age. Alcohol exposure during pregnancy was recorded in three mothers. CONCLUSIONS: A detailed study of limb reduction defects could lead to a better understanding of clinical presentation and to an etio-pathogenic diagnosis to control risk factors.

Defectos de reducción de extremidades en Asturias, 1986-1997: prevalencia y presentación clínica / Limb reduction defects in asturias (1986-1997): prevalence and clinical presentation

OBJETIVO: Conocer la prevalencia y forma de presentación clínica de los defectos por reducción de extremidades en la población asturiana. PACIENTES Y MÉTODOS: Estudio de niños con defectos de reducción de extremidades entre los 91.300 nacidos vivos, nacidos muertos mayores de 500 g y abortos inducidos por defectos congénitos, de mujeres residentes en Asturias, controlados por el Registro de Defectos Congénitos de Asturias (registro de base poblacional) en el período 1986-1997. La frecuencia se expresa como prevalencia total por 10.000 nacidos. RESULTADOS: Durante el período estudiado, se registraron 73 casos, siendo la prevalencia total de 8 por 10.000 (intervalo de confianza del 95 por ciento, 6,2-9,8). El 65,7 por ciento de las anomalías observadas afectaban a las extremidades superiores, el 23,3 por ciento a las inferiores y el 11 por ciento a ambas. El 49,3 por ciento presentaba un defecto terminal transverso, el 16,4 por ciento un defecto intercalar, el 8,2 por ciento longitudinal preaxial, el 9,6 por ciento longitudinal postaxial, el 9,6 por ciento mano o pie hendido, y en el 6,8 por ciento el defecto era múltiple. El 52 por ciento eran formas aisladas y el 48 por ciento se manifestaron como defecto asociado a otras malformaciones. En 4 existía alteración cromosómica, y en 20 la reducción de extremidades formaba parte de un síndrome, asociación o secuencia definida. El 31,5 por ciento presentaba bajo peso para la edad de gestación. En tres madres se constató ingestión importante de alcohol. CONCLUSIÓN: El estudio detallado de los defectos congénitos por reducción de extremidades permite un mejor conocimiento de sus formas clínicas de presentación, además de acercarnos a un diagnóstico etiopatogénico, con posibilidad de actuar sobre los factores de riesgo (AU)

[Helicobacter pylori antibiotic sensitivity by microdilution]. / Antibioticosensibilidad del Helicobacter pylori mediante microdilución.

The gastric pathogen Helicobacter pylori has been recognized as the major aetiologic agent of chronic gastritis and peptic ulcers and also a risk factor for gastric cancer; eradication of H pylori prevents peptic ulcer recurrence and may also decrease the prevalence of gastric cancer in high risk populations around the world. Currently the only accepted indication for treatment is ulcer disease and maltosa, infected with Helicobacter pilory. However treatment is difficult and easily develops resistance. The elaboration of an antibiotic profile is recommended after a treatment failure. There is a lack of information in developing countries so the aim of this work was to determine the antibiotic profile of 51 strains isolated from patients gastric biopsies attended at Hospital San Juan de Dios in Costa Rica, using egg yolk broth and finding a resistance of 63.0% to metronidazole with a breakpoint of 8.0 microg/ml and 20.0% resistance to tetracycline (MIC1.0 microg/ml), 6.0% to clarithromicyn with a MIC of 0.125 microg/ml. There was no resistance to amoxicilin (MIC 0.015 microg/ml). The microdilution technique is very laborious, but highly reproducible with results accordingly to previous work, and we recommended it for the designing of therapeutical scheme.

Antibioticosensibilidad del Helicobacter pylori mediante microdilución / Helicobacter pylori antibiotic sensitivity by microdilution

The gastric pathogen Helicobacter pylori has been recognized as the major aetiologic agent of chronic gastritis and peptic ulcers and also a risk factor for gastric cancer; eradication of H pylori prevents peptic ulcer recurrence and may also decrease the prevalence of gastric cancer in high risk populations around the world. Currently the only accepted indication for treatment is ulcer disease and maltosa, infected with Helicobacter pilory. However treatment is difficult and easily develops resistance. The elaboration of an antibiotic profile is recommended after a treatment failure. There is a lack of information in developing countries so the aim of this work was to determine the antibiotic profile of 51 strains isolated from patients gastric biopsies attended at Hospital San Juan de Dios in Costa Rica, using egg yolk broth and finding a resistance of 63.0% to metronidazole with a breakpoint of 8.0 microg/ml and 20.0% resistance to tetracycline (MIC1.0 microg/ml), 6.0% to clarithromicyn with a MIC of 0.125 microg/ml. There was no resistance to amoxicilin (MIC 0.015 microg/ml). The microdilution technique is very laborious, but highly reproducible with results accordingly to previous work, and we recommended it for the designing of therapeutical scheme.

[Evaluation of a fast urease test for the detection of Helicobacter pylori]. / Evaluación de una prueba de ureasa rápida para la detección de Helicobacter pylori.

Helicobacter Pylori colonize the gastric mucosa and their adaptation to this environment is related with its high activity urease. This enzyme hydrolyzes the gastric urea, neutralizing the acid environment of the bacteria. Based on that reaction numerous presumptive diagnosis tests, have been developed using a solution of urea (usually 6%) with a pH indicator (usually 0.05% fenol-red); nevertheless, the color changes are so light that some persons do not detect it. For that reason, a modification of that reaction was proposed using a mix of pH indicators (0.05% fenolred and 0.002 bromothymol blue) which induces a color change from light green to deep purple. Also, the reaction of urease was evaluated using only bromothymol blue. The reaction using fenol red as indicator showed the higher values for sensitivity of 58.8% and the specificity of 66.6%; whereas using only bromothymol-blue those values were 46 y 71.4% respectively. The efficiency of the test using fenol-red or the mix of this bromothymol- was 64.2 y 62.2%, respectively; however, the mix of indicators induce a change color easily detected, because of changes from ligh-green to deep-purple.

Foliar nitrogen and phosphorus dynamics of three Chilean Nothofagus (Fagaceae) species in relation to leaf lifespan.

This study examined foliar nutrient dynamics and nutrient resorption (retranslocation) in three species of Chilean Nothofagus (Fagaceae) that differed in leaf lifespan and elevational distribution. In our central Chile study area the elevations at which these three species are most abundant increase from N. obliqua (deciduous) at low elevations to N. dombeyi at intermediate elevation and N. pumilio (deciduous) at higher elevations up to treeline. We sampled a single stand at 1680 m in which all three species co-occurred. Nothofagus dombeyi leaves were structurally heavier, with specific leaf mass approximately twice that of the two deciduous species. On a concentration basis, foliar N increased in the order N. dombeyi < N. pumilio < N. obliqua and foliar P increased in the order N. dombeyi < N. obliqua < N. pumilio. However, when the differences in specific leaf mass among species were taken into account by calculating N and P content on a leaf area basis, N. dombeyi had the greatest N and P content. N and P remained relatively constant throughout most of the 4-yr N. dombeyi leaf lifespan, then decreased prior to abscission. Nothofagus dombeyi resorbed significantly less N (44-50%) than did the two deciduous species (63-78%), both on proportional and absolute bases. In contrast, N. pumilio and N. dombeyi resorbed similar amounts of P prior to abscission (40-50%), whereas no significant resorption of P from leaves of N. obliqua was noted. We use these results to clarify the relative importance of environmental gradients associated with elevation vs. genetically fixed leaf lifespans in controlling the nutrient dynamics of these congeneric tree species.

Evaluación de una prueba de ureasa rápida para la detección de Helicobacter pylori. / [Evaluation of a fast urease test for the detection of Helicobacter pylori]

Helicobacter Pylori colonize the gastric mucosa and their adaptation to this environment is related with its high activity urease. This enzyme hydrolyzes the gastric urea, neutralizing the acid environment of the bacteria. Based on that reaction numerous presumptive diagnosis tests, have been developed using a solution of urea (usually 6

) with a pH indicator (usually 0.05

fenol-red); nevertheless, the color changes are so light that some persons do not detect it. For that reason, a modification of that reaction was proposed using a mix of pH indicators (0.05

fenolred and 0.002 bromothymol blue) which induces a color change from light green to deep purple. Also, the reaction of urease was evaluated using only bromothymol blue. The reaction using fenol red as indicator showed the higher values for sensitivity of 58.8

and the specificity of 66.6

; whereas using only bromothymol-blue those values were 46 y 71.4

respectively. The efficiency of the test using fenol-red or the mix of this bromothymol- was 64.2 y 62.2

, respectively; however, the mix of indicators induce a change color easily detected, because of changes from ligh-green to deep-purple.

Evaluación de una prueba de ureasa rápida para la detección de Helicobacter pylori / Evaluation of a fast urease test for the detection of Helicobacter pylori

La mucosa gástrica coloniza el Helicobacter pylori siendo la adaptación al medio relacionada con su alta actividad de la ureasa. Este enzima hidroliza la urea gástrica neutralizando el medio ácido que rodea la bacteria. Sobre la base de esta reacción se desarrollaron numerosos test diagnósticos usando una solución de urea (habitualmente 6 por ciento) con un indicador de pH (Rojo Fenol 0.05 por ciento), pero el contenido de color es tan leve que a veces no se detecta. Por esta razón, se propone una modificación usando una mezcla de indicadores de pH (Rojo Fenol 0.05 por ciento y 0.002 de azul de Bromotimol) que induce un control de calor del verde suave al púrpura fuerte. También se usa solamente azul de bromotimol. El uso de este indicador muestra los valores más altos de sensibilidad y especificidad (69 y 56 por ciento respectivamente). La mezcla de ambos 58.8 y 66.6 por ciento y el azul de bromotimol 46 y 71 por ciento. La eficacia usando Rojo Fenol o la mezcla con bromotimol es de 64.2 y 62.2 por ciento respectivamente; sin embargo, la mezcla de estos indicadores induce un cambio de calor más facilmente detectable. (AU)

Evaluación de una prueba de ureasa rápida para la detección de Helicobacter pylori / Evaluation of a fast urease test for the detection of Helicobacter pylori

La mucosa gástrica coloniza el Helicobacter pylori siendo la adaptación al medio relacionada con su alta actividad de la ureasa. Este enzima hidroliza la urea gástrica neutralizando el medio ácido que rodea la bacteria. Sobre la base de esta reacción se desarrollaron numerosos test diagnósticos usando una solución de urea (habitualmente 6 por ciento) con un indicador de pH (Rojo Fenol 0.05 por ciento), pero el contenido de color es tan leve que a veces no se detecta. Por esta razón, se propone una modificación usando una mezcla de indicadores de pH (Rojo Fenol 0.05 por ciento y 0.002 de azul de Bromotimol) que induce un control de calor del verde suave al púrpura fuerte. También se usa solamente azul de bromotimol. El uso de este indicador muestra los valores más altos de sensibilidad y especificidad (69 y 56 por ciento respectivamente). La mezcla de ambos 58.8 y 66.6 por ciento y el azul de bromotimol 46 y 71 por ciento. La eficacia usando Rojo Fenol o la mezcla con bromotimol es de 64.2 y 62.2 por ciento respectivamente; sin embargo, la mezcla de estos indicadores induce un cambio de calor más facilmente detectable.

[Prevalence of Down's syndrome in Asturias, 1987-1993. Members of the Work Group of the RCDA]. / Prevalencia del síndrome de Down en Asturias, 1987-1993. Miembros del grupo de Trabajo del RDCA.

OBJECTIVE: To determine the frequency of Down Syndrome (DS) in Asturias and the prenatal diagnosis impact on the birth prevalence of this chromosomal anomaly. METHODS: The analysed data came from the Registry of Congenital Defects of Asturias (1990-1993) and from a retrospective study conducted by the same working group (1987-1989). The total prevalence rates and the prevalence at birth were calculated. RESULTS: Out of 55,601 births, DS was recorded in 83 cases: 69 livebirths, two fetal deaths and 12 induced abortions following prenatal diagnosis, giving a total prevalence rate of 14.9 per 10,000 and a birth prevalence of 12.8. The proportion of induced abortions was 15 per cent in this period; the proportion of cases in the high risk maternal age group (35 years and over) was around 50% of the total. The proportion of induced abortions was 15 per cent in this period. CONCLUSIONS: The frequency of DS in Asturias is comparable to the other populations. Prenatal diagnosis had little impact on the birth prevalence figures. These results may help us draw up prevention and prenatal diagnosis policies for these defects in Asturias when giving the frequency of this health problem.