Gender-related factors affecting access to TB services and treatment outcomes in the Philippines.

SETTING: The Philippines is one of the countries with the highest TB burdens. While TB affects men and women differently, studies also show that gender affects people's experience of and access to healthcare. Men and women have usually assigned roles and responsibilities that affect their decisions and health-seeking behaviour. OBJECTIVE: The gender analysis aimed to examine the relationship between gender and access to TB services and treatment outcomes according to five domains: cultural norms and beliefs; patterns of power and decision-making; gender roles and responsibilities; access to resources; laws and policies. DESIGN: The team conducted 19 in-depth interviews and five focus group discussions with project staff, TB coordinators from healthcare facilities, representatives from the private and informal business sector and representatives from the Philippine Department of Health from August to November 2019. RESULTS: Study findings indicated that men faced greater limitations than women in terms of accessing TB resources and services, which highlight the differences between genders in relation to health-seeking behaviours and ability to access healthcare. CONCLUSION: This demonstrates the importance of integrating a gender lens into the service provision set up, from screening to treating and monitoring, to ensure equitable health benefits for men, women, transgender and gender-diverse persons.

CADRE: Les Philippines font partie des pays ayant les plus lourds fardeaux liés à la TB. Bien que la TB affecte différemment les hommes et les femmes, des études montrent également que le genre influence l'expérience et l'accès aux soins de santé. Les hommes et les femmes ont généralement des rôles et des responsabilités assignés qui influencent leurs décisions et leur comportement en matière de recherche de soins de santé. OBJECTIF: L'analyse de genre visait à examiner la relation entre le genre et l'accès aux services de lutte contre la TB et les résultats du traitement selon cinq domaines : les normes et croyances culturelles ; les modèles de pouvoir et de prise de décision ; les rôles et responsabilités liés au genre ; l'accès aux ressources ; les lois et les politiques. MÉTHODE: L'équipe a réalisé 19 entretiens approfondis et cinq groupes de discussion avec le personnel du projet, les coordinateurs de la lutte contre la TB dans les établissements de santé, des représentants du secteur privé et informel, ainsi que des représentants du Ministère de la Santé des Philippines, d'août à novembre 2019. RÉSULTATS: Les résultats de l'étude ont indiqué que les hommes étaient confrontés à des limitations plus importantes que les femmes en termes d'accès aux ressources et aux services de lutte contre la TB, mettant en évidence les différences entre les genres en ce qui concerne les comportements en matière de recherche de soins de santé et la capacité d'accéder aux soins de santé. CONCLUSION: Cela démontre l'importance d'intégrer une perspective de genre dans la mise en place des services, de la détection au traitement et au suivi, afin de garantir des avantages sanitaires équitables pour les hommes, les femmes, les personnes transgenres et de genre diversifié.

Valoración de la efectividad y seguridad de dos técnicas de radiofrecuencia para el tratamiento de la gonalgia secundaria a gonartrosis. Estudio prospectivo randomizado doble ciego / Assessment of the effectiveness and safety of two radiofrequency techniques for the treatment of knee pain secondary to gonarthrosis. Prospective randomized double blind study

Antecedentes y objetivo: En los pacientes con gonalgia por gonartrosis, disponemos de tratamientos no exentos de efectos secundarios. Objetivo: evaluar la eficacia analgésica de la radiofrecuencia (pulsada y convencional) sobre el nervio safeno a nivel subsartorial y los nervios geniculares de la rodilla, mediante la localización por ultrasonografía. Materiales y métodos: Ensayo clínico prospectivo, aleatorizado, doble ciego. G1 (RDF1): sujetos sometidos a radiofrecuencia, G2 (PLCB): sujetos sometidos a placebo. Se consideró clínicamente relevante una disminución ≥30% del dolor, según escala visual numérica y en el Western Ontario and McMaster Universities Osteoartritis Index, cuestionario de impresión global del paciente (PGIC) y cuestionario de estado de salud (SF-12) en la evaluación al mes, a los tres meses y a los seis meses de la realización de la técnica. Resultados: Veintiocho pacientes (G1: 12, G2: 16), 72% mujeres, edad: 75,2 (9,1) años, índice de masa corporal: 29,9 (4,64). El análisis no mostró una reducción del dolor, ni estadísticamente significativa, ni clínicamente relevante, al mes, tres, o seis meses respecto al inicio del tratamiento, en el cuestionario Western Ontario and McMaster Universities Osteoartritis Index y en la escala visual numérica (reposo, movimiento). Respecto al PGIC y al cuestionario SF-12, tampoco existieron diferencias estadísticamente significativas entre G1 y G2 antes ni después del tratamiento. Conclusiones: La combinación de dos técnicas de radiofrecuencia, no provoca una reducción en la intensidad de la gonalgia, al mes, tres, ni a los seis meses después de su realización. Es necesario cambiar la técnica de radiofrecuencia e incluir más variables para proseguir con el estudio de eficacia

Background and objective: In patients with knee pain due to gonarthrosis, we have treatments that are not free of side effects. Objective: to evaluate the analgesic efficacy of radiofrequency (pulsed and conventional) on the saphenous nerve at the subsartorial level and the genicular nerves of the knee, by ultrasonography. Materials and methods: Prospective, randomized, double-blind clinical trial. G1 (RDF1): subjects subjected to radiofrequency, G2 (PLCB): subjects subjected to placebo. A decrease ≥30% of the pain was considered clinically relevant, according to numerical rating scale and in the Western Ontario and McMaster Universities Osteoarthritis Index, global patient impression questionnaire (PGIC) and health status questionnaire (SF-12) in the evaluation at month, three months and six months after the completion of the technique. Results: 28 patients (G1: 12, G2: 16), 72% women, age: 75.2+/-9.1 years, body mass index: 29.9+/-4.64. The analysis did not show a pain reduction, neither statistically significant, not clinically relevant, at one month, three, or six months with respect to the start of treatment, in the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire and numerical rating scale (rest, movement). Regarding PGIC and the SF-12 questionnaire, there were no statistically significant differences between G1 and G2 either before or after treatment. Conclusions: The combination of two radiofrequency techniques, does not cause a reduction in the intensity of the knee pain, at month, three, or at six months after its completion. It is necessary to change the radiofrequency technique and include more variables to continue with the efficacy study

Assessment of the effectiveness and safety of two radiofrequency techniques for the treatment of knee pain secondary to gonarthrosis. Prospective randomized double blind study. / Valoración de la efectividad y seguridad de dos técnicas de radiofrecuencia para el tratamiento de la gonalgia secundaria a gonartrosis. Estudio prospectivo randomizado doble ciego.

BACKGROUND AND OBJECTIVE: In patients with knee pain due to gonarthrosis, we have treatments that are not free of side effects. OBJECTIVE: to evaluate the analgesic efficacy of radiofrequency (pulsed and conventional) on the saphenous nerve at the subsartorial level and the genicular nerves of the knee, by ultrasonography. MATERIALS AND METHODS: Prospective, randomized, double-blind clinical trial. G1 (RDF1): subjects subjected to radiofrequency, G2 (PLCB): subjects subjected to placebo. A decrease ≥30% of the pain was considered clinically relevant, according to numerical rating scale and in the Western Ontario and McMaster Universities Osteoarthritis Index, global patient impression questionnaire (PGIC) and health status questionnaire (SF-12) in the evaluation at month, three months and six months after the completion of the technique. RESULTS: 28 patients (G1: 12, G2: 16), 72% women, age: 75.2±9.1 years, body mass index: 29.9±4.64. The analysis did not show a pain reduction, neither statistically significant, not clinically relevant, at one month, three, or six months with respect to the start of treatment, in the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire and numerical rating scale (rest, movement). Regarding PGIC and the SF-12 questionnaire, there were no statistically significant differences between G1 and G2 either before or after treatment. CONCLUSIONS: The combination of two radiofrequency techniques, does not cause a reduction in the intensity of the knee pain, at month, three, or at six months after its completion. It is necessary to change the radiofrequency technique and include more variables to continue with the efficacy study.

[Subcutaneous catheter used for administration of low-molecular-weight-heparin in pediatrics]. / Catéter subcutáneo para la administración de heparina de bajo peso molecular en pediatría.

INTRODUCTION: Subcutaneous catheter is a device easy to assemble, which was created for the administration of insulin in diabetic patients, especially in children, aiming to reduce the number of punctures, pain and anxiety of patients and their parents. OBJECTIVE: To describe the experience using the catheter for subcutaneous administration of low molecular weight heparin (LMWH) in hospitalized pediatric patients. PATIENTS AND METHOD: A prospective descriptive study in 28 patients who used 87 subcutaneous catheters for the administration of LMWH in the Pediatric Service of the Universidad Catolica de Chile between July, 2010 and November, 2011. RESULTS: Complications associated with the catheter had an incidence of 33 % in total catheters evaluated; the most frequent complication was the presence of hematoma at the site of insertion (26%). These complications occurred more frequently in male (38% versus 31% in females) and younger patients (9 months versus 12 months), who received dalteparin (54% versus 30% of other types of heparin) administered every 24 hours (41% versus 30%, administered every 12 hours), and when the catheter was located on both thighs (36 % versus 32% in both arms); however, these differences were not statistically confirmed. CONCLUSION: The subcutaneous catheter is a good technique to be considered for LMWH in children as it presents minor complications for drug administration.

Visual generalization in honeybees: evidence of peak shift in color discrimination.

In the present study, we investigated color generalization in the honeybee Apis mellifera after differential conditioning. In particular, we evaluated the effect of varying the position of a novel color along a perceptual continuum relative to familiar colors on response biases. Honeybee foragers were differentially trained to discriminate between rewarded (S+) and unrewarded (S-) colors and tested on responses toward the former S+ when presented against a novel color. A color space based on the receptor noise-limited model was used to evaluate the relationship between colors and to characterize a perceptual continuum. When S+ was tested against a novel color occupying a locus in the color space located in the same direction from S- as S+, but further away, the bees shifted their stronger response away from S- toward the novel color. These results reveal the occurrence of peak shift in the color vision of honeybees and indicate that honeybees can learn color stimuli in relational terms based on chromatic perceptual differences.

Catéter subcutáneo para la administración de heparina de bajo peso molecular en pediatría / Subcutaneous catheter used for administration of low-molecular-weight-heparin in pediatrics

Introduction: Subcutaneous catheter is a device easy to assemble, which was created for the administration of insulin in diabetic patients, especially in children, aiming to reduce the number of punctures, pain and anxiety of patients and their parents. Objective: To describe the experience using the catheter for subcutaneous administration of low molecular weight heparin (LMWH) in hospitalized pediatric patients. Patients and Method: A prospective descriptive study in 28 patients who used 87 subcutaneous catheters for the administration of LMWH in the Pediatric Service of the Universidad Catolica de Chile between July, 2010 and November, 2011. Results: Complications associated with the catheter had an incidence of 33 percentin total catheters evaluated; the most frequent complication was the presence of hematoma at the site of insertion (26 percent). These complications occurred more frequently in male (38 percent versus 31 percent in females) and younger patients (9 months versus 12 months), who received dalteparin (54 percent versus 30 percent of other types of heparin) administered every 24 hours (41percent versus 30 percent, administered every 12 hours), and when the catheter was located on both thighs (36 percent versus 32 percent in both arms); however, these differences were not statistically confirmed. Conclusion: The subcutaneous catheter is a good technique to be considered for LMWH in children as it presents minor complications for drug administration.

Introducción: El catéter subcutáneo es un dispositivo de fácil instalación, el cual fue ideado para la administración de insulinas en pacientes diabéticos, especialmente en pediatría, con el fin de disminuir el número de punciones, el dolor y la ansiedad de los pacientes y sus padres. Objetivo: Describir la experiencia del uso del catéter subcutáneo para la administración de heparina de bajo peso molecular (HBPM) en pacientes pediátricos hospitalizados. Pacientes y Método: Estudio descriptivo prospectivo en 28 pacientes que utilizaron 87 catéteres subcutáneos instalados para la administración de HBPM, en el Servicio de Pediatría de la Pontificia Universidad Católica de Chile en el período comprendido entre los meses de julio de 2010 y noviembre de 2011. Resultados: Las complicaciones asociadas al catéter presentaron una incidencia de 33 por ciento en el total de catéteres evaluados, siendo la más frecuente la presencia de hematoma en el sitio de inserción (26 por ciento). Estas complicaciones se presentaron con mayor frecuencia en pacientes de sexo masculino (38 por ciento versus 31 por ciento en sexo femenino) de menor edad (9 meses versus 12 meses), con indicación de dalteparina (54 por ciento versus 30 por ciento con otros tipos de heparina) administrada cada 24 h (41 por ciento versus 30 por ciento cuando fue administrada cada 12 h), y cuando el catéter estuvo ubicado en ambos muslos (36 por ciento versus 32 por ciento en ambos brazos); sin embargo, estas diferencias no fueron confirmadas estadísticamente. Conclusión: El catéter subcutáneo es una buena técnica a considerar para la administración de HBPM en la edad pediátrica, ya que permite la administración del medicamento con complicaciones leves asociadas a su uso.

Can red flowers be conspicuous to bees? Bombus dahlbomii and South American temperate forest flowers as a case in point.

It has been argued that trichromatic bees with photoreceptor spectral sensitivity peaks in the ultraviolet (UV), blue and green areas of the spectrum are blind to long wavelengths (red to humans). South American temperate forests (SATF) contain a large number of human red-looking flowers that are reported to be visited by the bumblebee Bombus dahlbomii. In the present study, B. dahlbomii's spectral sensitivity was measured through electroretinogram (ERG) recordings. No extended sensitivity to long wavelengths was found in B. dahlbomii. The spectral reflectance curves from eight plant species with red flowers were measured. The color loci occupied by these flowers in the bee color space was evaluated using the receptor noise-limited model. Four of the plant species have pure red flowers with low levels of chromatic contrast but high levels of negative L-receptor contrast. Finally, training experiments were performed in order to assess the role of achromatic cues in the detection and discrimination of red targets by B. dahlbomii. The results of the training experiments suggest that the bumblebee relies on achromatic contrast provided by the L-receptor to detect and discriminate red targets. These findings are discussed in the context of the evolutionary background under which the relationship between SATF species and their flower visitors may have evolved.

Efecto del masaje terapéutico en prematuros del Servicio de Neonatología del Hospital San José / Effects of massage in prematures at the neonatology unit of San Jose Hospital

Antecedentes: En Chile, la estadística poblacional reporta 259.069 recién nacidos vivos anualmente, corregidos para el año 2001, de los cuales, 6 por ciento son prematuros. Este grupo presenta la más alta morbimortalidad neonatal, requiere prolongadas hospitalizaciones e involucra un fuerte gasto de recursos para la salud pública del país. Objetivos: Esta investigación evaluó los efectos del masaje como terapia complementaria, al tratamiento habitual de los recién nacidos prematuros del Servicio de Neonatología del Hospital San José. Método: Se realizó un ensayo clínico de casos y controles que incluyó al azar 40 niños menores de 37 semanas de edad gestacional e inferior a 1.700 g al nacer que no presentaban condiciones patológicas al momento del estudio y que fueron agrupados por peso y edad gestacional al inicio de la intervención y pareados posteriormente por edad gestacional y categoría de peso de nacimiento (pequeño, normal o grande para la edad gestacional). Los padres de los niños fueron capacitados en masaje shiatsu y lo aplicaron a sus hijos por 15 minutos, tres veces al día, seis días alternos, por dos semanas. Se registró peso de inicio y diario en ambos grupos y días de hospitalización. El análisis estadístico se realizó mediante test t de Student para datos no pareados. Resultados: Los niños masajeados aumentaron en promedio, 14 gramos diarios más que el grupo control (p=0,0001) y permanecieron 15 días menos hospitalizados (p=0,0169). Conclusión: El masaje shiatsu produce una más rápida ganancia de peso en niños prematuros. Aplicando esta técnica a niños de 1000 gal nacer se ahorraría en promedio $1.216.000 por niño, sólo por concepto de días cama de hospitalización y una potencial ganancia en el desarrollo psicomotor.

Background: In Chile every year 259.069 childs were borned, 6 percent of them are prematures. This group has the highest neonatal mortality and morbidity, spending prolonged hospitalizations and monetary resources for the public health of Chile. Objective: This investigation looks for the effects of massage as a complementan/ therapy to the common treatment of our hospitalized prematures babies at the Neonatal Unit of San José Hospital. Method: We performed a clinic assay of cases and controls that included 40 babies under 37 weeks of gestation and less than 1700 g which had no pathologies. They were classified by weight and gestational age at the beginning of the assay and compared by weight and gestational age at the end of the study. Parents were trained in shiatsu massage and they applied it to their babies 15 minutes, 3 times per day, 6 every other days during 2 weeks. We registered the initial weight and then daily and hospitalization days in both groups. Statistical analysis was performed by test t student for data no paired. Results: The group of babies stimulated by massage, increased their weight 14 g per day in average more than the control group (p=0.0001) and spent 15 days less of hospitalization (p=0.0169). Conclusions: The shiatsu massage produces a fast gain of weight in newborns prematures babies. Applying this therapy to babies under 1000 g, we can save $1,216,000 per baby, just only for hospitalization concept and a potential gain in psychomotor development.

Phenylpropanoid NF-kappaB inhibitors from Bupleurum fruticosum.

Two phenylpropanoids from Bupleurum fruticosum (Apiaceae/Umbelliferae) were shown to inhibit the transcriptional activity induced by PMA or TNFalpha of an NF-kappaB-controlled reporter gene. Western blot experiments indicated that the phenylpropanoids did not prevent IkappaBalpha degradation, suggesting that their molecular target is at a post-IKB degradation level. Both compounds prevented cytokine (IL-1, IL-6, TNF, IL-8) release and prostaglandin E2 synthesis.

Staphylococcus aureus meticilino resistente: detección de PBP 2' mediante la técnica de látex y evaluación de la resistencia asociada / Methicillin-resistant staphylococcus aureus: detection of PBP 2 'latex using the technique and evaluation of the resistance associated

El Staphylococcus aureus meticilino resistente representa un patógeno importante en infecciones nosocomiales y adquiridas en la comunidad. Su detección en el laboratorio es en ocasiones difícil motivado a factores tales como la presencia de cepas con patrones de resistencia cercana a los puntos de corte (borderline), heterorresistencia o problemas en la metodología. El objetivo del presente estudio fue la detección mediante la técnica de látex de la proteína PBP 2', responsable de la resistencia a meticilina en Staphylococcus aureus, y la evaluación de la resistencia asociada a antibióticos marcadores de este fenotipo de resistencia: clindamicina, gentamicina, eritromicina, tetraciclina y ciprofloxacina. Para cumplir el objetivo propuesto fueron evaluadas 65 cepas de Staphylococcus aureus meticilino resistente, aisladas entre octubre 2001 y diciembre 2003 a partir de muestras clínicas y conservadas en el cepario del Labortorio Metropolitano de Caracas. De las 65 cepas evaluadas, 30 (46,15 por ciento) mostraron heterorresistencia y 35 (53,85 por ciento) resistencia absoluta (homorresistencia). La resistencia asociada a los antibióticos evaluados fue la siguiente: clendamicina (49,2 por ciento), gentamicina (64,7 por ciento), eritromicina (67,7 por ciento), tetraciclina (46,2 por ciento) y ciprofloxacina (57,0 por ciento). En una de las cepas no se detectó la presencia de la proteína PBP2', pudiendo atribuirse la resistencia a oxacilina a la presencia de otras PBP modificadas o a la hiperproducción de beta lactamasa.

Tracking the cell cycle origins for escape from topotecan action by breast cancer cells.

The anticancer agent topotecan is considered to be S-phase specific. This implies that cancer cells that are not actively replicating DNA could resist the effects of the drug. The cycle specificity of topotecan action was investigated in MCF-7 cells, using time-lapse microscopy to link the initial cell cycle position during acute exposures to topotecan with the antiproliferative consequences for individual cells. The bioactive dose range (0.5-10 microM) for 1-h topotecan exposures was defined by rapid drug delivery and topoisomerase I trapping. Topotecan caused pan-cycle induction and activation of p53. Lineage analysis of the time-lapse sequences identified cells initially in S-phase and G2, and defined the time to mitosis for cells originating from G2, S-phase and G1. Topotecan prevented all mitoses from S-phase cells and G1 cells (half-maximal effects at 0.14 microM and 0.96 microM, respectively). No dose of topotecan completely prevented mitosis among G2 cells, and at saturating doses of topotecan about half the cells of G2 origin continued dividing (the half-maximal effects was at 0.31 microM). Overall, topotecan differentially targeted G1-, S- and G2-phase cells, but many G2 cells were resistant to topotecan, presenting a clear route for cell cycle-mediated drug resistance.

Sindrome de ovario poliquistico: presentacion clinica, bioquimica y ultrasonografica

En forma retrospectiva se efectúa una revisión de 115 historias clínicas de pacientes con Síndrome de Ovario Poliquístico (SOP) que consultan en la Unidad de Endocrinología del Servicio de Ginecología del Hospital San José en el periodo comprendido entre los años 1996 y 2002. Se determinó la prevalencia y se estableció una caracterización demográfica, hormonal y ultrasonográfica de estas pacientes. Destaca la presencia de un alto porcentaje de obesidad que alcanzó el 63% y una insulinoresistencia del orden del 76%. La LH se encontró elevada en el 47% de nuestras pacientes y la testosterona total y libre mostraron un bajo porcentaje de incremento (11% y 27% respectivamente). La Ultrasonografía mostró patrones característicos de SOP, de acuerdo a los criterios estandarizados actuales, en alrededor del 70% de los casos. Estos hallazgos nos inducen a priorizar el estudio de estas pacientes en base a LH y a insulinoresistencia por sobre los niveles de andrógenos. Desde el punto de vista metabólico se encontró un bajo porcentaje de Hipertensión Arterial y Diabetes Mellitus II (2,6 y 6,1% respectivamente).

Representación social de las técnicas de reproducción asistida / Social representation of the techniques of atended reproduction

Este artículo constituye parte de un trabajo más amplio sobre La Representación Social de las Técnicas de Reproducción Asistida; se plantea como Problema de la Representación Social de las razones para someterse a la Técnica de Fertilización in Vitro, de resultar necesario, en una muestra intencionada de 50 profesionales venezolanos, de ambos sexos, concurrentes a la líbreria SUMA situada en Caracas, durante enero-abril de 1990. Fue una investigación exploratoria-descriptiva-interpretativa en la cual se utilizó una entrevista estructurada aplicando un formulario de 39 preguntas. Aquí sólo se analizaron dos preguntas. La metodología fue fundamentalmente de Análisis de Contenido. Las respuestas fueron agrupadas en cuatro subcategorías: a) derecho de tener hijos, b) selección del sexo del hijo, c) tener descendencia, d) protección en la vejez. Hay respuestas que resultan similares a las obtenidas por Sadner que resaltan valores, creencias, actitudes y estereotipos sociales arraigados. Consideramos que existe poca información sobre la técnica y que deben estudiarse las motivaciones de una pareja desde el punto de vista psico-socio-cultural antes de someterla a este procedimiento; así como informar por los medios de comunicación de todos los aspectos psicológicos sociales, legales y bioéticos involucrados

Plan de cuidados al paciente geriátrico hospitalizado con síndrome confusional agudo / Care's plan of geriatric patient with acuse confesional syndrome at hospital

¿Sabemos cuidar a un paciente geriátrico hospitalizado con síndrome confusional agudo? ¿En qué medida podemos mejorar? En este artículo proponemos un Plan de Cuidados, que tomando como referencia teórica el Modelo de Autocuidado de Dorothea E. Orem, puede servir de guía en la práctica profesional a la enfermera que cuida pacientes ancianos hospitalizados. Partiendo de una valoración geriátrica focalizada, se identifican una serie de diagnósticos enfermeros que se asocian con mayor frecuencia a esta situación, y se proponen las intervenciones encaminadas a resolverlos. Dado que el síndrome confusional agudo es una complicación que se presenta con bastante frecuencia en los pacientes geriátricos hospitalizados, consideramos que la enfermera tiene un papel primordial, tanto en la identificación del mismo, como en su tratamiento, instaurando un plan de intervención que impida su cronificación. Por último, destacamos la importancia de incluir en el Plan de Cuidados a la familia del paciente o al cuidador principal, ya que una participación activa de estos puede contribuir de forma significativa a la recuperación del paciente (AU)

The application of lead isotope analysis to bullet individualization in two homicides.

Bullets were characterized by lead isotope ratio analysis and trace element analysis in two homicides. In one case, we concluded that a fatal bullet did not share a common origin with bullets in a box of ammunition containing 24 cartridges taken from suspects. Evidence in the second case included two bullets from the crime scene and 163 bullets taken from various suspects. We were able to infer that the two bullets from the crime scene did not share a common origin and that they differed from all of the bullets taken from suspects. All of the suspects' ammunition had been reloaded as was evident both from trace and isotopic analysis and, indeed, from visual inspection.

Cadmium effects on hypothalamic-pituitary-testicular axis in male rats.

This study analyzes cadmium effects at the hypothalamic-pituitary-testicular axis. Male rats were given cadmium during puberty or adulthood. Cadmium exposure through puberty increased norepinephrine content in all hypothalamic areas studied, but not in the median eminence. Metal exposure increased serotonin turnover in median eminence and the anterior hypothalamus, while decreased it in mediobasal hypothalamus. Also, decreased plasma levels of testosterone were found. Cadmium exposure during adulthood increased norepinephrine content in posterior hypothalamus and decreased the neuro-transmitter content in anterior and mediobasal hypothalamus. Decreased circulating levels of luteinizing hormone (LH) and testosterone and increased plasma follicle stimulating hormone (FSH) levels were also observed. Cadmium accumulated in all analyzed tissues. Various parameters showed age-dependent changes. These data suggest that cadmium globally effects hypothalamic-pituitary-testicular axis function by acting at the three levels analyzed and that an interaction between cadmium exposure and age emerge.

Cadmium effects on dopamine turnover and plasma levels of prolactin, GH and ACTH.

This paper analyzes possible dopamine (DA) mediated cadmium effects on plasma levels of prolactin, growing hormone (GH) and adrenocorticotropic hormone (ACTH), and if these changes are related to metal accumulation. For that purpose, adult male rats were treated with 50 mg/L of CdCl2 in the drinking water for one month. Plasma levels of prolactin, ACTH and GH were measured by specific double antibody radioimmunoassays. DA was measured by high performance liquid chromatography using electrochemical detection. Cadmium content in the tissues was measured by atomic absorption spectometry with graphite furnace. Analysis was performed by using a T-Student test. Metal exposure increased DA content (34.79+/-3.06 vs. 18.2+/-2.88 pg/mg protein) and decreased its turnover (0.40+/-0.07 vs. 0.75+/-0.06) in posterior hypothalamus. Cadmium also decreased DA turnover in median eminence (0.48+/-0.15 vs. 1.50+/-0.63). Plasma levels of prolactin and GH decreased (2.4+/-0.11 vs. 3.1+/-0.15 ng/mL and 5.37+/-0.05 vs. 9.87+/-1.8 ng/mL respectively), while those of ACTH increased (2.73+/-0.14 vs. 1.7+/-0.16 ng/mL). Cadmium concentration increased in both hypothalamus (4.88+/-0.34 vs. 0.72+/-0.2 microg/g) and pituitary (22.82+/-4.57 vs. 5.02+/-1.25 microg/g) after the metal exposure. These results suggest that cadmium effects on the secretion of these hormones are not mediated by dopamine and might be correlated to the metal accumulation at pituitary level.

Determinación de beta lactamasas de espectro expandido en el laboratorio: análisis comparativo de tres métodos / Determination of expanded spectrum beta lactamases in the laboratory: comparative analysis of three methods

58 cepas (16 escherichia coli y 42 klebsiella pneumoniae) aisladas de muestras clínicas entre septiembre 1999 y julio 2000 en las secciones de bacteriología del Laboratorio Metropolitano Hospital José Gregorio Hernández y Hospital de Clínicas Caracas, con patrón sugestivo de ser productoras de ß-lactamasa de espectro expandido (BLEE) sensibles a cefoxitin y resistentes a ceftazidime, cefotaxime, ceftriaxone y aztreonam) fueron evaluadas de forma prospectiva por los métodos del doble disco (DD), Etest (AB Biodisk) y ATB BLSE (bioMérieux) para la detección de BLEE, tomando como técnica de referencia la de DD, obteniéndose en general un 100 por ciento de correlación con la prueba de Etest y un 86,2 por ciento con la de ATB BLSE, estadísticamente no significativa (p>0,05). Se recomienda el uso de ambas técnicas para la confirmación de cepas productoras de BLEE en conjunto con el despistaje inicial realizado a través del análisis de los patrones de resistencia obtenido por las metodologías usadas rutinariamente en los laboratorios para la realización del antibiograma.

Pubertal and postpubertal cadmium exposure differentially affects the hypothalamic-pituitary-testicular axis function in the rat.

The effects of administration of cadmium on levels of hormones along the hypothalamic-pituitary-testicular axis were studied in rats. Male rats were treated subcutaneously from days 30 to 60 (pubertal rats) or from days 60 to 90 of life (postpubertal rats), with cadmium chloride (CdCl2) at a dose of 0.5 or 1 mg/kg, every 4 days in an alternate schedule, starting from the lower dose. Age-matched control rats received 0.3 m of saline subcutaneously every 4 days. The levels of norepinephrine (NE) increased on cadmium exposure in pubertal rats in all hypothalamic areas studied, but decreased in the median eminence. In contrast, in postpubertal rats the levels of NE only did not decrease in the posterior hypothalamus. Serotonin (5-HT) concentration in pubertal and postpubertal rats decreased in all hypothalamic regions, while serotonin turnover (measured by the ratio 5-hydroxyindolacetic acid/serotonin [5-HIAA/5-HT]) increased in the anterior hypothalamus. The serotonin metabolism was also increased in the median eminence in the pubertal and in the posterior hypothalamus in the postpubertal rats. Plasma levels of luteinizing hormone (LH) were not modified by cadmium in both age groups, but follicle stimulating hormone (FSH) levels decreased in postpubertal rats, but was not altered in pubertal rats. Plasma levels of testosterone increased in pubertal rats but decreased in postpubertal rats. Cadmium accumulation increased in the hypothalamus and testes in all the cadmium-treated animals, whereas in the pituitary accumulation of cadmium was found only in postpubertal rats. These data suggest that cadmium exerts age-dependent effects on the hypothalamic-pituitary-testicular axis function, and a disruption of the regulatory mechanisms of the hypothalamic-pituitary-gonadal axis emerges.

Possible estrogenic and/or antiandrogenic effects of methoxychlor on prolactin release in male rats.

Methoxychlor (MTX) is a pesticide currently used as a substitute for dichloro-diphenyl-trichloroethane (DDT). This organochloride insecticide has some estrogenic properties, and may modify the feedback mechanisms of steroids on the hypothalamus and pituitary. This work was undertaken to explore the possible effects of MTX on the episodic prolactin release and to analyze whether these effects are mediated by dopamine (DA), luteinizing hormone (LH), and/or testosterone. Adult male Sprague-Dawley rats were administered 25 mg/kg/day of MTX in sesame oil for 30 days. Control animals received vehicle only. The episodic prolactin release and plasma testosterone levels were measured as well as the dopamine (DA) content in the median eminence (ME) and in the anterior (AH), mediobasal (MBH), and posterior (PH) hypothalamus. The mean serum prolactin levels and absolute pulse amplitude of the hormone increased after the xenobiotic administration, whereas its relative pulse amplitude diminished. The frequency and duration of prolactin peaks and its half-life were not modified by the treatment with the pesticide. On the other hand, methoxychlor decreased the DA content in ME, increased it in AH, and did not change it in MBH or PH. MTX decreased plasma levels of LH and testosterone compared with controls. These data suggest estrogenic and antiandrogenic effects of MTX on the episodic prolactin secretion; the changes observed in prolactin release could be explained, at least in part, by some of the changes of DA at the hypothalamus and of LH at the pituitary, but not by changes of testosterone at the testicular level.