Enfermedad de Pompe de inicio tardío: análisis de una casuística de 19 pacientes mexicanos / Late onset Pompe disease: an analysis of 19 patients from Mexico

Introducción: La enfermedad de Pompe es una miopatía metabólica rara con espectro clínico heterogéneo, especialmente la de inicio tardío, cuya sintomatología es de progresión más lenta y representa un gran reto diagnóstico. Objetivo: Describir el genotipo y las características clínicas de pacientes mexicanos con Pompe de inicio tardío (LOPD). Material y métodos. Se incluyó a 19 pacientes mexicanos con LOPD confirmada mediante actividad enzimática y estudio molecular del gen GAA. Se evaluaron datos clínicos y se revisaron las mutaciones en bases de datos genómicas. Resultados: La mediana de edad de inicio de los síntomas fue de 19 años (rango: 2-43 años), y la edad de diagnóstico, de 36 años (rango: 9-52 años). Los síntomas más frecuentes fueron debilidad axial y proximal (n = 17; 89,5%), marcha basculante (n = 17; 89,5%) e hiperlordosis (n = 7; 36,8%). A 16 pacientes (84,2%) se les realizó electromiografía; 11 (57,8%) describieron patrón miopático y sólo en cinco pacientes (26%) se incluyó la valoración de los músculos paraespinales. Las variantes patogénicas más frecuentes en nuestra casuística fueron c.-32-13T>G, c.1799G>A y c.1082C>T. Conclusiones: Parecido a lo comunicado en publicaciones internacionales, la LOPD en México es clínicamente heterogénea; los pacientes pueden tardar años en llegar al diagnóstico. La debilidad muscular axial y proximal es el dato clínico más frecuente, por lo que la electromiografía debe incluir valoración de los músculos paraespinales. A excepción de una, las mutaciones encontradas en nuestra serie de casos se encuentran previamente descritas en las bases de datos de enfermedad de Pompe.(AU)

Introduction: Pompe disease (PD) is a rare metabolic myopathy with an ample and heterogeneous clinical spectrum, particularly late onset PD (LOPD), which is characterized by appearance at older age and slower disease progression, leading to diagnostic confirmation difficulty and delay. Aim: To describe the genotype and clinical characteristics of Mexican patients with LOPD. Material and methods: Clinical information from 19 Mexican patients with LOPD confirmed with enzyme activity and GAA gene analysis was reviewed. Genetic information of our population was crossed with international genetic databases. Results: Median age between onset of symptoms and diagnosis was 19 years (range 2-43) and diagnostic confirmation 36 years (range 9-52). Most frequently referred symptoms were proximal axial weakness (n = 17; 89.5%), waddling gait (n = 17; 89.5%) and hyperlordosis (n = 7; 36.8%). Sixteen patients (84.2%) were evaluated with electromyography; a myopathic pattern was reported in 11 (57.8%), but only in 5 patients (26%) paraspinal muscle evaluation was included. The most pathogenic mutations in our group were c.-32-13T>G, c.1799G>A and c.1082C>T. Conclusions: Similar to other international publications, LOPD in Mexico is clinically heterogeneous; patients may delay years before diagnosis is established. Axial and proximal weakness is the most frequent clinical feature; thus, electromyography with paraspinal muscle evaluation is essential. Except for one, the mutations found in our patients have been previously reported in PD genetic databases.(AU)

[Late onset Pompe disease: an analysis of 19 patients from Mexico]. / Enfermedad de Pompe de inicio tardío: análisis de una casuística de 19 pacientes mexicanos.

INTRODUCTION: Pompe disease (PD) is a rare metabolic myopathy with an ample and heterogeneous clinical spectrum, particularly late onset PD (LOPD), which is characterized by appearance at older age and slower disease progression, leading to diagnostic confirmation difficulty and delay. AIM: To describe the genotype and clinical characteristics of Mexican patients with LOPD. MATERIAL AND METHODS: Clinical information from 19 Mexican patients with LOPD confirmed with enzyme activity and GAA gene analysis was reviewed. Genetic information of our population was crossed with international genetic databases. RESULTS: Median age between onset of symptoms and diagnosis was 19 years (range 2-43) and diagnostic confirmation 36 years (range 9-52). Most frequently referred symptoms were proximal axial weakness (n = 17; 89.5%), waddling gait (n = 17; 89.5%) and hyperlordosis (n = 7; 36.8%). Sixteen patients (84.2%) were evaluated with electromyography; a myopathic pattern was reported in 11 (57.8%), but only in 5 patients (26%) paraspinal muscle evaluation was included. The most pathogenic mutations in our group were c.-32-13T>G, c.1799G>A and c.1082C>T. CONCLUSIONS: Similar to other international publications, LOPD in Mexico is clinically heterogeneous; patients may delay years before diagnosis is established. Axial and proximal weakness is the most frequent clinical feature; thus, electromyography with paraspinal muscle evaluation is essential. Except for one, the mutations found in our patients have been previously reported in PD genetic databases.

TITLE: Enfermedad de Pompe de inicio tardío: análisis de una casuística de 19 pacientes mexicanos.Introducción. La enfermedad de Pompe es una miopatía metabólica rara con espectro clínico heterogéneo, especialmente la de inicio tardío, cuya sintomatología es de progresión más lenta y representa un gran reto diagnóstico. Objetivo. Describir el genotipo y las características clínicas de pacientes mexicanos con Pompe de inicio tardío (LOPD). Material y métodos. Se incluyó a 19 pacientes mexicanos con LOPD confirmada mediante actividad enzimática y estudio molecular del gen GAA. Se evaluaron datos clínicos y se revisaron las mutaciones en bases de datos genómicas. Resultados. La mediana de edad de inicio de los síntomas fue de 19 años (rango: 2-43 años), y la edad de diagnóstico, de 36 años (rango: 9-52 años). Los síntomas más frecuentes fueron debilidad axial y proximal (n = 17; 89,5%), marcha basculante (n = 17; 89,5%) e hiperlordosis (n = 7; 36,8%). A 16 pacientes (84,2%) se les realizó electromiografía; 11 (57,8%) describieron patrón miopático y sólo en cinco pacientes (26%) se incluyó la valoración de los músculos paraespinales. Las variantes patogénicas más frecuentes en nuestra casuística fueron c.-32-13T>G, c.1799G>A y c.1082C>T. Conclusiones. Parecido a lo comunicado en publicaciones internacionales, la LOPD en México es clínicamente heterogénea; los pacientes pueden tardar años en llegar al diagnóstico. La debilidad muscular axial y proximal es el dato clínico más frecuente, por lo que la electromiografía debe incluir valoración de los músculos paraespinales. A excepción de una, las mutaciones encontradas en nuestra serie de casos se encuentran previamente descritas en las bases de datos de enfermedad de Pompe.

La actividad física y el estado nutricional en médicos / Physical activity and nutritional status in doctors

Contexto: el personal médico, debido a su conocimiento sobre la salud física y los medios para mantener la misma, constituye un ejemplo para la comunidad en general de un correcto estilo de vida en base a una alimentación saludable y la realización de ejercicio, pero la realidad es que no se conocen datos sobre el grado de actividad física y la nutrición del personal sanitario y su estado físico. Objetivo: establecer la prevalencia de sobrepeso y describir el nivel de actividad física del personal médico que labora en el Hospital San Francisco del IESS, de la ciudad de Quito. Sujetos y métodos: se realizó un estudio epidemiológico descriptivo transversal para describir la prevalencia de sobrepeso del personal médico, para lo cual se utilizó el IMC, el IPAQ versión corta y un cuestionario de consumo de alimentos. Mediciones principales: actividad física, estado nutricional, adición de sal, consumo de grasas saturadas y frutas. Resultados: se estudiaron 80 profesionales médicos, de los cuales 46, ( 57,5%; IC95%: 46,57%-67,74%) son mujeres. El 86,2% de los sujetos se encuentran en el rango de edad de 30 a 50 años. La clasificación realizada según la encuesta IPAQ, demostró que la mitad de los participantes (50%; n=40; IC95%: 39,30%-60,70%) realizan una actividad física leve, también denominada "caminata", y que solo 17 (21,3%; IC: 13,71%-31,42%) de los participantes realizan actividad física vigorosa. Las mujeres caminan más que los hombres (33% vs. 18%). El 53,8% (n= 43); IC95%: 42.9 ­ 64.3% de los médicos tienen sobrepeso y obesidad. Los hombres tienen mayor sobrepeso y obesidad que las mujeres (30% vs. 24%). El 41,3 % afirmaron que si agregan sal a sus alimentos diarios. El 22.5% si consumen grasas saturadas. En relación al consumo de frutas y verduras, el 60% (n=48); IC: 49,05%-70,04% revelaron que poseen un consumo moderado y relevante de estos productos. Habría cierta relación entre el incremento de actividad física y la disminución de IMC, la mediana del IMC tiende a disminuir. Igualmente, quienes disminuyen la actividad física incrementan el peso. Conclusión: la mitad del personal médico tiene sobrepeso. Debido a factores externos adicionales, la actividad física no es un determinante único para la reducción de peso en el personal médico. (AU)

Context: due to their knowledge about physical well-being and how to achieve it, healthcare professionalought to set the example for the community in general regarding a healthy lifestyle based on eating good food and exercising. However, in real terms, there are no data available concerning the physical condition, level oactivity and nutrition of health professionals. Objective: to establish the degree of excess weight and physical activity of the medical practitioners working aIESS (National Health Service) Hospital San Francisco in Quito. Subjects and methods: This is an epidemiologic cross-sectional descriptive study aimed at defining the prevalence of excess weight of medical personnel using BMI, IPAQ (short version) and a food consumption survey. Principal measurements: physical activity, nutritional condition, added salt, consumption of saturated fats and fruits. Results: the number of medical professionals taking part was 80, out of which 46, i.e. 57.5%; IC95%: 46.57%-67.74%) are women. 86.2% of the subjects are between 30 to 50 years of age. The IPAQ classification indicated that half of the participants (50%; n=40; IC95%: 39.30%-60.70%) undertake a moderate form ophysical activity such as walking, and that just 17 (21.3%; IC: 13.71%-31.42%) of the participants perform vigorous physical workouts. Females walk more than males (33% vs. 18%). Moreover, 53.8% (n= 43); IC95%:n 42.9 ­ 64.3% health practitioners are classed as overweight or obese. The males tended to be more overweight/ obese than the females: (30% vs. 24%). Also, 41.3 % of the subjects admitted adding salt to their food daily, and 22.5% knowingly consume saturated fats. Regarding the consumption of fruits and vegetables, 60% (n=48); IC: 49.05%-70.04% revealed that they have moderate or relevant consumption of these products. There is a correlation between increased physical activity and decreased BMI whereby the average BMI tends to go down. Likewise, those participants with decreased physical activity, tended to put on weight. Conclusion: half of the medical personnel are overweight. Due to additional external influences, physicaactivity is not the only determining factor for weight loss among the medical staff analysed. (AU)

Efecto de los micronutrientes en polvo en el estado nutricional y en los valores hemáticos de preescolares sanos. Medellín, 2013 / The effect of powdered micronutrients on the hematologic values and nutritional status of healthy preschoolers. Medellín, 2013 / Efeito dos micronutrientes em pó no estado nutricional e nos valores hemáticos de crianças sadias em idade pré-escolar. Medellín, 2013

Las carencias de micronutrientes son un problema de salud pública común en muchos países, principalmente en aquellos en vía de desarrollo; las deficiencias más prevalentes son las de vitamina A, hierro y yodo, para reducirlas se pueden ejecutar estrategias como la fortificación de alimentos. OBJETIVO: evaluar el efecto de la fortificación de la dieta con micronutrientes en polvo en el estado nutricional y los valores hemáticos de preescolares sanos. METODOLOGIA: ensayo clínico triple ciego, con asignación aleatoria de grupos y controlado con placebo. Se analizaron 90 preescolares sanos a quienes se suministró 1g de mezcla de micronutrientes al día con 12,50 mg de hierro (fumarato ferroso). Antes y después de nueve semanas, se midieron los niveles de hemoglobina, ferritina sérica, transferrina, ácido fólico y los indicadores nutricionales. RESULTADOS :la concentración de hemoglobina disminuyó en el grupo de intervención, pasando de 12,80 g/dL a 12,10 g/dL (p=0,000), mientras que en el grupo placebo no hubo variación (p=0,639); así mismo la transferrina disminuyó significativamente solo en el grupo intervenido (p=0,004); el nivel de ferritina al final del estudio no difirió intra o entre grupos de intervención. Las reacciones adversas fueron similares en ambos grupos: dos niños presentaron náusea y dos tuvieron dolor abdominal, sin diferencias estadísticas. CONCLUSIONES:la fortificación de alimentos durante nueve semanas con los micronutrientes en polvo empleados en el estudio, no mejoró los niveles hematológicos, ni el estado nutricional de los niños sanos estudiados; los alimentos fortificados fueron bien tolerados por los preescolares.

Micronutrient deficiencies are a common public health problem, particularly in developing countries. Vitamin A, iron and iodine deficiencies are the most prevalent. To reduce these, many strategies such as food fortification can be implemented. OBJECTIVE:to assess the effect of a diet fortified with powdered micronutrients on the nutritional status and hematological values of healthy preschoolers. METHODOLOGY: a randomized, triple-blind, placebo-controlled trial conducted with 90 healthy preschoolers who were given 1g of powdered micronutrients per day with 12.5 mg of iron (ferrous fumarate).The levels of hemoglobin, serum ferritin, transferrin, folic acid and the nutritional indicators were measured before and after nine weeks. RESULTS:for the group receiving powdered micronutrients, hemoglobin concentration decreased from 12.80 g / dL to 12.10 g / dL (p = 0.000), whereas the placebo group showed no change (p = 0.639); likewise, transferrin decreased significantly only for the powdered micronutrients group (p = 0.004); the ferritin level showed no difference between groups or inside any of them. Adverse reactions were similar for both groups:two children had nausea and two abdominal pain. There were no statistically significant differences. CONCLUSIONS:fortifying the individuals' diet with the powdered micronutrients used in this study for nine weeks did not improve the hematological levels or the nutritional status of the healthy preschoolers. Additionally, the fortified foods were well tolerated by the children.

As carências de micronutrientes são um problema de saúde pública comum em muitos países, principalmente naqueles em via de desenvolvimento; as deficiências mais prevalentes são de vitamina A, ferro e iodo, para reduzi-las podem ser realizadas estratégias como a fortificação de alimentos. OBJETIVO: avaliar o efeito da fortificação da dieta com micronutrientes em pó no estado nutricional e os valores hemáticos de pré-escolares sadios. METODOLOGIA: ensaio clínico triplo-cego, com afetação aleatória de grupos e controlado com placebo.Foram analisados 90 pré-escolares sadios aos quais foi proporcionado 1g de mescla de micronutrientes por dia com 12,50 mg de ferro (fumarato ferroso).Antes e após nove semanas, foram medidos os níveis de hemoglobina, ferritina sérica, transferrina, ácido fólico e os indicadores nutricionais. RESULTADOS: a concentração de hemoglobina diminuiu no grupo de intervenção, passando de 12,80 g/dL a 12,10 g/dL (p=0,000), enquanto no grupo placebo não houve variação(p=0,639); do mesmo modo, a transferrina apenas diminuiu expressivamente no grupo intervindo (p=0,004); o nível de ferritina no final do estudo não divergiu intra ou entre os grupos de intervenção.As reações adversas foram semelhantes em ambos os grupos:duas crianças apresentaram náusea e duas tiveram dor abdominal, sem diferenças estatísticas. CONCLUSÕES: a fortificação de alimentos durante nove semanas com os micronutrientes em pó utilizados no estudo não melhorou os níveis hematológicos, nem o estado nutricional das crianças saudáveis analisadas; os alimentos fortificados foram bem tolerados pelas crianças.

Phylogenetic clustering of hepatitis C virus among people who inject drugs in Vancouver, Canada.

UNLABELLED: Little is known about factors associated with hepatitis C virus (HCV) transmission among people who inject drugs (PWID). Phylogenetic clustering and associated factors were evaluated among PWID in Vancouver, Canada. Data were derived from the Vancouver Injection Drug Users Study. Participants who were HCV antibody-positive at enrolment and those with HCV antibody seroconversion during follow-up (1996 to 2012) were tested for HCV RNA and sequenced (Core-E2 region). Phylogenetic trees were inferred using maximum likelihood analysis and clusters were identified using ClusterPicker (90% bootstrap threshold, 0.05 genetic distance threshold). Factors associated with clustering were assessed using logistic regression. Among 655 eligible participants, HCV genotype prevalence was: G1a: 48% (n=313), G1b: 6% (n=41), G2a: 3% (n=20), G2b: 7% (n=46), G3a: 33% (n=213), G4a: <1% (n=4), G6a: 1% (n=8), G6e: <1% (n=1), and unclassifiable: 1% (n=9). The mean age was 36 years, 162 (25%) were female, and 164 (25%) were HIV+. Among 501 participants with HCV G1a and G3a, 31% (n=156) were in a pair/cluster. Factors independently associated with phylogenetic clustering included: age <40 (versus age≥40, adjusted odds ratio [AOR]=1.64; 95% confidence interval [CI] 1.03, 2.63), human immunodeficiency virus (HIV) infection (AOR=1.82; 95% CI 1.18, 2.81), HCV seroconversion (AOR=3.05; 95% CI 1.40, 6.66), and recent syringe borrowing (AOR 1.59; 95% CI 1.07, 2.36). CONCLUSION: In this sample of PWID, one-third demonstrated phylogenetic clustering. Factors independently associated with phylogenetic clustering included younger age, recent HCV seroconversion, prevalent HIV infection, and recent syringe borrowing. Strategies to enhance the delivery of prevention and/or treatment strategies to those with HIV and recent HCV seroconversion should be explored, given an increased likelihood of HCV transmission in these subpopulations.

Competitive adsorption of dyes and heavy metals on zeolitic structures.

The adsorption of Acid blue 25, basic blue 9, basic violet 3, Pb(2+), Ni(2+), Zn(2+) and Cd(2+) ions has been studied in single and dye-metal binary solutions using two mineral materials: Clinoptilolite (CL) and ER (Erionite). These zeolites were characterized by FT-IR spectroscopy; potentiometric titration and nitrogen adsorption isotherms at 77 K to obtain their textural parameters. Results indicated that ER has an acidic character and a high specific surface (401 m(2) g(-1)) in contrast with the zeolite CL (21 m(2) g(-1)). Surprisingly, the removal of dyes was very similar for the two zeolites and they showed a considerable selectivity by the basic dyes in comparison with the acid dyes. In the case of heavy metals, ER was more effective in the adsorption process showing a selectivity of: Pb(2+) > Ni(2+) > Zn(2+) > Cd(2+). In the multicomponent adsorption experiments an antagonistic effect was observed in the removal of basic dyes and heavy metals. Particularly, the adsorbed amount of basic violet 3 decreased more significantly when the heavy metals are presents in contrast with the basic blue 9.

Synergic adsorption in the simultaneous removal of acid blue 25 and heavy metals from water using a Ca(PO3)2-modified carbon.

We report the simultaneous adsorption of acid blue 25 dye (AB25) and heavy metals (Zn(2+), Ni(2+) and Cd(2+)) on a low-cost activated carbon, whose adsorption properties have been improved via a surface chemistry modification using a calcium solution extracted from egg shell wastes. Specifically, we have studied the removal performance of this adsorbent using the binary aqueous systems: AB25-Cd(2+), AB25-Ni(2+) and AB25-Zn(2+). Multi-component kinetic and equilibrium experiments have been performed and used to identify and characterize the synergic adsorption in the simultaneous removal of these pollutants. Our results show that the presence of AB25 significantly favors the removal of heavy metals and may increase the adsorption capacities up to six times with respect to the results obtained using the mono-cationic metallic systems, while the adsorption capacities of AB25 are not affected by the presence of metallic ions. It appears that this anionic dye favors the electrostatic interactions with heavy metals or may create new specific sites for adsorption process. In particular, heavy metals may interact with the -SO(3)(-) group of AB25 and to the hydroxyl and phosphoric groups of this adsorbent. A response surface methodology model has been successfully used for fitting multi-component adsorption data.

DIAGNÓSTICO PRELIMINAR DE LA PRODUCCIÓN Y COMERCIALIZACIÓN DEL CHIGÜIRO (Hydrochoerus hydrochaeris) EN LATINOAMÉRICA CON ÉNFASIS EN COLOMBIA / PRELIMINARY DIAGNOSIS OF THE PRODUCTION AND TRADE OF CAPYBARA (Hydrochoerus hydrochaeris) IN LATIN AMERICA WITH EMPHASIS IN COLOMBIA

A través de una revisión bibliográfica, se realizó una aproximación diagnóstica de la producción y comercialización de Hydrochoerus hydrochaeris en Brasil, Argentina, Venezuela y Colombia. Se determinaron los factores que afectan la producción y comercialización de la especie, y mediante un análisis de conglomerados basado en la información correspondiente al sistema productivo, se identificaron seis grupos de sistemas, que responden a las similitudes en aspectos relevantes de cada región, como los diferentes sistemas de uso del chigüiro, desde la caza comercial hasta la zoocría en cautiverio, las condiciones de desarrollo tecnológico y de manejo de la especie. Al realizar el análisis de los aspectos de comercialización, se identificaron cuatro grupos, los cuales corresponden a las similitudes entre productos comercializados, legalidad de la comercialización y existencia de cadenas de mercadeo. Específicamente para Colombia, se realizaron encuestas y talleres con algunos actores involucrados con el uso de la especie, aplicando la matriz tipo Vester para identificar la problemática y priorizarla. Se establecieron como problemáticas principales la falta de personal especializado, el deficiente acompañamiento institucional y la rigidez de la legislación en lo referente a las plantas de sacrificio y a la comercialización de productos. Por último, se identificaron líneas de acción que se deben desarrollar para lograr establecer un sistema de aprovechamiento, que ofrezca garantías para el uso, comercialización y conservación de la especie en el país.

A bibliographic search was carried out in order to establish a diagnostic approach on the production and trade of Hydrochoerus hydrochaeris in Brazil, Argentina, Venezuela and Colombia. The factors affecting production and trade of the species were determined using an analysis of conglomerate wich identified six groups of production systems. This groups responds to the similarities in several relevant aspects in every region, such as the different systems of breeding, from commercial hunting to breeding in captivity. It also responds to the conditions of technological development and the management of the species. We identified 4 groups related to trade aspects. The associations are related to the similarities among trading products, legal trading and trading channels as well. A survey and workshops were done in Colombia with some actors involved in the use of the species. Data was analyzed using the matrix of Vester in order to identify and give priority to the problems. The main problems identified were the lack of specialized staff, the deficient institutional support and the rigidity of the legislation related to abattoirs and trading of products. Finally, lines of action where identified that are needed to develop in order to establish a production system that offers guarantees of use, trade and conservation of the species in our country.

Review of the complexation of tetravalent actinides by ISA and gluconate under alkaline to hyperalkaline conditions.

Isosaccharinic (ISA) and gluconic acids (GLU) are polyhydroxy carboxylic compounds showing a high affinity to metal complexation. Both organic ligands are expected in the cementitious environments usually considered for the disposal of low- and intermediate-level radioactive wastes. The hyperalkaline conditions imposed by cementitious materials contribute to the formation of ISA through cellulose degradation, whereas GLU is commonly used as a concrete additive. Despite the high stability attributed to ISA/GLU complexes of tetravalent actinides, the number and reliability of available experimental studies is still limited. This work aims at providing a general and comprehensive overview of the state of the art regarding Th, U(IV), Np(IV), and Pu(IV) complexes with ISA and GLU. In the presence of ISA/GLU concentrations in the range 10(-5)-10(-2) M and absence of calcium, An(IV)(OH)x(L)y complexes (An(IV)=Th, U(IV), Np(IV), Pu(IV); L=ISA, GLU) are expected to dominate the aqueous speciation of tetravalent actinides in the alkaline pH range. There is a moderate agreement among their stability, although the stoichiometry of certain An(IV)-GLU complexes is still ill-defined. Under hyperalkaline conditions and presence of calcium, the species CaTh(OH)4(L)2(aq) has been described for both ISA and GLU, and similar complexes may be expected to form with other tetravalent actinides. In the present work, the available thermodynamic data for An(IV)-ISA/GLU complexes have been reviewed and re-calculated to ensure the internal consistency of the stability constants assessed. Further modelling exercises, estimations based on Linear Free-Energy Relationships (LFER) among tetravalent actinides, as well as direct analogies between ISA and GLU complexes have also been performed. This approach has led to the definition of a speciation scheme for the complexes of Th, U(IV), Np(IV) and Pu(IV) with ISA and GLU forming in alkaline to hyperalkaline pH conditions, both in the absence and presence of calcium.

Screening of commercial sorbents for removal of fluoride in synthetic and groundwater.

Numerous methods have been described employing various materials for fluoride removal due to the risk of high fluoride dosing for human health. There is a broad collection of commercial products for adsorption applications. The materials most recommended are activated alumina and bone char. Nineteen commercial sorbents were screened for fluoride removal in static experiments, with synthetic water and groundwater from the city of Aguascalientes (México), where some wells contain up to 15 mg l(-1) of fluoride. Removal efficiency of aluminas and activated carbons with a uniform particle diameter of 0.63 mm was compared. Four materials leading to a final concentration of 1 mg F- l(-1) were selected, pretreated, and characterized (X-ray diffractometry, infrared spectroscopy, titration, methylene blue and nitrogen adsorption) for further investigation. Adsorption rate constant was determined and obeyed a pseudo-first order equation. Fluoride removal was clearly improved after the conditioning procedure and was higher for aluminas than for bone carbons. The pretreated sample A5 adsorbed 5 mg g(-1) at 25 degrees C and pH 6 from a 20 mg F- l(-1) synthetic water solution after 7 hours by using a sorbent dose of 4 mg ml(-1). The specific saturation capacity with fluoride was aluminas - carbons for determined samples (10 mg g(-1), but the superficial capability was higher for the pretreated bone carbon sample CH5 (50 microg m(-2)) because of its higher acidity. At wells 4 and 5 (7.1 mg F- l(-1)) the reached efficiency was 91% for aluminas and 70% with bone carbon.

Obtención de oleorresina de pimentón (Capsicum annuum L) / Extraction of oleoresin from sweet pepper (Capsicum annuum L)

La oleorresina de pimentón (Capsicum annuum L.) contiene fundamentalmente carotenoides, capsaicinoides y algunas vitaminas. Tradicionalmente se usa en la industria alimentaria. Se obtiene mediante un proceso en las siguientes etapas: a) escaldado, b) troceado, c) secado, d) molienda, y e) extracción con solventes volátiles (hexano, acetona, acetato de etilo). Los pigmentos que se extraen se analizan mediante HPLC en fase reversa y se comparan con la oleorresina de paprika comercial importada por la empresa TECNAS©.El rendimiento que se obtiene en el laboratorio está entre 3 (por ciento) y 6 (por ciento). Los resultados muestran la importancia del escaldado y del secado: el escaldado permite alcanzar una humedad del 13,56 (por ciento) en 320 min (sin escaldar en el mismo tiempo se llega al 21,01 (por ciento) y el secado posibilita la extracción con solventes.

Comportamiento de la Mortalidad Violenta Antioquia 1990-2000 / Violent mortality behavior. Antioquia 1990-2000

La violencia representa una enorme carga para la economía de los países, con perdidas de billones de dólares, representado en costo de atención de salud, disminución de la productividad y gastos en la aplicación de la justicia. Por cada persona que muere como resultado de la violencia, muchas con heridas o sufren un amplio rango de problemas de salud, física, sexual o mental, debidos a la exposición a la violencia...

Análisis de algunos procesos en el sistema de selección de beneficiarios (SISBEN) y satisfacción en la prestación del servicio de salud, municipio de Rionegro, Antioquia, 1998 / Analysis of some processes in the System of Beneficiary Selection and satisfaction with the health service in Rionegro, Antioquia, Colombia, 1998

El Sistema General de Seguridad Social en Salud se compone de una organización mixta constituida por dos régimenes, el contributivo y el subsidiado, con una coordinación nacional y canales financieros de solidaridad. Este sistema plantea que la afiliación de los asalariados y de las personas con capacidad de pago sea obligatoria y se vinculen a él a través del régimen contributivo mediante el pago de cotizaciones; el resto de la población, es decir, los grupos sin capacidad de pago tendrían acceso a través del régimen subsidiado. Para estos entonces la ley previó la estructuración de un régimen de subsidios a la demanda, dirigidos a dicha población, que les permite su afiliación al sistema.En este artículo se analizan algunos aspectos de focalización, afiliación y satisfacción de los usuarios objetos del subsidio en el municipio de Rionegro, Antioquia en el año de 1998. Se tomaron 2.197 fichas de clasificación socioecconómica pertenecientes al núcleo familiar de la población de niveles I y II, de los cuales se seleccionó una muestra de 400 fichas para analizar las principales características de la población subsidiada de este municipio, comparando la situación real con la calidad de vida y la estratificación socioeconómica con respecto al sistema de selección de beneficiarios. Además se midió la satisfacción de los usuarios desde el momento de la focalización pasando por la afiliación y la misma utilización de los servicios. Para realizar las comparaciones se utilizan distribuciones de frecuencia, intervalos de confianza, aplicación de la distribución chi2, y la aplicación del índice de Kappa.Los resultados permiten concluir que la población con respecto a los servicios públicos se encuentran bastante beneficiada con las políticas municipales, ya que el porcentaje más bajo de las características en los servicios públicos es el de servicio sanitario conectado a alcantarillado (78 por ciento), con un intervalo de confianza del 95 por ciento de 73,94 a 82,05 por ciento, el cual es considerablemente alto. Con respecto a la tenencia de la vivienda se encontró que un 42 por ciento de la población subsidiada paga arriendo, un 24 por ciento tiene otra forma de vivienda (usufructo, ocupantes de hecho , anticresis), reflejándose las condiciones de desprotección de la población. La calidad de vida representada en vivienda, tenencia y servicios públicos, presentó una tendencia de mejoramiento, ya que solo el 11,25 por ciento disminuyó estas condiciones

Microflora periodontal / Periodontal microbiota

Estudios longitudinales de pacientes con diferentes formas de enfermedad periodontal, han indicado que la destrucción ocurre en períodos de tiempo relativamente cortos, seguidos por períodos prolongados de inactividad y con una microbiota predominante específica, asociada a cada entidad en particular. Si la destrucción periodontal ocurre durante períodos cortos de tiempo, en sitios individuales y con una flora específica asociada, es deseable tener la capacidad de detectar estos períodos y sitios de actividad, identificar los microorganismos predominantes y ser capaces de interpretar lo que está ocurriendo, desde el punto de vista clínico, microbiológico e inmunológico y suministrar así las bases para un diagnóstico correcto, un tratamiento racional y la prevención de la enfermedad

Percepción, manejo y significado que dan los estudiantes de ciencias de la salud a una acción educativa sobre el sindrome de inmunodeficiencia adquirida / Perception, dealing and meaning given by health science students towards an educational action concerning the acquired immunodeficiency syndrome

Se presenta una investigación descriptiva basada en métodos cualitativos de investigación (etnografía y hermenéutica) para determinar la percepción, manejo y significado que dan los estudiantes de ciencias de la salud a una acción educativa encaminada a controlar la diseminación de la infección por el virus de la inmunodeficiencia humana. Un grupo de 40 estudiantes al cual se proyectó un video y con el cual se discutió una historia hipotética permitió verificar que la percepción de los mensajes educativos se da de manera eficaz en la población estudiantil siendo enriquecida con el simbolismo propio de cada sujeto. Los conocimientos sobre el sindrome de inmunodeficiencia humana difieren de las actitudes y prácticas, lo cual enfrenta a los jóvenes a situaciones de riesgo para adquirir la infección. Se concluyó que las acciones educativas deben partir de la realidad sociocultural de los sujetos blanco de las acciones educativas para lograr cambios conductuales duraderos en el tiempo

[Type 1 diabetes mellitus and nephropathy. Predicting factors in pediatric age]. / Diabetes mellitus tipo I y nefropatía. Factores predictores en la edad pediátrica.

OBJECTIVE: To find the existence of early relationships between alterations in the glucidic metabolism and the glomerular and tubular basal function in diabetic insulin-dependent children without clinical evidence of diabetic nephropathy (DN). METHODS: We determined blood pressure, basal plasma concentrations of glucose, glycosilated hemoglobin and total proteins, glomerular filtration rate (GFR), and the glucose, proteins, calcium, phosphorus, uric acid, sodium, potassium and chloride excretions in diurnal, nocturnal and 24-hour urine samples in 43 diabetic children and 13 healthy controls. RESULTS: The microproteinuria mean value in all urine samples (always less than 15 micrograms/min/1.73 m.2), the GFR and blood pressure were similar in both groups. In the diabetic children, we found an inverse correlation between age and 24-hour urine microproteinuria (r-0.33; p less than 0.05) and between age and nocturnal urine microproteinuria (r-0.35; p less than 0.05). There was also a highly significant correlation between microproteinuria and the albumin/creatinine ratio in urine samples (r = 0.94, p less than 0.0001). Diabetic children showed a greater nocturnal excretion of calcium (p less than 0.05) and phosphorus (p less than 0.05). CONCLUSIONS: Our results suggest that microproteinuria, GFR and blood pressure have not served as predictors of DN in pediatric patients.

Malacoplaquia intestinal en pediatría: A propósito de un caso y revisión de la literatura / Intestinal Malacoplaquia

Se inform del caso de un niño de 13 años de edad hospitalizado en el Instituto Nacional de Salud del Niño, que ingresó con edema generalizado, diarrea crónica y hematoquezia. La biopsia de intestino estableció el diagnóstico de Malacoplaquia. A pesar del tratamiento instaurado la evolución clínica fué tórpida. Se revisa la literatura médica principalmente la relacionada al grupo pediátrico

Response of rat rhabdomyosarcoma tumors to split doses of mixed high- and low-let radiation.

Radiation-induced growth delay was measured in rat rhabdomyosarcoma tumors exposed to split doses of high-LET (linear energy transfer) neon ions in the extended-peak ionization region and low-LET X rays. Top-off doses of 7.5, 15, and 25 Gy of 225-kVp X rays were administered to the tumors at 0.5, 4.0, and 24.0 hr following priming doses of either peak neon ions or X rays. The priming doses used were 7 Gy of peak neon ions and 20 Gy of X rays, both of which produced a 10 day delay in tumor regrowth to a volume twice that measured on the day of irradiation. The tumor response to split doses of X rays indicated rapid repair of sublethal damage, with significant recovery occurring at 0.5 hr and complete recovery by 4 hr after the initial 20-Gy X ray dose. The top-off doses of X rays required to produce an additional 10 or 20 days of tumor growth delay were 18 and 7% larger, respectively, when the priming dose was 20 Gy of X rays as compared to 7 Gy of peak neon ions. This result indicates that relatively little interaction of the neon-ion and X ray radiations occurred, even when the time interval between split-dose irradiations was as short as 0.5 hr. Our data indicate that the interaction of high- and low-LET radiation modalities is small, and approaches a simple additivity of effects when the tumors repair a major portion of the sublethal radiation injury imparted by a priming dose before the second dose is administered.

The effect of glutathione (GSH) depletion in vivo by buthionine sulfoximine (BSO) on the radiosensitization of SR 2508.

The effect of glutathione depletion (GSH) on the efficacy of SR 2508 was evaluated in two murine tumor models with single large doses of radiation or with low doses administered in an accelerated fractionated schedule. To deplete tumor GSH, buthionine sulfoximine (BSO) was administered in the animals drinking water (10 mM) following two i.p. injections of 450 mg/kg. This treatment decreased RIF and MCA tumor GSH concentrations by 95% and 80%, respectively. Mice (C3H/Sed) received BSO for 48-72 hr before the first dose of radiation, and were maintained on BSO drinking water for the duration of the fractionated course of therapy. SR 2508 (200-1000 mg/kg) was injected 45 min prior to each fraction of radiation. Radiation was administered as a single dose of 15 Gy or 20 Gy, for RIF and MCA tumors, respectively. Alternatively, animals received a fractionated course of radiotherapy which consisted of 2.5 Gy/fraction for the RIF, and 3 Gy/fraction for the MCA tumors, b.i.d. for five days (total of 10 fractions). Tumor response with and without BSO, and with and without SR 2508, was determined by regrowth delay. BSO pretreatment increased the efficacy of SR 2508 with single dose radiation in the MCA but not RIF tumor. SR 2508 administered with fractionated radiation produced lower enhancement ratios (SER) than with a single radiation dose. However, BSO significantly enhanced the efficacy of SR 2508 with fractionated radiation. BSO increased the maximum SER for SR 2508 (3 mM/fraction) from 1.2 to 1.4 in the RIF tumor, and from 1.4 to 1.8 in the MCA tumor. BSO also increased the toxicity of SR 2508 by a factor of 2. However, the ability of BSO to increase the efficacy of low doses of sensitizer at clinically relevant doses of radiation suggests that this combined modifier treatment may be of clinical benefit.