Management of 3 Proliferating Pilar Tumors: Definition, Differential Diagnosis, and Treatment Options. / Experiencia en el manejo de 3 tumores pilares proliferantes: definición, diagnósticos diferenciales y alternativas terapéuticas.

A proliferating pilar tumor is a rare skin neoplasm that arises from the outer root sheath of a hair follicle. Presentation varies widely, as the tumor can be benign or malignant and has a high probability of recurring after excision. We report our experience managing 3 proliferating pilar tumors with different clinical presentations and pathology findings at Hospital de San José, Bogota, Colombia.

Physiological changes promoted by a strobilurin fungicide in the rice-Bipolaris oryzae interaction.

Strobilurins are among the most important fungicides that are used for plant disease control worldwide. In addition to their fungicide effect, strobilurins can also improve crop physiology. Nonetheless, the impact of azoxystrobin (Az), the main marketed strobilurin, on rice physiology is still unknown. Detailed gas exchange measurements and chlorophyll a fluorescence analysis were used to examine the Az effects on the photosynthetic performance of rice plants (cultivar Metica-1) either challenged or not with Bipolaris oryzae, the causal agent of brown spot. Az impaired carbon (C) fixation in the non-inoculated plants in a manner that was not related to photochemical or biochemical limitations, but rather to decreased stomatal conductance that limited the CO2 influx into the mesophyll cells. The photosynthesis of rice plants that were not sprayed with Az dramatically decreased upon B. oryzae infection, which was chiefly governed by photochemical and biochemical limitations. The energy surplus that was caused by limited C fixation in the rice plants that were treated with Az and inoculated with B. oryzae was thermally and effectively dissipated until 72h after inoculation. In Az absence, however, this mechanism was not sufficient to prevent chronic photoinhibition to photosynthesis. The inoculated plants were not able to fully capture and exploit the collected light energy, but these constraints were greatly limited in the presence of Az. In conclusion, Az impaired the photosynthetic performance of non-infected plants by diffusive constraints, but prevented, to a greater extent, the damage to the photosynthetic apparatus during the infection process of B. oryzae.

Photosynthetic and antioxidative alterations in coffee leaves caused by epoxiconazole and pyraclostrobin sprays and Hemileia vastatrix infection.

Coffee leaf rust (CLR), caused by Hemileia vastatrix, is a major disease affecting coffee production worldwide. In this study, an in-depth analysis of the photosynthetic performance of coffee leaves challenged or not with H. vastatrix and sprayed with either epoxiconazole (EPO) or pyraclostrobin (PYR) was performed by combining chlorophyll a fluorescence images, photosynthetic pigment pools and the activities of chitinase (CHI), ß-1,3-glucanase (GLU), peroxidase (POX) and catalase (CAT). The CLR severity was higher in the control plants, but reduced in plants sprayed with both PYR and EPO. Also, the CLR severity was reduced in plants sprayed with PYR compared with plants sprayed with EPO. Plants sprayed with either EPO or PYR showed maximal photosystem II quantum efficiency (Fv/Fm) values ranging from 0.78 to 0.80, which were quite similar to those obtained with inoculated plants (values ranging from 0.74 to 0.77). The decreases in the Fv/Fm ratio values and parallel increases in the F0 values in the inoculated plants, which were not observed in the control plants (sprayed with water) and were confirmed by images of the initial fluorescence (F0) and Fv/Fm parameters in the regions of the leaf tissue containing pustules and in the asymptomatic leaf tissue, indicated that photosynthesis was negatively impacted. When effective photosystem II quantum yield (Y(II)) values approached zero with a high photosynthetic photon flux density, high values of quantum yield of regulated energy dissipation (Y(NPQ)) in association with a high carotenoid concentration were noted in the inoculated plants sprayed either with PYR or EPO. The increased CLR severity in inoculated plants in contrast to inoculated plants sprayed with either PYR or EPO was associated with greater POX activity and a reduced photosynthetic pigment concentration. POX and CAT activities were increased in inoculated plants sprayed with either EPO or PYR when compared with control plants. CHI and GLU activities were maintained at high levels in the leaves of inoculated plants, regardless of the fungicide sprayed, indicating that CHI and GLU are less important for coffee resistance against CLR. The results of the present study clearly demonstrated that plants sprayed with either EPO or PYR showed milder CLR symptoms with adequate photosynthetic performance and optimal conditioning of their antioxidant systems.

Correlation between serum leptin levels and insulin sensitivity in diffuse toxic goiter.

OBJECTIVE: The aim of this survey was to assess the correlation between leptin and insulin sensitivity (IS) in cases of diffuse toxic goiter. DESIGN, PATIENTS, MEASUREMENTS: This is a descriptive study on patients with diffuse toxic goiter (DTG) assessing their body mass index (BMI), serum leptin concentrations, circulating insulin (area under the curve (AuC) of insulin), average insulin level, thyroid hormones, thyroid stimulating hormone (TSH), glycemia and IS (using a hyperinsulinemic-euglycemic clamp and the homeostasis model for assessment of insulin resistance (HOMA-IR) before and after euthyroidism induced with metimazol. RESULTS: The average patient age was 35 years old (range 31-40 years), height was 157 cm (range 151-160 cm), glycemia was 4.3 +/- 0.3 mmol/L and TSH 0.1 +/- 0.1 microU/mL. Average leptin level was 11.3 +/- 2.8 ng/dL, the average insulin level was 10.13 +/- 3.7 mIU/mL and the AuC for insulin was 50.6 +/- 18 microIU x min/mL. No correlation was found between leptin and BMI, thyroid hormones and glycemia. While controlling for the BMI effect, a correlation was found between leptin and TSH (r = -0.77, p = 0.042), as well as between leptin and insulinemia (r = 0.93, r2 = 0.86, p = 0.001) independently from the state of thyroid function. There was a tendency for a high correlation between leptin and the insulin AuC (hyperthyroidism: r = 0.89, p = 0.056; euthyroidism: r = 0.99, p = 0.056). A negative correlation was found between IS and the insulin AuC (rho = -0.58, p = 0.18). There was a high tendency for correlation between leptin and IS when the BMI effect (HOMA-IR: r = 0.70, p = 0.12; PHE: r = -0.55, p = 0.26) was taken into consideration. CONCLUSIONS: There is a high tendency for a negative correlation between leptin and IS when the BMI effect is controlled. There is a high tendency for a positive correlation between leptin and insulin and TSH.

[Screening of cervix uteri cancer in female health workers. Comparative analysis of insured individuals]. / Tamizaje de cáncer cervicouterino en trabajadoras de la salud. Un análisis comparativo con derechohabientes.

OBJECTIVE: To compare epidemiological characteristics and proportion of participation in a cervical cancer screening program in both, health-care professionals and insured on a health institute's women (Group A and Group B respectively). MATERIAL AND METHODS: Through questionnaires applied to both healthcare professionals and insured on a health institute's women (n = 96 for each group) randomly selected, a cross-sectional study was performed. To analyze the results, Yates' correction for continuity, was used. RESULTS: The characteristics from A and B groups were respectively: age 35 +/- 10 vs. 41 +/- 5 years (p < 0.001), years of scholarship: 8.3 +/- 5 vs. 12.0 +/- 1 (p < 0.001), frequency of screening test in the last two years: 1.2 +/- 0.4 vs. 1.0 +/- 0.1 (p < 0.001), time elapsed from the last test: 13.6 +/- 15 vs. 12.2 +/- 13 months (p = 0.52), attendance to screening test 55 (57%) vs. 72 (75%), (p < 0.001). Reasons for not attendance to screening test were indolence 13 (14%) vs. 13 (14%) and not enough time 7 (7%) vs. 2 (2%) by both groups, A and B, respectively. CONCLUSIONS: The proportion of attendance to cervical cancer screening is higher in health-care professionals than in insured on a health institute's women. The causes for not attendance to screening are the same in both groups.

[Risk factors for cesarean section: epidemiologic approach]. / Factores de riesgo para cesárea: un enfoque epidemiológico.

The increase in frequency of cesareans that has been noted through 70's, not diminished--like it was expected--perinatal morbidity and mortality. The most important indications to cesarean are distocias, previous cesarean and fetal stress. In 1998 frequency of cesarean deliveries in our hospital was 35% of the pregnancy attended. The claim of this study was to determine risks factors to cesarean in our hospital. A case-control study was performed, selecting 165 cases (cesareans) and 328 controls (via vaginal). It was determined OR of the risks factors and atribuible fraction. Data were analyzed by X2. The most important indications to cesarean delivery were: distocias (39%, n = 64); previous cesarean (23%, n = 41) and fetal stress (11%, n = 21). There was not significative differences in age, height and rupture membrane time in both groups. History of cesarean delivery gave major risk to another surgical intervention (OR = 12.7, p = < 0.0001, atribuible fraction 92%). Nuliparous (OR = 6.6, p < 0.00000, atribuible fraction 85%), second gestation (OR = 1.8, p = 0.002) or history of abortion (OR = 1.8, p = 0.04) were factors mainly associated to cesarean delivery. We concluded that the precise 'medications of this surgical intervention specially in nuliparous or previous cesarean delivery cases must be replanteated to diminish its elevated frequency.

[Perinatal mortality 1 in Colima, Col. Case-control study]. / Mortalidad perinatal 1 en Colima, Col. Estudio de casos y controles.

UNLABELLED: Perinatal mortality 1 (PM1) includes deads occurred from 28th week of gestation to 1st week of extrauterine life. The aim of this study was to describe, from medical records, clinical-epidemiological characteristics of 19 perinatal mortality 19 cases and 36 controls occurred in 1998 at a General Hospital. RESULTS: Interruption of the fetal-placental circulation, cardiopathy and ventricular hemorrhages were the main causes of PM1. There were no differences in cases and controls about maternal age 27.6 +/- 7 vs 28.8 +/- 5 years (p = 0.52), gestational age by amenorrhea: 39.2 +/- 1.4 vs 39.0 +/- 1.4 weeks (p = 0.82) and weight: 2892 +/- 769 vs 3352 +/- 549 g (p 0.03) respectively. In our study, the risk of PM1 was increased when history of one to four parity was present (OR = 4.67, p = 0.03) and was decreased when history of nulliparity was present (OR = 0.21, p = 0.03). Ten cases of 19 were mortinates, nine were hebdomadal deads. There was no difference in their characteristics: maternal age 26.1 +/- 5 vs 29.6 +/- 8 years (p = 0.34), gestational age 37.7 +/- 3 vs 34.1 +/- 3 weeks (p = 0.05) and weight 3025 +/- 699 vs 2780 +/- 853 g (p = 0.53) respectively. Hebdomadal death occurred 44 +/- 5 hours after their born. Results demonstrate the importance of improving prenatal attention particularly on last weeks of gestation, even in normal pregnancies.

Medicamentos en un servicio de cirugía hospitalaria / Drugs in a hospital surgery service

Un estudio que se llevó a cabo en el servicio de cirugía de mujeres del Hospital Universitario del Valle en Cali, Colombia, en mayo de 1980 puso de manifiesto una utilización inadecuada de los medicamentos que ascendía al 62% del costo de los mismos. Tal uso inadecuado correspondía a robo, deterioro o pérdida, ya que los medicamentos no se devolvían a la farmacia ni se entregaban a los pacientes cuando abandonaban el servicio. Se implantaron ciertas medidas de control entre las que se destacan el empleo de un formulario único que recogía en un solo pedido todas las órdenes médicas diarias individuales para cada paciente y supervisión de los medicamentos más utilizados por parte de la enfermera jefa del servicio. En mayo y junio de 1981 se repitió un estudio similiar y se comprobó que la utilización inadecuada había descendido al 29%. Si bien esto representa una mejora existe la necesidad de establecer sistemas de control en todo el proceso de adquisición, distribución y uso de los medicamentos con el fin de que la cantidad que prescribe el médico coincida con la que despachaba la farmacia y la que se administra a los enfermos