Sub-keV design for the National Ignition Facility's soft x-ray Opacity Spectrometer (OpSpec) and expansion plans for time-resolved measurements.

When compared with the National Ignition Facility's (NIF) original soft x-ray opacity spectrometer, which used a convex cylindrical design, an elliptically shaped design has helped to increase the signal-to-noise ratio and eliminated nearly all reflections from alternate crystal planes. The success of the elliptical geometry in the opacity experiments has driven a new elliptical geometry crystal with a spectral range covering 520-1100 eV. When coupled with the primary elliptical geometry, which spans 1000-2100 eV, the new sub-keV elliptical geometry helps to cover the full iron L-shell and major oxygen transitions important to solar opacity experimentation. The new design has been built and tested by using a Henke x-ray source and shows the desired spectral coverage. Additional plans are underway to expand these opacity measurements into a mode of time-resolved detection, ∼1 ns gated, but considerations for the detector size and photometrics mean a crystal geometry redesign. The new low-energy geometry, including preliminary results from the NIF opacity experiments, is presented along with the expansion plans into a time-resolved platform.

Síndrome congénito por Zika / Zika Congenital sindrome

Recién nacido de 37 semanas de edad gestacional, con antecedente materno de cuadro clínico compatible con infección por Zika en el primer trimestre de embarazo. Hallazgos en ultrasonido prenatal a las 22 semanas de edad gestacional de ventriculomegalia y calcificaciones intracraneales

Efectos del consumo elevado de fructosa y sacarosa sobre parámetros metabólicos en ratas obesas y diabéticas / Effects of a high fructose and sucrose intake on metabolic parameters in obese diabetic rats

The relationship between a high consumption of fructose-sweetened foods and obesity and its co-morbidities remains controversial. In this study the effects of three isocaloric and isolipidic diets containing different carbohydrates - fructose, sucrose and starch (AIN 93) - on biomass, abdominal fat depots, blood and liver lipid profile and hepatic histopathology in adult male IIMb/obese and diabetic rats were evaluated. Plasma cholesterol and triacylglycerol were significantly higher in fructose and sucrose groups, while liver lipids showed higher levels in the starch-fed group. There were no differences in hepatic histology in the three groups. The findings of this study support the hypothesis that sugar-rich diets -with fructose or sucrose - replacing starch in equivalent amounts produce similar effects in plasma glucose-lipid profile.

La controversia acerca de si el alto consumo de fructosa ha sido determinante en la prevalencia actual de la obesidad y sus comorbilidades, o si sus efectos son semejantes a los de un consumo equivalente de otros azúcares continúa vigente. En este trabajo se evaluaron los efectos de tres dietas isocalóricas e isolipídicas con fructosa, sacarosa o almidón -como control-, sobre la biomasa, el depósito adiposo abdominal, el perfil glucolipídico sanguíneo y los lípidos y la histología hepáticos en ratas adultas IIMb/β, obesas y diabéticas. Los valores de colesterol y triacilgliceroles plasmáticos fueron mayores en los grupos alimentados con fructosa y sacarosa, mientras que los lípidos hepáticos resultaron mayores en el grupo que consumió almidón. La histología hepática mostró leve esteatosis micro-macro vacuolar en los tres grupos. Los efectos de fructosa y sacarosa sobre las variables evaluadas no fueron diferentes.

Factores asociados con la transición en adolescentes con infección HIV perinatal / Factors associated with transition of adolescents with perinatal mother-to-child HIV infection

Los avances terapéuticos de los niños con infección HIV lograron una gran sobrevida y llevaron el foco de la atención al manejo de la infección cada vez más compleja de niños experimentados y al desafío de preparar a los adolescentes para la transición hacia un centro de adultos. Para ello se diseñó un Programa de Transición con pasos definidos que se implementó en el 2007 en el Servicio de Infectología del Hospital JP Garrahan. Este estudio tiene por objetivos describir las características de los adolescentes con infección VIH/SIDA incluidos en el Programa de Transición y analizar los factores asociados a la transición. Entre junio de 2007 y diciembre de 2013, se incluyeron 230 pacientes. Presentan un estadio clínico e inmunológico avanzado, la vía de infección fue perinatal en 96.5%. Presentan experiencia a varios esquemas de tratamiento con una respuesta adecuada virológica e inmunológica: 62.9 % presentan carga viral indetectable. Se registró una adherencia al seguimiento en el Hospital Garrahan del 59%. Concurrió solo alguna vez el 46.3% de los pacientes. La transición se efectivizó en 131pacientes (57%) y tuvieron una transición exitosa el 72.3% de ellos. En el análisis bivariado se encontró que estar al cuidado del propio paciente y la adherencia a los controles se asoció significativamente como factor protector para transición no exitosa. La no escolarización mostró una tendencia al límite de la significación estadística a aumentar el riesgo de transición no exitosa así como el uso de drogas (AU)

Advances in the management of HIV-infected children have led to long-term survival and shifted the focus to the care of children with an increasing complexity of the infection and the challenge to prepare children for the transition to adult care. For this purpose, a Transition Program with well-defined steps was implemented at the Deapartment of Infectious Diseases in 2007. The aim of this study was to describe the features of adolescents with HIV/AIDS infection included in the Transition Program and analyze factors associated with transitioning. Between June 2007 and December 2013, 230 patients were included. The patients had a clinically and immunologically advanced state. Infection had been from mother to child in 96.5%. The children had received different treatment schemes with adequate virological and immunological response: 62.9% had a detectable viral load. Adherence to follow-up at the Garrahan Hospital was 59%; 46.3% came to the hospital only sporadically. Of all patients, 131 (57%) were transitioned and transition was successful in 72.3% of them. Bivariate analysis showed that the patient being in charge of their own transition and adherence to follow-up visits were significantly associated with a successful transition. Not attending school showed a borderline statistically significant trend towards increasing failure of transition, as did drug use (AU)

Normal reference ranges from 11 to 41 weeks' gestation of fetal left modified myocardial performance index by conventional Doppler with the use of stringent criteria for delimitation of the time periods.

OBJECTIVE: To establish normal reference intervals of the fetal left modified myocardial performance index (MPI) with the use of stringent criteria for delimitation of the time periods. STUDY DESIGN: A cohort of consecutive singleton fetuses was created including at least 20 fetuses for each completed week of gestation between 11 and 41 weeks. The isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT), and ejection time (ET) were calculated using the clicks of the mitral and aortic valves as landmarks, and the MPI was calculated as follows: (ICT + IRT)/ET. Normal reference ranges for the MPI and its individual components were constructed by means of regression analysis of the mean and standard deviation against gestational age (GA). RESULTS: A total of 730 fetuses were included. After a natural logarithmic transformation, a third degree cubic polynomial model (log(e) mean MPI = 0.0477 × GA - 0.002565 × GA² + 0.000043 × GA³ -1.22, with GA measured in weeks) was selected to fit our data. There was a progressive increase in the mean MPI from 11 weeks (mean, 0.39; 95th centile, 0.51) to 41 weeks (mean, 0.55; 95th centile, 0.78) of gestation. While the mean ICT and IRT values increased with GA from 25 to 32 ms and from 39 to 51 ms, respectively, the ET showed an initial increase until 30 weeks and a progressive decrease thereafter. CONCLUSION: Normative references of left modified MPI from 11 to 41 weeks of gestation are provided, which could be useful in the assessment of cardiac function in fetuses.

Exogenous alkaline phosphatase treatment complements endogenous enzyme protection in colonic inflammation and reduces bacterial translocation in rats.

Alkaline phosphatase (AP) inactivates bacterial lipopolysaccharide and may therefore be protective. The small intestine and colon express intestinal (IAP) and tissue nonspecific enzyme (TNAP), respectively. The aim of this study was to assess the therapeutic potential of exogenous AP and its complementarity with endogenous enzyme protection in the intestine, as evidenced recently. IAP was given to rats by the oral or intrarectal route (700U/kgday). Oral budesonide (1mg/kgday) was used as a reference treatment. Treatment with intrarectal AP resulted in a 54.5% and 38.0% lower colonic weight and damage score, respectively, and an almost complete normalization of the expression of S100A8, LCN2 and IL-1ß (p<0.05). Oral AP was less efficacious, while budesonide had a more pronounced effect on most parameters. Both oral and intrarectal AP counteracted bacterial translocation effectively (78 and 100%, respectively, p<0.05 for the latter), while budesonide failed to exert a positive effect. AP activity was increased in the feces of TNBS colitic animals, associated with augmented sensitivity to the inhibitor levamisole, suggesting enhanced luminal release of this enzyme. This was also observed in the mouse lymphocyte transfer model of chronic colitis. In a separate time course study, TNAP was shown to increase 2-3 days after colitis induction, while dextran sulfate sodium was a much weaker inducer of this isoform. We conclude that exogenous AP exerts beneficial effects on experimental colitis, which includes protection against bacterial translocation. AP of the tissue-nonspecific isoform is shed in higher amounts to the intestinal lumen in experimental colitis, possibly aiding in intestinal protection.

Effects of flavonoids and other polyphenols on inflammation.

Flavonoids are a family of polyphenolic compounds which are widespread in nature (vegetables) and are consumed as part of the human diet in significant amounts. There are other types of polyphenols, including, for example, tannins and resveratrol. Flavonoids and related polyphenolic compounds have significant antiinflammatory activity, among others. This short review summarizes the current knowledge on the effects of flavonoids and related polyphenolic compounds on inflammation, with a focus on structural requirements, the mechanisms involved, and pharmacokinetic considerations. Different molecular (cyclooxygenase, lipoxygenase) and cellular targets (macrophages, lymphocytes, epithelial cells, endothelium) have been identified. In addition, many flavonoids display significant antioxidant/radical scavenging properties. There is substantial structural variation in these compounds, which is bound to have an impact on their biological profile, and specifically on their effects on inflammatory conditions. However, in general terms there is substantial consistency in the effects of these compounds despite considerable structural variations. The mechanisms have been studied mainly in myeloid cells, where the predominant effect is an inhibition of NF-κB signaling and the downregulation of the expression of proinflammatory markers. At present there is a gap in knowledge of in vitro and in vivo effects, although the pharmacokinetics of flavonoids has advanced considerably in the last decade. Many flavonoids have been studied for their intestinal antiinflammatory activity which is only logical, since the gastrointestinal tract is naturally exposed to them. However, their potential therapeutic application in inflammation is not restricted to this organ and extends to other sites and conditions, including arthritis, asthma, encephalomyelitis, and atherosclerosis, among others.

Flavonoids exert distinct modulatory actions on cyclooxygenase 2 and NF-kappaB in an intestinal epithelial cell line (IEC18).

BACKGROUND AND PURPOSE: Cyclooxygenase 2 (COX-2) is involved in inflammatory bowel disease, but the effect of flavonoids at the intestinal epithelial level is unknown. We aimed to characterize the effect and structure-activity relationship of nine selected flavonoids on COX-2 expression in intestinal epithelial cell (IEC)18 cells. We also investigated the signal transduction pathway(s) responsible for the effects observed. EXPERIMENTAL APPROACH: Intestinal epithelial cell 18, a non-tumour cell line with intestinal epithelial phenotype, was used. COX-2 was measured by Western blot and the involvement of the NF-kappaB pathway assessed by Western blot, pharmacological inhibition, luciferase reporter assays and nuclear translocation experiments. KEY RESULTS: The effect of flavonoids on COX-2 expression depended on the experimental conditions tested [non-stimulated and lipopolysaccharide (LPS)-stimulated]. Flavonoids caused an increase in COX-2 expression and NF-kappaB-dependent gene transcription under basal conditions. Conversely, under LPS stimulation flavonoids increased, decreased or did not affect COX-2 levels depending on the specific type. Variable effects were observed on extracellular signal regulated kinase/p38/c-Jun N-terminal kinase phosphorylation and p50/65 nuclear translocation. CONCLUSION AND IMPLICATIONS: The effect of flavonoids on COX-2 expression depended on the balance of the interference with IkappaB-alpha phosphorylation and other signalling targets, and therefore depends on the experimental conditions and on the type of flavonoids. This is expected to result in different effects in inflammatory conditions. In general, flavonoids may limit epithelial COX-2 expression in inflammatory conditions while favouring it when inflammation is not present.

La cascarilla de la soja: potencial componente de alimentos funcionales / Soybean hull: potential ingredients for functional foods

The effects of soybean bran, a residue of soybean oil extraction, rich in dietary fiber-both soluble and insoluble -on fat distribution, plasmatic and liver lipids, glycemia and glycemic load, were studied on adult male obese diabetic 0 rats. Two hundred days old ft rats were fed two diets with 15 percent sodium caseinate as protein source and 10 percent dietary fiber from soybean bran (S) or cellulose (C) during 30 and 60 days. Significant diminutions in blood cholesterol levels were registered in group S on day 30 as well as on day 60. Diet S significantly attenuated the characteristic increase in blood triacylglycerols levels and the usual progressive increase in blood glucose levels expressed in this line of rats. Diet S decreased significantly liver total lipids, cholesterol and triacylglycerols compared with C. No differences were registered between groups neither in food intake nor in biomass. These effects are attributed to the combined effects of the soluble and insoluble fiber fractions present in soybean bran. In conclusion, soybean bran may be considered as a useful component of functional foods designed for human nutrition.

Se estudiaron los efectos de la cascarilla o salvado de la soja, con alto contenido de fibra dietaria, de tipo insoluble y soluble, sobre la distribución del tejido adiposo, el perfil lipídico sanguíneo y hepático, la glicemia basal y post sobrecarga glucídica, en ratas adultas de la línea IIMb/p, obesa y diabética. Ejemplares de 200 días fueron alimentados durante 30 y 60 días con dos dietas con caseinato como fuente proteica y 10 g/100g de fibra de salvado de soja (S) o celulosa microcristalina (C). Tanto a los 30 como a los 60 días de tratamiento se constataron niveles de colesterol sérico significativamente menores en el grupo S con respecto a C. Los valores de C fueron asimismo superiores a los del inicio del experimento. La dieta S atenuó el aumento de los triacilgliceroles séricos, manifestado en el grupo C y el progresivo aumento de la glucemia basal habitual en estos roedores. Se registró una significativa disminución de los lípidos totales, el colesterol y los triacilgliceroles hepáticos en el grupo S. Se atribuyen estos efectos, a los mecanismos fisiológicos combinados de las fracciones de fibra del salvado de la soja. Se concluye que este producto podría evaluarse en humanos como un potencial componente de alimentos funcionales.

The bisphosphonate alendronate improves the damage associated with trinitrobenzenesulfonic acid-induced colitis in rats.

BACKGROUND AND PURPOSE: The nitrogen-containing bisphosphonates are drugs used successfully in the treatment of osteoporosis. They act inhibiting farnesyl diphosphate synthase. This mechanism may also produce anti-inflammatory effects. The therapeutic activity of alendronate was tested in vivo using a model of inflammatory bowel disease. EXPERIMENTAL APPROACH: The trinitrobenzenesulfonic acid model of colitis in the rat was used. Rats were treated orally with alendronate and its efficacy compared with that of oral sulphasalazine or vehicle, starting 2 h after colitis induction. The status of the animals was assessed 5 days later. KEY RESULTS: Alendronate treatment (25 or 75 mg kg(-1) day(-1)) resulted in a decrease in the colonic damage score and loss of body weight (at 25 mg kg(-1) day(-1) only). This was associated to a dramatic reduction in the mRNA levels of interleukin 1 beta (IL-1 beta), monocyte chemoattractant protein 1 (MCP-1) and interleukin 1 receptor antagonist (IL-1 ra). The magnitude of the beneficial effect was comparable to that of sulphasalazine (at a 6-20 fold higher dose). Thus sulphasalazine post-treatment reduced the mRNA levels of IL-1 beta/IL-1 ra and MCP-1 to the same extent as alendronate and additionally lowered colonic alkaline phosphatase activity, but failed to affect body weight loss or colonic damage score. Alendronate failed to exert beneficial effects when administered intraperitoneally. CONCLUSIONS AND IMPLICATIONS: Oral but not intraperitoneal alendronate significantly protected the colon in experimental rat colitis. Inflammatory bowel disease patients might benefit from exposure to oral alendronate.

Inmunogenicidad y eficacia de una nueva vacuna de DNA recombinante de Hepatitis B en el Perú / Inmunogenicity and efficacy of a new recombinant DNA vaccine for Hepatitis B virus in Peru

Aproximadamente 350 millones de personas están infectadas con hepatitis B en el mundo. El Perú es uno de los países con alta prevalencia de Hepatitis B en América Latina. La hepatitis B causa hepatitis crónica, cirrosis y carcinoma hepatocelular. La vacunación es el único método que ha demostrado ser eficaz en el control de la enfermedad. Este es un estudio prospectivo, aleatorio, conducido con el propósito de evaluar la inmunogenicidad y seguridad de la vacuna Hepavax-Gene, una nueva vacuna de DNA recombinante, en personas sanas mayores de 10 años de edad en el Perú. La vacuna fue administrada vía intramuscular en el músculo deltoides en dosis 10 microgramos a personas de 10 a 19 años y de 20 microgramos a mayores de 19 años, con el esquema de vacunación de tres dosis: el día O, a los 30 días y a los 180 días. 67 personas terminaron el estudio de un total de 188 personas admiitdas inicialmente. La inmunogenicidad fue satisfactoria: 100 por ciento de los participantes en el Grupo A (10 a 19 años) 100 por ciento de los participantes del Grupo B (mayores de 19 años). Con una media aritmética de 28,583.92 mLU/mL y una media geométrica de 5,754.32 mIU/mL en el grupo A. y con una media aritmética de 8,708.3 mIU/mL 2 y una media geométrica de 2,179.32 mIU/mL en el Grupo B. Los eventos adversos fueron de 4.69 por ciento. Ninguno fue severo. La vacuna de DNA recombinante derivada de H. Polymorpha es inmunogénica y segura en peruanos sanos mayores de 10 años aplicada en tres dosis a los días 0, 30 y 180.

Association between polymorphisms of the atrial natriuretic peptide gene and proteinuria: a population-based study.

AIMS/HYPOTHESIS: In case-control studies, polymorphisms at the atrial natriuretic peptide gene (ANP) locus have been associated with presence of albuminuria in Type 1 and Type 2 diabetes. We evaluated the relationship between the ScaIand BstxI polymorphisms and albuminuria in the general population of the Mexico City Diabetes Study. METHODS: Allele/genotype frequencies were analysed by PCR-RFLP analysis using ScaI (wild, A(2) vs mutated, A(1)) and BstxI (wild, C(708) vs mutated, T(708)) enzyme. RESULTS: Among 1288 subjects, hypertension was present in 112 subjects, Type 2 diabetes in 191 and impaired glucose tolerance in 136; microalbuminuria was present in 464 subjects, and clinical proteinuria in 199. General frequencies were 0.93 and 0.96 for the wild alleles, and 0.07 and 0.04 for the mutated alleles, respectively for ScaI and BstxI. Frequency of A(1)was 0.08 in normoalbuminuric, 0.05 in microalbuminuric, and 0.05 in proteinuric patients (chi(2)=7.3, p=0.025). Frequency of T(708) was 0.06 in normoalbuminuric and 0.03 microalbuminuric and 0.03 in proteinuric subjects (chi(2)=8.1, p=0.017). By multivariate analysis, the associations between A(1)or T(708) allele and albuminuria were independent of age, sex, BMI, diabetes, and hypertension, (odds ratio (OR) 0.60, p=0.01, (OR) 0.51, p=0.004, respectively). CONCLUSION/INTERPRETATION: In the general population of Mexico City, both polymorphisms of ANP are associated with albuminuria independently of hypertension, and could play a role in protecting subjects against development of albuminuria.

[Immunogenicity and efficacy of a new recombinant DNA vaccine for hepatitis B virus in Peru]. / Inmunogenecidad y eficacia de una nueva vacuna de DNA recombinante de hepatitis B en el Perú.

Approximately 350 million persons are infected with Hepatitis B virus around the world. Peru is one of the countries with high prevalence of Hepatitis B in Latin America and this disease is an important cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma in our country. Vaccination is the only method that has proved to be effective in the control of this disease. This is a prospective, randomized study performed with the purpose of evaluating immunogenicity and efficacy of the Hapavax-Gene vaccine in Peru, a new recombinant DNA vaccine, in healthy persons over 10 years of age. The vaccine was applied intramuscularly, on the deltoid muscle, in 10 microgram doses, to persons between 10 and 19 years of age and 20 microgram doses in persons over 19, using the three doses vaccination scheme: day 0, after 30 days and after 180 days. Out of a total of 188 persons initially admitted for this test, 67 persons completed the study. Immunogenicity was satisfactory: 100% of the participants of Group A (10 to 19 years of age) and 100% of the participants of Group B (over 19). With an arithmetical mean of 28,583.92 mlU/mL and a geometrical mean of 5,754.32 mlU/mL in Group A and an arithmetical mean of 8,708.3 mlU/mL 2 and a geometrical mean of 2,179.32 mlU/mL in Group B. Adverse events accounted for 4.69%, none of which was severe. The recombinant DNA vaccine derived from H. Polymorpha applied in three doses on day 0, after 30 days and after 180 days, is immunogenic and safe in healthy Peruvians over 10 years of age.

Simplified method for the detection of apo(a) isoforms.

Apolipoprotein a, is a high molecular weight glycoproteic component of Lp(a), a molecule associated with coronary arterial disease. Apo(a) exhibits considerable size heterogeneity due to variable repetitions of the carbohydrate-containing structural unit, termed kringle. There are five different kringle forms and 10 different kringle 4 types. Apo(a) polymorphism and molecular weight depend on the number of copies of kringle 4 type 2. In this paper we describe a modified 3.75% and 6% discontinuous polyacrylamide gel system and Western-blot technique that shortness the assay time and improves the identification of apo(a) isoforms with a theoretical error of less than 1 kringle. The assay uses a standard curve prepared with five different recombinant apo(a) molecules, detected up to 50 ng of protein in Lp(a), showed a maximal resolution of 2 kringles and, with the use of third degree polynominal regression analysis, had an error of 0.01275. The inter-assay coefficient of variation was 1.7, 2, and 1.4 for the 14 K, 18 K, and 22 K phenotypes, whereas the intra-assay coefficient of variation was 0.32%, 0.18%, and 0.17%, respectively. It is possible that this modified method will diminish the number of putative null alleles so far detected in various studies, but most of all, we are certain that it can be of use in epidemiological studies due to its ease of use, speed, low cost, and enhanced number of samples that can be tested.

Insulin-induced endothelin release and vasoreactivity in hypertriglyceridemic and hypertensive rats.

Insulin-elicited endothelin release in hypertriglyceridemic, hypertensive, hyperinsulinemic (HTG) rats was shown. Weanling male Wistar rats were given 30% sucrose in their drinking water for 20-24 wk. In vitro contractions of aorta and femoral arteries were elicited with 40 mM KCl. Endothelin release induced with KCl plus 50 microU/ml insulin resulted in increases in contractile responses: 41 +/- 5.9 and 57 +/- 6% for control and 65.5 +/- 6 and 95 +/- 9% for HTG aortas and femoral arteries, respectively. The endothelin ET(B)-receptor blocker BQ-788 decreased responses to KCl + insulin by 39 +/- 8 and 53 +/- 5% in control and 48 +/- 13 and 79 +/- 3.5% in HTG aortas and femoral arteries, respectively. The ET(A)-receptor antagonist PD-151242 inhibited these responses by 12 +/- 10 and 1 +/- 9% in control and by 51.5 +/- 9 and 58.5 +/- 1% in HTG aortas and femoral arteries, respectively. These results suggest that endothelin may contribute to the hypertension in this model.

Lípidos y lipoproteínas de ayuno y postprandiales durante la administración crónica de fármacos antihipertensivos / Fasting and post-prandial lipids and lipoproteins during chronic administration of antihypertensive drugs

Con el objeto de evaluar el efecto de diversos fármacos antihpertensivos sobre los lípidos de ayuno y la lipemia postprandial, se estudiaron 39 pacientes hipertensos normolipidémicos: 28 hombres y 11 mujeres con edades de 52.3 ñ 9.0 y 58.5 ñ 7.1 años, respectivamente. Después de 4 semanas de administración de placebo se midieron los lípidos de ayuno y se administró una carga de grasa estandarizada, que proporcionó 65 g/m² de superficie corporal, y se cuantificaron los lípidos y lipoproteínas postprandiales cada 3 horas durante 9 horas. A continuación, en forma aleatoria, los pacientes fueron asignados uno de 4 grupos de tratamiento activo: Grupo I (n=10) metoprolol, 100 mg/día; Grupo II (n=9) nicardipina, 90 mg/día; Grupo III (n=11) captopril, 75 mg/día; Grupo IV (n=9) clortalidona, 25 mg/día. Cuatro semanas más tarde se repitieron las cuantificaciones de lípidos y lipoproteínas de ayuno y postplandiales. Los valores de tensión arterial sistólica y diastólica descendieron significativamente en los cuatro grupos estudiados (p<0.05). Las concentraciones de lípidos y lipoproteínas en el ayuno y durante el postprandio no tuvieron cambios significativos. Sin embargo, la lipemia postprandial fue ligeramente menor en tres de los cuatro grupos estudiados (metoprolol, nicardipina y captopril), y no se modificó en los pacientes tratados con clortalidona. Estos resultados confirman que en pacientes hipertensos normolipidémicos la administración de estos fármacos antihipertensivos a dosis bajas, no produce efectos desfavorables en los lípidos de ayuno, y señalan por primera vez, que tampoco afectan la lipemia postprandial.

[Rett's syndrome: analysis of the 1st 5 cases diagnosed in Brazil]. / Síndrome de Rett: análise dos primeiros cinco casos diagnosticados no Brasil.

Five cases of patients with the Rett syndrome are reported. The criteria for this diagnosis in these cases are discussed. These are the first cases of the Rett syndrome reported in Brazil and the authors call attention to the fact that this syndrome seems to be in our country as frequent as in USA, Europe and Japan where it has been more studied.

Síndrome de Rett: análise dos primeiros cinco casos diagnosticados no Brasil / Rett syndrome: analysis of the first 5 cases diagnosed in Brazil

Cinco casos de pacientes com a síndrome de Rett säo estudados. Os critérios diagnósticos säo discutidos. Estes säo os primeiros casos de síndrome de Rett relatados no Brasil. Chama-se atençäo para o fato de esta entidade parecer ser em nosso país täo freqüente quanto nos EUA, Europa e Japäo onde ela tem sido bastante estudada

Hernia hiatal. Operacion de Belsey (Mark IV). / Hiatal hernia. Belseys operation (Mark IV)

Se presenta 18 pacientes con hernia hiatal sintomatica y esofagitis por reflujo, tratados quirurgicamente por via toracica, utilizando la tecnica de Belsey, mas conocida como la operacion Mark IV. Se resume la metodologia de estudio, y se evaluan los resultados postoperatorios alejados

Hernia hiatal. Operacion de Belsey (Mark IV). / Hiatal hernia. Belsey's operation (Mark IV)

Se presenta 18 pacientes con hernia hiatal sintomatica y esofagitis por reflujo, tratados quirurgicamente por via toracica, utilizando la tecnica de Belsey, mas conocida como la operacion Mark IV. Se resume la metodologia de estudio, y se evaluan los resultados postoperatorios alejados