Características clínicas del estado epiléptico en niños de un hospital de tercer nivel de Lima / Clinical characteristics of status epilepticus in children in a third level hospital of Lima

RESUMEN El estado epiléptico (EE) en niños exhibe altos niveles de morbi-mortalidad y ha sido poco estudiado en el Perú. Objetivo: Describir la frecuencia y características clínicas de niños con estado epiléptico, atendidos en el Hospital Cayetano Heredia de Lima. Material y métodos: Estudio retrospectivo y observacional, tipo serie de casos de niños menores de 14 años con diagnóstico de estado epiléptico, atendidos entre enero y diciembre de 2021. Resultados: Se registró EE en un 28,8% de todos los niños atendidos por crisis epilépticas durante el año 2021. Se incluyeron 23 niños que presentaron 46 EE, varones (73,9%), con una mediana de la edad de 2 años, diagnóstico subyacente de epilepsia o malformación cerebral (21,7%), atendidos en emergencia pediátrica (91%). El tipo semiológico predominante fue el EE motor generalizado (52,2%), con etiología sintomática remota (87%) y EEG registrado en un 63% de los casos, predominantemente de tipo normal (75,9%). La mediana de duración fue de 22 minutos, de resolución total, 7 minutos y resolución parcial, 2 minutos. Se empleó midazolam (78%) como primera línea de tratamiento y fenitoína (85%), como segunda línea. Conclusiones: El EE en niños fue una emergencia prevalente durante el año 2021. La mayoría fueron varones, cuya etiología predominante fue sintomática remota y el tipo semiológico más común fue el motor generalizado. Los niños fueron atendidos de acuerdo con las guías internacionales de manejo. Se insiste en la necesidad de un sistemático afronte de vigilancia epidemiológica.

SUMMARY Status Epilepticus (SE) in children exhibits high levels of morbidity and mortality and has been poorly studied in Perú. Objective: To describe the frequency and clinical characteristics of children with Status Epilepticus treated at Cayetano Heredia Hospital in Lima. Material and Methods: Retrospective and observational study, case series type, in children under 14 years of age, with Status Epilepticus treated between January and December of 2021. Results: SE was recorded in 28.8% of children with epileptic seizures seen during 2021. Twenty-three children presenting 46 SEs were included. The median age was 2 years, the majority (73,9%) being males, with diagnosis of epilepsy or brain malformation (21.7%) and treated in the pediatric emergency (91%). The predominant semiological pattern was of generalized motor type (52.2%), with remote symptomatic etiology (73.9%), and EEG recorded in a 63% of all cases, mainly reported as normal (75,9%). The median duration was 22 minutes of total resolution, 7 minutes, and of partial resolution, 2 minutes. Midazolam was used as the first line of treatment (78%), and phenytoin as the second line (85%). Conclusions: SE was a frequent condition observed in children throughout the year 2021. Most affected children were male, the predominant etiology was remote symptomatic, and the most common semiological type was the generalized motor. The children were treated according to international management guidelines. Asystematic epidemiological surveillance approach is highly encouraged.

Tratamientos alternativos en tumor venéreo transmisible en caninos / Alternative treatments in transmissible venereal tumor in canines / Tratamentos alternativos em tumor venéreo transmissível em caninos

Resumen El Tumor Venéreo Transmisible (TVT), es una neoplasia común de la especie canina, se localiza principalmente en la mucosa de los genitales; es altamente contagiosa y es la única que puede ser transmisible mediante el trasplante celular por contacto directo. Se diagnostica por estudio citológico y su tratamiento es la quimioterapia con sulfato de vincristina, fármaco de elección por tener un alto porcentaje de efectividad y baja recidiva; sin embargo, se han descrito efectos adversos como trastornos digestivos, hemáticos y nerviosos por parte de la población tratada. El objetivo de este trabajo es dar a conocer la efectividad y comportamiento de otras alternativas para el tratamiento de TVT; primero con un protocolo de autohemoterapia y el otro mediante la inmunoterapia con ácido yatrénico mas caseína, que actúan sobre el sistema inmunológico del animal, haciendo que sea el mismo organismo quien realice la eliminación del tumor.

Abstract Transmissible Venereal Tumor (TVT) is a common canine neoplasia; it is mainly located in the genital mucosa. This pathology is highly contagious and can be transmitted by direct contact cell transplantation from a diseased to a non-diseased mucosa. It is primarily diagnosed by cytology and its treatment is chemotherapy being the vincristine sulfate the medicine of choice. The Vincristine has a high rate of effectiveness and low recidivism; however, this alternative has important side effects. The treatment with Vincristine could cause primarily digestive upset, hematological, and nervous diseases. The objective of this work is to determine the efficacy and performance of alternative therapies for the treatment of TVT, firstly, with an autohemoterapy protocol, and using an immunotherapy treatment with yatrenic acid and casein, which acts in the animal's immune system and causes the same organism to eradicate the tumor.

Resumo O Tumor Venéreo Transmissível (TVT), é uma neoplasia comum da espécie canina, localiza-se principalmente na mucosa dos genitais; é altamente contagioso e é o único que pode ser transmitido por transplante de células de contato direto. É diagnosticado por estudo citológico e seu tratamento é a quimioterapia com sulfato de vincristina, a droga de escolha por apresentar alto percentual de eficácia e baixa recorrência; entretanto, efeitos adversos como distúrbios digestivos, sanguíneos e nervosos foram relatados na população tratada. O objetivo deste trabalho é apresentar a eficácia e o comportamento de outras alternativas para o tratamento do TVT; a primeira com um protocolo de auto-hemoterapia e a outra por meio de imunoterapia com ácido yatrênico mais caseína, que atuam no sistema imunológico do animal, fazendo com que o mesmo organismo realize a retirada do tumor.

Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia: Imaging and Clinical Features of a Frequently Delayed Diagnosis.

OBJECTIVE. The purpose of this study was to assess features of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) on CT, clinical presentation, and delays in radiologic and clinical diagnosis in a series of 32 patients. MATERIALS AND METHODS. Medical records of patients with DIPNECH from the years 2000-2017 were obtained from an institutional data warehouse. Inclusion criteria were an available CT examination and either a pathologic diagnosis of DIPNECH or pathologic findings of multiple carcinoid tumorlets or carcinoid tumor with CT features suggesting DIPNECH. Two thoracic radiologists with 10 and 14 years of experience reviewed CT examinations and scored cases in consensus. RESULTS. All 32 patients were women, and most had never smoked (69%). The mean age at presentation was 61 years. Symptoms included chronic cough (59%) or dyspnea (28%), and the initial clinical diagnosis was asthma in 41%. DIPNECH was clinically suspected at presentation in only one case and was mentioned by the interpreting radiologist in only 31% of cases. CT characteristics included numerous nodules with a lower zone and peribronchiolar predominance, mosaic attenuation, and nodular bronchial wall thickening. Number of nodules at least 5 mm in diameter showed strong inverse correlations with the percentage predicted for both forced vital capacity and forced expiratory volume in 1 second and a moderate inverse correlation with total lung capacity percentage predicted. In cases with a follow-up CT interval of 3 years or longer, 85% of patients showed an increase in size of the largest nodule, and 70% had an increase in size in multiple nodules. CONCLUSION. Many cases of DIPNECH are originally missed or misdiagnosed by radiologists and clinicians. Awareness of the typical clinical and imaging features of DIPNECH may prompt earlier diagnosis of this condition.

Relación entre determinantes sociales de salud y perfil de funcionamiento de personas con discapacidad del municipio Los Patios, Norte de Santander, Colombia / Relationship between social determinants of health and functioning profile of people with disabilities from Los Patios Municipality, Norte de Santander, Colombia

RESUMEN Objetivo Analizar la relación de los determinantes sociales en salud con el perfil de funcionamiento de personas con discapacidad del municipio Los Patios, Norte de Santander. Método A una muestra de 246 personas con algún tipo de discapacidad del municipio Los Patios, Norte de Santander, bajo selección no probabilística intencionada, se administraron los instrumentos denominados Registro para la Localización y Caracterización de Personas con Discapacidad (RLPCD) y el del perfil de funcionamiento según la Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud (CIF), para identificar los determinantes sociales de salud y el perfil de funcionamiento, y determinar su relación. Resultados La muestra se caracterizó por un mayor porcentaje de hombres con discapacidad (60,2%), en relación con las mujeres (39,8%), residentes en estratos socioeconómicos 1,2 y 3 y grupos etarios entre 5 y 93 años, con un alto porcentaje que no recibe algún tipo de ingreso (79,2%). Las principales discapacidades que presentaron fueron de movilidad y su grado de funcionamiento se ubicó entre no deficiencia y deficiencia moderada, con una relación de dependencia con los determinantes sociales de salud. Conclusiones El estudio muestra evidente relación entre los determinantes sociales y el perfil de funcionamiento de personas con discapacidad. Género, nivel de escolaridad, ingresos y estrato socioeconómico son elementos que determinan el grado de funcionalidad de individuos con discapacidad. Estos factores se deben considerar cuando se desarrollan políticas públicas orientadas al beneficio de este tipo de población; Tenerlos en cuenta podría garantizar el éxito en la aplicación de las políticas diseñadas.(AU)

ABSTRACT Objective To analyze the relationship between social factors in health with the functioning profile of people with disabilities in the municipality of Los Patios, Norte de Santander. Method A sample of 246 people with a type of disability in the municipality Los Patios, Norte de Santander, under intentional non-probabilistic selection, were studied using the Registry for the Location and Characterization of Persons with Disabilities (RLPCD) and the functioning profile of people with disabilities (CIF) to identify the social determinants of health and the functioning profile, and determine their relationship. Results The sample was characterized by a higher percentage of men with disabilities (60.2%), in relation to women (39.8%), members in socioeconomic strata 1, 2 and 3 and age groups between 5 and 93 years old, with a high percentage that does not receive any type of income (79.2%). The main disabilities identified were mobility and the degree of functioning located between no deficiency and moderate deficiency with a relationship of dependence with the social determinants of health. Conclusions The study shows an evident relationship between the social determinants and the functioning profile of people with disabilities. Gender, level of education, income and socioeconomic status are elements that determine the degree of functionality of people with disabilities. It is fundamental, in the development of public policies aimed at the well-being of this type of population, that these factors are considered to ensure success in the implementation of appropriate policies.(AU)

[Relationship between social determinants of health and functioning profile of people with disabilities from Los Patios Municipality, Norte de Santander, Colombia]. / Relación entre determinantes sociales de salud y perfil de funcionamiento de personas con discapacidad del municipio Los Patios, Norte de Santander, Colombia.

OBJECTIVE: To analyze the relationship between social factors in health with the functioning profile of people with disabilities in the municipality of Los Patios, Norte de Santander. METHOD: A sample of 246 people with a type of disability in the municipality Los Patios, Norte de Santander, under intentional non-probabilistic selection, were studied using the Registry for the Location and Characterization of Persons with Disabilities (RLPCD) and the functioning profile of people with disabilities (CIF) to identify the social determinants of health and the functioning profile, and determine their relationship. RESULTS: The sample was characterized by a higher percentage of men with disabilities (60.2%), in relation to women (39.8%), members in socioeconomic strata 1, 2 and 3 and age groups between 5 and 93 years old, with a high percentage that does not receive any type of income (79.2%). The main disabilities identified were mobility and the degree of functioning located between no deficiency and moderate deficiency with a relationship of dependence with the social determinants of health. CONCLUSIONS: The study shows an evident relationship between the social determinants and the functioning profile of people with disabilities. Gender, level of education, income and socioeconomic status are elements that determine the degree of functionality of people with disabilities. It is fundamental, in the development of public policies aimed at the well-being of this type of population, that these factors are considered to ensure success in the implementation of appropriate policies.

OBJETIVO: Analizar la relación de los determinantes sociales en salud con el perfil de funcionamiento de personas con discapacidad del municipio Los Patios, Norte de Santander. MÉTODO: A una muestra de 246 personas con algún tipo de discapacidad del municipio Los Patios, Norte de Santander, bajo selección no probabilística intencionada, se administraron los instrumentos denominados Registro para la Localización y Caracterización de Personas con Discapacidad (RLPCD) y el del perfil de funcionamiento según la Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud (CIF), para identificar los determinantes sociales de salud y el perfil de funcionamiento, y determinar su relación. RESULTADOS: La muestra se caracterizó por un mayor porcentaje de hombres con discapacidad (60,2%), en relación con las mujeres (39,8%), residentes en estratos socioeconómicos 1,2 y 3 y grupos etarios entre 5 y 93 años, con un alto porcentaje que no recibe algún tipo de ingreso (79,2%). Las principales discapacidades que presentaron fueron de movilidad y su grado de funcionamiento se ubicó entre no deficiencia y deficiencia moderada, con una relación de dependencia con los determinantes sociales de salud. CONCLUSIONES: El estudio muestra evidente relación entre los determinantes sociales y el perfil de funcionamiento de personas con discapacidad. Género, nivel de escolaridad, ingresos y estrato socioeconómico son elementos que determinan el grado de funcionalidad de individuos con discapacidad. Estos factores se deben considerar cuando se desarrollan políticas públicas orientadas al beneficio de este tipo de población; Tenerlos en cuenta podría garantizar el éxito en la aplicación de las políticas diseñadas.

Use of cardiovascular magnetic resonance in the evaluation of a giant right atrial appendage aneurysm: a case report and review of the literature.

BACKGROUND: Right atrial appendage aneurysms are rare entities that may have significant clinical consequences. When co-existing with atrial fibrillation, patients are at risk of developing pulmonary or paradoxical systemic emboli. CASE PRESENTATION: An elderly patient presented to medical attention with symptoms of acute diverticulitis. On abdominal computed tomography, a massively enlarged right atrial appendage aneurysm was discovered incidentally. The aneurysm caused marked compression of the right ventricle and contained an area of hypoenhancement concerning for an intraluminal thrombus. Gadolinium-enhanced cardiovascular magnetic resonance was performed and first-pass perfusion images demonstrated that the area of hypoenhancement was in fact poorly mixing blood. The patient was therefore managed medically. CONCLUSION: Right atrial appendage aneurysms are infrequently encountered cardiac abnormalities. In the literature, surgery has been offered to patients who are young, symptomatic, or have evidence of thrombotic disease, although whether this practice pattern is associated with superior clinical outcomes is unclear. In the present case, gadolinium-enhanced cardiovascular magnetic resonance imaging was used to exclude the presence of intraluminal thrombus in an elderly patient, which helped orient the patient's treating team towards medical-rather than surgical-therapy.

The Crucial Role of Cardiac Imaging in Transcatheter Aortic Valve Replacement (TAVR): Pre- and Post-procedural Assessment.

OPINION STATEMENT: Transcatheter valve interventions have emerged as one of the most important developments in structural heart disease over the past 20 years. Initially, these interventions were directed at patients with severe aortic stenosis and high surgical risk; however, their applications have extended to involve other native valves' pathologies, degenerated prosthetic valves, as well as patients of lower surgical risk. In this article, we discuss the importance of cardiac imaging in transcatheter aortic valve replacement (TAVR) by exploring the current practices, guidelines, and recommendations with the supporting data. We believe that the key for a successful TAVR is careful pre-procedural planning and early detection of any possible post-implantation complications. To achieve this, multimodality imaging is cornerstone. Throughout the stages of patient-evaluation, echocardiography and computed tomography play complementary roles. MRI, on the other hand, has emerged as a useful tool in quantifying post-implantation paravalvular regurgitation.

Volumetric Single-Beat Coronary Computed Tomography Angiography: Relationship of Image Quality, Heart Rate, and Body Mass Index. Initial Patient Experience With a New Computed Tomography Scanner.

BACKGROUND: Cardiac computed tomography (CT) image quality (IQ) is very important for accurate diagnosis. We propose to evaluate IQ expressed as Likert scale, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) from coronary CT angiography images acquired with a new volumetric single-beat CT scanner on consecutive patients and assess the IQ dependence on heart rate (HR) and body mass index (BMI). METHODS: We retrospectively analyzed the data of the first 439 consecutive patients (mean age, 55.13 [SD, 12.1] years; 51.47% male), who underwent noninvasive coronary CT angiography in a new single-beat volumetric CT scanner (Revolution CT) to evaluate chest pain at West Kendall Baptist Hospital. Based on patient BMI (mean, 29.43 [SD, 5.81] kg/m), the kVp (kilovolt potential) value and tube current were adjusted within a range of 80 to 140 kVp and 122 to 720 mA, respectively. Each scan was performed in a single-beat acquisition within 1 cardiac cycle, regardless of the HR. Motion correction software (SnapShot Freeze) was used for correcting motion artifacts in patients with higher HRs. Autogating was used to automatically acquire systolic and diastolic phases for higher HRs with electrocardiographic milliampere dose modulation. Image quality was assessed qualitatively by Likert scale and quantitatively by SNR and CNR for the 4 major vessels right coronary, left main, left anterior descending, and left circumflex arteries on axial and multiplanar reformatted images. Values for Likert scale were as follows: 1, nondiagnostic; 2, poor; 3, good; 4, very good; and 5, excellent. Signal-to-noise ratio and CNR were calculated from the average 2 CT attenuation values within regions of interest placed in the proximal left main and proximal right coronary artery. For contrast comparison, a region of interest was selected from left ventricular wall at midcavity level using a dedicated workstation. We divided patients in 2 groups related to the HR: less than or equal to 70 beats/min (bpm) and greater than 70 bpm and also analyzed them in 2 BMI groupings: BMI less than or equal to 30 kg/m and BMI greater than 30 kg/m. RESULTS: Mean SNR was 8.7 (SD, 3.1) (n = 349) for group with HR 70 bpm or less and 7.7 (SD, 2.4) (n = 78) for group with HR greater than 70 bpm (P = 0.008). Mean CNR was 6.9 (SD, 2.7) (n = 349) for group with HR 70 bpm or less and 5.9 (SD, 2.2) (n = 78) for group with HR 70 bpm or greater (P = 0.002). Mean SNR was 8.8 (SD, 3.2) (n = 249) for group with BMI 30 kg/m or less and 8.1 (SD, 2.6) (n = 176) for group with BMI greater than 30 kg/m (P = 0.008). Mean CNR was 7.0 (SD, 2.8) (n = 249) for group with BMI 30 kg/m or less and 6.4 (SD, 2.4) (n = 176) for group with BMI greater than 30 kg/m (P = 0.002). The results for mean Likert scale values were statistically different, reflecting difference in IQ between people with HR 70 bpm or less and greater than 70 bpm, BMI 30 kg/m or less, and BMI greater than 30 kg/m.

Efectos quimiopreventivos del jugo de Morindia citrifolia (noni) sobre cáncer mamario experimental en ratas: estudio preliminar / Chemopreventive Effects of Morindia Citrifolia Juice (noni) on Experimental Breast Cancer in Rats: Preliminary Study / Efeitos químico-preventivos do suco de Morindia citrifolia (noni) sobre câncer mamario experimental em ratos: estudo preliminar

Este estudio determina el efecto del jugo de Morindia citrifolia (Tahitian Noni®) en el desarrollo de cáncer mamario inducido por el agente carcinogénico 7,12-dimetilbenzantraceno (DMBA) en ratas. Para esto se utilizó el modelo de inducción de cáncer de mama con 1,7-DMBA en ratas nulíparas Spraguey dawley de 35 días de edad, divididas al azar en tres grupos: grupo 1 control, el cual no recibió ningún tratamiento, y los grupos 2 y 3, inducidos con DMBA a una dosis de 55 mg/kg. El último recibió una dosis de jugo de noni de 4 ml/kg por día, durante 90 días. Los resultados mostraron que un porcentaje significativo (83,33%) de las ratas del grupo inducido con DMBA no tratadas con jugo de noni desarrollaron tumores mamarios palpables (≤ 2 cm) de tipo carcinoma ductal in situ e hiperplasia ductal atípica, en comparación con los otros grupos que no desarrollaron tumores de ningún tipo. Así mismo, se encontró que las ratas que desarrollaron cáncer mamario tuvieron una menor ganancia de peso y un mayor consumo de agua significativo (p < 0,05), en comparación con los otros dos grupos. Los resultados de los parámetros hematológicos y bioquímicos no presentaron cambios significativos entre los grupos. Se encontraron cambios histopatológicos compatibles con toxicidad hepática en las ratas tratadas con jugo de noni. En conclusión, en este estudio preliminar se observó que el jugo de noni ejerce efectos positivos en la modulación del desarrollo de cáncer mamario inducido por DMBA.

This study determines the effect of Morindia citrifolia juice (Tahitian Noni®) in the development of breast cancer induced by carcinogen agent 7.12-dimethylbenzanthracene (DMBA) in rats. For this purpose, the breast cancer induction model 1.7-DMBA was used on Spraguey Dawley nulliparous rats of 35 days of age, randomly divided into three groups: group 1 control, which received no treatment, and groups 2 and 3, induced with DMBA at a dose of 55 mg/kg. The latter received a dose of noni juice of 4 ml/kg per day for 90 days. The results showed that a significant percentage (83.33%) of the rats from the group induced with DMBA not treated with noni juice developed palpable breast tumors (≤ 2 cm) of the ductal carcinoma in situ type and atypical ductal hyperplasia, compared to the other groups that did not develop any kind of tumors. In addition, it was found that rats that developed breast cancer had a lower weight gain and significantly increased water consumption (p < 0.05) compared to the other two groups. The results of the hematological and biochemical parameters showed no significant changes between groups. Histopathological changes compatible with liver toxicity were found in rats treated with noni juice. In conclusion, it was found in this preliminary study that noni juice has positive effects in modulating the development of breast cancer induced by DMBA.

Este estudo determina o efeito do suco de Morindia citrifolia (Tahitiam Noni®) no desenvolvimento de câncer mamário induzido pelo agente carcinogênico 7,12-dimetilbenzantraceno (DMBA) em ratos. Para isto se utilizou o modelo de indução de câncer de mama com 1,7-DMBA em ratos fêmeas nulíparas Spraguey dawley de 35 dias de idade, divididas ao acaso em três grupos: grupo 1 controle, o qual não recebeu nenhum tratamento, e os grupos 2 e 3, induzidos com DMBA a uma dose de 55 mg/kg. o último recebeu uma dose de suco de noni de 4 ml/kg por dia, durante 90 dias. Os resultados mostraram que uma porcentagem significativa (83,33%) dos ratos do grupo induzido com DMBA não tratados com suco de noni desenvolveram tumores mamários palpáveis (≤ 2 cm) de tipo carcinoma ductal in situ e hiperplasia ductal atípica, em comparação com os outros grupos que não desenvolveram tumores de nenhum tipo. Da mesma forma, encontrou-se que os ratos que desenvolveram câncer mamário tiveram um menor ganho de peso e um maior consumo de água significativo (p < 0,05), em comparação com os outros dois grupos. Os resultados dos parâmetros hematológicos e bioquímicos não apresentaram mudanças significativas entre os grupos. Encontraram-se mudanças histopatológicas compatíveis com toxicidade hepática nos ratos tratados com suco de noni. Em conclusão, neste estudo preliminar se observou que o suco de noni exerce efeitos positivos na modulação do desenvolvimento de câncer mamário induzido por DMBA.

Effectiveness of the aromatase (P450 Arom) inhibitors Letrozole and Exemestane for masculinization of red tilapia (Oreochromis spp.) / Efectividad de los inhibidores de la aromatasa (aromP450) Letrozol y Exemestano para la masculinización de tilapia roja (Oreochromis spp.) / Efetividade dos inibidores da aromatase (aromP450) Letrozol e Exemestano para a masculinização da tilápia vermelha (Oreochromis spp)

Background: cytochrome P450 aromatase enzyme (aromP450) is a key enzyme in the conversion of androgens into estrogens, a crucial step in the control of sexual differentiation in fish. Objective: the aim of this study was to evaluate the efficiency of two aromatase inhibitors (AIs) as an alternative method for the masculinization of red tilapia (Oreochromis spp.). Methods: Letrozole (LT) and Exemestane (EM) aromatase inhibitors were used at two experimental doses (25 and 100 mg/Kg). Five days post-hatching larvae (5 dph) were fed the inhibitors for 30 days (35 dph). The control treatments consisted of 17α metil testosterone (MT) at a concentration of 60 mg/ Kg (positive control) and food with 300 ml/Kg ethanol (negative control). On 60 dph, gonadal extraction of fishes was performed for histological processing and staining with hematoxylin-eosin for analysis. Results: there were no significant differences (p>0.05) between any compound and implemented doses with the controls in terms of larval survival. Percentage of male fish increased for LT, EM, and MT (positive control), which showed significant differences (p<0.05) with the negative control. The dose analysis showed significant differences (p<0.05) for 100 mg/Kg dose and positive control with 25 mg/Kg dose and negative control; there were also differences between 25 mg/Kg dose and negative control. Conclusions: our results suggest that oral administration of third generation AIs (Type I or Type II) is effective for increasing the proportion of males without differences between inhibitor types. There is also a direct effect of the dose on male proportion. Suppression of aromatase activity allows guiding sexual differentiation towards final testicular development.

Antecedentes: la citocromo P450 aromatasa (aromP450) es una enzima clave en la conversión de andrógenos a estrógenos; un paso crucial en el control de la diferenciación sexual en peces. Objetivo: evaluar la eficiencia de dos inhibidores de la aromatasa (IAs) como método alternativo para la masculinización de tilapia roja (Oreochromis spp.). Métodos: se evaluaron los inhibidores de la aromatasa, letrozol (LT) y exemestano (EM), a dos dosis experimentales de 25 y 100 mg/Kg. Larvas de 5 días post eclosión (dpe) fueron alimentadas durante 30 días (35 dpe) con los tratamientos. Como testigos se implementaron 17α metil testosterona (MT) a una concentración de 60 mg/Kg (control positivo), y alimento con etanol 300 ml/Kg (control negativo). El día 60 dpe se realizó extracción gonadal de los peces para procesamiento histológico y tinción con hematoxilina-eosina para su análisis. Resultados: no hubo diferencias significativas (p>0,05) entre ninguno de los tratamientos y los controles para la variable sobrevivencia larvaria. La proporción de machos aumentó con la implementación de LT, EM y MT (control positivo), los cuales presentaron diferencias significativas (p<0,05) con el control negativo. Hubo diferencias significativas (p<0,05) entre la dosis de 100 mg/Kg y el control positivo con la dosis de 25 mg/Kg y el control negativo; también se presentaron diferencias entre las dosis de 25 mg/kg y el control negativo. Conclusiones: nuestros resultados sugieren que el suministro vía oral de IAs de tercera generación, tipo I o tipo II, es eficiente en aumentar la proporción de machos en los grupos tratados, sin diferencias entre el tipo de inhibidor, pero con un efecto directo de la dosis sobre la proporción de machos. La supresión de la actividad de la aromatasa, permitió orientar la diferenciación sexual hacia el desarrollo testicular.

Antecedentes: a enzima aromatase citocromo P450 (aromP450) é uma enzima chave na conversão de andrógenos em estrógenos, um passo fundamental no controle da diferenciação sexual em peixes. Objetivo: avaliar a eficiência de dois inibidores da aromatase (AIs), como um método alternativo para a masculinização da tilápia vermelha (Oreochromis spp.). Métodos: avaliaram-se os inibidores da aromatase, letrozol (LT) e exemestano (EM), em duas doses experimentais de 25 e 100 mg/Kg. Larvas 5 dias pós-eclosão (dpe) foram alimentadas durante 30 dias (35 dpe) com os tratamentos. Como testemunho, controle positivo, se implementaram 17α metil testosterona (MT) a uma concentração de 60 mg/Kg e como controle negativo alimento com etanol 300 ml/Kg. No dia 60 dpe extraíram-se as gônadas dos peixes para processamento histológico e coloração com hematoxilina-eosina para sua analise. Resultados: não houve diferenças significativas (p>0,05) entre os tratamentos e os controles para a variável sobrevivência larvária. A percentagem de machos foi aumentada com a utilização de LT, EM e MT (controle positivo), com diferenças significativas (p<0,05) comparados com o controle negativo. A análise da dose mostrou diferenças significativas (p<0,05) entre a dose de 100 mg/Kg e o controle positivo com a dose de 25 mg/Kg e o controle negativo; também apresentaram diferenças entre a dose de 25 mg/kg e o controle negativo. Conclusões: nossos resultados sugerem que o fornecimento oral de IAs de terça geração, tipo I ou II, são eficientes para aumentar a proporção de machos nos grupos tratados, sem diferenças entre o tipo de inibidor, porem com efeito direto da dose sobre a proporção de machos. A supressão da atividade da aromatase permitiu orientar a diferenciação sexual até um desenvolvimento testicular final.

Evaluación del manejo de diabetes mellitus y la evolución clínica materno fetal en pacientes con diabetes mellitus ingresadas en el hospital Bertha Calderon Roque en el periodo comprendido del 1 de enero 2004-31 de diciembre del 2004 / Evaluation of management of diabetes mellitus and maternal fetal clinical course in patients with diabetes mellitus admitted to the hospital Bertha Calderon Roque in the period from January 1, 2004 - December 31

Se realizó un estudio de corte transversal, donde se realizó el seguimiento de pacientes embarazadas con diagnóstico de diabetes, que se ingresaron a las salas del Hospital Berta Calderón Roque durante el Perído de 01 de enero del 2004- 31 de diciembre del 2007. El universo estuvo constituido por todas las pacientes embarazadas con diagnóstico de diabetes a las cuales se les brindó atención en las salas de esta unidad hospitalaria con un total de 163 pacientes. La muestra fue selecionada de forma probabilistica en las pacientes que cumplieron como requisito tener completo todos los datos en el expediente clínico con un total de 147 pacientes...