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Introducción: La obsesión por la delgadez y la insatisfacción corporal pueden llevar a las adolescentes a seguir dietas sin supervisión, lo que podría asociarse además a conductas riesgosas de control de peso, tales como ayuno, vómitos, uso de diuréticos y laxantes. El objetivo fue explorar conductas de control de peso en adolescentes dietantes y relacionarlas con insatisfacción corporal (IC) y obsesión por la delgadez (DT). Pacientes y Método: Estudio transversal en 439 adolescentes de colegios públicos de Valparaíso diseñado para indagar conductas de control de peso riesgosas a través de escalas de IC y DT del Cuestionario de Trastornos Alimentarios (EDI-2), comparando dietantes y no dietantes. Resultados: El 43% había realizado dieta sin supervisión médica. Las dietantes presentan valores superiores en DT e IC. El 29,6% de ellas presenta restricción alimentaria de riesgo moderado a alto, tomando como base el criterio de expertos, y se encuentran diferencias en la presencia y severidad de las conductas purgativas de control de peso entre los dos grupos estudiados. Conclusiones: Un tercio de las adolescentes estudiadas hacen dietas sin supervisión profesional, presentan mayor IC y DT y conductas riesgosas de control de peso. Aquellas con sobrepeso y obesidad realizan dietas más restrictivas y conductas de control de peso más riesgosas.

Introduction: Obsession with thinness and body dissatisfaction can lead adolescents to follow unsupervised diets, which could result in risky weight control behaviors such as fasting, vomiting, use of diuretics and laxatives. The aim of the current study is to examine weight control behaviors in dieting adolescents and relate them to body dissatisfaction (BD) and obsession with thinness (OT). Methods: A cross-sectional study was conducted on 439 adolescents from Valparaiso public schools to investigate risky weight control behaviors due to BD and OT scales from the Eating Disorders Inventory-2 (EDI-2), comparing restrained eaters and non-restrained eaters. Results: A total of 43% adolescents had followed a weight loss diet without medical supervision. The dieters had higher BD and OT values. Moderate to severe food restriction, based on expert judgment, was observed in 29.6%, and differences in the presence and severity of purging behaviors were found between the 2 groups. Conclusions: One third of the adolescents studied followed diets without professional supervision and had higher BD and OT values, as well as risky weight control behaviors. Overweight and obese adolescents followed more restrictive diets and developed riskier weight control behaviors.

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Trophic interactions between Mytilus chilensis and the toxic dinoflagellate Alexandrium catenella were studied over a 21-day period to determine the absorption kinetics of biochemical components and the enzymatic activity of the digestive gland (i.e. amylase, cellulase complex, laminarinase and protease). For the duration of the experiment, logarithmic relationships were established for the assimilatory balance and carbohydrase activities (amylase, laminarinase and cellulase) of the mussels fed with a toxic diet. The study shows that M. chilensis was able to develop mechanisms which allow exploitation of the toxic microalgae as a food source, despite that its feeding and digestive processes were affected during the first days of contamination.

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AIM: The purpose of the present study was to know the incidence and risk factors associated with amikacin nephrotoxicity in a cohort of patients form a general medial center. STUDY DESIGN: Prospective follow-up of a cohort of 104 patients treated with intravenous amikacin for at least 36 hours. We assessed serum creatinine every other day and amikacin plasma levels at 48 and 96 hours after treatment was begun. Patients with other risk factors to develop acute renal failure were excluded. The study was conducted at the Hospital de Especialidades, Centro Médico de Occidente, Instituto Mexicano del Seguro Social. RESULTS: Ten patients developed nephrotoxicity (9.6%). According to the logistic regression model, the most powerful predictor of high nephrotoxicity probability was the serum albumin concentration. The lower the serum albumin concentration, the higher the risk of toxicity. The mean serum albumin in the group of patients with nephrotoxicity was 2.6 +/- 0.55 g/dL, while in the group of patients without toxicity it was 3.5 +/- 0.55 g/dL. No differences were observed in the age, sex, diagnosis, renal function and amikacin doses between both groups. Furthermore, low serum albumin concentration was also associated with amikacin accumulation in plasma. The group of patients with hypoalbuminemia (< or = 3.0 g/dL) had a significantly higher trough amikacin plasma level (assessed at 48 and 96 hours of the initiation of treatment) than those with normal serum albumin, with no differences among the age, sex, baseline renal function and received amikacin doses. CONCLUSIONS: We conclude that serum albumin concentration is the most powerful predictor of amikacin nephrotoxicity. The risk factors observed in the present study are similar to those previously observed by us at the Instituto Nacional de la Nutrición Salvador Zubirán.

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PIP: The effects of 2 basic socioeconomic processes of the 1980s on urban dynamics in the Dominican Republic are described. The 2 processes were the restructuring of the national productive apparatus following anew model of accumulation that stressed external markets, and the urban political economy of the years 1986-90, in which priority was given to public investment in construction as an activity favoring economic growth and employment. The interest in urban remodeling and transit renovation implied neglect of other basic sectors including education, agriculture, energy,and health. A series of fiscal measures was necessary to finance the investment program, and the inflation resulting from the investment program had significant effects on real income of the population. The new economic model encountered its competitive edge in wage depression and constant devaluations. The process of inflation-devaluation reinforced the regressive effects of the model on income, resulting in price increases for urban land and exclusion of the majority of the population from the urban housing market. The new economic model has led to dismantling of the national productive apparatus and consolidation of so-called "productive extroversion," with free economic zones and tourism the focus of accumulation related to the international market. The informal sector has grown because of inflation and because of the crisis in industrial activities destined for the internal market. Agricultural production for internal consumption declined over the decade, encouraging rural-urban migration and further swelling of the informal sector. Growth of Santo Domingo's suburbs and surrounding rural areas is 1 of the main effects of the model. By the year 2000, it is estimated that metropolitan Santo Domingo will contain 45% of the total population of the Dominican Republic. Although no exact functional correspondence can be established between urban policy and the model of accumulation, there are 3 aspects in which the dynamics of the 2 processes complement each other synergistically and perniciously: income concentration, social exclusion, and spatial segregation. Income concentration is increased by inflation and the repeated devaluations, the dismantling of small and medium-sized enterprises, and declining social expenditures. Social exclusion and spatial segregation are furthered by rising urban land prices and exclusion of most of the population from the urban land and housing market and demographic consolidation of periurban centers and rural sectors of the National District.^ieng

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Hypoalbuminemia has been recently informed by us as a risk factor in aminoglycoside nephrotoxicity. Since amikacin has a low serum binding capacity to albumin, the present study was designed to determine if the higher risk of amikacin nephrotoxicity in patients with hypoalbuminemia was due to low serum albumin per se or to malnutrition. One-hundred and thirteen ward patients who received endovenous amikacin for greater than 36 hours were studied prospectively. All were evaluated for the following factors: age, sex, diagnosis, serum creatinine, serum albumin, and nutritional status. They were followed with serum creatinine twice a week until cessation of therapy. Amikacin pharmacokinetics was studied in 11 subjects: 6 patients had a serum albumin less than 3.0 g/dL and 5 greater than 3.0 g/dL, but there were no differences in age, sex, weight, diagnosis, arterial pressure and nutritional status. The overall incidence of toxicity was 11%. In patients with serum albumin less than 3.0 g/dL it was 17.3% and in those greater than 3.0 g/dL it was 2.2%, p less than 0.05. There was no difference in the nutritional status between toxicity and non-toxicity groups. In the pharmacokinetic study, the peak levels obtained one hour after amikacin administration were higher in patients with serum albumin less than 3.0 g/dL than in those with normal serum albumin (12.7 +/- 1.6 vs 9.0 +/- 1.2, p less than 0.002). In conclusion hypoalbuminemia is a risk factor in aminoglycoside nephrotoxicity regardless of the nutritional status.

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