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Polycyclic aromatic hydrocarbons (PAHs) are organic compounds generated mainly by anthropogenic sources. They are considered toxic to mammals, since they have carcinogenic, mutagenic and genotoxic properties, among others. Although mycoremediation is an efficient, economical and eco-friendly technique for degrading PAHs, the fungal degradation potential of the phylum Ascomycota has not been widely studied. In this work, we evaluated different fungal strains from the polluted soil of 'La Escondida' lagoon in Reynosa, Mexico to know their potential to degrade phenanthrene (PHE). Forty-three soil isolates with the capacity to grow in the presence of PHE (0·1% w/v) were obtained. The fungi Aspergillus oryzae MF13 and Aspergillus flavipes QCS12 had the best potential to degrade PHE. Both fungi germinated and grew at PHE concentrations of up to 5000 mg l-1 and degraded 235 mg l-1 of PHE in 28 days, with and without an additional carbon source. These characteristics indicate that A. oryzae MF13 and A. flavipes QCS12 could be promising organisms for the remediation of sites contaminated with PAHs and detoxification of recalcitrant xenobiotics.

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INTRODUCTION AND AIMS: Laparoscopic sleeve gastrectomy (LSG) is the most widely performed bariatric surgery worldwide but complications and failed procedures are on the rise. AIMS: To determine the reasons for failed LSGs and report the results of conversion to gastric bypass surgery, comparing the outcomes with those of primary gastric bypass surgery. MATERIALS AND METHODS: Patients with failed LSG that underwent conversion to gastric bypass surgery through a robotic-assisted and laparoscopic (hybrid) technique were evaluated. Outcomes and follow-up related to weight loss failure (WLF) were compared with those in patients that underwent primary laparoscopic gastric bypass (pLGB) surgery. RESULTS: Revisional surgery was performed on 13 patients due to WLF, on 3 patients because of refractory gastroesophageal reflux disease (GERD), and on 2 patients due to gastric stricture. There were no differences between the preoperative characteristics of the patients with WLF before undergoing conversion to gastric bypass and the patients that underwent pLGB surgery. At postoperative month 36, the percentage of excess weight loss was greater in the patients that underwent pLGB surgery, than in those with WLF that underwent conversion to gastric bypass (69.17±23.73 vs. 54.17±12.48, respectively; P<0.05). Refractory GERD, symptoms due to gastric stricture, and comorbidities all improved after the revisional surgery. CONCLUSION: Revisional surgery resulted in acceptable weight loss at 36 months of follow-up and favored comorbidity remission. In addition, it resolved symptoms of refractory GERD and gastric stricture.

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INTRODUCTION: Bilioenteric fistulas are the abnormal communication between the bile duct system and the gastrointestinal tract that occurs spontaneously and is a rare complication of an untreated gallstone in the majority of cases. These fistulas can cause diverse clinical consequences and in some cases be life-threatening to the patient. AIM: To identify the incidence of bilioenteric fistula in patients with gallstones, its clinical presentation, diagnosis through imaging study, surgical management, postoperative complications, and follow-up. MATERIALS AND METHODS: A retrospective study was conducted to search for bilioenteric fistula in patients that underwent cholecystectomy at our hospital center due to cholelithiasis, cholecystitis, or cholangitis, within a 3-year time frame. RESULTS: Four patients, 2 men and 2 women, were identified with cholecystoduodenal fistula. Their mean age was 81.5 years. Two of the patients presented with acute cholangitis and 2 presented with bowel obstruction due to gallstone ileus. All the patients underwent surgical treatment and the diagnostic and therapeutic management of each of them was analyzed. CONCLUSIONS: The incidence of cholecystoduodenal fistula was similar to that reported in the medical literature. It is a rare complication of gallstones and its diagnosis is difficult due to its nonspecific symptomatology. It should be contemplated in elderly patients that have a contracted gallbladder with numerous adhesions.

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By using the principles behind phononic crystals, a periodic array of circular holes made along the polarization thickness direction of piezoceramic resonators are used to stop the planar resonances around the thickness mode band. In this way, a piezoceramic resonator adequate for operation in the thickness mode with an in phase vibration surface is obtained, independently of its lateral shape. Laser vibrometry, electric impedance tests and finite element models are used to corroborate the performances of different resonators made with this procedure. This method can be useful in power ultrasonic devices, physiotherapy and other external medical power ultrasound applications where piston-like vibration in a narrow band is required.

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SETTINGS: Amazonas is facing increasing challenges in tuberculosis (TB) control, with nearly 3000 cases per year, and multidrug-resistant TB (MDR-TB) may jeopardise the TB control programme. OBJECTIVE: To assess the number of MDR-TB cases in the Amazonas and to improve estimates of the burden of TB. DESIGNS: The Brazilian National Mandatory Disease Reporting System (SINAN) and the Brazilian Epidemiological Surveillance System of Multidrug Resistance (TBMR) were searched for MDR-TB cases in the State of Amazonas from 2000 to 2011. RESULTS: Eighty-one MDR-TB cases were notified. The rates of primary MDR-TB, initial MDR-TB during the first treatment regimen and acquired MDR-TB were respectively 3.8%, 13.7% and 82.7%; 26.9% of previously treated patients had ⩾ 4 treatment cycles. The MDR-TB cases reported 263 contacts, only 35.0% of whom were examined. The cure and death rates among the 81 patients with MDR-TB were respectively 45.7% and 25.9%. CONCLUSIONS: The number of MDR-TB cases seems incompatible with the high TB prevalence in the Amazonas. Most patients were unaware of contact with TB patients. TB is endemic in the Amazonas. This highlights the need for improving resistance investigation among all TB cases.

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The emergence of Klebsiella pneumoniae producing carbapenemase (KPC) has now become a global concern. As a part of a nationwide multicentre surveillance study in Cuba, three K. pneumoniae clinical isolates resistant to carbapenems were detected for a 1-month period (September to October 2011). PCR and sequence analysis revealed that the three strains harboured bla KPC-2. They showed resistance or intermediate susceptibility to expanded-spectrum cephalosporins, other ß-lactams, a ß-lactam/ß-lactamase inhibitor combination, and gentamicin. Two strains were susceptible only to colistin, whereas the other strain showing colistin resistance was susceptible to fluoroquinolones. These bla KPC -2-positive K. pneumoniae strains were classified into ST1271 (CC29), a novel clone harbouring bla KPC -2, and were revealed to be genetically identical by PCR-based DNA fingerprinting. The three patients infected with the KPC-producing K. pneumoniae had common risk factors, and had no overseas travel experience outside Cuba, suggesting local acquisition of the resistant pathogen. This is the first report of a KPC-producing K. pneumoniae in Cuba. Although detection of KPC in Enterobacteriaceae is still rare in Cuba, our finding indicated that KPC-producing bacteria are a global concern and highlighted the need to identify these microorganisms in clinical laboratories.

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BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is the main indicator of previous treatment in tuberculosis (TB) patients. MDR-TB among treatment-naïve patients indicates infection with drug-resistant Mycobacterium tuberculosis strains, and such cases are considered primary drug-resistant cases. OBJECTIVE: To estimate the prevalence of drug resistance in pulmonary TB (PTB) treatment-naïve patients and to identify the socio-demographic and clinical characteristics of the resistant population. METHODS: A total of 205 treatment-naïve PTB patients from Manaus, Amazonas State, Brazil, were enrolled. Drug susceptibility testing (DST) was performed on all positive mycobacterial cultures using the 1% proportion method. RESULTS: Positive M. tuberculosis cultures were obtained from only 175 patients for DST. The prevalence of primary MDR-TB was 1.7% (3/175); 14.3% (25/175) of the cultures presented resistance to at least one of the drugs. Resistance to streptomycin, isoniazid, rifampicin and ethambutol was respectively 8.6%, 6.9%, 3.4% and 2.3%. An association between TB patients with resistance to more than one drug and known previous household contact with a TB patient was observed (P= 0.008, OR 6.7, 95%CI 1.2-67.3). CONCLUSIONS: Although the prevalence of primary MDR-TB currently is relatively low, it may become a major public health problem if tailored treatment is not provided, as resistance to more than one drug is significantly associated with household contact.

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Based on its ideal PK/PD ratios, doxycycline hyclate (DOX-h), a time-dependant antibacterial, is ideally expected to achieve sustained plasma drug concentrations at or slightly above the MIC level for as long as possible between dosing intervals. Pursuing this end, a poloxamer-based matrix was used to produce a 10% long-acting injectable preparation (DOX-h-LA) and its serum concentrations vs. time profile investigated after its injection to pigs in the pericaudal s.c. by parallel design. Results were compared with the forced oral bolus dose and i.v. pharmacokinetics of DOX-h. For this study, 12 recently weaned pigs per group were included in this trial, and a dose of 20 mg/kg was injected in all cases. DOX-h-LA showed the greatest values for bioavailability (115.38%); maximum serum concentration (Cmax) value was 1.5 ± 0.2 with a time to reach Cmax of 3.41 ± 0.04 h and an elimination rate constant of 70.93 ± 0.87( ) h. Considering minimum effective serum concentration of 0.5 µg/mL, a dose interval of at least 5 days can be achieved for DOX-h-LA, whereas p.o. and i.v. dosing of DOX-h may only last 11 and 15 h, respectively. Pigs were slaughtered on day 30 after this trial, and no visible remnants of the preparation were detected neither fibrosis was observed after a thorough macroscopic and histopathological analysis.

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INTRODUCTION: According to the Rome III Criteria, functional dyspepsia (FD) is classified as postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). On the other hand, the satiety test (ST) has been used to evaluate gastric accommodation and emptying, distinguishing healthy individuals from those with dyspepsia. AIMS: To determine whether the ST can distinguish dyspeptic individuals from healthy ones and to evaluate its usefulness in differentiating the two FD subtypes. METHODS: Adults with FD were consecutively enrolled in a cross-sectional study within the time frame of August 2011 and October 2012. Healthy subjects participated as controls. The ST consisted of the intake of a nutritional supplement (Fortisip®, Nutricia Bagó®) at a constant speed; satiety was graded at 5-minute intervals (1 to 5 points). Intake was suspended when the maximum score was reported. The total ingested volume and caloric intake was recorded and the Mann-Whitney U test was used in the statistical analysis. RESULTS: The study included 39 dyspeptic patients and 20 control individuals. The patients were predominantly women (84.6 vs. 25%; p < 0.0001) and they were similar in age (39.59 ± 13.53 vs. 34.70 ± 9.85 years) and BMI (24.32 ± 3.52 vs. 25.82 ± 3.34 kg/m2) with respect to the controls. The FD subtype percentages were PDS: 61%, EPS: 31%, and Mixed syndrome: 8%. There was a lower ingested volume and caloric intake on the part of the dyspeptic patients (185 vs. 300 ml and 277 vs. 520 Kcal, respectively. Both: P<.001). No differences in the ST were observed between the two pure dyspepsia subtypes. CONCLUSIONS: There was a difference in the ST between healthy individuals and those with dyspepsia, but the ingested volume and caloric intake in the two FD subtypes were similar.

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Antecedentes: El plan AUGE recomienda para detectar cardiopatías congénitas (CC), la realización de ecografía obstétrica de pesquisa y ecocardiografía fetal confirmatoria. Estos elementos son indispensables para informar adecuadamente a las familias y organizar en forma óptima el cuidado perinatal, estableciendo continuidad con el manejo postnatal y mejorar la oportunidad de vida del recién nacido. Objetivo: Determinar el impacto del plan AUGE en la frecuencia de detección perinatal de cardiopatías congénitas, a través de un estudio comparativo de la incidencia de estas patologías detectadas en el periodo 2000-2002 (pre AUGE) y 2003-2005 (AUGE), registradas en la Unidad de Neonatología del Hospital San José, evaluando la resolución de los casos en el Hospital Roberto del Río. Método: Estudio de tipo observacional, descriptivo, retrospectivo, de corte longitudinal, con una muestra no probabilística, recogida por acumulación de fichas clínicas del Hospital San José en la detección antenatal, y los datos de resolución quirúrgica del Hospital Roberto del Río de 231 recién nacidos. Resultados: Se encontraron diferencias estadísticamente significativas (p<0,0001), en la distribución por tipo de CC detectadas ante y postnatalmente en el periodo AUGE y en la distribución por tipo de CC detectadas antenatalmente entre los periodos pre-AUGE y AUGE (p=0,0467). Conclusiones: La implementación del plan AUGE, produjo un mayor número de diagnósticos de CC, todo esto determinó una mayor sobrevida neonatal.

Background: The AUGE plan (spanish initials for Universal Access with Explicit Guarantees in Health), is the realization of a screening through obstetric ultrasonography to detect congenital hearth disease (CHD) and fetal echocardiography to confirm diagnosis. These elements are indispensable to be able to inform appropriately to the families and to organize in good form the prenatal care, establishing continuity with the postnatal handling and to improve the opportunity of life of the newly born. Objective: To determine the impact of the plan peak in the frequency of prenatal detection of CHD, through a comparative study of the incidence of these pathologies detected in the period 2000-2002 (pre AUGE) and 2003-2005 (AUGE), registered in the Neonatology Unit of the Hospital San José, evaluating the resolution of the clinical cases in the Hospital Roberto del Rio. Method: Descriptive study, non experimental, retrospective of longitudinal court, with a non probabilistic sample, picked up by accumulation of clinical records of the Hospital San José (prenatal detection) and the data of surgical resolution of the Hospital Roberto del Rio of 231 newborns. Results: There were significant statistically differences (p<0.0001) as for the incidence of the prenatal and postnatal detection of CHD in AUGE and in the prenatal detection of congenital hearth diseases, among the periods pre AUGE and AUGE (p=0.0467). Conclusions: Implementing the AUGE, produced a greater number of CHD diagnoses, all this produced a higher neonatal survival.

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Antecedentes: La vitamina A, principalmente en su forma de ácido todo trans-retinoico, desempeña una función de vital importancia durante el desarrollo gestacional en todos los tejidos y órganos del cuerpo. Objetivo: Determinar los niveles de ácido retinoico en el suero de sangre de cordón umbilical y relacionarlos con el peso/edad gestacional del recién nacido y el consumo materno de vitamina A, conjuntamente con variables socio-económicas y nutricionales. Método: Estudio descriptivo de corte transversal, analizando un total de 62 neonatos y sus madres, provenientes de las maternidades de los Hospitales San José y Barros Luco-Trudeau, Santiago de Chile. Resultados: En la población en estudio se observó una relación directa entre el peso/edad gestacional del neonato y el consumo materno de vitamina A, pero no con los niveles de esa vitamina en el suero de sangre de cordón umbilical. Se encontró que el consumo medio de vitamina A en las embarazadas fue sólo de 2298 +/- 1416,8 Ul, siendo la dosis recomendada por OMS de 8000 Ul. Conclusión: Existe asociación entre la ingesta de vitamina A y el estado nutricional materno en relación con el peso/edad gestacional del neonato. Debido a que los requerimientos nutricionales del feto están privilegiados por sobre los maternos, no se observaron diferencias en las características antropométricas del neonato asociadas a la ingesta materna de vitamina A.

Background: Vitamin A, mainly in their form of retinoic acid, it carries out a function of vital importance during the gestational development, in all the tissues and organs of the body. Objective: To evaluate the levels of retinoic acid in the serum of blood from umbilical cord and to relate them with the weight/gestational age ratio of the newborns and the maternal intake of vitamin A, jointly with socioeconomic and nutritional variables. Method: A descriptive study of traverse court, in the maternities of the Hospitals San José and Barros Luco-Trudeau of Santiago, Chile, studying a total of 62 cases. Results: In the population in study a direct relationship was observed between the newborn ratio weight/gestational age and the maternal consumption of vitamin A, but no relationship was found among the same weight/gestational age ratio and the levels of this vitamin in the serum of blood of umbilical cord. On the other hand, it was found that the average consumption of vitamin A in the maternities it was of 2298 +/- 1416.8 IU, being the dose recommended by WHO for pregnant of 8000 IU, therefore, the whole population in study had a faulty consumption of vitamin A. Conclusion: Exists association among the intake of vitamin A and the maternal nutritional state with the weight/gestational age ratio of the newborn and the concentration of trans-retinoic acid in the umbilical cord. Because the nutritional requirements of the fetus are privileged over the maternal ones, differences were not observed in the newborn anthropometries features associated to the maternal vitamin A intake.

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Objetivo: Determinar el grado de conocimiento de la fase del climaterio y su relación con el nivel de instrucción que tiene un grupo de mujeres de 40-64 años usuarias de atención primaria. Método: La muestra de tipo probabilística compuesta por 150 mujeres de 40 a 64 años, a quienes se aplicó una encuesta validada de preguntas de alternativas múltiples, puntuadas para su evaluación. Las variables estudiadas fueron divididas en tres grupos: a) aquellas que definen el perfil sociodemográfico de las mujeres; b) variables relacionadas con el grado de conocimientos de causas, síntomas, tratamientos, cuidados, cambios en la salud y calidad de vida de la etapa climatérica; c) fuentes de información del conocimiento. El análisis de estas variables se realizó a través de la determinación de medidas de tendencia central y la prueba de Kruskal-Wallis, con un p<0,05. Resultados: El perfil de las mujeres en este estudio fue: edad promedio 51,89 +/- 7,35 años, 52 por ciento casadas, 52 por ciento previsión FONASA-A (pobreza e indigencia) y 60 por ciento con educación media incompleta. Solo el 11 por ciento de la población encuestada refirió haber asistido a talleres del tema, y un 40 por ciento refirió haber recibido información de médicos y/o matronas. En relación al conocimiento general de la población sobre la etapa climatérica, un 72 por ciento tiene un nivel medio y un 2 por ciento nivel bajo de conocimiento, respectivamente. Conclusiones: No existe relación estadísticamente significativa entre el grado de conocimiento sobre la etapa climatérica y la edad de las mujeres en el estudio, así como tampoco por la adquisición de información de fuentes válidas, pero sí con el nivel educacional de las mismas.

Objective: To determine the grade of knowledge of the climateric phase and their relationship with the instruction level that has a group of 40-64 year-old women users of primary care. Method: The sample was probabilistics made up of 150 women of 40 to 64 years and were submitted to a validated survey of questions with multiple answers, punctuated for its evaluation. The variables included in this study were divided in three groups: a) those that define the social-demographic profile of the women; b) variables related with the grade of knowledge of causes, symptoms, treatments, cares, changes in the health and quality of life of the climateric stage; c) sources of information. The analysis of these variables was carried out through the determination of measures of central tendency, and the non parametric Kruskal-Wallis test with a significance level p<0.05. Results: The profile of the women studied was, 51.89 +/- 7.35 years, 52 percent married, 52 percent health forecast FONASA-A (poverty and indigence) and 60 percent with incomplete high school. Only the 11 percent of the interviewed population referred to have attended lectures of the topic, and 40 percent refers to have received doctors' information and/or midwife. In relation to the population's general knowledge on the climateric stage, 72 percent has a medium level of knowledge and 2 percent had low level. Conclusions: Did not exists relationship with significant statistics among the grade of knowledge on the climateric stage and age of the women in the study, as well as neither for the acquisition of information from valid sources but exists with the educational level of the women.

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Antecedentes: La osteoporosis es una enfermedad crónica no transmisible con factores de riesgo como sedentarismo, consumo de tabaco y alcohol, e ingesta de dieta no balaceada. Objetivos: Establecer la relación entre el estilo de vida saludable y la prevención de la osteoporosis en la mujer climatérica sin patología asociada. Métodos: Análisis descriptivo comparativo con diseño no experimental, transversal y correlacional, en muestra formada por 80 mujeres climatéricas en tratamiento de osteoporosis y 80 mujeres climatéricas sin diagnóstico de osteoporosis, con características sociodemográficas similares. Para recopilar la información se utilizó una encuesta semiestructurada validada en el estudio. Para el análisis estadístico se aplicaron las pruebas de Mann-Whitney y McNemar, según correspondiera. Resultados: Las mujeres con osteoporosis eran más sedentarias e ingerían menores cantidades de calcio que las mujeres sin el diagnóstico médico de la patología, de igual manera han utilizado en menor extensión terapia de reemplazo hormonal. En el grupo de mujeres con osteoporosis fue factor de riesgo para la enfermedad el consumo de tabaco pero no el de alcohol. Conclusiones: Tener un estilo de vida saludable durante el climaterio es una estrategia útil para prevenir la osteoporosis en el climaterio, puesto que en este estudio se detectaron como factores de riesgo en esta población: el estado nutricional enflaquecido, el no realizar actividad física y el ser sedentaria, tener antecedentes de consumo de tabaco y su consumo actual, el consumo insuficiente de calcio dietario y/o su uso terapéutico por periodos menores a un año.

Background: Osteoporosis is classified as a chronic illness non transferable with risk factors like: sedentary, consumption of tobacco and alcohol, and intake of a non balanced diet. Objective: The present studied it sought to establish the relationship between the healthy lifestyle and the prevention of the osteoporosis in the climacteric woman without associate pathology. Method: Comparative and descriptive analysis with non experimental traverse correlation design. The sample was conformed by 80 climacteric women in osteoporosis treatment and 80 climacteric women without medical diagnosis of osteoporosis, but with similar sociodemographic features. To gather the information a semistructurated survey it was used and validated in the study. The statistical analysis was based on the application of the Mann-Whitney and McNemar Test. Results: The osteoporotic women were more sedentary and they ingested smaller quantities of calcium that the women without medical diagnosis of the pathology, in a same way have used in smaller extension hormonal replacement therapy. In the osteoporotic group the consumption of tobacco was a risk factor for osteoporosis but not the alcohol. Conclusions: Having a healty lifestyle during climatery is an useful strategy for preventing osteoporosis in this population, cause were detect as osteoporosis risk factors in this study, the emaciated nutritional state, not carrying out physical activity and being sedentary, to have antecedents of consumption of tobacco and their current consumption, the insufficient consumption of dietary calcium and/or their therapeutic use for smaller periods to one year.

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ANTECEDENTES: El predominio de la diabetes gestacional está aumentando en nuestra población y sus efectos en el metabolismo celular y estatus oxidativo están siendo estudiados. OBJETIVO: Determinar si existe una relación entre la actividad de la glutatión reductasa eritrocitaria, evaluada a través del test CAGRE y la diabetes gestacional. MÉTODO: Estudio transversal de casos y controles, incluyó a 30 embarazadas con diagnóstico de diabetes gestacional y 30 sin patologías asociadas, pertenecientes a la Maternidad del Hospital Barros Luco-Trudeau, Santiago de Chile. La actividad de la glutatión reductasa de eritrocitos fue determinada espectrofotométricamente a través del test CAGRE, la que fue relacionada con variables maternas como: edad, hematocrito, presencia de antecedentes de enfermedades familiares, estado nutricional materno e índice de masa corporal. Para comparar las variables entre ambos grupos, se realizaron medidas de disparidad, posición y análisis de la correlación. RESULTADOS: El grupo de madres diabéticas presentó edad materna, índice de masa de corporal y antecedentes de diabetes gestacional mayores que el grupo control, aunque sin diferencia estadísticamente significativa. El predominio de anemia y la respuesta al suplemento del cofactor FAD en la actividad de la glutatión reductasa eritrocitaria fue similar entre los grupos. La mayor incidencia de diabetes familiar en el grupo control fue estadísticamente significativa. La distribución de los valores de CAGRE, utilizado también como un indicador de los niveles de riboflavina, mostró en el grupo de casos riesgo medio a alto de malnutrición, mientras que en el grupo control la tendencia fue normal o de riesgo bajo. CONCLUSIÓN: Las embarazadas diabéticas gestacionales, presentaron mal nutrición y un estrés oxidativo mayor que el grupo control, evidenciado por el test de CAGRE.

BACKGROUND: The prevalence of the gestational diabetes is increasing in our population and its effects in the cellular metabolism and oxidative status had been studied. OBJECTIVE: Determine if exists a relationship between the erythrocyte glutathione reductase activity evaluated by EGRAC test and the gestational diabetes. METHODS: This traversal study of cases and controls, included at 30 pregnant with diagnostic of gestational diabetes and 30 without associate pathologies, belonging to the Maternity of the Hospital Barros Luco-Trudeau, Santiago-Chile. The activity of the glutathione reductase was determined by spectrophotometric assay through the EGRAC test, and their values were related with maternal variables as: age, hematocrite, presence of antecedents of family illnesses, maternal nutritional status and the body mass index. To compare the variables between both groups, they were carried out measures of disparity, position and analysis of the correlation. RESULTS: We determine that the group of diabetic mothers was older, with higher body mass index and a bigger frequency of antecedents of gestational diabetes that the control group, although without significant difference. The prevalence of anemia and the answer to the supplement with FAD in the activity of the glutathione reductase was similar among the groups. On the other hand, the incidence of familiar diabetes in the group control was bigger. The distribution of the values of EGRAC, also used as an indicator of the riboflavin levels, showed in the group of cases half risk to high of malnutrition, while in the group control the tendency was normal or low risk. CONCLUSION: We can conclude that the gestational diabetics pregnant presented malnutrition and higher oxidative stress that the control group, evidenced by means of the EGRAC test.

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This study provides evidence for a novel mechanism of voltage-gated Ca(2+) channel regulation in mammalian spermatogenic cells by two agents that affect sperm capacitation and the acrosome reaction (AR). Patch-clamp experiments demonstrated that serum albumin induced an increase in Ca(2+) T current density in a concentration-dependent manner, and significant shifts in the voltage dependence of both steady-state activation and inactivation of the channels. These actions were not related to the ability of albumin to remove cholesterol from the membrane. In contrast, beta-estradiol significantly inhibited Ca(2+) channel activity in a concentration-dependent and essentially voltage-independent fashion. In mature sperm this dual regulation may influence capacitation and/or the AR.

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Malaria should be considered a risk factor in women who are pregnant, principally when the infection is Plasmodium falciparum. Moreover, the risk is greater if the woman is pregnant for the first time; if she has no immunity for malaria; if the diagnosis is made late; or if P. falciparum shows resistance to antimalarial drugs. This article presents the most significant aspects of P. falciparum malaria during pregnancy, including information about treatments and prophylaxis.

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Fertilization is a matter of life or death. In animals of sexual reproduction, the appropriate communication between mature and competent male and female gametes determines the generation of a new individual. Ion channels are key elements in the dialogue between sperm, its environment, and the egg. Components from the outer layer of the egg induce ion permeability changes in sperm that regulate sperm motility, chemotaxis, and the acrosome reaction. Sperm are tiny differentiated terminal cells unable to synthesize protein and difficult to study electrophysiologically. Thus understanding how sperm ion channels participate in fertilization requires combining planar bilayer techniques, in vivo measurements of membrane potential, intracellular Ca2+ and intracellular pH using fluorescent probes, patch-clamp recordings, and molecular cloning and heterologous expression. Spermatogenic cells are larger than sperm and synthesize the ion channels that will end up in mature sperm. Correlating the presence and cellular distribution of various ion channels with their functional status at different stages of spermatogenesis is contributing to understand their participation in differentiation and in sperm physiology. The multi-faceted approach being used to unravel sperm ion channel function and regulation is yielding valuable information about the finely orchestrated events that lead to sperm activation, induction of the acrosome reaction, and in the end to the miracle of life.

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This work describes the incidence of ventricular aneurysms in patients with angiographically normal epicardial coronary arteries, who have epidemiological, clinical and serologic features suggesting chronic Chagasic cardiomyopathy (C.C.C). Eight out of 22 patients (36%) with such features had ventricular aneurysm. Three were located on the apex, 3 anteroapical and 2 basal. All patients had arrhythmia. In a case it was necessary a surgical approach to control a medically intractable life threatening ventricular tachyarrhythmia. In regard of the incidence of ventricular aneurysms in C.C.C., our results are in agreement with published experiences in South America. Surgical treatment of chagasic aneurysm should be considered when medical treatment is unable to control dangerous arrhythmia and an electrophysiological study supports this approach.

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