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Women with a history of preeclampsia (PE) have a greater risk of pulmonary arterial hypertension (PAH). In turn, pregnancy at high altitude is a risk factor for PE. However, whether women who develop PE during highland pregnancy are at risk of PAH before and after birth has not been investigated. We tested the hypothesis that during highland pregnancy, women who develop PE are at greater risk of PAH compared to women undergoing healthy highland pregnancies. The study was on 140 women in La Paz, Bolivia (3640m). Women undergoing healthy highland pregnancy were controls (C, n = 70; 29 ± 3.3 years old, mean±SD). Women diagnosed with PE were the experimental group (PE, n = 70, 31 ± 2 years old). Conventional (B- and M-mode, PW Doppler) and modern (pulsed wave tissue Doppler imaging) ultrasound were applied for cardiovascular íííassessment. Spirometry determined maternal lung function. Assessments occurred at 35 ± 4 weeks of pregnancy and 6 ± 0.3 weeks after birth. Relative to highland controls, highland PE women had enlarged right ventricular (RV) and right atrial chamber sizes, greater pulmonary artery dimensions and increased estimated RV contractility, pulmonary artery pressure and pulmonary vascular resistance. Highland PE women had lower values for peripheral oxygen saturation, forced expiratory flow and the bronchial permeability index. Differences remained 6 weeks after birth. Therefore, women who develop PE at high altitude are at greater risk of PAH before and long after birth. Hence, women with a history of PE at high altitude have an increased cardiovascular risk that transcends the systemic circulation to include the pulmonary vascular bed.

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Li-Fraumeni syndrome is an inherited, autosomal dominant disease. It is categorized as a rare disease caused by mutations of the TP53 gene, which causes increased susceptibility of the patients and their children to many types of cancer. Choroid plexus tumor is rare, which occurs in 0.3 cases per 1,000,000 people, of which 40% turn out to be carcinomas. We present a 12-year-old boy with a history of worsening headaches of more than one month, gait disturbance, projectile vomiting, and right hemiparesis. An intraventricular tumor was identified in the occipital of the left lateral ventricle, which turned out to be a TP53-mutant choroidal plexus carcinoma.

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OBJETIVO: describir los hábitos alimenticios y estilo de vida de los comerciantes del mercado Campesino. MÉTODOS: se realizó un estudio descriptivo, transversal con 170 personas comprendidas entre 14 a 80 años. Para la recolección de datos se aplicó una encuesta. RESULTADOS: la mayor parte de la población encuestada es del sexo femenino, comparando el número de veces durante la semana del consumo de comida chatarra entre hombres y mujeres se encontró que con más frecuencia las mujeres consumen de 1 a 3 veces por semana la comida chatarra. Hay más jóvenes de entre 14 y 21 años que realizan actividad deportiva que el resto de las edades, hay más sujetos en la población de entre 38 a 45 años que consumen sustancias como alcohol, nicotina y tabaco.

OBJECTIVE: describe the eating habits and lifestyle of the farmers of the peasant market. METHODS: a descriptive, cross - sectional study was carried out with 170 people between 14 and 80 years old. For data collection, a survey was applied. RESULTS: most of the surveyed population is female, comparing the number of times during the week of junk food consumption between men and women, it was found that women consume junk food more frequently 1 to 3 times a week. There are more young people between 14 and 21 years of age who perform sports activity than the rest of the ages, there are more subjects in the population between 38 and 45 years of age who consume substances such as alcohol, nicotine and tobacco.

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As cartilagens alares da falange distal, também chamadas de cartilagens laterais da falange distal,exercem funções de apoio e auxílio no retorno sanguíneo das regiões distais. Essas cartilagens podem calcificar devido vários fatores fisiológicos ou ambientais. A calcificação não causa nenhum problema ao animal, mas a fratura dessa cartilagem calcificada pode causar claudicação. O objetivo desse trabalho é mostrar alguns fatores que influenciam essa condição e um relato de caso de uma égua que apresentou fratura da cartilagem alar da falange distal.

The alar cartilages of the distal phalanx, also called lateral cartilages of the distat phalanx, perform support functions and assistant in blood return from distal regions. These cartilages can be ossified by many physiological or environmental factors. The ossification may cause no problem for the animal, but the fracture ofthe ossified cartilage may cause lameness. the objective of this work is to show some tactors the influence thiscondition and a case report of amare that presented fracture of ossified alar cartilage of distal phalanx.

Los cartílagos alares de Ia falange distal, también lIamados cartílagos laterales de Ia falange distal,tienen funciones de apoyo y asistencia en el retorno de Ia sangre de Ias regiones distales. Estos cartílagos secalcifican debido a diversos factores fisiológicos o ambientales. La calcificación hay dano aios animales, peroIas fracturas que calcifica dos cartílago puede causar cojera. EI objetivo de este trabajo es mostrar algunos de losfactores que influyen en esta condición y un reporte de caso de una yegua que presentó Ia fractura dei cartílagoalar de Ia falange distal.

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As cartilagens alares da falange distal, também chamadas de cartilagens laterais da falange distal,exercem funções de apoio e auxílio no retorno sanguíneo das regiões distais. Essas cartilagens podem calcificar devido vários fatores fisiológicos ou ambientais. A calcificação não causa nenhum problema ao animal, mas a fratura dessa cartilagem calcificada pode causar claudicação. O objetivo desse trabalho é mostrar alguns fatores que influenciam essa condição e um relato de caso de uma égua que apresentou fratura da cartilagem alar da falange distal.(AU)

The alar cartilages of the distal phalanx, also called lateral cartilages of the distat phalanx, perform support functions and assistant in blood return from distal regions. These cartilages can be ossified by many physiological or environmental factors. The ossification may cause no problem for the animal, but the fracture ofthe ossified cartilage may cause lameness. the objective of this work is to show some tactors the influence thiscondition and a case report of amare that presented fracture of ossified alar cartilage of distal phalanx.(AU)

Los cartílagos alares de Ia falange distal, también lIamados cartílagos laterales de Ia falange distal,tienen funciones de apoyo y asistencia en el retorno de Ia sangre de Ias regiones distales. Estos cartílagos secalcifican debido a diversos factores fisiológicos o ambientales. La calcificación hay dano aios animales, peroIas fracturas que calcifica dos cartílago puede causar cojera. EI objetivo de este trabajo es mostrar algunos de losfactores que influyen en esta condición y un reporte de caso de una yegua que presentó Ia fractura dei cartílagoalar de Ia falange distal.(AU)

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BACKGROUND: Care plans provide guidelines to offer all patients the same quality assistance. Care plans constitute a base where every stage of the nursing process can be recorded, which will save time when handling documentation. Bolivian nurses are very keen to participate in this global trend in order to grasp the opportunity offered by the international cooperation programmes carried out between Spain and South America. AIMS: To identify obstacles and enablers encountered when implementing the nursing process and to set clear strategies and actions so as to develop the nursing process and care plans in Santa Cruz department (Bolivia) both in hospitals and universities. METHODS: The participatory action research was conducted between the Autonomous University of Gabriel René Moreno (Bolivia) and the University of Almería (Spain). The procedure for data collection included meetings with key informants, interviews, observation and workshops. Data were analysed using the constant comparison and categorized by common themes. RESULTS: Lack of time and instruments, shortage of resources and the need for continuous training came up as obstacles, whereas enablers were the nurses' involvement, the university-hospital coordination and the support given by institutions. Actions taken were the creation of a care plan unit, the implementation of a training programme, design of instruments and meetings held with authorities and institutional representatives. CONCLUSIONS: Conducting action research schemes within international cooperation programmes signifies an excellent opportunity for the nursing system in less-developed countries to be included in international plans with the aim of standardizing the nursing practice.

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Este trabajo de investigación fue desarrollado durante noviembre y diciembre de 2004 y entre enero y marzo de 2005, en las comunidades de Muñani (Región natural Suni) y Suatía (Región natural Puna) de la provincia de Lampa, Región Puno. El objetivo fue determinar las especies vegetales y el uso alimenticio, medicinal y biocida en ambas comunidades. Para determinar la riqueza se aplicaron cuadrantes de 1 m2 al azar y para determinar su uso, se realizó entrevistas a los pobladores de mayor de edad. Comparando la riqueza vegetal en ambas comunidades, el índice de diversidad de Shannon - Weaner expresó 2.2963 para la comunidad de Suatía y 2.4964 para Muñani. Aplicando la prueba de significancia, se encontró diferencia significativa entre ambas comunidades (P < 0.05). Se recopiló información sobre el uso de la flora etnobotánica, encontrándose 15 especies alimenticias, 56 medicinales y 6 biocidas para la comunidad de Suatía; en Muñani son 4 especies alimenticias y 25 medicinales.

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OBJECTIVE: To describe the use of mechanical anastomoses in cases of laparoscopically assisted vaginal rectosigmoidectomy for the treatment of rectosigmoid endometriosis. METHODS: Pilot study evaluating eight patients with rectosigmoid endometriosis referred for surgical treatment. All patients were submitted to laparoscopically assisted vaginal segmental resection of the rectosigmoid with anastomoses performed using linear and circular staplers. RESULTS: The average length of the surgical procedure was 177.5 min and average duration of hospitalization was 4.13 days. There were no intra-operative complications and integrity of the anastomoses was confirmed in all patients. One patient reported partial improvement of symptoms and 7 patients presented complete clinical remission 12 months following surgery. CONCLUSION: Laparoscopically assisted vaginal segmental resection of the sigmoid infiltrated by endometriosis is a feasible surgical procedure. The technique combines transvaginal access with mechanical intestinal anastomoses performed using linear and circular staplers, and achieves good results with low morbidity.

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OBJECTIVES: To identify and describe the work related injuries in both the formal and informal work sectors captured in an emergency department based injury surveillance system in Managua, Nicaragua. SETTING: Urban emergency department in Managua, Nicaragua serving 200-300 patients per day. METHODS: Secondary analysis from the surveillance system data. All cases indicating an injury while working and seen for treatment at the emergency department between 1 August 2001 and 31 July 2002 were included. There was no exclusion based on place of occurrence (home, work, school), age, or gender. RESULTS: There were 3801 work related injuries identified which accounted for 18.6% of the total 20 425 injures captured by the surveillance system. Twenty seven work related fatalities were recorded, compared with the 1998 International Labor Organization statistic of 25 occupational fatalities for all of Nicaragua. Injuries occurring outside of a formal work location accounted for more than 60% of the work related injuries. Almost half of these occurred at home, while 19% occurred on the street. The leading mechanisms for work related injuries were falls (30%), blunt objects (28%), and stabs/cuts (23%). Falls were by far the most severe mechanism in the study, causing 37% of the work related deaths and more than half of the fractures. CONCLUSIONS: Occupational injuries are grossly underreported in Nicaragua. This study demonstrated that an emergency department can be a data source for work related injuries in developing countries because it captures both the formal and informal workforce injuries. Fall prevention initiatives could significantly reduce the magnitude and severity of occupational injuries in Managua, Nicaragua.

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Las modificaciones de los estilos de vida conforman un recurso importante en el tratamiento de la hipertensión arterial. Es una estrategia de prevención secundaria válida para evitar las complicaciones de este problema de salud. Diveros estudios han demostrado la eficacia de los cambios en aspectos como: peso corporal, ingesta de sodio, potasio, calcio, maggnecio, grasas polisaturadas, ejercicio, alcohol, tabaco y estrés. Estas recomendaciones deben ir acompañadas de un adecuado tratamiento farmacológico y de un oportuno abordaje social y familiar. En la presente revisión, se propone algunas pautas para la aplicación práctica de las modificaciones del estilo de vida en el tratamiento de la hipertensión arterial.

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Recogimos los datos clínicos de evaluación y tratamiento 134 pacientes con heridas penetrantes localizadas en la región toracoabdominal operados en el Servicio de Emergencia del Hospital Luis Vernaza de 1998 al 2000. Predominaron los varones en 94,02 por ciento; un 40 por ciento por arma cortopunzante y 60 por ciento por arma de fuego. La lesión más frecuente fue herida de hígado.

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Explica que en la parte productiva del conurbano y del interior bonaerense el agua para riego presenta problemas generalizados de alcalinidad. Este fenómeno se produce por el enriquecimiento de iones no absorbidos por las raíces, por el uso de fertilizantes de reacción ácida o básica, y/o por la corrección de los valores de pH del medio a través de distintas enmiendas. El problema de aguas para riego con altos niveles de alcalinidad es de fácil corrección con la inyección de ácidos, los que manejándolos con cuidado dan excelentes resultados

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Explica que en la parte productiva del conurbano y del interior bonaerense el agua para riego presenta problemas generalizados de alcalinidad. Este fenómeno se produce por el enriquecimiento de iones no absorbidos por las raíces, por el uso de fertilizantes de reacción ácida o básica, y/o por la corrección de los valores de pH del medio a través de distintas enmiendas. El problema de aguas para riego con altos niveles de alcalinidad es de fácil corrección con la inyección de ácidos, los que manejándolos con cuidado dan excelentes resultados

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Rhodnius prolixus fed with azadirachtin A showed significant changes in the ultrastructural organization of the epithelial cells of the stomach and the intestine. Changes included (a) clustering of the microvilli, (b) disorganization of the extracellular membrane layers, (c) modifications in the array of spherocytes, and (d) disorganization of the basal portion of the epithelial cells. We suggest that these changes interfere significantly with the intestinal environment, making it unsuitable for survival and multiplication of the protozoan Trypanosoma cruzi.

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