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Resumen: Objetivo: Analizar la eficacia de un programa de intervención psicológica grupal en formato online diseñado para reducir la sobrecarga y el malestar emocional de los cuidadores informales de pacientes oncológicos en fase final de vida. Método: El programa se desarrolló para cuidadores principales de pacientes oncológicos en situación de enfermedad avanzada, con pronóstico de vida inferior a 6 meses. La intervención consistió en cuatro sesiones semanales. Los instrumentos de evaluación fueron la Escala de Detección de Malestar Emocional del Cuidador Principal y la Escala Zarit Reducida y se aplicaron al inicio y al final del programa. Además, se categorizaron las principales preocupaciones de los cuidadores a través de la Escala de Detección del Malestar del Cuidador Principal. Se utilizaron estadísticos descriptivos y t de Student. Resultados: En el estudio participaron 38 familiares de los cuales el 81,6% eran mujeres. En cuanto el grado de parentesco, el 44,7% eran descendientes del paciente. El malestar emocional se redujo significativamente después de la intervención. La incertidumbre se mantuvo como principal preocupación en ambos momentos de medida. Antes del programa, la segunda preocupación más frecuente fue el sufrimiento por el ser querido enfermo, mientras que después de la intervención fue la preocupación por el sufrimiento de otros miembros de la familia. Conclusiones: La realización de este programa de intervención psicológica grupal online demostró ser efectiva para reducir el malestar emocional en los cuidadores principales de pacientes oncológicos al final de la vida. La incertidumbre fue una preocupación constante a lo largo del programa en los familiares. (AU)

Abstract:Aim: analyze the effectiveness of an online delivered psychological intervention program for oncological palliative caregivers in order to reduce the distress and caregiver burden. Methods: The program was developed for primary caregivers of advanced cancer patients, with a life expectancy of less than 6 months. The intervention consisted of 4 weekly sessions. The assessment instruments were the Caregiver Emotional Distress Detection Scale and the Zarit’s Reduced Scale and were applied at the beginning and end of the program. In addition, the main worries of the caregivers were categorized by the Caregiver Emotional Distress Detection Scale. Descriptive statistics and Student’s t were used. Results: 38 caregivers enrolled in intervention, 81.6% of whom were women. Regarding the degree of kinship, 44.7% were descendants of the patient. The distress was significantly reduced after the intervention. Uncertainty remained the main worry at both moments of measurement. Before the program, the second most frequent worry was the suffering of the patient, while after the intervention it was worries about the suffering of other family members. Conclusions: Carrying out this online group psychological intervention program proved to be effective in reducing emotional distress in the main caregivers of cancer patients at the end of life. Uncertainty was a constant concern throughout the program in the relatives. (AU)

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Pituitary apoplexy (PA) is a rare clinical syndrome in which the pituitary gland undergoes infarction or hemorrhage, predominantly in the setting of an underlying tumor. We report on apoplexy of an expanding pituitary macroadenoma that was compressing the optic chiasm in a patient with progressively worsening neurologic deficits. Due to the patient's rapidly declining clinical status and family's goals of care, no neurosurgical intervention took place, and the patient expired a few days following discharge to hospice. This case highlights the importance of early suspicion for apoplexy in a patient with a history of pituitary adenoma and signs of neurologic deficit.

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Introducción: El tabaquismo puede tener un papel importante en la infección por SARS-CoV-2 y en el curso de la enfermedad. Los estudios previos muestran resultados contradictorios o no concluyentes sobre la prevalencia de fumar y la severidad en la enfermedad por coronavirus (COVID-19).Material y métodosEstudio de cohortes observacional, multicéntrico y retrospectivo de 14.260 pacientes que ingresaron por COVID-19 en hospitales españoles desde febrero hasta septiembre de 2020. Se registraron sus características clínicas y se clasificaron en el grupo con tabaquismo si tabaquismo activo o previo, o en el grupo sin tabaquismo si nunca habían fumado. Se realizó un seguimiento hasta un mes después del alta. Se analizaron las diferencias entre grupos. La relación entre tabaquismo y mortalidad intrahospitalaria se valoró mediante una regresión logística multivariante y curvas de Kapplan Meier.ResultadosLa mediana de edad fue 68,6 (55,8-79,1) años, con un 57,7% de varones. El grupo con tabaquismo presentó mayor edad (69,9 [59,6-78,0 años]), predominio masculino (80,3%) y mayor índice de Charlson (4 [2-6]). La evolución fue peor en estos pacientes, con una mayor tasa de ingreso en UCI (10,4 vs. 8,1%), mayor mortalidad intrahospitalaria (22,5 vs. 16,4%) y reingreso al mes (5,8 vs. 4,0%) que el grupo sin tabaquismo. Tras el análisis multivariante, el tabaquismo permanecía asociado a estos eventos.ConclusionesEl tabaquismo de forma activa o pasada es un factor predictor independiente de mal pronóstico en los pacientes con COVID-19, estando asociado a mayor probabilidad de ingreso en UCI y a mayor mortalidad intrahospitalaria. (AU)

Introduction: Smoking can play a key role in SARS-CoV-2 infection and in the course of the disease. Previous studies have conflicting or inconclusive results on the prevalence of smoking and the severity of the coronavirus disease (COVID-19).MethodsObservational, multicenter, retrospective cohort study of 14,260 patients admitted for COVID-19 in Spanish hospitals between February and September 2020. Their clinical characteristics were recorded and the patients were classified into a smoking group (active or former smokers) or a non-smoking group (never smokers). The patients were followed up to one month after discharge. Differences between groups were analyzed. A multivariate logistic regression and Kapplan Meier curves analyzed the relationship between smoking and in-hospital mortality.ResultsThe median age was 68.6 (55.8-79.1) years, with 57.7% of males. Smoking patients were older (69.9 [59.6-78.0 years]), more frequently male (80.3%) and with higher Charlson index (4 [2-6]) than non-smoking patients. Smoking patients presented a worse evolution, with a higher rate of admission to the intensive care unit (ICU) (10.4 vs 8.1%), higher in-hospital mortality (22.5 vs. 16.4%) and readmission at one month (5.8 vs. 4.0%) than in non-smoking patients. After multivariate analysis, smoking remained associated with these events.ConclusionsActive or past smoking is an independent predictor of poor prognosis in patients with COVID-19. It is associated with higher ICU admissions and in-hospital mortality. (AU)

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Introduction: Smoking can play a key role in SARS-CoV-2 infection and in the course of the disease. Previous studies have conflicting or inconclusive results on the prevalence of smoking and the severity of the coronavirus disease (COVID-19). Methods: Observational, multicenter, retrospective cohort study of 14,260 patients admitted for COVID-19 in Spanish hospitals between February and September 2020. Their clinical characteristics were recorded and the patients were classified into a smoking group (active or former smokers) or a non-smoking group (never smokers). The patients were followed up to one month after discharge. Differences between groups were analysed. A multivariate logistic regression and Kapplan Meier curves analysed the relationship between smoking and in-hospital mortality. Results: The median age was 68.6 (55.8-79.1) years, with 57.7% of males. Smoking patients were older (69.9 (59.6-78.0 years)), more frequently male (80.3%) and with higher Charlson index (4 (2-6)) than non-smoking patients. Smoking patients presented a worse evolution, with a higher rate of admission to the intensive care unit (ICU) (10.4 vs. 8.1%), higher in-hospital mortality (22.5 vs. 16.4%) and readmission at one month (5.8 vs. 4.0%) than in non-smoking patients. After multivariate analysis, smoking remained associated with these events. Conclusions: Active or past smoking is an independent predictor of poor prognosis in patients with COVID-19. It is associated with higher ICU admissions and in-hospital mortality.

Introducción: El tabaquismo puede tener un papel importante en la infección por SARS-CoV-2 y en el curso de la enfermedad. Los estudios previos muestran resultados contradictorios o no concluyentes sobre la prevalencia de fumar y la severidad en la enfermedad por coronavirus (COVID-19). Material y métodos: Estudio de cohortes observacional, multicéntrico y retrospectivo de 14.260 pacientes que ingresaron por COVID-19 en hospitales españoles desde febrero a septiembre de 2020. Se registraron sus características clínicas y se clasificaron en el grupo con tabaquismo si tabaquismo activo o previo o en el grupo sin tabaquismo si nunca habían fumado. Se realizó un seguimiento hasta un mes después del alta. Se analizaron las diferencias entre grupos. La relación entre tabaquismo y mortalidad intrahospitalaria se valoró mediante una regresión logística multivariante y curvas de Kapplan Meier. Resultados: La mediana de edad fue 68,6 (55,8­79,1) años, con un 57,7% de varones. El grupo con tabaquismo presentó mayor edad (69,9 (59,6­78,0 años)), predominio masculino (80,3%) y mayor índice de Charlson (4 (2−6)). La evolución fue peor en estos pacientes, con una mayor tasa de ingreso en UCI (10,4 vs 8,1%), mayor mortalidad intrahospitalaria (22,5 vs 16,4%) y reingreso al mes (5,8 vs 4,0%) que el grupo sin tabaquismo. Tras el análisis multivariante, el tabaquismo permanecía asociado a estos eventos. Conclusiones: El tabaquismo de forma activa o pasada es un factor predictor independiente de mal pronóstico en los pacientes con COVID-19, estando asociada a mayor probabilidad de ingreso en UCI y a mayor mortalidad intrahospitalaria.

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Herpes zoster opthalmicus (HZO) is the reactivation of latent varicella zoster virus (VZV) within the ophthalmic branch of the trigeminal ganglion (V1). Common complications are postherpetic neuralgia and vasculopathy. Here, we report a rare case of a 47-year-old female presenting with HZO and aseptic cavernous sinus thrombosis (CST). Early screening for rare and deadly complications such as CST using CT cerebral venography (CTV) and magnetic resonance venography (MRV), as was done, is crucial to detection at earlier stages when intervention is most effective. Anticoagulation therapy was promptly started, and the patient's symptoms continued to improve during the hospital stay.

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BACKGROUND: The inflammatory cascade is the main cause of death in COVID-19 patients. Corticosteroids (CS) and tocilizumab (TCZ) are available to treat this escalation but which patients to administer it remains undefined. OBJECTIVE: We aimed to evaluate the efficacy of immunosuppressive/anti-inflammatory therapy in COVID-19, based on the degree of inflammation. DESIGN: A retrospective cohort study with data on patients collected and followed up from March 1st, 2020, to May 1st, 2021, from the nationwide Spanish SEMI-COVID-19 Registry. Patients under treatment with CS vs. those under CS plus TCZ were compared. Effectiveness was explored in 3 risk categories (low, intermediate, high) based on lymphocyte count, C-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, and D-dimer values. PATIENTS: A total of 21,962 patients were included in the Registry by May 2021. Of these, 5940 met the inclusion criteria for the present study (5332 were treated with CS and 608 with CS plus TCZ). MAIN MEASURES: The primary outcome of the study was in-hospital mortality. Secondary outcomes were the composite variable of in-hospital mortality, requirement for high-flow nasal cannula (HFNC), non-invasive mechanical ventilation (NIMV), invasive mechanical ventilation (IMV), or intensive care unit (ICU) admission. KEY RESULTS: A total of 5940 met the inclusion criteria for the present study (5332 were treated with CS and 608 with CS plus TCZ). No significant differences were observed in either the low/intermediate-risk category (1.5% vs. 7.4%, p=0.175) or the high-risk category (23.1% vs. 20%, p=0.223) after propensity score matching. A statistically significant lower mortality was observed in the very high-risk category (31.9% vs. 23.9%, p=0.049). CONCLUSIONS: The prescription of CS alone or in combination with TCZ should be based on the degrees of inflammation and reserve the CS plus TCZ combination for patients at high and especially very high risk.

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INTRODUCTION: Smoking can play a key role in SARS-CoV-2 infection and in the course of the disease. Previous studies have conflicting or inconclusive results on the prevalence of smoking and the severity of the coronavirus disease (COVID-19). METHODS: Observational, multicenter, retrospective cohort study of 14,260 patients admitted for COVID-19 in Spanish hospitals between February and September 2020. Their clinical characteristics were recorded and the patients were classified into a smoking group (active or former smokers) or a non-smoking group (never smokers). The patients were followed up to one month after discharge. Differences between groups were analyzed. A multivariate logistic regression and Kapplan Meier curves analyzed the relationship between smoking and in-hospital mortality. RESULTS: The median age was 68.6 (55.8-79.1) years, with 57.7% of males. Smoking patients were older (69.9 [59.6-78.0 years]), more frequently male (80.3%) and with higher Charlson index (4 [2-6]) than non-smoking patients. Smoking patients presented a worse evolution, with a higher rate of admission to the intensive care unit (ICU) (10.4 vs 8.1%), higher in-hospital mortality (22.5 vs. 16.4%) and readmission at one month (5.8 vs. 4.0%) than in non-smoking patients. After multivariate analysis, smoking remained associated with these events. CONCLUSIONS: Active or past smoking is an independent predictor of poor prognosis in patients with COVID-19. It is associated with higher ICU admissions and in-hospital mortality.

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Moyamoya disease (MMD) is a rare cerebrovascular disease characterized by progressive stenosis of the terminal portions of the internal carotid arteries (ICAs) and the development of a network of abnormal collateral vessels. This case depicts a 25-year-old African American female patient with neurofibromatosis type 1 (NF-1), whose initial hospital presentation occurred in a hypertensive emergency setting. Surveillance studies with magnetic resonance imaging (MRI) revealed multiple asymptomatic right cortical strokes. Genetic testing evidenced a novel, unique pathogenic variant on the NF-1 gene. The patient underwent combined bypass surgery first and then was placed on aspirin and a blood pressure control regimen. Our case illustrates the need for clinicians to include moyamoya disease in the list of differential diagnoses when encountering a young patient, without major risk factors, presenting with ischemic stroke. It should be considered even with no known history of previously diagnosed MMD or NF-1, as these pathologies may have yet to be evaluated in subclinical cases.

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BACKGROUND: The objective is to analyse and compare the effects of an adapted tennis cardiac rehabilitation programme and a classical bicycle ergometer-based programme on the type of motivation towards sports practice and quality of life in patients classified as low risk after suffering acute coronary syndrome. METHODS: The Behavioural Regulation in Exercise Questionnaire (BREQ-2) and Velasco's Qualityof Life Test were applied. The sample comprised 110 individuals (age = 55.05 ± 9.27) divided into two experimental groups (tennis and bicycle ergometer) and a control group. RESULTS: The intra-group analysis showed a significant increase between pre- and post-test results in intrinsic regulation in the tennis group and in the control group. In identified regulation, the bicycle ergometer group presented significant differences from the control group. On the other hand, in the external regulation variable, only the tennis group showed significant differences, which decreased. Significant improvements in all quality-of-life factors when comparing the pre-test period with the post-test period were only found in the experimental groups. As per the inter-group analysis, significant differences were observed in favour of the tennis group with respect to the control group in the variables of health, social relations and leisure, and work time as well as in favour of the bicycle ergometer group compared with the control group in the variables of health, sleep and rest, future projects and mobility. No significant differences were found in any of the variables between the tennis group and the bicycle ergometer group. CONCLUSION: It is relevant to enhance the practice of physical exercise in infarcted patients classified as low risk as it improves the forms of more self-determined regulation towards sporting practice and their quality of life.

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Ambulatory electroencephalogram (AEEG) can be a cost-effective and valuable alternative to in-patient long-term EEG monitoring. A potential benefit of AEEG is that it allows monitoring in the patient's unique home environment. While this can be more affordable and convenient for the patient, it can also present unique challenges for the reviewer. Unlike long-term monitoring in an epilepsy unit, the AEEG recording occurs in a less controlled environment and most often without immediate EEG technical assistance during the recording. As a result, unique EEG artifacts can occur with AEEG. Their recognition and correct interpretation are crucial for proper EEG analysis. This report presents a case of a patient who underwent a 72-hour AEEG to evaluate symptoms initially concerning for subclinical seizures. During the AEEG recording, the patient had a tactile encounter with an electric fence. This tactile event resulted in a unique, not previously reported, pattern clouding an otherwise normal study. By conducting a brief review of the most common non-physiologic environmental artifacts encountered in modern EEG monitoring, we aim to emphasize the importance of patient education to prevent artifactual pollution. This knowledge can facilitate planning and help avoid environmental influences that may create artifacts when recording in an uncontrolled setting.

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INTRODUCTION: High rates of tobacco smoking among people who are homeless or living in temporary accommodation exacerbate poor health outcomes and financial disadvantage. There is limited research on this population's perceptions of smoking cessation benefits or support strategies. METHODS: We conducted a cross-sectional survey of 68 male smokers living in a temporary accommodation hostel in Brisbane, Australia. The survey measured smoking and quit attempt history, perceptions of cessation aids and benefits of cessation, and awareness of the Intensive Quit Support program-a free Queensland government-funded program comprising 12 weeks of nicotine replacement therapy supplemented with weekly calls from Quitline. RESULTS: Participants (56% aged ≤40 years) spent a high proportion of their income on smoking (median $80/week). Although the most commonly reported perceived benefit of smoking cessation was improved health, more participants were interested in a campaign promoting the financial savings of quitting rather than the health benefits. Twice as many participants reported the high cost of smoking-provoked thoughts of quitting than graphic health warning labels on cigarette packs (70.6% vs. 30.9%). Participants reported a high level of interest in e-cigarettes as a cessation aid. There was a low level of awareness but moderate level of interest in the Intensive Quit Support program. DISCUSSION AND CONCLUSIONS: Smoking cessation campaigns promoting the financial savings of cessation may be more salient than health-focused campaigns among relatively young men who smoke and experience homelessness. There is a clear need for innovative, targeted strategies promoting smoking cessation among this population.

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BACKGROUND: Identification of patients on admission to hospital with coronavirus infectious disease 2019 (COVID-19) pneumonia who can develop poor outcomes has not yet been comprehensively assessed. OBJECTIVE: To compare severity scores used for community-acquired pneumonia to identify high-risk patients with COVID-19 pneumonia. DESIGN: PSI, CURB-65, qSOFA, and MuLBSTA, a new score for viral pneumonia, were calculated on admission to hospital to identify high-risk patients for in-hospital mortality, admission to an intensive care unit (ICU), or use of mechanical ventilation. Area under receiver operating characteristics curve (AUROC), sensitivity, and specificity for each score were determined and AUROC was compared among them. PARTICIPANTS: Patients with COVID-19 pneumonia included in the SEMI-COVID-19 Network. KEY RESULTS: We examined 10,238 patients with COVID-19. Mean age of patients was 66.6 years and 57.9% were males. The most common comorbidities were as follows: hypertension (49.2%), diabetes (18.8%), and chronic obstructive pulmonary disease (12.8%). Acute respiratory distress syndrome (34.7%) and acute kidney injury (13.9%) were the most common complications. In-hospital mortality was 20.9%. PSI and CURB-65 showed the highest AUROC (0.835 and 0.825, respectively). qSOFA and MuLBSTA had a lower AUROC (0.728 and 0.715, respectively). qSOFA was the most specific score (specificity 95.7%) albeit its sensitivity was only 26.2%. PSI had the highest sensitivity (84.1%) and a specificity of 72.2%. CONCLUSIONS: PSI and CURB-65, specific severity scores for pneumonia, were better than qSOFA and MuLBSTA at predicting mortality in patients with COVID-19 pneumonia. Additionally, qSOFA, the simplest score to perform, was the most specific albeit the least sensitive.

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Establecer las normas de los procedimientos asistenciales en materia de seguridad y salud en los Servicios de Medicina Complementaria.

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Objetivo: Determinar el efecto del tratamiento con arcilla medicinal (geoterapia) en pacientes con quemaduras de II grado pertenecientes al Hospital Nacional Alberto Sabogal Sologuren (HNASS), durante julio 2008 a abril 2009. Materiales y métodos: Estudio preexperimental. Se realizó geoterapia con arcilla medicinal gris Luvus al ingreso y se siguió la evolución de la quemadura por cinco semanas. Se evaluó la edad y sexo de los pacientes; el agente que causó la quemadura; la situación de ocurrencia; el tiempo que demoró en llegar al hospital; variables clínicas de la quemadura como el lugar, los síntomas y signos; la extensión; las manifestaciones al primer día de tratamiento y la evolución visual del proceso inlamatorio. Resultados: Se evaluó a 42 pacientes con una media de edad de 47,3±19.2 años. Un 61,9% de sexo femenino. El 81% de las quemaduras fueron clasificadas como leves y las localizaciones más frecuentes fueron los miembros superiores e inferiores. El 95,2% tuvo una mejora en la piel quemada en la primera semana y el 4,2% a partir de la segunda semana. El 64,3% de los pacientes presentó piel en proceso de pigmentación y el 33,3% piel normal al finalizar el seguimiento. Ningún paciente presentó infección dérmica durante el seguimiento, y solo uno (2,4%) presentó cicatriz queloide. Conclusiones: El tratamiento con arcilla medicinal acorta el proceso inlamatorio de las quemaduras de II grado, disminuye los síntomas de dolor y ardor y no se presentaron infecciones en el sitio de la lesión.

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Large landscapes encompassing reserves and areas with other human uses are necessary for conservation of many species. Generating information for conservation planning over such landscapes may be expensive and time-consuming, though resources for conservation are generally limited and conservation is often urgent. We developed a sign-based occupancy survey to help prioritize conservation interventions by simultaneously assessing the distribution of 3 species, the lesser rhea, guanaco, and mara, and their association with human activities in a 20,000-km2 landscape in the northern Patagonian steppe. We used a single-season occupancy model with spatial rather than temporal replication of surveys in order to reduce costs of multiple visits to sites. We used covariates related to detectability, environmental factors, and different human activities to identify the most plausible models of occupancy, and calculated importance weights of covariates from these models to evaluate relative impacts of human activities on each species. Abundance of goats had the strongest negative association with lesser rheas and guanacos, and road density with maras. With six months of fieldwork, our results provided initial hypotheses for adaptive conservation interventions for each species. Addressing high livestock densities for rheas and guanacos, poaching by urban hunters for all three species, and hunting by rural people for rheas are priorities for conservation in this landscape. Our methodology provided new insights into the responses of these species, although low detection probabilities for maras indicate that the sampling scheme should be altered for future monitoring of this species. This method may be adapted for any large landscape where a rapid, objective means for prioritizing conservation actions on multiple species is needed and data are scarce.

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Introducción: análisis de un caso clínico de mujer operada de mama con linfadenectomía remitida por su oncólogo en el año 2009 al no realizar ningún movimiento con el brazo por temor a contraer linfedema. Objetivos: 1. Psicoeducación sobre el linfedema y cuidados del brazo. 2. Vencer el miedo al movimiento del brazo. 3. Mejorar la calidad de vida de la paciente. Metodología: eelaboración de un programa de exposición a través de las situaciones en que la paciente experimentaba gran ansiedad y temor, relacionadas con actividades habituales de su vida diaria, realizando la siguiente lista de actividades, de menor a mayor ansiedad:comer, vestirse, labores domésticas, aseo personal y realizar ejercicio físico. Se utilizó el autorregistro con las tareas de exposición realizadas. Resultados: la paciente superó sus miedos hacia el linfedema, realizando una vida totalmente normal, conociendo cuáles son los cuidados que debe tener a modo de prevención. Conclusiones: el tratamiento de exposición ha mostrado eficacia en el presente caso y confirma que es una intervención en el caso de fobias en pacientes oncológicos (AU)

Introduction: Clinical case study of a woman who has been operated on breast cancer and lymphadenectomy who was referred by her oncologist in 2009, given because she didn’t move her arm for fear of acquire lymphedema. Purposes: 1. Psychoeducation about lymphedema and how to look after the arm. 2. Overcoming fear of moving the arm. 3. Improving the patient’s quality of life. Method: Designing an exposure therapy in which the patient has to cope with situations that arouse great anxiety and fear. These situations are related to common activities in the patient’s daily life and has been rated in a list of increasing level of anxiety: Eating, getting dressed, housework, personal hygiene and physical exercise. The patient kept a record book with the exposure tasks that she confronted. Results: The patient overcame all her fears for lymphedema, leading a completely normal life and learning about the measures and cares to take for lymphedema prevention. Conclusions: Exposure is the most appropriate treatment option for phobic disorders in patients who suffer cancer (AU)

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La versatilidad en el uso del vanadio, incluye a la industria del acero, de la cerámica, la industria de catalizadores químicos, pinturas, insecticidas, materiales fotográficos y en la fabricación de superconductores. Los efectos toxicológicos de los compuestos de vanadio son muy amplios ya que es capaz de inhibir un elevado numero de enzimas, siendo su acción dependiente de su valencia. El Vanadio al igual que otros metales se bioacumula y tiene un largo tiempo de vida media en los seres vivos, su contaminación debería tener mayor importancia en nuestro medio, ya que el estado Zulia es una región petrolera por excelencia y el petroleo pesado y el Carbon, son hidrocarburos que están en el Lago de Maracaibo y en algunas áreas de sus Cuencas. En este estudio se realizaron ensayos de genotoxicidad con especies Tilapia Roja (Oreochromis sp) con el objeto de determinar alteraciones morfologicas e histologicas (teratogénesis) en los descendientes de hembras expuestas a 0,75 ppm de metavanadato de amonio (MVA) y cuyos resultados fueron comparados con los controles, encontrándose diferencias significativas para un nivel de confianza del 5 por ciento. La exposicion al vanadio de Tilapias hembras correspondió a un período de 120 días, conducido en tanques de 1000 L de capacidad para su reproduccion con machos no expuestos. Las evaluaciones de los da os incluye además de la descendencia a los progenitores. Los resultados demostraron la accion genotoxica del vanadio a la concentracion subletal de 0,75 ppm en Tilapia Roja

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