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RESUMEN: El nervio interóseo posterior (NIP) ha sido utilizado como sinónimo ocontinuación inmediata del ramo profundo del nervio radial (RPNR) al emerger en el compartimiento posterior del antebrazo. Su origen tampoco es claro, describiéndose como nervio interóseo posterior a su trayecto proximal, intermedio o distal al músculo supinador. El objetivo de esta revisión es detallar la visión de diversos autores respecto al origen y trayecto del NIP, proponiendo una correcta terminología para estas estructuras. Se realizó una revisión bibliográfica de varios textos y de algunos artículos utilizados para la enseñanza de la anatomía humana, publicados entre los años 1800 y la actualidad. En la búsqueda, se determinaron criterios de inclusión que consideraban, anatomía humana, escritos en español, francés o inglés y que aludieran al NIP. Tras la exploración inicial se localizaron 18 libros, procedentes de Francia, Rusia, España, Argentina, Estados Unidos, Canadá, Reino Unido, Alemania, India y México. Una descripción del NIP más precisa, en cuanto al origen, trayecto y función, es aquella postulada por la vertiente francesa, correspondiendo a un origen terminal del ramo profundo del nervio radial, luego de emitir sus ramos musculares. Este delgado nervio transcurre adosado a la membrana interósea para luego avanzar por el cuarto compartimiento extensor, distribuyéndose en las articulaciones dorsales del carpo a quienes inerva sensitiva y propioceptivamente.

SUMMARY: The posterior interosseous nerve (PIN) has been used as a synonym or immediate continuation of the deep branch of the radial nerve as it emerges in the posterior compartment of the forearm. Its origin is not clear either, being described as a posterior interosseous nerve to its proximal, intermediate or distal path to the supinator muscle. The objective of this review is to detail the vision of various authors regarding the origin and path of the PIN, proposing a correct terminology for these structures. A bibliographic review of several texts and some articles used for the teaching of human anatomy, published between the 1800s and the present day, was carried out. In the search, inclusion criteria were determined that considered human anatomy, written in Spanish, French or English and that alluded to the PIN. After the initial exploration, 18 books were located, coming from France, Russia, Spain, Argentina, the United States, Canada, the United Kingdom, Germany, India and Mexico. A more precise description of the PIN, in terms of origin, path and function, is that postulated by the French literature, corresponding to a terminal origin of the deep branch of the radial nerve, after emitting its muscular branches. This thin nerve runs attached to the interosseous membrane to then advance through the fourth extensor compartment, distributing itself in the dorsal carpal joints to which it innervates sensitively and proprioceptively.

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RESUMEN Introducción: La Chlamydia trachomatis es una de las infecciones de transmisión sexual más comunes en la población menor de 25 años, causante de graves problemas para la salud pública y la calidad de vida de las personas. Objetivo: Describir el conocimiento y creencias en la población joven entre 15 y 25 años, en relación a la infección por Clamidia, enmarcado en el contexto chileno e internacional. Métodos: Revisión narrativa que incluye 14 artículos cualitativos y cuantitativos de los últimos 10 años, en idioma inglés y español. Resultados: Existe desconocimiento sobre la infección por Clamidia, en cuanto a las características clínicas, el medio de transmisión y las pruebas diagnósticas, lo que genera que la población joven subestime el riesgo percibido y aumente conductas sexuales riesgosas. Por otro lado, se observa que el conocimiento aumenta de forma proporcional a la edad de la población, nivel educacional e historia previa de ITS. Conclusión: El déficit de conocimientos frente a las conductas sexuales de riesgo en la población joven favorece a un aumento en la prevalencia la infección por Clamidia, por lo cual es de suma importancia realizar nuevos estudios con el fin de aportar datos para potenciar programas de salud orientados a la concientización de los jóvenes frente a esta infección para así lograr disminuir la incidencia de esta enfermedad y sus complicaciones.

SUMMARY Introduction: Chlamydia trachomatis is one of the most common sexually transmitted infections in the population under 25 years old, causing serious problems for public health and the people's quality of life. Objective: Describe the knowledge and beliefs in the young population between 15 and 25 years old, related to Chlamydia infection in the Chilean and international context. Methods: Narrative review that includes qualitative and quantitative articles of the last 10 years, published in English and Spanish. Results: There is a lack of knowledge about Chlamydia infection, in the clinical characteristics, the transmission, and in the diagnostic tests, which causes the young population to underestimate the perceived risk and increase risky sexual behaviors. On the other hand, it is observed that knowledge increases proportionally to the population's age, educational level, and previous history of STIs. Conclusion: The lack of knowledge about risky sexual behavior in young population increase the prevalence of Chlamydia infection, due to this generates risky behaviors in the population, due to this, it is very important to conduct new studies in order to provide data to promote health programs oriented to raising awareness of young people against this infection and thus achieve to reduce the incidence of this disease and complications.

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Objetivo: Se realizó una investigación cuyo propósito fue comparar la DVO determinada mediante métodos convencionales y la determinada por el craneómetro de Knebelman en el mismo paciente. Método: Se consideró como metodología convencional la DVO medida estando el paciente con sus prótesis en máxima intercuspidación. El estudio se realizo en una muestra de 45 individuos desdentados totales y parciales sin referencia oclusiva, rehabilitados con prótesis removible en la en la Clínica Integral del Adulto I y II. Los resultados fueron analizados empleando el test t pareado expresado en mm. de la DVO determinada con cada metodología. Resultado: Se encontraron diferencias significativas entre ambas mediciones y se empleó el test Chi-Cuadrado para analizar la influencia en la magnitud de la DVO observada cuando se emplea una o más referencias en su determinación, donde no se encontraron diferencias significativas. El rango de diferencias entre ambas metodologías de determinación en promedio fue de 2.93 mm considerado no relevante desde el punto de vista clínico. Conclusión: En este contexto el craneómetro de Knebelman puede ser un valioso instrumento que permita simplificar la determinación de la DVO en pacientes desdentados.

Objective: The purpose of this investigation was to compare the OVD obtained with the conventional methods and the one that is obtained with the Knebelman craniometric system in the same patient. Methods: The OVD considered as "conventional" was the one obtained with the patient using his/her dental prosthesis in maximum intercuspidation. This study was made using a sample of 45 edentulous and partially edentulous subjects, all treated with full removable denture and RPD in "Odontologia Integral del Adulto I & II". The results were analyzed using pair comparison system for the different OVD obtained with both methods (all expressed in millimeters). Results: Significant differences were found between both methods. The Chi-Square test to analyze de influence in the OVD when one or more references are used, didn´t show any significant differences. The average discrepancy between the two methods was 2.93 mm, which is considered as not clinically significant. Conclusion: In this context the Knebelman craneometer can be considered as an important instrument to simplify the determination of the OVD in edentulous patients.

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We report a 54-year-old male presenting with a history or recurrent nose bleeds and ecchymoses. The coagulation study showed a prolonged partial thromboplastin time, a factor VIII of 8% and a high inhibitor titer (193 Bethesda units). A diagnosis of acquired hemophilia A was reached. The patient was initially treated with cyclophosphamide for seven months without response. Therefore rituximab in doses of 375 mglm²/week for four weeks was started. After starting treatment, the patient had a hematoma in the psoas muscle with a concomitant factor VIII of less than 5%, that was treated with local measures. Thereafter, a progressive reduction in inhibitor titers was observed, until its disappearance at five months of treatment. Factor VIII levels normalized and the patient has not experienced abnormal bleeding episodes. The patient remains in remission after 67 months of follow up. Rituximab, a chimeric monoclonal antibody against the protein CD 20 is an effective treatment in acquired hemophilia A.

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We report a 54-year-old male presenting with a history or recurrent nose bleeds and ecchymoses. The coagulation study showed a prolongedpartial thromboplastin time, a factor VIII of 8 percent and a high inhibitor titer (193 Bethesda units). A diagnosis of acquired hemophilia A was reached. The patient was initially treated with cyclophosphamide for seven months without response. Therefore rituximab in doses of 375 mglm²Iweek for four weeks was started. After starting treatment, the patient had a hematoma in the psoas muscle with a concomitantfactor VIII ofless than 5 percent, thatwas treated with local measures. Thereafter, aprogressive reduction in inhibitor titers was observed, until its disappearance atfive months of treatment. Factor VIII levéis normalized and the patient has not experienced abnormal bleeding episodes. The patient remains in remission after 67 months offollow up. Rituximab, a chimeric monoclonal antibody against theprotein CD 20 is an effective treatment in acquired hemophilia A.

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Se realizó un estudio in vitro que tuvo por objetivo medir el grado de adaptación del sistema espiga muñón, debido a que es uno de los factores fundamentales para lograr un buen anclaje de estos artificios, medido a nivel del núcleo de éste con respecto a los planos radiculares y de la espiga a las paredes del conducto, cuando es conformado con fresas Peeso y cuando es conformado usando fresas Peeso terminando con fresas del sistema Mooser. Seleccionamos 40 dientes que se dividieron al azar en dos grupos de 20, denominados P y M, respectivamente. Se confeccionó en cada muestra, previamente tratado su conducto mediante método indirecto, un perno muñón colado que fue probado en la preparación donde se midió el ajuste del muñón propiamente tal, después de logrado el asentamiento adecuado mediante desgastes en las interferencias de la espiga fueron cementados, posteriormente se realizaron dos cortes transversales a todo el espesor de la raíz a diferentes alturas, donde se midió la interfase entre la espiga y las paredes del conducto (adaptación). Los resultados fueron analizados utilizando los test de Mann-Whitney, Tukey y test T pareado, con software Systat versión 11, encontrándose que la mejor adaptación se observa en las muestras del grupo M en los dos sitios observados, comparadas con las del grupo P Estas diferencias son estadísticamente significativas.

We carried out a research aimed to determine the adaptation of the system called cast post and core, because it's one of the main factors to achieve a good adaptation of these devices measured from the core of this device to radicular plan, and from the post to the canal protesic's surface, when this one was prepared with Peeso's burs, and when was also prepared starting with Peeso's burs but finishing with Mooser system's burs. For that objective, we selected 40 teeth that were divided randomly into two groups of 20, called P and M respectively. A cast post and core was made in each sample through indirect method, previously treated the protesic canal. The cast post and core was tested in the preparation where the fit of the core was measured. Once achieved the proper settlement through the wearing out of the post's interferences and once the cast post and core was cemented, we made two cross cuttings to the thickness of the root at two differents levels, where the interface between the post and canal protesic's surface was measured (adaptation). The results were analyzed using the Mann-Whithny test, Tukey and paired T test, with Systast software version 11, having found that the best adaptation was observed in the samples of group M at the two points analyzed, compared to group P. These differences are statistically significant.

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The isotopic composition (13C and 15N) and C:N ratio of sediment and particulate were investigated to assess the origin and dynamic of the organic matter in two river basins located in the Parana State, Brazil. The main sources of organic matter, plants, litter and soil, were analyzed in the study. This study was carried out during the dry and wet seasons. Although organic matter contribution for the particulate material has been mixed, the main contribution in the two seasons for both rivers was autochthonous characterized by delta13C and C:N ratio values ranging from -31.0 to -21.8 per thousand and from 5.1 to 11.4, respectively. The soil with delta13C values ranging from -25.9 to -20.6 per thousand, and C:N ratio from 10.2 to 15.8, was the main carbon source for the river sediment for the two tributaries in the wet and dry seasons. The sediment delta15N values for both the rivers in the wet season showed an 15N enrichment trend in most of studied sites when compared to the dry season values, suggesting major input of nutrients as dissolved organic nitrogen and sewage nitrate. In the dry season, 14N enriched compounds, could have been used by phytoplankton, causing 15N enrichment. The isotope and C:N ratio data clearly showed that the agricultural activity has been influencing the origin and dynamic of organic matter in the two rivers, with potential biochemical consequences for the lower basin of the major Tibagi river.

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Background:Multiple myeloma is rarely curable. Advances in high dose chemotherapy and stem cell transplantation have improved overall survival and event-free disease periods, but relapses are inevitable. Aim: To report our experience with AT in multiple myeloma, between 1994 and 2003. Material and Methods: Retrospective analysis of 20 patients (12 women), with a mean age of 51.1 years. VAD (vincristine, doxorubicin and dexamethasone) was used as initial therapy in 19 patients. High dose cyclophosphamide (11 patients) and variations of VAD regimen (7) associated with granulocyte colony stimulating factor were used for peripheral-blood stem cell harvest. The conditioning regimen consisted of melphalan 200 mg/m2 followed by the reinfusion of peripheral-blood stem cells 24 hours later. The median number of CD34 cells infused was 3,3x106/kg. Three patients were subjected to a second auto graft and one to a non-myeloablative transplant. Mean follow up was 35.5 months. Results: Mucositis and febrile neutropenia were common complications. The median number of days for neutrophyl engraftment was 9 (range 8-11) and for platelets, 10 (range 7-13). No patient died. Complete remission was obtained in 60% (12/20), progession-free survival was 30 months and overall median survival, 47 months. Conclusions: The AT with high-dose melphalan is a safe procedure in our hospital, without mortality and engraftment in all the patients. Complete remission and progression free survival were similar to those reported abroad but the overall median survival was lower.

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A study was designed aimed to know rates of influenza vaccine prescriptions among medical staff personnel and postgraduate medical student in a tertiary care teaching hospital. Data was collected by a questionnaire asking forprevious year prescription, age of patients seen at the outpatient clinic, years of professional experience and other potential factors that may influence its use. A total of 103 physicians were consulted, including 14.8 percent of 452 staff physicians and 16.3 percent of 220 postgraduate medical students. Forty percent of the requested doctors indicated influenza vaccine during 1999. This rate was quite similar among doctors that work seeing older persons at outpatient clinics (43.5 percent). Rates were similar among staff doctors and postgraduate medical students. Prescription of the vaccine was more frequently declared among physicians working at the Internal Medicine Department although differences with other services were not significant. Thirty percent of the vaccine indications were temporarily inadequate and used after the reasonable time-frame before the influenza season. Influenza vaccine is an underprescribed preventive strategy

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La plasmaféresis, palabra acuñada por John Jacob Abel en 1914, se refiere a retirar o remover el plasma sanguíneo con devolución del resto de los componentes sanguíneos hacia el donante o paciente. Aunque en el pasado se utilizaron métodos manuales, solo con la introducción de bolsas de sangre estériles, equipos desechables y el desarrollo de máquinas separadoras de células han permitido hoy realizar los procedimientos de plasmaféresis de manera segura y eficaz. El objetivo principal de los procedimientos de plasmaféresis es la remoción del plasma y con ello el retiro del elemento responsable del daño patológico. Actualmente las máquinas de plasmaféresis poseen una moderna tecnología computacional (microprocesadores) que permiten programar el procedimiento completo. Utilizan sensores ópticos para detectar la interfase deseada y proceder a recolectar el hemocomponente. El gran incremento en las indicaciones clínicas de la plasmaféresis en los últimos 20 años es reflejo del desarrollo de esta nueva tecnología y también se debe a un mejor conocimiento de la fisiopatología de las enfermedades. En este artículo se resumen las indicaciones actuales de la plasmaféresis terapéutica

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Paleoecological and geomorphological studies indicate that, during the middle Holocene, there was a predominance of drier conditions with grassy savannahs replacing forests across the South American continent. Modern savannahs are composed mainly of C4 plants and soils developed under this type of vegetation show enrichment in 13C compared to soils under C3 vegetation cover. If soils contain stabilized organic matter formed in the middle Holocene, we hypothesize that former C4 vegetation would be evidenced by a large enrichment of 13C in soil organic matter (SOM). We investigate this possibility examining the depth variation of carbon isotopic composition in 21 soil profiles collected by different researchers at 14 different sites in Brazil. Of these, profiles from only three sites showed a marked increase of 13C with depth (9-10‰ enrichment in δ13C difference between the surface soil and deepest depth); two sites showed intermediate enrichment (4-5‰), and nine sites showed a small enrichment of approximatelly 2.5‰. The majority of sites showing all-C3 derived SOM were in the Amazon region. Possible causes for the absence of a large 13C enrichment with depth are: (1) dominance of C3 rather than C4 grasses in mid-Holocene savannahas, (2) soil profiles did not preserve organic matter derived from mid-Holocene plants, (3) the retreat of forest areas did not occur on a regional scale, but was a much more localized phenomenon.

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The duration of breast-feeding and the growth of fully breast-fed infants during the first year of life were analyzed according to sex, birth weight, characteristics of the mother, and breast-feeding pattern. All infants (n = 1217) were healthy and fully breast-fed at 30 d postpartum and 63% and 24% were still fully breast-fed at 6 and 12 mo, respectively. The median ages at introduction of nondairy food and of milk supplements were 6.0 and 7.4 mo, respectively. The probability of remaining fully breast-fed for 12 mo was significantly higher in infants with higher birth weight and higher maternal weight, and in infants who breast-fed seven times a day or more in the first 6 mo. The comparison of the monthly weight and length of fully breast-fed infants with the World Health Organization/National Center for Health Statistics reference data showed the adequacy of breastfeeding to support infant growth. When mothers and infants are healthy, breast milk is sufficient to support adequate infant growth and health during the first months of life. The main variables that affect the duration of breast-feeding, nutrition and suckling frequency, are susceptible to interventions by health services. The results reinforce the need to care for maternal nutrition during pregnancy and to provide the support that women need to sustain a high suckling frequency.

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The contraceptive efficacy of breastfeeding was assessed in 236 healthy urban women who were followed at monthly intervals during the first postpartum year. Proportional hazard models were used to evaluate the influence of time postpartum, menstrual status and breastfeeding pattern upon the risk of pregnancy. Time and menstrual status had a highly significant effect on this risk. Those women who remained in amenorrhea had cumulative probabilities of pregnancy of 0.9% and 17% at 6 and 12 months postpartum, respectively. In those who recovered menstrual cycles, the risk rose to 36% and 55% at 6 and 12 months, respectively. Milk supplementation also increased significantly the risk when considered alone but not when time and/or menstrual status were included in the analysis. However, amenorrheic women who introduced bottle feeding, had a higher risk of pregnancy after 6 months postpartum than those who remained fully nursing. The analysis was unable to detect a significant influence of the nursing frequency. The results confirm that lactational amenorrhea is an effective contraceptive during the first six months postpartum. The first postpartum bleeding marks a great increase in the risk of pregnancy. Supplementation also increases the risk, particularly in amenorrheic women.

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Se aplicó una versión modificada del Cuestionario de Evaluación del Reajuste Social (CERS) de Holmes y Rahe a una muestra de 30 estudiantes universitarios, de sexo masculino, con edades entre 20 y 28 años y una muestra de 20 empleados administrativos, varones, con edades entre 23 y 35 años y con estudios técnicos o universitarios, a los que se pidió que evaluaran las situaciones de vida presentadas en esta versión modificada del CERS. Se encontró que las evaluación realizadas por los sujetos de ambos grupos se correlacionaron significativamente (r = 0,843, p < 0.001, df =56). Con los puntajes asignados por estos 2 grupos se construyó una escala resumen, según el procedimiento descrito por Holmes y Rahe (1967), encontrandose una correlación significativa (r = 0.85, p < 0.001) con los resultados publicados por estos mismos autores para una muestra de sujetos norteamericanos. La comparación intergrupo de los promedios en cada ítem mostró que los estudiantes asignaron puntajes significativamente más altos (-x = 55) que los sujetos del otro grupo (-X = 41.9) en el ítem N§ 17: "Muerte de un amigo(a) cercano(a)". En cambio, en los ítem N§ 27: "Hijo o hija de deja el hogar (por matrimonio, estudio, etc.)", N§ 32: "Cambios importantes en las condiciones de vida (ampliación de la casa, deterioro de la casa o vecindario)" y N§ 36: "Incautación de un bien o juicio hipotecario (Ej.: quitar una compra por no pagarla)" los puntajes promedios del grupo de estudiantes(43.9; 29,3 y 35) fueron significativamente inferiores (p < 0.05) a los del otro grupo (54.6; 39.2 y 47.5 respectivamente). Los resultados muestran una correlación significativa de las evaluación de situaciones de vida de los dos grupos y además indicarían que la escala sobrepasa las limitaciones derivadas de las influencias culturales. Sin embargo, los resultados sólo pueden ser aplicados a poblaciones con características similares a las de las muestras intencionadas que se utilizó en este estudio. Se indica la necesidad de efectuar otros estudios antes de poder generalizar los resultados a la población total de varones chilenos. Se señala que desde el punto de vista teórico, la evaluación de las situaciones de vida puede ser explicada por el modelo de las cogniciones humanas de Lazarus(1966, 1974, 1980) y se relaciona con el concepto de determinismo recíproco de Bandura (1977)

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