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Introduction: Small testicular lesions ≤20 mm (STL) detected by ultrasound (US), usually non-palpable, have been reported to be benign in up to 80% of cases. Thus, partial orchiectomy with or without frozen section examination and surveillance has been advocated for these kinds of lesions. We seek to report the proportion of benign lesions in testicular tumors ≤20 mm detected by US in our population and explore the predicting factors of malignancy. Material and methods: A retrospective descriptive study of orchiectomies performed for testicular tumors in patients older than 15 years between 2005 and 2019 was performed, including all patients with lesions ≤20 mm on US imaging. Results: A total of 70 patients with STL were included (mean age 34.6 ±10.8 years). Overall, 69% of the lesions were malignant while the smallest lesions (≤10 mm) showed 61% of cancer. Moreover, in the subgroup of non-palpable lesions ≤10 mm, 50% were malignant. Multifocal tumors were found in 18 subjects with a malignancy rate of 88%. There was a significant association between maximum size on US, multifocality and malignancy. Neither tumor markers nor palpability foretold a malignant lesion. A predictive model including size and multifocality was created showing a positive predictive value of 83.3%. Conclusions: US maximum size and multifocality were predictors of malignancy in STL. However, even the smallest lesions showed a 50% chance of being malignant, thus surgery with or without intraoperative biopsy is warranted in most cases.

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One of the environmental challenges that is currently negatively affecting the ecosystem is the continuous discharge of untreated industrial waste into both water sources and soils. For this reason, one of the objectives of this qualitative study of exploratory-descriptive scope was the review of scientific articles in different databases-Scopus, Web of Science, and Science Direct-published from 2010 to 2021 on the use of fruit peels as a sustainable waste in the removal of heavy metals present in industrial wastewater. For the selection of articles, the authors used the PRISMA guide as a basis, with which 210 publications were found and 93 were compiled. Considering the reported work, a content analysis was carried out using NVivo 12 Plus and VOSviewer 1.6.17 software. The results show that the fruits mentioned in these publications are lemon, banana, mango, tree tomato, pineapple, passion fruit, orange, coconut, avocado, apple, lulo, and tangerine. However, no studies were found with lulo and tree tomato peels. On the other hand, the heavy metals removed with the selected fruit peels were Pb+2, Cr+3, Cr+6, Ni+2, Cd+2, As+5, Cu+2, and Zn+2.

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Some of the diverse agro-industrial waste generated in primary or secondary stages have proved to be promising biomaterials for treating aqueous effluents contaminated, in this case, with heavy metals. Therefore, it is necessary to know their optimal operating conditions and the regeneration or reusability of the solid by-product, an aspect related to desorption. Considering the above, this article presents the findings of a preliminary study related to the desorption process of coffee pulp without physicochemical modification (Castilla variety), an agricultural waste used as a sorbent of Cr(III and VI) ions in synthetic wastewater. The desorption efficiency of four eluting agents at defined concentrations (0.10M)-HC1, HNO3, H2SO4, and EDTA-was evaluated in a time interval of 1 to 9 days. Likewise, the proposals for the sorption and/or desorption mechanisms proposed and reported in the literature with respect to the use of biosorbents derived from the coffee crop are presented. With respect to the results, the coffee pulp used in previous studies of the adsorption of chromium species mentioned (optimal conditions in synthetic water of particle size 180 µm, dose 20 g·L-1, agitation 100 RPM, room temperature, time of 90 to 105 min) showed efficiencies in the removal of Cr(III) and Cr(VI) of 93.26% and 74.80%, respectively. Regarding the extracting substances used, H2SO4 0.10 M was the one that presented the highest desorption percentage in both chromic species, with a desorption of 45.75% Cr(VI) and 66.84% Cr(III) in periods of 5 and 9 days, respectively, with agitation of 100 RPM and room temperature. Finally, the dissemination of preliminary results on the desorption of coffee pulp contaminated with chromic species without physicochemical modification is novel in this study, as similar work with this specific material has not yet been reported in the literature. On the other hand, the limitations of the study and future research are related to the evaluation at different concentrations and of other extractor solutions that allow improving the efficiency of desorption of these chemical species in a shorter time from the coffee pulp (with and without modification) as well as the reuse cycles. As a result, the desorption of coffee pulp used as an adsorbent material in real water could help researchers identify the possible interfering factors that affect the process (foreign anions and cations, organic matter, environmental conditions, among others).

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AIMS: This study aims to investigate the acute haemodynamic effects of percutaneous transluminal flow regulation (PTCR®) with an inferior vena cava regulator balloon in heart failure patients. Preload reduction in heart failure has been achieved with high potency diuretics. However, no study has been conducted in humans to assess the effect of inferior vena cava intermittent occlusion for preload reduction. METHODS AND RESULTS: Six patients were included in the study: four men (55 ± 6 years old) and two women (63 ± 4 years old). Baseline evaluations included Doppler echocardiogram, coronary angiogram, and right heart catheterization. Caval balloon was kept inflated for 30 min, and right catheterization and control echocardiogram were performed while the balloon was still inflated. The balloon was then deflated and removed. Right haemodynamic variables were evaluated before balloon insertion and with the inflated balloon. The mean right atrial pressure decreased by 42.59% (P = 0.005); systolic right ventricular pressure decreased by 30.19% (P < 0.003); mean pulmonary arterial pressure decreased by 25.33% (P < 0.043); mean pulmonary capillary wedge pressure decreased by 31.37% (P > 0.016); and cardiac output increased by 9.92% (P < 0.175). CONCLUSIONS: The haemodynamic and echocardiographic changes obtained in our study using PTCR® suggest that this innovative approach can play a beneficial role in the heart failure treatment.

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Out-of-office blood pressure (BP) monitoring appears to be a very useful approach to hypertension management insofar it allows to obtain multiple measurements in the usual environment of each individual, allows the detection of hypertension phenotypes, such as white-coat and masked hypertension, and appears to have superior prognostic value than the conventional office BP measurements. Out-of-office BP can be obtained through either home or ambulatory monitoring, which provide complementary and not identical information. Home BP monitoring yields BP values self-measured in subjects' usual living environment; it is an essential method for the evaluation of almost all untreated and treated subjects with suspected or diagnosed hypertension, best if combined with telemonitoring facilities, also allowing long-term monitoring. There is also increasing evidence that home BP monitoring improves long-term hypertension control rates by improving patients' adherence to prescribed treatment. In Latin American Countries, it is widely available, being relatively inexpensive, and well accepted by patients. Current US, Canadian, Japanese, and European guidelines recommend out-of-office BP monitoring to confirm and refine the diagnosis of hypertension.

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Accurate office blood pressure measurement remains crucial in the diagnosis and management of hypertension worldwide, including Latin America (LA). Office blood pressure (OBP) measurement is still the leading technique in LA for screening and diagnosis of hypertension, monitoring of treatment, and long-term follow-up. Despite this, due to the increasing awareness of the limitations affecting OBP and to the accumulating evidence on the importance of ambulatory BP monitoring (ABPM), as a complement of OBP in the clinical approach to the hypertensive patient, a progressively greater attention has been paid worldwide to the information on daytime and nighttime BP patterns offered by 24-h ABPM in the diagnostic, prognostic, and therapeutic management of hypertension. In LA countries, most of the Scientific Societies of Hypertension and/or Cardiology have issued guidelines for hypertension care, and most of them include a special section on ABPM. Also, full guidelines on ABPM are available. However, despite the available evidence on the advantages of ABPM for the diagnosis and management of hypertension in LA, availability of ABPM is often restricted to cities with large population, and access to this technology by lower-income patients is sometimes limited by its excessive cost. The authors hope that this document might stimulate health authorities in each LA Country, as well as in other countries in the world, to regulate ABPM access and to widen the range of patients able to access the benefits of this technique.

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Com base numa etnografia realizada profissionais de Serviço Social em diversos serviços de protecção social e de desenvolvimento social local no norte de Portugal, o artigo propõe uma reflexão crítica sobre os limites do holismo etnográfico e evidencia as possibilidades da abordagem fenomenológica, considerando para tal os processos intersubjectivos e de poder inerentes à compreensão cultural. O acompanhamento destas profissionais no terreno, em contextos de trabalho, permitiu-nos compreender, a partir de uma perspectiva fenomenológica, como as mesmas constroem, mobilizam e recontextualizam o saber profissional no decurso das práticas e interacções dos seus quotidianos laborais. Por outro lado, mostrou-nos como as dinâmicas interaccionais entre quem faz a etnografia e os sujeitos sob observação fomentam processos de reflexão e de compreensão entre estes últimos que se entrecruzam com incrementos de estatuto e poder, não só no quadro da relação etnográfica, mas também no âmbito das relações com demais actores da ecologia profissional.

Drawn from an ethnography conducted with social workers working in welfare and local community development services in northern Portugal, the paper proposes a critical reflection on the limits of holism and on the prospects offered by the phenomenological approach as well as the implied intersubjective process of cultural comprehension. A series of professional ethnographies allowed the researchers to perceive how social workers constructed, mobilized and recontextualized professional knowledge in the course of everyday practice and social interaction. The phenomenological approach allowed perceiving how the participating social workers intersubjectively built their professional knowledge, either in the course of professional social interaction or while reflecting on and interpreting their own interactions with others. In this course, we discuss how the interactional rapport between ethnographers and observed social workers bolsters a process of power relativization that leads to professional empowerment.

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El déficit de hierro con o sin anemia está siendo reconocido cada vez más como una comorbilidad importante en los pacientes con Insuficiencia Cardíaca (IC). Aunque la deficiencia de hierro es fácilmente diagnosticada por medio de dos marcadores (ferritina sérica y saturación de transferrina), es subdiagnosticada en estos pacientes y pudiera afectar hasta el 50% de los mismos. Aún antes del inicio de la anemia, los pacientes con IC y déficit de hierro muestran disminución en el rendimiento físico y cognitivo con una mala calidad de vida. Más aún, la deficiencia de hierro es un factor de riesgo, independiente de la anemia, de evolución desfavorable (muerte o trasplante cardíaco) en los pacientes con IC crónica. Varios estudios aleatorios controlados han mostrado mejoría en la capacidad de ejercicio, clase funcional de la New York Heart Association y calidad de vida luego de la corrección del déficit de hierro. Diversos factores contribuyen al desarrollo de este déficit, incluyendo edad avanzada, falla renal, hemodilución, inflamación crónica y severidad de la IC. Una variedad de mecanismos se han postulado para explicar la asociación de déficit de hierro e IC y su corrección, como un blanco terapéutico, está ganando una mayor atención(AU)

Iron deficit with or without anemia is being increasingly recognized as an important comorbidity in patients with heart failure. Although iron deficiency is easily diagnosed with two biomarkers (serum ferritin and transferrin saturation), it is underdiagnosed in these patients and could affects up to 50% of them. Even before the onset of anemia, heart failure patients with iron deficiency have decreased physical and cognitive performances and a poorer quality of life. Moreover, iron deficiency is a risk factor, independent of anemia, of unfavorable outcome (death or heart transplantation) in patients with chronic heart failure. Several randomized controlled studies have shown improvement in exercise capacity, New York Heart Association functional class and quality of life after correction of iron deficiency. Different factors contribute to the development of iron deficiency, including increasing age, renal insufficiency, hemodilution, chronic inflammation, and heart failure severity. A variety of mechanisms have been implicated in the association between iron deficiency and heart failure, and its correction as a therapeutic target in these patients is gaining increased attention(AU)

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BACKGROUND: Conventional calculation of mean 24-h ambulatory blood pressure (BP), SBP and DBP based on the average of all BP readings disregards the fact that a larger number of measurements is usually scheduled during the daytime than at night, an imbalance possibly leading to an overestimation of 24-h average BP. The aim of our study was to quantify this possible bias and to explore its determinants. METHODS: Four hundred and fifty untreated individuals were subdivided into three groups (150 individuals each) with three different ambulatory blood pressure measurement schedules for day/night: group I, four (day)/two (night) readings/h; group II, four (day)/three (night) readings/h; and group III, with BP readings every 30 min throughout 24 h. Hourly and 24-h averages were computed. The conventional 24-h averages of all SBP and DBP values were compared with the averages of hourly SBP and DBP mean values (time-weighted quantification). The difference between 24-h conventional and 24-h time-weighted BP was computed in each group and related to the degree of nocturnal BP dip and to the ratio between the number of readings of day and night. RESULT: In the three groups, 24-h conventional and 24-h time-weighted BP values were highly correlated (r > 0.99), 24-h conventional SBP and DBP being significantly higher (P < 0.01) than the corresponding 24-h time-weighted values in groups I and II but not in group III (Bland-Altman analysis). The bias magnitude was related to the day/night ratio in number of readings and to nocturnal BP dip in groups I and II (P < 0.01) but not in group III. CONCLUSION: The higher number of readings/h during daytime leads to an overestimation of conventional 24-h average BP, particularly in individuals with preserved nocturnal BP dipping. This can be avoided either by scheduling the same number of readings/h throughout 24 h or by performing a time-weighted quantification of 24-h BP. The clinical implications of these different approaches deserve further investigation.

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Patients undergoing percutaneous coronary intervention procedures, as in patients with coronary disease, should receive treatment indefinitely with acetylsalicylic acid and clopidogrel. New brands of clopidogrel have been developed at lower costs, for helping to avoid premature suspension of antiplatelet therapy, as Cravid Leti Laboratories clopidogrel. Its effectiveness and safety must be compared with Plavix international standard. A prospective, comparative, cross-over, and randomized study was conducted in healthy volunteers. Each group received 1 tablet of Clopidogrel Leti or Clopidogrel Sanofi, 75 mg in a single dose daily for 7 days, followed by 7-day washout period before administration of second treatment. Platelet aggregation was measured at the start of each period and at 7 days of treatment through optical aggregometry, using an optical aggregometer 490-2D Chrono-Log, with a self-calibration system working with platelet-rich plasma with readings 0%-100% of light transmission. An important decrease of platelet aggregation was observed in both groups at 7 days of treatment of more than 50%, independent of adenosine diphosphate reactive (Helena and Chrono-Log) used for aggregation (P < 0.05). The relationship between the mean and 90% confidence interval ratio obtained with the 2 different adenosine diphosphate brands were between 80% and 125%, therefore, it can be considered that both brands are bioequivalent and perfectly exchangeable.

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La transmisión de electrocardiogramas por vía telefónica es una técnica ampliamente difundida en el mundo. Se describe la experiencia de 17 meses (marzo 2006-agosto 2007) de utilización de un sistema de transmisión de electrocardiogramas, desde 23 centros urbanos y suburbanos ubicados en el Estado Lara. Los electrocardiogramas son tomados y transmitidos por los médicos generales mediante equipos Aerotel ®, ubicados en los hospitales o ambulatorios, a la central de llamadas ubicada en Caracas. El cardiólogo de guardia transmite el electrocardiograma el cual es recibido e interpretado por el especialista de guardia de telemedicina. El trazo electrocardiográfico, interpretado es enviado en pocos minutos al médico referente vía Fax. Se realizaron 3.690 electrocardiogramas a 3.104 pacientes. El motivo de la realización del electrocardiograma fue en la mayoría de los casos, dolor torácico (25 por ciento) o hipertensión arterial (26 por ciento). Los electrocardiogramas con anormalidades alcanzaron el 65 por ciento. Los trastornos isquémicos representaron el porcentaje mayor de anormalidades (32 por ciento). De las arritmias, la de mayor frecuencia la fibrilación y el “flutter”auricular (43 por ciento). Los trastornos de conducción el bloqueo de rama derecha y el hemibloqueo anterior izquierdo ocuparon la mayor frecuencia (23 por ciento y 35 por ciento respectivamente). Los electrocardiogramas cuyo diagnóstico requirió una conducta inmediata alcanzaron a 428 electrocardiogramas, siendo los más frecuentes la fibrilación auricular y la lesión subepicárdica: 203 (47 por ciento) y 161 (38 por ciento respectivamente. Este estudio muestra la utilidad de un sistema de tele-electrocardiografía, que presta asesoramiento cardiológico a centros urbanos y suburbanos en los cuales no existen especialistas de manera permanente.

Telephone transmission of electrocardiograms is widely practiced around the world. This study describes the experience with a tele-electrocardiography system, over 17 months (March, 2006-August, 2007), in 23 urban and suburban centers located in Lara State. Electrocardiograms were obtained by general practitioners using Aerotel® devices located in clinics and hospitals and transmitted to a call center located in Caracas. There a receiving cardiologist interpreted the tracings. Within a few minutes the interpretation was sent back to the referring physician. A total of 3,690 electrocardiograms were obtained from 3,104 patients. The reason for obtaining an electrocardiogram in these patients was, in most cases, a presenting history of chest pain (25%) or a finding of arterial hypertension (26%). An abnormality was found in 65% of the tracings. Conduction disturbances accounted for the highest percentage (32%). Among rhythm disturbances, atrial fibrillation and flutter were present in 43% of the electrocardiograms. Right bund le branch block and left anterior hemiblock were the most frequent conduction abnormalities (23% and 35% respectively). There were 428 electrocardiographic diagnoses, resulting in an immediate intervention, of which atrial fibrillation and a subepicardial lesion accounted for 203 (47%) and 161 (38%) cases respectively. This study shows the utility of a tele-electrocardiography system, which provides cardiologic support to urban and suburban centers, where specialists arenot available.

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La enfermedad tromboembólica es un área de creciente interés; un diagnóstico y tratamiento adecuados son imprescindibles para la buena práctica médica, por lo cual requiere certeza en la toma de decisiones. Motivados por la diversidad de opciones del arsenal terapéutico, se decidió actualizar las pautas venezolanas de terapia antitrombótica y trombolítica, a través de la guía 2005. Metodología para el Desarrollo de las Guías de Práctica -Clínica Basadas en Evidencia.

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En el presente estudio se encontró una prevalencia de Strepcoccus del grupo B del 16.2 porciento, valor que se encuentra dentre los rangos reportados a nivel mundal 5 al 40 porciento).Esta prevalencia pareciera ser baja si se compara al 26.6 porciento reportado por un estudio conducido en el mismo hospital en 2004. Los resultados reflejan que el 69.7 porciento de la población estudiada y el 75.72 porciento de las pacientes con cultivos pisitivos tenían edad entre 20 y 35 años. La mayoría de los pacientes con resultados positivos para Streptococcus del grupo B (grupo colonizado), habían tenido 1-3 embarazos. En cuanto a procesos patológicos asociados se encontró alta frecuencia de leucorrea en ambos grupos (pacientes colonizadas y altamente colonizadas) De acuerdo a la literatura la mayor parte de leucorreas tienen un origen polimicrobiano y entre los microorganismos más frecuentes se encuentra la Chlamydia Trachomatis. Otro proceso patológico asociado a infección por Streptococcus del grupo B en mujeres embarazadas son las infecciones de transmisión sexual que se encontraron casi en la mitad de las pacientes altamente colonizadas (43 porciento) otro proceso patológico es la ruptura prematura de membranas ovulares en el estudio solamente una mujer colonizadas tuvo RPM. En este estudio se encontró que aproximadamente 3/4 de las pacientes iniciaron su vida sexual precoz. De los resultados obtenidos se constata que hasta el momento ninguna de las cepas de SGB estudiadas mostró resistencia a Beta-lactámicos, por lo tanto estos siguen siendo los antibioticos de elección el la profilaxis antibiótica intraparto de las mujeres colonizadas por SGB

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El envejecimiento está asociado a un aumento de la variabilidad de la presión sistólica y a una reducción de la frecuencia cardíaca. Sin embargo, no existen, en nuestro conocimiento estudios, sobre la relación de variabilidades de la presión sistólica y la frecuencia cardíaca a lo largo de las 24 horas para individuos de diferentes edades. Pacientes y métodos: Se analizaron los perfiles de 24 horas de la presión sistólica y de la frecuencia cardíaca, a partir de registros ambulatorios de 24 horas, obtenidos con registradores oscilométricos automáticos, en 55 sujetos sanos y normotensos de ambos sexos: 25 sujetos con edades comprendidas entre los 20 y 29 años (Grupo I), 15 sujetos con edades entre 50 y 59 años (Grupo II) y 15 sujetos entre 60 y 69 años (Grupo III). La variabilidad global de la presión sistólica y de la frecuencia cardíaca se analizó como la desviación estándar (DE) del promedio de los valores de las 24 horas y se obtuvieron los cocientes de variabilidad DEPS/DEFC para los 3 grupos de individuos. El promedio de la presión sistólica 24h fue significativamente menor en el grupo I que en los grupos II y III. El promedio de la frecuencia cardíaca 24h fue similar en los tres grupos. Los valores de DEPS fueron significativamente menores en el grupo I con respecto a los grupos II y III. Los valores de DEFC en el grupo I fueron significativamente mayores en el grupo I que en el grupo II y III El cociente DEPS / DEFC fue aumentando progresivamente desde el grupo I (0,75 ± 0,1) al grupo II (1,4 ± 0,3) y III (1,85 ± 0,5), con diferencias significativas entre los tres grupos (P< 0,05). Nuestros resultados muestran, por primera vez en la literatura, que en una población de sujetos sanos normotensos, la edad está asociada a un progresivo predominio de la variabilidad de 24 horas analizada como desviación estándar, de la presión sistólica sobre la de la frecuencia cardíaca. Este cociente podría representar un indicador de envejecimiento del sistema

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INTRODUCTION AND OBJECTIVES: Impairment of the autonomous nervous system in early stages of Chagas' disease is still a matter of debate, although multiple approaches (including heart rate response to orthostatism and the Valsalva maneuver, and spontaneous variability) have been used to ascertain its occurrence. The circadian profile of heart rate and its variability have not been investigated in patients with Chagas' disease. PATIENTS AND METHOD: We analyzed the 24-hour heart rate by Holter recordings in 63 patients with and without ECG alterations, who had positive serological findings for Chagas' disease. These results were compared with those in 22 healthy subjects matched for sex and age. Mean 24-hour heart rate and its circadian amplitude were analyzed with Cusum analysis and nocturnal dip. In a subgroup of 45 subjects (30 with Chagas' disease and 15 healthy controls), heart rate instantaneous variability (24-hour pNN50 and r-MSSD) and circadian amplitude were also calculated by Cusum analysis. RESULTS: 24-hour and diurnal heart rates were lower in patients with Chagas' disease than in healthy subjects (P<.05). Circadian amplitude and dip were lower in patients, but these differences did not reach statistical significance. In the subgroup of 45 subjects, the reductions in instantaneous heart rate variability (pNN50 and r-MSSD) in Chagasic patients were small, and circadian amplitudes were preserved, when compared with healthy subjects. CONCLUSIONS: The lower heart rate in patients with Chagas' disease occurred only during diurnal activity, and instantaneous heart rate variability was preserved. These findings suggest an alteration in the sympathetic branch of the autonomous nervous system. The circadian heart rate profile, which has not been studied previously in patients with Chagas' disease, does not seem appreciably blunted in this stage of the disease.

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La aplicación del análisis de la variabilidad de la frecuencia cardíaca es útil en el diagnóstico y pronóstico cardiológico. Nosotros evaluamos su aplicabilidad en pacientes con enfermedad de Chagas sin daño estructural cardíaco. Evaluamos 143 pacientes distribuidos en tres grupos 1-Controles sanos 2-Grupo CH1 (evidencia inmunológica de enfermedad de Chagas sin daño cardíaco) 3-Grupo CH2 (evidencia inmunológica de enfermedad de Chagas y alteración cardíaca leve o moderada). Se les practicó evaluación con métodos no invasivos, incluyendo análisis de la variabilidad de la frecuencia cardíaca. La variabilidad de la frecuencia cardíaca no discriminó entre los sujetos sanos y grupo CH1. Sólo estableció diferencia (p<0,01) en el análisis espectral entre el grupo CH2 y el grupo control: baja frecuencia/alta frecuencia fue mayor en CH2 que en el grupo control. Nuestros resultados se inscriben en la controversia sobre la utilidad de la aplicación de la variabilidad de la frecuencia cardíaca para detectar afectación cardíaca precoz en la enfermedad de Chagas. En estudios previos demostramos la utilidad de la aplicación de técnicas de modelado no lineal en este grupo de pacientes. Creemos que su utilización, conjuntamente con la determinación de la turbulencia de la frecuencia cardíaca, puede mejorar la detección de afectación cardíaca temprana en la enfermedad de Chagas

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En este estudio se identificaron y contrastaron los índices de placa (IP) e inflamación gingival (IG) en dos grupos (experimental y control) antes de la administración y 15 y 30 días después del uso continuo de un enjuague bucal elaborado con gel de aloe vera al 50 por ciento de concentración. Los sujetos, entre 18 y 26 años de edad, que participaron en el experimento, fueron seleccionados en el Servicio Odontológico del Fuerte Tavacares, Venezuela, Estado Barinas, previa evaluación gingivoperiodontal y verificación de que reunían las características exigidas para integrar el grupo experimental y control. El diseño experimental de series cronológicas múltiples permitió compara en el grupo experimental y en los dos grupos los resultados obtenidos en diferentes momentos. Los enjuagues, experimental y placebo, fueron preparados en el Departamento de Galénica, Facultad de Farmacia, U. de Los Andes, Venezuela, y la cantidad de placa e inflamación gingival se determinó utilizando el índice de placa de Silness y Loe y el índice gingival de Loe y Silness. Los resultados indicaron una significativa disminución de los valores de los índices (IP, IG) en el grupo experimental a los 15 y 30 días de uso del enjuague con aloe vera, en relación al grupo control tratado con un placebo. La significación de los valores fue avalada por pruebas estadísticas (t de Student y Rangos Signados de Wilcoxon) permitiendo concluir que en el contexto de esta investigación, el gel de aloe vera utilizado en la composición del enjuague experimental a un 50 por ciento de concentración desminuye la cantidad de placa y la inflamación gingival

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Con el objeto de estudiar el perfil de la presión arterial de 24 horas en una población de sujetos jóvenes y sanos, se practicó monitoreo ambulatorio de la presión arterial a 50 estudiantes universitarios de ambos sexos con edades comprendidas entre los 19 y los 28 años. La población mostró un claro perfíl circadiano, con valores de presión arterial inferiores a los encontrados en la literatura extranjera para poblaciones de esta edad. Los valores diurnos y de 24 horas resultaron inferiores también a los valores encontrados en una población universitaria equivalente a la que se le midió la presión arterial por los métodos convencionales, lo cual pone en evidencia un probable componente de reactividad vascular en las tomas casuales. El consumo miocárdico de oxígeno, estimado por el doble producto también mostró un claro perfil circadiano, el cual se relacionó en esta población más con los cambios de frecuencia cardíaca que con los de la presión arterial sistólica. Este hecho tal vez sea debido a la mayor variabilidad de la frecuencia cardíaca que de la presión arterial, que se encontró en esta población joven

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