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BACKGROUND: Bile duct injury (BDI) repair surgery is usually associated with morbidity/mortality. The neutrophil-to-lymphocyte ratio (NLR) easily assesses a patient's inflammatory status. The study aims to determine the possible relationship between preoperative NLR (pNLR) with postoperative outcomes in BDI repair surgery. METHODS: Approved Ethics/Research Committee retrospective study, in patients who had a Bismuth-Strasberg type E BDI repair (2008-2023). Data registered was: morbidity, mortality, and long-term outcomes (primary patency and loss of primary patency) (Kaplan-Meier). Group comparison (U Mann-Whitney), receiver operator characteristic (ROC): area under curve [AUC]; cut-off value, and Youden index [J], and logistic regression analysis were used for pNLR evaluation. RESULTS: Seventy-three patients were studied. Mean age was 44.4 years. E2 was the commonest BDI (38.4%). Perioperative morbidity/mortality was 31.5% and 1.4%. Primary patency was 95.9%. 8.2% have lost primary patency (3-year actuarial patency: 85.3%). Median pNLR was higher in patients who had any complication (4.84 vs. 2.89 p = 0.015), biliary complications (5.29 vs. 2.86 p = 0.01), and patients with loss of primary patency (5.22 vs. 3.1 p = 0.08). AUC's, cut-off values and (J) were: any complication (0.678, pNLR = 4.3, J = 0.38, p = 0.007), serious complication (0.667, pNLR = 4.3, J = 0.34, p = 0.04), biliary complications (0.712, pNLR = 3.64, J = 0.46, p = 0.001), and loss of primary patency (0.716, pNLR = 3.24, J = 0.52, p = 0.008). Logistic regression was significant in any complication (Exp [B]: 0.1, p = 0.002), serious complications (Exp [B]: 0.2, p = 0.03), and biliary complications (Exp [B]: 8.1, p = 0.003). CONCLUSIONS: pNLR is associated with complications in BDI repair with moderate to acceptable predictive capacity. pNLR could potentially predict patency of a BDI repair.

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Glycoside hydrolases (GHs) are enzymes that participate in many biological processes of fungi and other organisms by hydrolyzing glycosidic linkages in glycosides. They play fundamental roles in the degradation of carbohydrates and the assembly of glycoproteins and are important subjects of studies in molecular biology and biochemistry. Based on amino acid sequence similarities and 3-dimensional structures in the carbohydrate-active enzyme (CAZy), they have been classified in 171 families. Members of some of these families also exhibit the activity of trans-glycosydase or glycosyl transferase (GT), i.e., they create a new glycosidic bond in a substrate instead of breaking it. Fungal glycosidases are important for virulence by aiding tissue adhesion and colonization, nutrition, immune evasion, biofilm formation, toxin release, and antibiotic resistance. Here, we review fungal glycosidases with a particular emphasis on Sporothrix species and C. albicans, two well-recognized human pathogens. Covered issues include a brief account of Sporothrix, sporotrichosis, the different types of glycosidases, their substrates, and mechanism of action, recent advances in their identification and characterization, their potential biotechnological applications, and the limitations and challenges of their study given the rather poor available information.

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The cell wall (CW) of fungi exhibits a complex structure and a characteristic chemical composition consisting almost entirely of interacting crystalline and amorphous polysaccharides. These are synthesized by a number of sugar polymerases and depolymerases encoded by a high proportion of the fungal genome (for instance, 20% in Saccharomyces cerevisiae). These enzymes act in an exquisitely coordinated process to assemble the tridimensional and the functional structure of the wall. Apart from playing a critical role in morphogenesis, cell protection, viability and pathogenesis, the CW represents a potential target for antifungals as most of its constituents do not exist in humans. Chitin, ß-glucans and cellulose are the most frequent crystalline polymers found in the fungal CW. The hexosamine biosynthesis pathway (HBP) is critical for CW elaboration. Also known as the Leloir pathway, this pathway ends with the formation of UDP-N-GlcNAc after four enzymatic steps that start with fructose-6-phosphate and L-glutamine in a short deviation of glycolysis. This activated aminosugar is used for the synthesis of a large variety of biomacromolecules in a vast number of organisms including bacteria, fungi, insects, crustaceans and mammalian cells. The first reaction of the HBP is catalyzed by GlcN-6-P synthase (L-glutamine:D-fructose-6-phosphate amidotransferase; EC 2.6.1.16), a critical enzyme that has been considered as a potential target for antifungals. The enzyme regulates the amount of cell UDP-N-GlcNAc and in eukaryotes is feedback inhibited by the activated aminosugar and other factors. The native and recombinant forms of GlcN-6-P synthase has been purified and characterized from both prokaryotic and eukaryotic organisms and demonstrated its critical role in CW remodeling and morphogenesis after exposure of some fungi to agents that stress the cell surface by interacting with wall polymers. This review deals with some of the cell compensatory responses of fungi to wall damage induced by Congo Red and Calcofluor White.

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The most frequently isolated human fungal pathogen is Candida albicans which is responsible for about 50% of all Candida infections. In healthy individuals, this organism resides as a part of the normal microbiota in equilibrium with the host. However, under certain conditions, particularly in immunocompromised patients, this opportunistic pathogen adheres to host cells causing serious systemic infections. Thus, much effort has been dedicated to the study of its physiology with emphasis on factors associated to pathogenicity. A representative analysis deals with the mechanisms of glycoprotein assembly as many cell surface antigens and other macromolecules that modulate the immune system fall within this chemical category. In this regard, studies of the terminal protein glycosylation stage which occurs in Golgi vesicles has led to the identification of nucleotidases that convert glycosyltransferase-generated dinucleotides into the corresponding mononucleotides, thus playing a double function: their activity prevent inhibition of further glycosyl transfer by the accumulation of dinucleotides and the resulting mononucleotides are exchanged by specific membrane transporters for equimolecular amounts of sugar donors from the cytosol. Here, using a simple protocol for protein separation we isolated a bifunctional nucleotidase from C. albicans active on GDP and UDP that was characterized in terms of its molecular mass, response to bivalent ions and other factors, substrate specificity and affinity. Results are discussed in terms of the similarities and differences of this nucleotidase with similar counterparts from other organisms thus contributing to the knowledge of a bifunctional diphosphatase not described before in C. albicans.

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It is well documented that disturbance of cell surface by some agents triggers compensatory responses aimed to maintain the cell wall integrity in fungi and other organisms. Here, the thermodimorphic fungus Sporothrix globosa, a member of the pathogenic clade of the Sporothrix complex, was propagated in yeast-peptone-dextrose medium under conditions to obtain the mycelium (pH 4.5, 27-28 °C) or the yeast (pH 7.8, 32-34 °C) morphotypes in the absence and presence of the wall-interacting dyes Congo Red (CR) and Calcofluor White (CFW) either alone or in combination. After different periods of time, growth, cell morphology and activity of glucosamine-6-phosphate synthase (GlcN-6-P synthase), an ubiquitous enzyme that plays a crucial role in cell wall biogenesis, were determined. CR and to a lower extent CFW affected growth and morphology of both fungal morphotypes and significantly increased enzyme activity. Notoriously, CR or CR in combination with CFW induced the transient conversion of yeasts into conidia-forming filamentous cells even under culture conditions adjusted for yeast development, most likely as a strategy to evade the noxious effect of the dye. After sometime, hypha returned to yeast cells. An hypothetical model to explain the effect of CR on morphology and enzyme activity based on the possible role of membrane-spanning proteins known as mechanosensors is proposed. Results are discussed in terms of the fungal responses to cell wall damage.

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Abstract Introduction: Pain control in total knee arthroplasty (TKA) is a determining factor in the patient's rehabilitation process. With conventional peripheral blocking techniques for the posterior compartment, foot drop, and distal motor deficit have been reported. The infiltration between popliteal artery and capsule of the knee (IPACK) block is a promising emerging analgesic technique. Objective: To describe analgesic control, opioid consumption, and mobility of patients scheduled for TKA using IPACK block as adjunct analgesic to the femoral block. Methods: We conducted a prospective observational cohort study over a 6-month period in adults taken to TKA. Sociodemographic and anthropometric characteristics, laterality, postoperative pain, and opioid consumption, patient and surgeon satisfaction (Likert), postoperative nausea and vomiting, and walk in the first 24hours, were evaluated and reported with a descriptive analysis. Results: Twenty-seven patients taken to TKA received an IPACK block. The pain score remained in a mild level during the 48 hours of evaluation. In 73% of the cases, an opioid rescue dose was not required; 81% of the patients managed to walk in the first 24 hours. Conclusion: The IPACK block, combined with femoral block and neuraxial anesthesia, turn out to be an excellent analgesic strategy for TKA, achieving adequate pain management, prompt rehabilitation, and early ambulation of the patient.

Resumen Introducción: El control del dolor en artroplastia total de rodilla (ATR) es determinante en el proceso de rehabilitación del paciente. Con las técnicas convencionales de bloqueo periférico para el compartimiento posterior se ha reportado pie caído y déficit motor distal. Por lo anterior, se decidió evaluar en una cohorte las cualidades analgésicas del bloqueo IPACK como una técnica emergente prometedora. Objetivo: Describir el control analgésico, consumo de opioides y movilidad de pacientes programados para ATR usando bloqueo IPACK como adyuvante analgésico al bloqueo femoral. Métodos: Se realizó un estudio de cohorte prospectivo, en adultos llevados a ATR, durante 6 meses. Se evaluaron las características sociodemográficas, antropométricas, lateralidad, dolor postopera torio y consumo de opioides, satisfacción del paciente y del cirujano, náuseas y vómito postoperatorio, caminata en las primeras 48 h. Se informar los resultados de forma descriptiva. Resultados: En total, 27 pacientes a quienes se les realizó ATR obtuvieron bloqueo IPACK. La puntuación del dolor se mantuvo en una escala leve en un rango de 1-3 durante las 48 horas de seguimiento. En el 73% de los casos no se requirió una dosis de opioide de rescate. El 81% de los pacientes logró caminar en las primeras 24 horas. Conclusión: El IPACK, combinado con el bloqueo femoral y la anestesia neuroaxial, resultan ser una excelente estrategia analgésica para logar un adecuado control del dolor en ATR, pronta rehabilitación y deambulación temprana del paciente.

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Fungi colonizing cadavers are capable of drug metabolism and may thus change the metabolite pattern or concentration of drugs in forensic postmortem samples. The purpose of this study was to check for the presence of such changes by searching fungi-specific metabolites of four model drugs (amitriptyline, metoprolol, mirtazapine, and zolpidem) in decomposed postmortem blood samples from 33 cases involving these drugs. After isolation and identification of fungal strains present in the samples, each isolate was incubated in Sabouraud medium at 25°C for up to 120h with each model drug. One part of the supernatants was directly analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS), another after liquid-liquid extraction with chlorobutane and concentration. From 21 out of 33 decomposed postmortem blood samples (64%) a total of 30 different strains could be isolated, one from the class of Ascomycete and the rest belonging to 15 species from 8 different genera (number of species): Aspergillus (2), Botrytis (1), Candida (8), Fusarium (1), Mucor (1), Penicillium (1), and Rodothorula (1). In the in vitro studies, these microorganisms were found capable of N-demethylation and N-oxidation of amitriptyline and mirtazapine, O-demethylation followed by side chain oxidation of metoprolol as well as hydroxylation of all four-model drugs. In two of the postmortem blood samples, from which the fungi Aspergillus jensenii, Candida parapsilosis. and Mucor circinelloides had been isolated, a fungi-specific hydroxy zolpidem metabolite was detected. The presence of this metabolite in postmortem samples likely indicates postmortem fungal biodegradation.

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The present study investigated the in vitro metabolic capacity of 28 fungal strains isolated from post-mortem material towards five model drugs: amitriptyline, metoprolol, mirtazapine, promethazine, and zolpidem. Each fungal strain was incubated at 25 °C for up to 120 h with each of the five models drugs. Cunninghamella elegans was used as positive control. Aliquots of the incubation mixture were centrifuged and 50 µL of the supernatants were diluted and directly analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) with product ion scanning. The remaining mixture was analyzed by full scan gas chromatography-mass spectrometry (GC-MS) after liquid-liquid extraction and acetylation. The metabolic activity was evaluated through the total number of detected metabolites (NDM) produced in each model and fungal strains and the percentage of parent drug remaining (%RPD) after up to five days of incubation. All the tested fungal strains were capable of forming mammalian phase I metabolites. Fungi from the normal fungal flora of the human body such as Candida sp., Geotrichum candidum, and Trichosporon asahii) formed up to seven metabolites at %RPD values greater than 52% but no new fungal metabolites (NFM). In contrast, some airborne fungal strains like Bjerkandera adusta, Chaetomium sp, Coriolopsis sp., Fusarium solani and Mucor plumbeus showed NDM values exceeding those of the positive control, complete metabolism of the parent drug in some models and formation of NFM. NFM (numbers in brackets) were detected in four of the five model drugs: amitriptyline (18), metoprolol (4), mirtazapine (8), and zolpidem (2). The latter NFM are potential candidates for marker substances indicating post-mortem fungal metabolism.

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RESUMEN El objetivo del presente trabajo fue identificar las políticas públicas que se han desarrollado en los países latinoamericanos frente a la intervención de los Determinantes Sociales de la Salud. Para esto se realizó una revisión temática de artículos científicos a partir de bases de datos y de documentos oficiales de organismos multilaterales y de los Ministerios de Salud de los 22 países latinoamericanos. Se hace un recuento del concepto e historia de los determinantes sociales de la salud de la Organización Mundial de la Salud y del trabajo desarrollado en el ámbito mundial en regiones como Europa, así como en Latinoamérica. Posteriormente se describen como ejemplos los casos de ocho países (Argentina, Brasil, Bolivia, Chile, Colombia, Costa Rica, México y Venezuela) y las políticas públicas desarrolladas en el área de estudio. Se concluye que en Latinoamérica hay un panorama desigual de aplicación de políticas de abordaje hacia los determinantes sociales de la salud así como una intervención segmentada principalmente hacia los determinantes intermedios de la salud, sin tener en cuenta la intervención integral desde diferentes puntos de entrada, según el marco conceptual.

ABSTRACT The study was aimed at identifying Latin-American countries’ public policy which has been related to the social determinants of health. A topic review was thus made of papers kept in the 22 Latin-American countries’ databases and official documents issued by their multilateral organisations and ministries of health. The World Health Organization’s concept of the social determinants of health has been summarised and a history given of the pertinent work developed worldwide in regions such as Europe and Latin-America. Public policy regarding the field of study in Argentina, Brazil, Bolivia, Chile, Colombia, Costa Rica, México and Venezuela has been described. It was concluded that Latin-America provides a panorama of inequality regarding the application of policy concerning the social determinants of health and that there was segmented intervention, mainly regarding intermediate determinants of health, without taking an integrated approach from different entrance points into account, according to the stated conceptual framework.

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MicroRNAs (miRNAs) are a class of small, non-coding RNA molecules that can regulate gene expression, thereby affecting crucial processes in cancer development. miRNAs offer great potential as biomarkers for cancer detection because of their remarkable stability in blood and their characteristic expression in different diseases. We investigated whether quantitative RT-PCR miRNA profiling on serum could discriminate between breast cancer patients and healthy controls. We performed miRNA profiling on serum from breast cancer patients, followed by construction of ROC (Receiver Operating Characteristic) curves to determine the sensitivity and specificity of the assay. We found that seven miRNAs (miR-10b, miR-21, miR-125b, miR-145, miR-155 miR-191 and miR-382) had different expression patterns in serum of breast cancer patients compared to healthy controls. ROC curve analyses revealed that three serum miRNAs could be valuable biomarkers for distinguishing BC from normal controls. Additionally, a combination of ROC curve analyses of miR-145, miR-155 and miR-382 showed better sensitivity and specificity of our assay. miRNA profiling in serum has potential as a novel method for breast cancer detection in the Mexican population.

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The study was aimed at identifying Latin-American countries' public policy which has been related to the social determinants of health. A topic review was thus made of papers kept in the 22 Latin-American countries' databases and official documents issued by their multilateral organisations and ministries of health. The World Health Organization's concept of the social determinants of health has been summarised and a history given of the pertinent work developed worldwide in regions such as Europe and Latin-America. Public policy regarding the field of study in Argentina, Brazil, Bolivia, Chile, Colombia, Costa Rica, México and Venezuela has been described. It was concluded that Latin-America provides a panorama of inequality regarding the application of policy concerning the social determinants of health and that there was segmented intervention, mainly regarding intermediate determinants of health, without taking an integrated approach from different entrance points into account, according to the stated conceptual framework.

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RESUMEN Introducción: la coexistencia de enfermedad cardiaca y gestación constityue un estado de especial relevancia, trascendencia y complejidad clínica. Objetivos: Determinar la prevalencia de cardiopatía en gestantes y sus resultados perinatales. Metodología: estudio observacional, descriptivo, retrospectivo de corte transversal realizado en gestantes del Departamento de Ginoco-obstetricia del Hospital Nacional entre los años 2005 al 2009. Se determinó el tipo de cardiopatía y su clasificación funcional, las complicaciones obstétricas y/o cardiovasculares, edad gestacional al momento del parto, modo de nacimiento, peso y puntaje de Apgar en el recién nacido, mortalidad materna y del recién nacido. Resultados: La prevalencia de cardiopatías entre las gestantes fue 0,25 %. De las 42 cardiopatías, 31 fueron valvulopatías adquiridas y 11 cardiopatías congénitas. Las lesiones más frecuentes fueron valvulopatías mitrales. Aparecieron complicaciones maternas en 15 pacientes, el edema pulmonar constituyo una de las complicaciones más frecuentes. El distress respiratorio y la restricción del crecimiento intrauterino constituyeron las complicaciones fetales más halladas. Conclusiones: la prevalencia de cardiopatía en gestantes fue 0,25%. La complicación materna más frecuente fue el edema pulmonar. Las complicaciones perinatales más halladas fueron el distress respiratorio y la restricción del crecimiento intrauterino.

ABSTRACT Introduction: The coexistence of pregnancy and heart disease constitutes a condition of special relevance, transcendence and clinical complexity. Objectives: To determine the prevalence of heart disease in pregnant women and their perinatal outcomes. Methodology: An observational, descriptive, retrospective cross-sectional study was conducted in pregnant women at the Gynecology and Obstetrics Department at the National Hospital between 2005 and 2009. The type and functional classification of the heart disease were determined, obstetric and/or cardiovascular complications, gestational age at the time of delivery, mode of delivery, weight and Apgar score of the newborn, maternal and newborn mortality. Results: The prevalence of heart disease among pregnant women was of 0.25%. Of the 42 encountered heart diseases, 31 were acquired valvular disease and 11 congenital heart diseases. The most frequent lesion was mitral valve disease. Maternal complications appeared in 15 patients, pulmonary edema was among the most frequently found. Among the encountered fetal complications were Respiratory Distress and Intra Uterine Growth Restriction (IUGR). Conclusions: The prevalence of heart disease in pregnancy is 0.25%. The most frequent maternal complication is Pulmonary Edema. The most encountered perinatal complications were Respiratory Distress and Intra Uterine Growth Restriction (IUGR).

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Despite of the apparent simplicity of Pavlovian conditioning, research on its mechanisms has caused considerable debate, such as the dispute about whether the associated stimuli are coded in an "elementistic"(a compound stimuli is equivalent to the sum of its components) or a "configural" (a compound stimuli is a unique exemplar) fashion. This controversy is evident in the abundant research on the contrasting predictions of elementistic and the configural models. Recently, some mixed solutions have been proposed, which, although they have the advantages of both approaches, are difficult to evaluate due to their complexity. This paper presents a computer program to conduct simulations of a mixed model ( replaced elements model or REM). Instructions and examples are provided to use the simulator for research and educational purposes.

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Se documenta por primera vez en Costa Rica, el nivel de susceptibilidad al tetanos y a la rubeola en la poblacion femenina costarricense entre los 25 y 29 años. Se encuesto a 805 de las mujeres (93% ) que conformaba la muestra el 88% (762) dio su consentimiento para la obtencion de muestras de sangre para el analisis serologico. El nivel de susceptibilidad encontrado para la rubeola y el tetano fue de 10.9 y 7.9 por ciento, respectivamente. Las mujeres susceptibles al tetanos presentaron una asociacion estadisticamente significativa (p<0.05) con la edad, la educacion y el estrato socioeconomico. En contraste, las susceptibles a la rubeola no presentaron ninguna asociacion estadistica. La entrevista oral para determinar susceptibilidad a la rubeola mostro una sensibilidad solo del 26 por ciento, en contraposicion a la del tetanos que fue de un 40 por ciento. Se discuten las medidas complementarias a los programas de vacunacion ya existentes, necesarias para disminuir o eliminar los acumulos de susceptibles en la poblacion de mujeres costarricenses.

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Por medio de la técnica de inhibición de la hemaglutinación, se realizó una encuesta serológica para determinar el nivel inmunitario hacia la rubeola en mujeres costarricenses de edad fértil. De los 1000 sueros analizados se obtuvo un 22.7 por ciento de mujeres susceptibles, ubicadas principalmente en el grupo de 15 a 35 años de edad, lo cual constituye un potencial problema de salud pública. Se plantean posibles políticas de inmunización tendientes a disminuir el porcentaje de susceptibles en estos grupos de población

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Desde 1978 Costa Rica posee un programa sistemático de vacunación contra el tétanos, orientado a mujeres en edad fértil. Este ha permitido bajar la tasa de mortalidad por tétanos a 0.5/100.000 habitantes a partir de 1980. Con el fin de evaluar la cobertura y eficacia del programa se determinó los niveles de antitoxinas en 957 mujeres en edad fértil. Se detectaron niveles protectores en un 99.6 por ciento de las mujeres entre 15-25 años, un 97.6 por ciento entre 26-35 y en un 98.15 por ciento entre 36-45 años. En el grupo de 36-45 años, se encontró niveles de antitoxinas más bajos, comparado con los otros grupos etarios. No se demostró diferencia en los porcentajes de mujeres inmunes de acuerdo a la región de procedencia

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Se determina la inmunidad hacia poliovirus, mediante la técnica de microneutralización, en 83 sueros de niños menores de dos años, seleccionados por un muestreo por conglomerado realizado en población urbana de la región central, San José, Costa Rica. Las historias de vacunación estuvieron disponibles, para todos los niños. Se definió como negativos aquellos títulos menores de 1:4, encontrándose que un 82 por ciento de los niños presentaban actividad neutralizante para los tres serotipos, 14 por ciento hacia solo dos, y un 2 por ciento a un serotipo. La frecuencia de inmunidad en los niños aumenta con el número de dosis de vacunas administradas, obteniéndose un 100 por ciento después de tres dosis y un refuerzo

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Con el presente estudio se tuvo como objetivo evaluar la cobertura y respuesta a la vacunación con DPT, en una muestra de 132 niños menores de 2 años seleccionados en 30 conglomerados de la Región Central Urbana, San José, Costa Rica. En cada caso, se entrevistó a los jefes o encargados de familia, de quienes se obtuvo, mediante el carnet de vacunación, la información sobre el número de dosis de DPT recibidas por el niño. Asimismo, cuando fue posible y previa autorización, se obtuvo una muestra de sangre venosa para el análisis serológico. De los 132 niños encuestados, se obtuvo una cobertura de un 88 por ciento la primera dosis de DPT, un 79 por ciento y 74 por ciento para la segunda y tercera dosis. En 128 casos fue posible realizar el análisis serológico, demostrándose respuesta a la vacuna en un 77 por ciento hacia difteria, un 91 por ciento para tétanos y en un 61 por ciento para tos ferina. La encuesta oral con la serológica muestra una buena correlación entre el título de anticuerpos y las dosis de vacuna aplicada para difteria y tétanos, no así en lo que se refiere a las ablutininas hacia B. pertusis

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El presente estudio reporta la relación de los percentiles de crecimiento con algunos indicadores del estado nutricional de Zinc, en un grupo de 114 niños costarricenses con edades entre los seis y los 14 meses. Se seleccionaron de áreas urbanas pobres en la provincia San José, mediante el sistema de muestreo por conglomerados. Para medir la adecuación nutricional de zinc se utilizó el valor de zinc plasmático, el valor en el plasma de las principales proteínas relacionadas con su transporte (albúmina y alfa 2 macroglobulina) y de la proteína transportadora del retinol (P.T.R) como indicador de disponibilidad de zinc a nivel hepático. En el 14 por ciento de los casos los niveles plasmáticos de zinc están por debajo del límite inferior normal (< 70 ug/dl) que estadísticamente encontramos con confiabilidad del 95 por ciento para los niños con percentiles normales de crecimiento (peso/talla, edad/talla, mayores del 10 percentil). Es en este grupo de niños normales (55 por ciento) donde se encuentran la mayoría de los dieciseis casos con niveles subnormales de zinc. Los niños con concentraciones menores de 70 ug/dl de zinc en al plasma y los que tenían valores normales no mostraron diferencias significativas (p <0.05), ni relación con las categorías de estado nutricional según medidas antropométricas y bioquímicas del estudio (albúmina, alfa 2 macroglobulina y P.T.R). En los niños con desgaste y achicamiento, se encontraron concentraciones promedio de zinc plasmático significativamente mayores (p <0.05), de 123.7 ug/dl. El 37.2 por ciento de los niños se localizan por debajo del 10 percentil (edad/talla, peso/talla) sin relación con los indicadores de deficiencia de zinc, reportada como factor ambiental que contribuye a la frecuencia de retraso en el crecimiento en determinados grupos de población

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